Lung nodules identification in CT scans using multiple instance learning.

Computer Aided Diagnosis (CAD) systems for lung nodules diagnosis aim to classify nodules into benign or malignant based on images obtained from diverse imaging modalities such as Computer Tomography (CT). Automated CAD systems are important in medical domain applications as they assist radiologists in the time-consuming and labor-intensive diagnosis process. However, most available methods require a large collection of nodules that are segmented and annotated by radiologists. This process is labor-intensive and hard to scale to very large datasets. More recently, some CAD systems that are based on deep learning have emerged. These algorithms do not require the nodules to be segmented, and radiologists need to only provide the center of mass of each nodule. The training image patches are then extracted from volumes of fixed-sized centered at the provided nodule\u27s center. However, since the size of nodules can vary significantly, one fixed size volume may not represent all nodules effectively. This thesis proposes a Multiple Instance Learning (MIL) approach to address the above limitations. In MIL, each nodule is represented by a nested sequence of volumes centered at the identified center of the nodule. We extract one feature vector from each volume. The set of features for each nodule are combined and represented by a bag. Next, we investigate and adapt some existing algorithms and develop new ones for this application. We start by applying benchmark MIL algorithms to traditional Gray Level Co-occurrence Matrix (GLCM) engineered features. Then, we design and train simple Convolutional Neural Networks (CNNs) to learn and extract features that characterize lung nodules. These extracted features are then fed to a benchmark MIL algorithm to learn a classification model. Finally, we develop new algorithms (MIL-CNN) that combine feature learning and multiple instance classification in a single network. These algorithms generalize the CNN architecture to multiple instance data. We design and report the results of three experiments applied on both generative (GLCM) and learned (CNN) features using two datasets (The Lung Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI) \cite{armato2011lung} and the National Lung Screening Trial (NLST) \cite{national2011reduced}). Two of these experiments perform five-fold cross-validations on the same dataset (NLST or LIDC). The third experiment trains the algorithms on one collection (NLST dataset) and tests it on the other (LIDC dataset). We designed our experiments to compare the different features, compare MIL versus Single Instance Learning (SIL) where a single feature vector represents a nodule, and compare our proposed end-to-end MIL approaches to existing benchmark MIL methods. We demonstrate that our proposed MIL-CNN frameworks are more accurate for the lung nodules diagnosis task. We also show that MIL representation achieves better results than SIL applied on the ground truth region of each nodule

Pengaruh Keadilan Pajak, Kualitaspelayanan Pajak, Kemungkinan Terdeteksinya Kecurangan, Sanksi Perpajakan, Dan Tarif Pajak Terhadap Persepsi Wajib Pajak Mengenai Penggelapan Pajak (Tax Evasion)

This study aims to determine whether the tax justice, the quality of tax services, the possibility of detection of fraud, tax sanctions and tax rates have an influence on taxpayer perceptions about tax evasion. The sampling technique using purposive sampling method with the number of samples used in this study are 90 UMKM pempek, kerupuk, and kemplang that exist in the city of Palembang. The variables were tested by multiple linear regression method with 5% significant level. From the results of the research note that the tax justice, the quality of tax services, the possibility of detection of fraud affect the perception of taxpayers about tax evasion and tax sanctions and tax rates do not affect the taxpayer's perception of tax evasion

Pengaruh Keadilan Pajak, Kualitaspelayanan Pajak, Kemungkinan Terdeteksinya Kecurangan, Sanksi Perpajakan, Dan Tarif Pajak Terhadap Persepsi Wajib Pajak Mengenai Penggelapan Pajak (Tax Evasion)

This study aims to determine whether the tax justice, the quality of tax services, the possibility of detection of fraud, tax sanctions and tax rates have an influence on taxpayer perceptions about tax evasion. The sampling technique using purposive sampling method with the number of samples used in this study are 90 UMKM pempek, kerupuk, and kemplang that exist in the city of Palembang. The variables were tested by multiple linear regression method with 5% significant level. From the results of the research note that the tax justice, the quality of tax services, the possibility of detection of fraud affect the perception of taxpayers about tax evasion and tax sanctions and tax rates do not affect the taxpayer's perception of tax evasion

Rudolph Sohm and his influences of the definition of the law of property in the Middle Ages. A reinterpretation of ownership in Transylvania (1308-1342)

