Android application for conjunctive and disjunctive normal form calculation

U ovom radu napravljena je aplikacija za rješavanje konjunktivne i disjunktivne normalne forme. Aplikacija na temelju uneseng matematičkog izraza generira tablicu istinitosti te računa konjunktivnu i disjunkitivnu normalnu formu. Tijekom rada naveden je teorisjki dio potreban za izradu te korištene tehnologije i okruţenja prilikom izrade. Na kraju je detaljno objašnjena realizacija aplikacije.In this work an application for solving conjunctive and disjunctive normal form was developed. An application is based on math expression input and after that it generates a truth table and calculates conjunctive and disjunctive normal form. Firstly, theoretical part and technologies that are used in application development are described. Finally, application development is explained in detail

Microcontroller system for automated hand reckognition

U ovom radu izrađen je mikroupravljački sustav za prepoznavanje položaja ruku. Sustav se sastoji od tri glavna dijela: dio za izradu slike, obrada napravljene slike i upravljanje uređajem na temelju slike,odnosno položaja ruke. Tijekom rada navedeni su i objašnjeni alati i komponente koje su korištene za izradu sustava. Nakon opisa alata i komponenti, detaljnije je objašnjena realizacija sustava.In this work microproccesor system for hands gesture recognition was developed. It consists of three main parts: system for making pictures, image processing and device managmenet based on image, respectively hand gesture. Firstly, the tools and components that are used in system development are described. After that, the system implementation is described

Prognostic Indicators for First and Repeated Hospitalizations in Heart Failure Patients with Reduced Left Ventricular Ejection Fraction

Heart failure with reduced ejection fraction (HFrEF) is a progressive clinical syndrome defined by changes in the myocardial structure, which lead to predominant systolic myocardial function impairment, with a left ventricle ejection of fraction ≤40%. The rehospitalization burden in HFrEF patients (pts) remains very high, with poor quality of life, increased mortality and large healthcare expenditures. In this research project, we investigated the risk factors for first and repeated hospitalization in pts with HFrEF. This retrospective study included 50 adult pts with a diagnosis of HFrEF and who were within the age range of 55 to 89 years old and of both sexes. Demographic and clinical data (HFrEF etiology, renal function parameters, complete blood count, markers of inflammation, electrocardiogram, troponin I, NTproBNP, echocardiographic parameters and comorbidities data) were collected from the pts’ medical histories. Statistical analysis was performed via Fischer’s exact test, the Shapiro-Wilk test and the Spearman correlation coefficient. This study included 70% male and 30% female HFrEF pts. Males were younger in both group of pts and had a higher incidence of rehospitalization. The most important HFrEF etiologic risk factors are arterial hypertension (82%), coronary heart disease (54%), atrial fibrillation (52%) and diabetes mellitus (40%). The most important noncardiac comorbidity related with the first HFrEF hospitalization is pneumonia (P=0.03), while progression of left ventricle systolic and diastolic dysfunction is related to rehospitalization risk (left ventricle end systolic diameter, P=0.003; diastolic dysfunction degree, P=0.04). The troponin level was associated with an increased risk of rehospitalization, but this was not statistically significant at this sample size (troponin I, p=0.10). Following the first and repeated hospitalizations of HFrEF pts, comorbidities, ageing and gender difference are crucial to HFrEF development, while echocardiographic parameters and biomarkers critically affect HFrEF rehospitalization risk

