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Lessons learned from RadiologyNET foundation models for transfer learning in medical radiology
No full textDeep learning models require large amounts of annotated data, which are hard to obtain in the medical field, as the annotation process is laborious and depends on expert knowledge. This data scarcity hinders a model's ability to generalise effectively on unseen data, and recently, foundation models pretrained on large datasets have been proposed as a promising solution. RadiologyNET is a custom medical dataset that comprises 1,902,414 medical images covering various body parts and modalities of image acquisition. We used the RadiologyNET dataset to pretrain several popular architectures (ResNet18, ResNet34, ResNet50, VGG16, EfficientNetB3, EfficientNetB4, InceptionV3, DenseNet121, MobileNetV3Small and MobileNetV3Large). We compared the performance of ImageNet and RadiologyNET foundation models against training from randomly initialiased weights on several publicly available medical datasets: (i) Segmentation-LUng Nodule Analysis Challenge, (ii) Regression-RSNA Pediatric Bone Age Challenge, (iii) Binary classification-GRAZPEDWRI-DX and COVID-19 datasets, and (iv) Multiclass classification-Brain Tumor MRI dataset. Our results indicate that RadiologyNET-pretrained models generally perform similarly to ImageNet models, with some advantages in resource-limited settings. However, ImageNet-pretrained models showed competitive performance when fine-tuned on sufficient data. The impact of modality diversity on model performance was tested, with the results varying across tasks, highlighting the importance of aligning pretraining data with downstream applications. Based on our findings, we provide guidelines for using foundation models in medical applications and publicly release our RadiologyNET-pretrained models to support further research and development in the field. The models are available at https://github.com/AIlab-RITEH/RadiologyNET-TL-models
Proteomic research of the stress response of Saccharomyces cerevisiae W303 yeast to metal ions eluted from orthodontic appliances_part 2
No full textGenetics of retinitis pigmentosa
No full textRetinitis pigmentosa (RP) označava skupinu nasljednih distrofija mrežnice koje dovode do progresivne degeneracije fotoreceptora, osobito štapića, a kasnije i čunjića. Bolest se najčešće manifestira niktalopijom, sužavanjem vidnog polja i, u kasnijim fazama, gubitkom vida. RP se odlikuje velikom genetičkom heterogenošću - do danas je identificirano više od 90 gena povezanih s bolešću, pri čemu se razlikuju autosomno dominantni, autosomno recesivni i X-vezani oblici nasljeđivanja. U ovom radu analizirani su molekularni mehanizmi bolesti, klinička slika te suvremeni dijagnostički i terapijski pristupi. Poseban naglasak stavljen je na važnost genetičke dijagnostike u potvrđivanju bolesti, procjeni prognoze i izboru pacijenata za eksperimentalne ili ciljanje terapije, uključujući genetičku terapiju. Unatoč tome što još ne postoji univerzalni lijek, intenzivna istraživanja u području regenerativne medicine i genetičkog inženjeringa otvaraju nove mogućnosti u liječenju RP-a.Retinitis pigmentosa (RP) is a group of inherited retinal dystrophies characterized by progressive degeneration of photoreceptors, primarily rods and later cones. The disease typically presents with night blindness, narrowing of the visual field, and in advanced stages, severe vision loss. RP is marked by significant genetic heterogeneity, with more than 90 associated genes identified to date, and includes autosomal dominant, autosomal recessive, and X-linked forms of inheritance. This thesis explores the molecular mechanisms of the disease, clinical manifestations, and current diagnostic and therapeutic strategies. Special emphasis is placed on the role of genetic testing in confirming the diagnosis, predicting disease progression, and selecting patients for targeted or experimental therapies, including gene therapy. Although no universal cure currently exists, ongoing research in regenerative medicine and genetic engineering offers promising prospects for the future treatment of RP
Pneumococcal infections
No full textPneumokokne infekcije, uzrokovane bakterijom Streptococcus pneumoniae, predstavljaju značajan javnozdravstveni problem zbog visokog morbiditeta, osobito u djece i starijih osoba. Najvažniji čimbenik virulencije je polisaharidna kapsula koja omogućava bakteriji izbjegavanje imunološkog odgovora domaćina. Pneumokok uzrokuje različite kliničke slike, od lokaliziranih infekcija poput akutne upale srednjeg uha do teških sepsi i meningitisa. Dijagnosticiraju se kultivacijom, molekularnim metodama i brzim antigenskim testovima. Liječenje se temelji na antibiotskoj terapiji, pri čemu sve veća rezistencija zahtijeva oprez i racionalnu uporabu lijekova. Cijepljenje je ključno za prevenciju infekcija i smanjenje tereta bolesti, no praćenje zamjene serotipova i prilagodba cjepiva ostaju važni izazovi.Pneumococcal infections, caused by Streptococcus pneumoniae, represent a significant public health concern due to high morbidity, particularly in children and the elderly. The most important virulence factor is the polysaccharide capsule, which allows the bacteria to evade the host's immune response. Pneumococcus causes a variety of clinical manifestations, ranging from localized infections such as acute otitis media to severe conditions like sepsis and meningitis. They are diagnosed by culture, molecular methods and rapid antigen testing. Treatment relies on antibiotic therapy, with rising resistance necessitating caution and rational drug use. Vaccination is crucial for preventing infections and reducing the disease burden, but monitoring serotype replacement and adapting vaccines remain ongoing challenges