This article addresses firstly the terminological problems modern historians encounter when discussing the law of property in the Middle Ages, and how its decontextualization has led to numerous inaccurate studies in the field of legal history, and secondly it is dedicated to Rudolph Sohm and his interpretation of the law of property and how his idea of institutional law can be applied to the medieval institutions of Transylvania in the early 14th century. Rudolph Sohm considers in his work Outlines of Church History that in the Middle Ages, society was composed of only two classes, the nobility and the clergy. They alone possessed property and they alone ruled. He describes landed property as the only kind of property recognized in that period. It is interesting to investigate in light of recent studies how political authority went hand in hand with the possession of land, and how were the classes defined by Sohm identified with and within the nation or the realm. His classification is still used by many Hungarian and Romanian historians, and we argue against the use of the modern concept of property and offer a new definition for the numerous and various types of possession we encounter. Was the history of the nation their history? What defines the society in the Middle Ages? Is Sohm’s definition of medieval property still functional correlated with the new developments in legal history? These are several questions that this research aims to answer by investigating the roman and medieval terminology used to define possession and nobility in 13th and 14th century Transylvania.Questo articolo riguarda, in primo luogo, i problemi terminologici per gli storici moderni quando si discute la legge della proprietà nel Medioevo, e come la decontestualizzazione ha creato numerosi studi erronati nel campo della storia del diritto, e in secondo luogo è dedicata a Rudolph Sohm e la sua interpretazione di la legge della proprietà e di come la sua idea di legge può essere applicata alle istituzioni medievali della Transilvania nei primi anni del 14° secolo. Rudolph Sohm considera, nella sua opera Outlines of Church History, che nel Medioevo, la società era composta da solo due classi, la nobiltà e il clero. Solo loro possedevano proprietà e solo loro governati. Egli descrive la proprietà fondiaria come l'unico tipo di proprietà riconosciuto in quel periodo. E 'interessante indagare alla luce di recenti studi come l'autorità politica è andato di pari passo con il possesso della terra, e di come sono state le classi definite da Sohm identificato con e all'interno della nazione o il regno. La sua classificazione è ancora utilizzato da molti storici ungheresi e rumene, e ci sostengono contro l'uso del moderno concetto di proprietà e offrire una nuova definizione per i numerosi e vari tipi di possesso che incontriamo. Era la storia della nazione loro storia? Ciò che definisce la società nel Medioevo? È la definizione di Sohm di struttura medievale ancora funzionali correlati con i nuovi sviluppi nella storia del diritto? Queste sono alcune domande che questa ricerca si propone di rispondere indagando la terminologia romana e medievale utilizzato per definire il possesso e nobiltà nel 13 ° e 14 ° secolo la Transilvania.Ciencias ReligiosasDerech

Systemic approach to HIV/AIDs in the current conditions of the Republic of Moldova