Attraction Effect in the Visual Working Memory

Temeljno obilježje vidnoga radnog pamćenja jest da preciznost dosjećanja opada porastom broja podražaja koji se pamti. Ovaj se nalaz tumači kao posljedica raspodjele ograničene količine resursa, pri čemu porastom broja podražaja koji se pamti pada količina resursa pridana svakom podražaju. Nedavna istraživanja pokazuju kako dosjećanje u zadacima vidnoga radnog pamćenja ovisi i o karakteristikama seta podražaja koji se pamti. Konkretno, u zadatku pamćenja jednostavnih vidnih karakteristika dvaju podražaja (npr. orijentacije) dosjećanje jednog podražaja karakterizira sustavna pogreška u smjeru drugog zapamćenog podražaja, tzv. efekt privlačenja. U ovom smo istraživanju željeli provjeriti koliko je ovaj efekt otporan na eksperimentalne manipulacije preciznosti pamćenja podražaja. U četiri su eksperimenta sudionici (N = 33) pamtili i dosjećali se istovremeno prikazanih orijentacija podražaja. U prvom je eksperimentu redoslijed dosjećanja odabiran po slučaju; u drugom su eksperimentu sudionici trebali samostalno birati redoslijed kojim će se dosjećati, a u trećem i četvrtom eksperimentu redoslijed dosjećanja ponovno je odabiran po slučaju, no sudionicima je na svakoj sekvenci unaprijed (eksp. 3) ili unatrag (eksp. 4) signalizirano kojeg će se podražaja najvjerojatnije morati dosjetiti prvog. Efekt privlačenja bio je vidljiv u sva četiri eksperimenta, i to pri dosjećanju obaju podražaja. Ovo istraživanje demonstrira robusnost efekta privlačenja u vidnom radnom pamćenju, što implicira da mehanizmi u podlozi tog efekta nisu podložni korekciji, odnosno da su sastavni dio temeljnih procesa kodiranja vidnih podražaja.One of the basic characteristics of visual working memory (VWM) is that recall precision declines with the number of items to be memorised. This finding is interpreted as a consequence of the allocation of a limited pool of resources, whereby the amount of resources allocated to each item drops with each additional stimulus. Recent studies show that recall in VWM tasks also depends on the characteristics of the stimulus set which is to be memorised. Specifically, when memorising simple visual features of two stimuli (e.g. their orientations), the recall of one stimulus\u27s features is marked by a systematic bias towards the other stimulus\u27s features. In this study, we wanted to examine how robust this effect is to experimental manipulations of memory precision. In four experiments, participants (N = 33) memorised and recalled the orientations of two simultaneously presented stimuli. In the first experiment, the recall order was chosen at random. In the second, participants had to choose the recall order themselves. In the third and fourth experiments, recall order was again chosen at random, but participants were presented with a cue before (exp. 3) or after (exp. 4) the stimuli were displayed, which indicated which of the stimuli is most likely to be recalled first. The attraction effect was observed in all four experiments and affected the recall of both stimuli. This study demonstrates the robustness of the attraction effect in VWM, implying that the mechanisms underlying the effect are not susceptible to correction, or in other words, that it is a part of the fundamental processes of coding visual stimuli

Usporedba točnosti stupnjevanja diferencijacije raka prostate u uzorcima dobivenim ciljanom i sustavnom biopsijom prostate