Prenatal Management of Spinal Muscular Atrophy in the Era of Genetic Screening and Emerging Opportunities in In Utero Therapy
No full textSpinal muscular atrophy (SMA) is a severe autosomal recessive neuromuscular disorder and a leading genetic cause of infant mortality. Advances in disease-modifying therapies have significantly improved outcomes when treatment is initiated early, underscoring the importance of timely diagnosis. With the growing availability of prenatal genetic screening and high-resolution molecular diagnostics, opportunities for early detection, and potentially in utero intervention, are rapidly expanding. This narrative review synthesizes current evidence on the prenatal management of SMA, focusing on diagnostic strategies, the clinical application of fetal genetic testing, and the emerging potential of fetal therapy. We explore both invasive and non-invasive diagnostic approaches and evaluate experimental prenatal treatment modalities, while critically addressing the associated ethical, regulatory, and economic considerations. As the field progresses, integrating in utero strategies into clinical care may reshape perinatal medicine and offer transformative potential for genetic neurodegenerative disorders diagnosed before birth. The convergence of early diagnosis, fetal intervention, and personalized genetic counseling will be central to optimizing care pathways and outcomes in the era of precision medicine. Although significant challenges remain, the translation of fetal therapy into routine clinical practice is approaching feasibility. Future clinical trials, anchored in definitive prenatal diagnosis, will be essential, with benefits potentially outweighing the inherent procedural risks
On-Line Survey About Autonomic Dysreflexia in Individuals with Spinal Cord Injury in Croatia
No full textBackground/Objectives: Autonomic dysreflexia (AD) is a clinical syndrome affecting persons with spinal cord injury (SCI). The aim of the study was to present the experience of individuals with SCI and AD in Croatia. Single-center questionnaire study. Setting: Faculty of Medicine, University of Rijeka, Rijeka, Croatia. Persons with SCI were divided into those with an SCI at T6 and above (n = 41) and those with an SCI at T7 and below (n = 29). Based on anamnestic data, patients with an SCI at T6 and above were further divided into those with and without self-reported clinical symptoms of AD (respectively: n = 33 and n = 8). Methods: The online survey included 23 questions of various types. It consisted of a general (demographic) section, section with specific questions about AD, and a section on self-assessment and quality of life. Based on the answers, the experience and knowledge of AD among individuals with an SCI in Croatia was assessed. Results: A total of 70 individuals with an SCI completed the whole survey. The average age was 40.6 years. The patients were predominantly male (72.9%) and mostly with a traumatic SCI (84.3%). Of the 70 individuals with an SCI, 35 (50%) reported they were familiar with AD, with the majority indicating that the internet was their primary source of information. Among those with an SCI who were unaware of AD, most (34/35 = 97.1%) wanted to learn about AD. The self-assessed quality of life was insignificantly better in patients with an SCI below T6 than in those with higher lesions. Patients with AD reported different symptoms and the most frequently reported symptom was a headache (70%). In 64% of participants, the primary trigger of AD were issues with the urinary bladder. In most individuals (55%), symptoms were not recognized by the healthcare providers. The individuals with AD were dissatisfied with the information about AD they received from doctors or nurses. Overall, 61% of all participants with AD rated their quality of life as good. Conclusions: Persons with an SCI are not adequately informed about AD. In most persons with AD, their symptoms are not properly recognized by healthcare providers. Our results suggest the need for more education of healthcare professionals about AD
Myocardial deposition of aluminum, arsenic, cadmium, and lead accelerates heart failure and alters UPRmt in humans
No full textIn the myocardium of control subjects and patients undergoing heart transplantation or left ventricular assist device implantation (LVAD), we analyzed concentrations of Al, As, Cd, Pb, and Ni using inductively coupled plasma mass spectrometry. Myocardial generation of oxidative-stress-induced lipid peroxidation was analyzed by quantifying concentration of 4-Hydroxynonenal (4-HNE) with ELISA and pro-apoptotic DAPK2 gene expression was determined with quantitative RT-PCR. Compared to six control hearts, myocardial samples of 128 individuals undergoing heart transplantation or LVAD implantation exhibited a moderate increase in deposition of five tested non-essential elements, which was significantly increased only for Cd and cumulative deposition of Al, As, Cd, and Pb. Patients with higher cumulative deposition of Al, As, Cd, and Pb, underwent heart transplantation or LVAD implantation at a younger age than those with lower cumulative deposition, which was not observed in individual elements. Also, Al, As, and Ni exhibited a positive correlation with DAPK2 expression. Moreover, Al, As, Cd, and Ni showed positive correlations and Pb negative correlations with several mitochondrial quality control (MQC) genes. None of the elements showed correlation with 4-HNE generation in the myocardium. There was no difference in tested non-essential element deposition between dilated and ischemic cardiomyopathy. In conclusion, patients with higher cumulative deposition of Al, As, Cd, and Pb in the myocardium underwent heart transplantation or LVAD implantation at a younger age, indicating that they may accelerate heart failure, which is associated with induction of DAPK2 expression. Deposition of Al, As, Cd, Ni, and Pb also altered the expression of several MQC genes