Virusul Imunodeficienţei Umane (HIV) reprezintă o problemă prioritară la nivel global. În Republica Moldova pacienţi care urmează tratamentul antiretroviral sunt în număr de 5675, iar numărul celor infectaţi este în jur de 10 000 de persoane. Unul din problemele principale la momentul actual este monitorizarea și consilierea pacienţilor care sunt depistaţi drept cazuri noi și menţinerea dialogului constructiv cu cei care administrează tratament regulat. Pericolul epidemiologic ridicat și evoluţia severã a bolii în lipsa administrării tratamentului necesar impun existenţa unor mãsuri de supraveghere epidemiologicã. SCOPUL LUCRĂRII Analiza abordării sistemice în lupta cu infecţia HIV/SIDA. MATERIAL ȘI METODE Studiul efectuat a fost retrospectiv, observaţional. Datele utilizate au fost obţinute din fișele medicale ale bolnavilor de ambulator infectaţi cu HIV, din cabinete tertoriale al IMSP SDMC. REZULTATE Tratamentul HIV/SIDA în Republica Moldova este abordat printr-o serie de segmente și anume, prevenire, testare, tratament și consiliere pe parcurusl vieţii. În urma apariţiei epidemiei de Coronavirus pacienţii s-au confruntat cu o serie de provocări pentru a urma tratamentul fără întrerupere. În urma analizei datelor din anul 2018 incidenţa cea mai mare a infecţiei HIV la 100 000 populaţie pe segmentul de vărstă este de 25,47 pentru 0-39 ani. În 2019 la evidenţă medicală se aflau 7290 de persoane (inclusiv 137 copii pînă la 15 ani) care trăiesc cu HIV, din ele 856 au fost luate pentru prima dată în supraveghere medicală, în 8 centre de tratament antiretroviral (din ele 4 sunt în teritoriile de est). Toţi pacienţii au fost trataţi indiferent de stadiul bolii. S-a acordat prioritate schemei TARV în varianta combinaţiei a 3 preparate într-o singură pastilă o dată/zi. În 2019 se aflau în tratament antiretroviral 5865 persoane care trăiesc cu HIV, iar în 2018 - 1053 persoane (1040 adulţi și 13 copii). Aderenţa la tratament a fost peste în 2018 a atins valoare de 86.8% (83,3% - 2017), peste 24 luni a atins indicatorul 78.7% (80,0% - 2017), peste 60 luni – 70.3% (2017-70,1%). CONCLUZII Angajarea și participarea corectă a pacientului la planul de îngrijire și tratament în colaborare cu medicul și farmacistul implică înţelegerea informaţiilor medicale, consimţământul pacientului și stabilirea unei relaţii de parteneriat pacient-medic-farmacist.INTRODUCTION Human Immunodeficiency Virus (HIV) infection is a global priority. In the Republic of Moldova there are 5675 patients on antiretroviral treatment and around 10 000 infected people. One of the main issues at the moment is monitoring and counselling patients who are detected as new cases and maintaining a constructive dialogue with those who administer regular treatment. The high epidemiological risk and the severe evolution of the disease in the absence of the necessary treatment require epidemiological surveillance measures. PURPOSE OF THE WORK. Analysis of the systemic approach to HIV/AIDS. MATERIAL AND METHODS The study was retrospective, observational. The data used were obtained from the medical records of HIV-infected outpatients in the tertiary clinics of IMSP SDMC. HIV/AIDS treatment in the Republic of Moldova is addressed through a number of segments, namely prevention, testing, treatment and lifelong counselling. Following the Coronavirus outbreak, patients faced a number of challenges to follow treatment without interruption. Based on the analysis of 2018 data, the highest incidence of HIV infection per 100 000 population in the age segment is 25.47 for 0-39 years. In 2019 there were 7290 people (including 137 children up to 15 years old) living with HIV on the medical register, of whom 856 were taken for the first time under medical supervision in 8 antiretroviral treatment centres (of which 4 are in the Eastern Territories). All patients were treated regardless of the stage of the disease. Priority was given to the TARV scheme in the combination variant of 3 preparations in one pill once/day. In 2019 there were 5865 people living with HIV on antiretroviral treatment, and in 2018 - 1053 people (1040 adults and 13 children). Adherence to treatment was over in 2018 reached the value of 86.8% (83.3% - 2017), over 24 months reached the indicator 78.7% (80.0% - 2017), over 60 months - 70.3% (2017-70.1%). CONCLUSIONS. Proper patient engagement and participation in the care and treatment plan in collaboration with the physician and pharmacist involves understanding medical information, patient consent, and establishing a patient-physician-pharmacist partnership relationship

Case report: Acute peritonitis from non-traumatic rupture of the bladder

Spontaneous bladder rupture (SBR) is rare. This entity occurs outside of any traumatic context. A 70 years-old man was admitted for acute peritonitis, acute urinary retention and hematuria. Laparotomy and exploration showed acute generalized peritonitis related to a centimeter hole in the bladder dome. Peritoneal lavage was done with biopsy of the perforation edges, a cystostomy and suturing of the bladder. The immediate postoperative course was uneventful. The etiological investigation revealed a locally advanced and metastatic prostate cancer. The evolution was rapidly fatal and the patient’s death occurred two months later due to metastatic disease. The causes, diagnosis and treatment of SBR are reviewed by the authors

Investments in Romania before and after the E.U. accession

The investments are still an important factor for economic and social development through their implications, structure and quality. An analysis of the investments role in our country can be achieved only by having in view both Retrospective and the prospective context. The present paper analyses economic efficiency of investments as well as the role of investments in economy, as an economic growth factor. Overall, this paper has implications for research examining the investment efficiency and the economic consequences on our country between 2000 and 2008, namely before and after Romania accession to E.U.Investments; Efficiency; Economic growth