All malignancies, including prostate cancer, require accurate diagnosing and staging before making a treatment decision. The introduction of targeted biopsies based on prostate MRI findings has raised prostate biopsy accuracy. Guided biopsies target the tumor itself during the biopsy instead of the most common tumor sites as is the case with a systemic biopsy. Some studies report that targeted biopsies should lower prostate cancer biopsy undergrading and overgrading. To determine the incidence of prostate cancer biopsy undergrading in patients who underwent a classic systemic biopsy compared to patients who underwent a mpMRI cognitive targeted biopsy. We identified the patients from our database who underwent a radical prostatectomy at our institution from January 1st, 2021, to June 30th, 2021.There were 112 patients identified. Patients were stratified into two groups based on the type of biopsy that confirmed prostate cancer. The mpMRI (N=50) group had a mpMRI cognitive guided transrectal ultrasound (TRUS) prostate biopsy performed, and the non-mpMRI group (N=62) received a classic, systemic TRUS biopsy. We compared the biopsy results with the final pathological results, and searched for undergrading or overgrading in the biopsies compared to the final histological reportThe undergrading was found in 17,7 % (N=11) cases in the non-mpMRI group and in 12,0 % (N=6) of cases in the mpMRI group (p=0,02, Mann-Whitney U test). No overgrading was found in our cohort. All cases of undergrading had Grade Group 1 in the biopsy report and Grade Group 2 in the final specimen report. The charasteristics of patients are listed in Table 1. In our cohort, the patients who underwent a mpMRI targeted biopsy had a lower undergrading incidence. During a systemic TRUS biopsy, the urologist targets the areas of the prostate where cancer is most commonly located, which is usually the peripheral zone of the prostate. Since different areas of the tumor have different areas of differentiation, only a low-grade part of the tumor is sometimes biopsied, which results in a sampling error. Once the prostate is removed, the whole tumor is analyzed, so the obtained pathological results related to the removed prostate are far more accurate than the analysis of prostate cores obtained by biopsy.Sve maligne bolesti, uključujući rak prostate, zahtijevaju preciznu dijagnostiku prije odluke o liječenju. Uvođenjem ciljanih biopsija na temelju nalaza MRI prostate povećana je točnost biopsije prostate. Vođene biopsije ciljaju na sam tumor u umjesto na najčešće lokacije tumora u prostati kao što je slučaj sa sistemskom biopsijom. Neke studije pokazuju da bi ciljane biopsije trebale smanjiti podcjenjivanje stupnja diferenciranosti raka prostate u uzorcima dobivenim biopsijom prostate. Odrediti incidenciju podcjenjivanje stupnja diferenciranosti raka prostate kod pacijenata koji su bili podvrgnuti klasičnoj sistemskoj biopsiji u usporedbi s pacijentima koji su bili podvrgnuti mpMRI kognitivnoj ciljanoj biopsiji. Identificirali smo pacijente iz naše baze podataka koji su podvrgnuti radikalnoj prostatektomiji u našoj ustanovi od 1. siječnja 2021. do 30. lipnja 2021. Identificirano je 112 pacijenata. Pacijenti su podijeljeni u dvije skupine na temelju vrste biopsije kojom je potvrđen rak prostate. Skupina mpMRI (N=50) primila je mpMRI kognitivno vođenu transrektalnu ultrazvučnu (TRUS) biopsiju prostate, a skupina non-mpMRI (N=62) primila je klasičnu, sistemsku TRUS biopsiju. Usporedili smo rezultate biopsije s konačnim patološkim nalazima i tražili smo podcjenjivanje stupnja diferenciranosti karcinoma prostate u biopsijama u usporedbi s konačnim histološkim nalazom. Podcjenjivanje stupnja diferenciranosti nađeno je u 17,7 % (N=11) u non-mpMRI skupini i u 12,0 % (N=6) slučajeva u mpMRI skupini (p=0,02, Mann-Whitney U test). U našoj kohorti nije pronađeno precjenjivanje stupnja diferenciranosti. Svi slučajevi podcjenjivanja imali su Gradus grupu 1 na nalazu biopsije prostate i Gradus grupu 2 u konačnom patohistološkom nalazu. U našoj kohorti, pacijenti koji su bili podvrgnuti ciljanoj biopsiji imali su nižu incidenciju podcjenjivanja stupnja diferenciranosti što je posljedica točnijeg uzorkovanja. Tijekom sistemske TRUS biopsije, urolog cilja na područja prostate gdje se rak najčešće nalazi, što je obično periferna zona prostate. Budući da različita područja tumora imaju različita područja diferencijacije, ponekad se bioptira samo dio tumora koji je bolje diferenciran, što rezultira pogreškom uzorkovanja. Nakon što je prostata uklonjena, analizira se cijeli tumor, tako da su rezultirajući patohistolološki rezultati uklonjene prostate daleko točniji od analize uzoraka prostate dobivenih biopsijom

Karcinom sabirnih kanalića i endemska nefropatija - prikazi slučaja i pregled literature