Repetitive Mild but Not Single Moderate Brain Trauma Is Associated with TAR DNA-Binding Protein 43 Mislocalization and Glial Activation in the Mouse Spinal Cord
No full textBackground/Objectives: Traumatic brain injury (TBI) occurs after a sudden mechanical force to the skull and represents a significant public health problem. Initial brain trauma triggers secondary pathophysiological processes that induce structural and functional impairment of the central nervous system, even in the regions distant to the lesion site. Later in life, these changes can be manifested as neurodegenerative sequalae that commonly involve proteinopathies, such as transactive DNA-binding protein 43 (TDP-43). The progression of pathophysiological changes to the spinal cord motor neurons has been detected after repetitive TBI, while such changes have been less investigated after single TBI. Methods: Single TBI was applied over the left parietal cortex of mice by using the lateral fluid percussion injury apparatus and a separate cohort of animals received repetitive mild TBI by weight drop apparatus, with two mild injuries daily, for five days in a row. Mice were sacrificed 14 days after single moderate or last mild TBI and their spinal cords were prepared for the analyses. For both types of injury, sham-injured mice were used as a control group. Results: Here, we found an early formation of toxic phosphorylated TDP-43 species on the 3rdday post-injury which, together with TDP-43 cytoplasmic translocation, remained present in the subacute period of 14 days after repetitive mild but not single moderate TBI. During the subacute period following a repetitive brain trauma, we found an increased choline acetyltransferase protein expression and significant microgliosis in the cervical part of the spinal cord, which was not detected after single TBI. Astrogliosis presented similarly after both experimental procedures. Conclusions: This study demonstrates the differences in the spinal cord TDP-43 pathology and inflammation, depending on the brain trauma type, and may contribute to the development of targeted therapeutic strategies
Analyzing Predictive Factors for the Media’s Impact on the Nursing Profession
No full textIntroduction: Mass media play a crucial role not only in informing the public but also in shaping public perception, educating, and enhancing the visibility of various professions, including nursing. Despite being the most populous healthcare profession, nursing remains underrepresented in media coverage. This imbalance affects the social status of the nursing profession and its public perception. Methods: This cross-sectional study utilized a validated questionnaire with high internal reliability (Cronbach’s alpha coefficients) to assess nurses’ perceptions of the media’s role in society and the nursing profession. Data were collected from 203 participants using an online survey employing the snowball sampling method. Statistical analyses included Welch ANOVA, t-tests, and hierarchical regression to predict the importance of media education. Results: Participants demonstrated positive perceptions of the media’s societal influence but identified a lack of adequate representation of nurses. Younger nurses and those with higher education levels emphasized the need for media education. Regression analysis revealed that perceptions of the media’s power and self-assessed media competencies were significant predictors of valuing media education. Conclusions: The findings highlight the need for integrating media literacy training into nursing education to enhance professional visibility and public engagement. This can empower nurses to actively contribute to shaping their professional image and addressing public misconceptions. Future research should expand the sample size and explore diverse healthcare settings to validate these findings
European Guideline on Chronic Nausea and Vomiting—A UEG and ESNM Consensus for Clinical Management
No full textIntroduction: Chronic nausea and vomiting are symptoms of a wide range of gastrointestinal and non-gastrointestinal conditions. Diagnosis can be challenging and requires a systematic and well-structured approach. If the initial investigation for structural, toxic and metabolic disorders is negative, digestive motility and gut-brain interaction disorders should be assessed. United European Gastroenterology (UEG) and the European Society for Neurogastroenterology and Motility (ESNM) identified the need for an updated, evidence-based clinical guideline for the management of chronic nausea and vomiting. Methods: A multidisciplinary team of experts in the field, including European specialists and national societies, participated in the development of the guideline. Relevant questions were addressed through a literature review and statements were developed and voted on according to a Delphi process. Results: Ninety-eight statements were identified and voted following the Delphi process. Overall agreement was high, although the grade of scientific evidence was low in many areas. Disagreement was more evident for some pharmacological treatment options. A diagnostic algorithm was developed, focussing on the differentiating features between gastrointestinal motility and gut-brain interaction disorders with predominant nausea and vomiting. Conclusion: These guidelines provide an evidence-based framework for the evaluation and treatment of patients with chronic nausea and vomitin