Application of machine learning and artificial intelligence in the diagnosis and classification of polycystic ovarian syndrome: a systematic review

IntroductionPolycystic Ovarian Syndrome (PCOS) is the most common endocrinopathy in women of reproductive age and remains widely underdiagnosed leading to significant morbidity. Artificial intelligence (AI) and machine learning (ML) hold promise in improving diagnostics. Thus, we performed a systematic review of literature to identify the utility of AI/ML in the diagnosis or classification of PCOS.MethodsWe applied a search strategy using the following databases MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Web of Science, and the IEEE Xplore Digital Library using relevant keywords. Eligible studies were identified, and results were extracted for their synthesis from inception until January 1, 2022.Results135 studies were screened and ultimately, 31 studies were included in this study. Data sources used by the AI/ML interventions included clinical data, electronic health records, and genetic and proteomic data. Ten studies (32%) employed standardized criteria (NIH, Rotterdam, or Revised International PCOS classification), while 17 (55%) used clinical information with/without imaging. The most common AI techniques employed were support vector machine (42% studies), K-nearest neighbor (26%), and regression models (23%) were the commonest AI/ML. Receiver operating curves (ROC) were employed to compare AI/ML with clinical diagnosis. Area under the ROC ranged from 73% to 100% (n=7 studies), diagnostic accuracy from 89% to 100% (n=4 studies), sensitivity from 41% to 100% (n=10 studies), specificity from 75% to 100% (n=10 studies), positive predictive value (PPV) from 68% to 95% (n=4 studies), and negative predictive value (NPV) from 94% to 99% (n=2 studies).ConclusionArtificial intelligence and machine learning provide a high diagnostic and classification performance in detecting PCOS, thereby providing an avenue for early diagnosis of this disorder. However, AI-based studies should use standardized PCOS diagnostic criteria to enhance the clinical applicability of AI/ML in PCOS and improve adherence to methodological and reporting guidelines for maximum diagnostic utility.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022295287

Skin Manifestations of Insulin Resistance: From a Biochemical Stance to a Clinical Diagnosis and Management

Worldwide, more than 1.9 billion adults are overweight, and around 600 million people suffer from obesity. Similarly, *382 million individuals live with diabetes, and 40–50% of the global population is labeled at ‘‘high risk’’ (i.e., prediabetes). The impact of these two chronic conditions relies not only on the burden of illnesses per se (i.e., associated increased morbidity and mortality), but also on their increased cost, burden of treatment, and decreased health-related quality of life. For this review a comprehensive search in several databases including PubMed (MEDLINE), Ovid EMBASE, Web of Science, and Scopus was conducted. In both diabetes and obesity, genetic, epigenetic, and environmental factors overlap and are inclusive rather than exclusive

Early Clinical Expressions of Insulin Resistance: The Real Enemy to Look For

ABSTRACT The type 2 diabetes mellitus epidemic threatens public healthcare systems worldwide. Efforts to prevent chronic complications of diabetes and reduce their associated mortality have been ineffective. Hence, early prevention of type 2 diabetes mellitus and cardiovascular disease needs to be prioritized. This strategy, however, must be centered not on an approach based on hyperglycemia but on early pathophysiologic mechanisms, such as insulin resistance. Nonalcoholic fatty liver disease, androgenic alopecia, acanthosis nigricans, and polycystic ovarian syndrome are all well-accepted early clinical manifestations of insulin resistance that represent, in themselves, a risk for further development of type 2 diabetes and that appear years before hyperglycemia. Therefore, focusing efforts on detecting and rigorously treating patients with early clinical expression of insulin resistance (insulin resistance clinical syndrome) is probably the course of action that needs to be taken to counterbalance the type 2 diabetes mellitus epidemic

Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P≤0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P=0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r=0.78; P≤0.001, r=0.74;  P≤0.001, and r=0.71;  P≤0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P=0.001) and free T and DHEA-S declined significantly (P=0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction

Characteristics of Buffalo Production and Research Systems in Southern Mexico

Background: This research aimed to characterize the production units of water buffalo (Bubalus bubalis) and review the published scientific literature in southeastern Mexico. Methods: Between May and June 2020, a questionnaire was created in Google forms, distributed through social networks, and emailed to buffalo breeders. In addition, a review of different scientific databases on the experimental studies developed in Mexico on buffalo was performed. Results: Data was collected from 8,867 animals from 13 producers located in southeastern Mexico; dual-purpose (milk-meat) is the primary zootechnical purpose (69.24%), and the rest is meat production. The buffalo herd is mainly composed of females (72.09%). Females are used primarily to repopulate the herd and males for meat production. Mortality in adults remained between 2 to 5%. 30.76% of the producers produce milk (495 females) with 5.1 L/d on average. 100% of the producers stated that they transform the milk into dairy products, mainly cheeses and other products. In the case of meat production, 31.97% of the males are fattened based on pastures with a weight range between 400-600 kg at the age of 22 months (range 18-30 months). Between 2012-and 2021, 19 studies related mainly to herd health (63.15%) were registered. Conclusion: It is concluded that this Mexican species has great productive potential with different areas for improvement. Due to sanitary management and rusticity, mortality is low. It is necessary to develop other lines of research associated with the reproduction, production of milk/meat, health, quality of products, safety, and sustainability of buffalo activity in Mexico

Long-term outcomes in patients with multiple endocrine neoplasia type 1 and pancreaticoduodenal neuroendocrine tumours

Summary Background In patients with multiple endocrine neoplasia type 1 (MEN-1), pancreaticoduodenal (PD) neuroendocrine tumours (NETs) are associated with early mortality, yet the best treatment strategy remains uncertain. Aim To assess patient important outcomes (mortality and metastasis) of PD-NETs and predictors of outcomes in patients with MEN-1. Methods Retrospective cohort of patients with MEN-1 who attended the Mayo Clinic, Rochester, MN from 1997 to 2014. Results We identified 287 patients with MEN-1; 199 (69%) patients had 217 PD-NETs. Among those with a PD-NETs, 129 (65%) had surgery of which 90 (70%) had their primary surgery performed at Mayo Clinic. The median postoperative follow-up was 8 years during which 13 (14%) patients died. The mean (±standard deviation) age of death was 51 (±9) years. Tumour size, metastasis at surgery or tumour type were not predictive of mortality, but for every year older at surgery, the odds of metastasis increased by 6%. Surgery was not performed in 70 (35%) patients. Among those who were observed/medically managed without known metastatic disease, mean tumour growth was 0·02 cm/year (range, -0·13–0-4 cm/year). Four patients (7%) died at a median age of 77 (range, 51–89) years. Conclusion PD-NETs are common in patients with MEN-1 and are associated with early mortality even after surgical intervention. Active surveillance is a viable option in nonaggressive PD-NETs, although definitive factors identifying such patients are lacking. Therefore, counselling regarding risks and benefits of current treatment options remains integral to the care of patients with MEN-1

Effect of Sex Steroids on the Bone Health of Transgender Individuals: A Systematic Review and Meta-Analysis

A comprehensive search of several databases to 7 April 2015 was conducted for studies evaluating bone health in transgender individuals receiving sex steroids. Pairs of reviewers selected and appraised studies. A random effects model was used to pool weighted mean differences and 95% confidence intervals (CI

Validación del método experimental en la elaboración de una fórmula de salsa verde de tomate Shanty

La investigación se basó en validación del método experimental en la elaboración de una fórmula de salsa verde a base de la variedad de tomate Shanty. El desarrollo del estudio se realizó en la Universidad Nacional Autónoma de Nicaragua UNAN MANAGUA en su circuito FAREM-ESTELI, en el laboratorio de la carrera de Agroindustria. El presente estudio es experimental por la manipulación de la variable experimental, además las condiciones en la que se desarrollaron fueron rigurosamente controladas en el laboratorio de agroindustria en la facultad. De acuerdo al método de investigación el enfoque es cuantitativa ya que se obtuvieron datos atreves de la experimentación con la finalidad de describir de qué modo o por que afectaron las cantidades de vinagre en la vida útil de la salsa verde. Aplicando las técnicas de investigación como es la encuesta y entrevistas, sustitución de aditivos alimentarios por técnicas de cocción y tiene como objetivo específico la preparación de una salsa verde con una buena evaluación sensorial de los atributos color, olor, sabor y textura, así como la inocuidad y calidad. Se realizó análisis de las características organolépticas para poder determinar su vida útil a la salsa, la cual fue un periodo mayor a 200 días, en refrigeración. Se hizo uso de la prueba de Chi cuadrado para la relación entre la cantidad de vinagre y la vida útil, la efectividad del vinagre en la conservación de dicha salsa, se realizó un análisis entre la relación los grados Brix y vida útil. Se desarrollaron 3 formulas con 21 muestras con 3 repeticiones por cada tratamiento. La validación de una formula, esta es una parte integral de los sistemas de gestión de calidad al cuidado y la salud del consumidor esto se debe a los beneficios fundamentales que trae con ella la fórmula aceptada de una salsa verde