Although collecting duct carcinoma is a subtype of renal cell carcinoma, several studies implicate association with urothelial carcinoma. The coexistence of collecting duct carcinoma and another renal neoplasm is rare. Endemic nephropathy is a renal disease causing chronic renal failure. It is highly associated with urothelial neoplasm and occurs in endemic villages in Bosnia, Croatia, Bulgaria, Romania and Serbia. Recent studies have confirmed the important role of exposure to aristolochic acid as an etiologic factor. We present three cases of collecting duct carcinoma with literature overview. In one case, we describe collecting duct carcinoma with metachronous urothelial carcinoma of the pyelon and urinary bladder in an endemic nephropathy patient. To our knowledge, this is the first case report describing this coexistence. Certain similarities between collecting duct carcinoma and urothelial carcinoma were found, e.g., higher incidence in female compared to male, higher mean age, and multifocal and multicentric occurrence of the tumor. Our observations support the hypothesis that collecting duct carcinoma and urothelial carcinoma could be connected.Iako je karcinom sabirnih kanalića podvrsta karcinoma bubrežnih stanica, određena istraživanja ukazuju na povezanost ovog entiteta s karcinomom prijelaznog epitela. Istodobna pojava karcinoma sabirnih kanalića i drugih bubrežnih neoplazma je rijetka. Endemska nefropatija je bubrežna bolest koja dovodi do kroničnog bubrežnog zatajenja. Vrlo je povezana s urotelnim tumorima i javlja se u endemskim selima u Bosni, Hrvatskoj, Bugarskoj, Rumunjskoj i Srbiji. Nedavna istraživanja potvrdila su značajnu ulogu izloženosti aristolohičnoj kiselini kao etiološkom čimbeniku. Predstavljamo tri slučaja karcinoma sabirnih kanalića s pregledom literature. U jednom slučaju opisujemo karcinom sabirnih kanalića s metakronom pojavom urotelnog karcinoma pijelona te mokraćnog mjehura u bolesnika s potvrđenom endemskom nefropatijom. Prema našim saznanjima ovo je prvi slučaj koji opisuje ovakvu koegzistenciju. Pronađene su određene sličnosti između karcinoma sabirnih kanalića i karcinoma prijelaznog epitela, a to su veća učestalost u ženskoj populaciji, viša prosječna dob, multifokalna i multicentrična pojava tumora. Naša zapažanja podupiru hipotezu o mogućoj povezanosti karcinoma sabirnih kanalića i karcinoma prijelaznog epitela

Trenutno mjesto magnetske rezonance u probiru, dijagnostici i liječenju raka prostate

Prostate cancer is the most common cancer in men. Diagnosis of prostate cancer poses a significant challenge, due to several different key parameters that need to be evaluated, such as age, history of prostate specific antigen (PSA), clinical examination and more recently magnetic resonance imaging (MRI). The current diagnostic pathway for prostate cancer has resulted in overdiagnosis and overtreatment as well as underdiagnosis and missed diagnoses in many men. Multiparametric MRI (mp-MRI) of the prostate has been identified as a test that could alleviate these diagnostic errors. Before prostate cancer treatment pathological confirmation is mandatory. Prostate biopsy is an invasive procedure with rare but not negligible potential complications. There are several methods of prostate biopsy of which most common are systemic or planar prostate biopsy and cognitive or targeted MRI-guided prostate biopsy. Multiparametric MRI has demonstrated better accuracy and reproducibility in detecting, locating and evaluating prostate cancer and also sparing some men unnecessary biopsies. Recent studies have shown a mpMRI benefit for better procedure planning regarding prostate cancer location, extent of disease and length of the urethra. There are still some challenges ahead, such as ensuring high-quality execution and reporting of mpMRI and ensuring that this diagnostic pathway is cost-effective. According to the latest urological clinical guidelines mpMRI became fundamental tool in management of prostate cancer. The aim of this study is to give a brief insight in use of mpMRI in prostate cancer diagnosis and treatment.Rak prostate najčešći je karcinom u muškaraca. Dijagnoza raka prostate predstavlja značajan izazov zbog nekoliko različitih ključnih parametara koje je potrebno procijeniti, kao što su dob, povijest prostata specifičnog antigena (PSA), klinički pregled i u novije vrijeme multiparametrijski MRI (mp-MRI). Trenutna dijagnostika raka prostate rezultirala je prekomjernom dijagnostikom i liječenjem, kao i poddijagnozom i propuštenom dijagnozom kod mnogih muškaraca. Multiparametrijski MRI prostate identificiran je kao test koji bi mogao ublažiti ove pogreške. Prije liječenja raka prostate obavezna je patološka potvrda. Biopsija prostate je invazivan postupak s rijetkim, ali ne i zanemarivim potencijalnim komplikacijama. Postoji nekoliko metoda biopsije prostate od kojih su najčešće sistemska ili planarna biopsija prostate i kognitivna ili ciljana biopsija prostate vođena MRI-om. Mp-MRI pokazao je bolju točnost i reproducibilnost u otkrivanju, lociranju i procjeni raka prostate, a također je poštedio neke muškarace nepotrebne biopsije. Nedavne studije pokazale su korist mpMRI-e za bolje planiranje zahvata s podacima o lokaciji raka prostate, opsegu bolesti i duljini uretre. Pred nama su još neki izazovi, poput osiguravanja visokokvalitetne izvedbe i izvješćivanja o mpMRI-u te osiguravanja da je ovaj dijagnostički put isplativ. Prema najnovijim urološkim kliničkim smjernicama mpMRI je postao temeljni alat u liječenju raka prostate. Cilj ove studije je dati kratak uvid u upotrebu mpMRI-e u dijagnostici i liječenju raka prostate

Multiparametrijska magnetska rezonancija u procjeni karcinoma prostate

Multiparametric magnetic resonance is assuming an increasingly important role in the diagnosis, initial assessment and monitoring of patients with prostate cancer. This paper offers a more complex insight into the application of magnetic resonance imaging with prostate cancer, with a current literature overview. The focus is on the problem of initial prostate cancer evaluation which strongly affects further decision-making and therapeutic interventions. Clinical suggestions based on the current guidelines are also offered.Multiparametrijska magnetska rezonancija preuzima sve značajniju ulogu u dijagnostici, inicijalnoj procjeni, kao i praćenju pacijenata s karcinomom prostate. Ovaj rad nudi složeniji uvid u pitanje primjene magnetske rezonancije kod karcinoma prostate, uz pregled trenutne literature iz područja. Posebno težište je stavljeno na problem inicijalne procjene karcinoma prostate koje uvelike determinira daljnje odlučivanje i terapijsko postupanje. Ponuđene su i preporuke temeljene na trenutnim smjernicama

DIJAGNOSTIČKI ZNAČAJ BIOPSIJE PROSTATE VOĐENE KOGNITIVNOM FUZIJOM MULTIPARAMETRIJSKE MAGNETNE REZONANCE I TRANSREKTALNOG ULTRAZVUKA (mpmri-TRUS) KOD BOLESNIKA S PRETHODNO NEGATIVNOM TRUS VOĐENOM BIOPSIJOM

The aim of this prospective clinical study was to determine the detection rate of prostate cancers by multiparametric magnetic resonance and transrectal ultrasound (mpMRI-TRUS) cognitive fusion biopsies in patients with a previously negative TRUS-guided biopsy. Between 1 October 2016 and 1 July 2017, in 101 consecutive patients with elevated antigen (PSA) and/or positive digital rectal examination and after a negative first TRUS biopsy, a second, repeated prostate biopsy was performed. In 24 patients, cognitive fusion mpMRI-TRUS biopsy of the prostate with 8-10 system cores and 1-3 target biopsies was performed, in line with the European Association of Urology guidelines. In 77 patients, only a classic, repeated TRUS guided biopsy was performed. In patients with mpMRI, the detection rate according to PIRADS-v2 reporting system was: PIRADS 1, n = 0; PIRADS 2, n = 0; PIRADS 3, n = 0; PIRADS 4, n = 6/8 (75%); and PIRADS 5, n = 2/3 (67%). In the group of patients with MR-TRUS cognitive fusion biopsy, the prostate cancer detection rate was 8/24 (33%), while in the control group the detection rate was 12/77 (16%), which was statistically significant (t test, p = 0.037, CI 95% is 0.01 to 0.37). Patients with PIRADS ≤ 3 (54%) could have avoided the biopsy.U ovoj prospektivnoj kliničkoj studiji cilj je odrediti stopu detekcije raka prostate biopsije vođene kognitivnom fuzijom multiparametrijske magnetne rezonance i transrektalnog ultrazvuka (mpMRI-TRUS) kod bolesnika s prethodno negativnom TRUS vođenom biopsijom. U razdoblju od 1. 10. 2016. do 1. 7. 2017. kod 101 uzastopnog bolesnika s povišenim prostata specifičnim antigenom (PSA) i/ili pozitivnim digitorektalnim pregledom, a nakon negativne prve TRUS biopsije je učinjena druga, ponovljena biopsija prostate. Kod 24 bolesnika učinjena je, u skladu sa Smjernicama Europskog urološkog društva, prethodna mpMRI i potom kognitivna fuzijska biopsija prostate s 8-10 sistemskih cilindara i 1-3 ciljane biopsije prema mpMRI nalazu. Kod 77 bolesnika je učinjena samo klasična, ponovljena TRUS biopsija bez prethodne slikovne obrade. Kod bolesnika s mpMRI, stopa detekcije raka prema PIRADSU-v2 je PIRADS 1, n = 0; PIRADS 2, n = 0; PIRADS 3, n = 0; PIRADS 4, n = 6/8 (75%) i PIRADS 5, n = 2/3 (67%). U skupini bolesnika s MR-TRUS kognitivnom fuzijskom biopsijom stopa detekcije raka prostate je 8/24 (33%), dok je u kontrolnoj skupini stopa detekcije 12/77 (16%), što se pokazalo statistički značajnom razlikom (t test; p=0.037, CI 95% je 0.01 to 0.37). Bolesnici s PIRADS ≤ 3 (54%) su mogli izbjeći biopsiju

Analiza isplativosti uvođenja biopsije prostate navođene multiparametrijskom magnetskom rezonancom

Continuous increase of the cost of medical services around the world has become a major topic in the world today. Multiparametric prostate MRI has recently become a new standard in prostate cancer detection, especially in repeated biopsy settings. The method, although superior in cancer detection rates, is costly and requires additional training and equipment. The purpose of our study was to determine the costs and benefits that arise when introducing this method in prostate cancer diagnostics. Repeated prostate biopsy was performed in 101 consecutive patients in the period from 1 October 2016 to 1 July 2017. Patients were divided into two groups based on whether prostate mp-MRI was performed or not. The prices of specific procedures were obtained from the billing service of the Sestre milosrdnice University Hospital Center and patient models were created to determine financial costs and benefits. The cost of the entire diagnostic process per patient in the non-MRI group was HRK 1.931,05 and HRK 1.848,42 in the mpMRI group, or 4.28% less. Prostate mpMRI and subsequent mpMRI guided biopsies can reduce the overall cost in prostate cancer diagnostics despite the procedure itself being an additional cost. This is achieved by omitting prostate biopsies in patients with low malignancy risk.Kontinuirani rast troškova medicinskih postupaka aktualna je tema i razlog zabrinutosti u cijelome svijetu. Ciljana, multiparametrijskim magnetom (mpMRI) navođena biopsija prostate polako postaje standard u dijagnostici karcinoma prostate, pogotovo kod ponovljene biopsije. Iako superiorna klasičnoj, sistemskoj biopsiji prostate, navedena metoda zahtijeva skupu dodatnu opremu i vješte, educirane kliničare. Naš cilj je analizirati ekonomsku isplativost uvođenja multiparametrijske magnetne rezonance prostate i posljedične kognitivno mpMRI-om navođene biopsije prostate u dijagnostički protokol bolesnika sa inicijalno negativnom sistemskom biopsijom prostate, kod kojih postoji daljnja klinička sumnja na karcinom prostate. U periodu od 01.10.2016. do 01.07.2017 kod 101 uzastopnog bolesnika s povišenim PSA i/ili pozitivnim DRP, a nakon negativne prve TRUS biopsije učinjena je druga, ponovljena biopsija prostate. Bolesnici su podijeljeni u dvije skupine ovisno o tome dali je učinjen mpMRI prostate ili ne. Učinjena je analiza broja i troškova posjeta specijalisti urologu kao i broja i troškova ordiniranih pretraga za svaku skupinu. Tijek kliničkih postupaka standardiziran je na temelju prosjeka za pojedine promatrane skupine te preračunat na 100 bolesnika za svaku skupinu radi lakše usporedbe rezultata. Kalkulacije su vršene na temelju dobivenih modela. Prosječna cijena obrade bolesnika u skupini bez mpMRI-a iznosi 1931,05 HRK dok u sa mpMRI-em iznosi 1848,42 HRK tj. 4,28% manje. Iako mpMRI prostate pojedinačno predstavlja značajan dodatan trošak u dijagnostici karcinoma prostate, kod bolesnika sa inicijalno negativnom biopsijom prostate isti omogućava velikom broju bolesnika izbjegavanje biopsije te posljedično smanjenje ukupnog troška