Prediction of robo-advisory acceptance in banking services using tree-based algorithms.

The banking sector is increasingly recognising the need to implement robo-advisory. The introduction of this service may lead to increased efficiency of banks, improved quality of customer service, and a strengthened image of banks as innovative institutions. Robo-advisory uses data relating to customers, their behaviors and preferences obtained by banks from various communication channels. In the research carried out in the work, an attempt was made to obtain an answer to the question whether the data collected by banks can also be used to determine the degree of consumer interest in this type of service. This is important because the identification of customers interested in the service will allow banks to direct a properly prepared message to a selected group of addressees, increasing the effectiveness of their promotional activities. The aim of the article is to construct and examine the effectiveness of predictive models of consumer acceptance of robo-advisory services provided by banks. Based on the authors' survey on the use of artificial intelligence technology in the banking sector in Poland, in this article we construct tree-based models to predict customers' attitudes towards using robo-advisory in banking services using, as predictors, their socio-demographic characteristics, behaviours and attitudes towards modern digital technologies, experience in using banking services, as well as trust towards banks. In our study, we use selected machine learning algorithms, including a decision tree and several tree-based ensemble models. We showed that constructed models allow to effectively predict consumer acceptance of robo-advisory services.

The effect of adding berry fruit juice concentrates and by-product extract to sugar solution on osmotic dehydration and sensory properties of apples.

Osmotic dehydration (OD) of apples caused a reduction of normalized water content (NWC) and an increase of normalized solids gain (NSG), independently of the kind of osmotic solution. The use of 22°Brix osmotic solutions with the addition of fruit concentrates or bilberry extract resulted in only slight reduction in the NWC in the samples, i.e. by about 15 and 20%, respectively after 6 and 24 h, against a value up to 80% in case of 65°Brix use. Similarly, larger NSG was achieved at higher solution concentrations, but the differences were smaller. In the case of the use of 80% bilberry press cake extract the NSG was very low but NWC was relatively high. Such a low concentration of slightly concentrated fruit juices is not effective for dehydration of apples, but it may be sufficient to enrich the fruit with the desired colorants. This higher concentration of osmotic solution and a larger addition, especially of the concentrate of chokeberry juice, significantly affected the color changes of dehydrated apples. The apple dehydrated in mixture of 65°Brix sucrose and 15% chokeberry juice concentrate solution exhibited the highest sensory parameters. The addition of berry fruit juices and extract was able to improve the apple sensory quality after 24 h OD in comparison with sucrose solution. Ethanol extract was a good osmotic agent, but not accepted due to taste and overall quality. However, the addition of the extract can be successfully used in conjunction with a sugar solution.

Quality control of riboflavin-treated platelet concentrates using Mirasol® PRT system: Polish experience.

BACKGROUND: The quality of platelet concentrates (PCs) is affected by preparation, storage, the type of container, and pathogen reduction technology (PRT). The Mirasol® Pathogen Reduction Technology (PRT) system (Terumo BCT Inc., Lakewood, USA), which uses riboflavin and ultraviolet (UV) light, has recently been proven effective against bacteria, viruses, parasites, and leukocytes. OBJECTIVES: The aim of the study was to evaluate the effect of the Mirasol® PRT system, based on riboflavin and UV light exposure, on the most common in vitro platelet quality parameters of PCs prepared from whole blood-derived buffy coats. MATERIAL AND METHODS: The study included 15 trials (n = 15). For each trial, 2 PCs were used: 1 for treatment with the Mirasol® PRT system (M) and 1 for a control (C). In the M group, PCs were illuminated. In the C group, saline solution was added. PCs from groups M and C were stored at 20-24°C, with agitation. Samples were collected on days 1, 3 and 5 to determine platelet concentration, total platelet count/unit, mean platelet volume (MPV), power of hydrogen (pH), glucose and beta-thromboglobulin concentration (BTG), hypotonic shock response (HSR), aggregation, CD42b and CD62P expression, pCO2, and pO2. RESULTS: No significant differences in HSR or CD42b expression were observed between groups M and C. All pH values were stable during the whole storage period (7.1-7.5). On storage day 1, CD62P expression in group C was significantly higher than in group M. In the Mirasol® group, significantly higher glucose consumption was noted on storage days 3 and 5. On day 5, a 2-3-fold increase in BTG was observed in both groups as compared to day 1; on day 5, BTG concentration was 32% higher in group M than in group C. On all storage days, pCO2 was comparable in groups M and C; lower pO2 values were reported for group M. CONCLUSIONS: In vitro results demonstrated that pH, HSR, aggregation, CD42b antigen expression, and MPV and platelet count parameters were comparable in groups M and C.

Molecular and serological infection marker screening in blood donors indicates high endemicity of hepatitis E virus in Poland.

BACKGROUND: Until now, markers of hepatitis E virus (HEV) infection have not been studied in blood donors throughout Poland, and no acute case of HEV infection has been closely documented or confirmed by HEV RNA detection. The prevalence of HEV infection markers, including HEV RNA in Polish blood donors and virus genotypes was investigated. STUDY DESIGN AND METHODS: In total, 12,664 individual donations from 22 Polish blood transfusion centers were tested for HEV RNA by transcription-mediated amplification. In addition, 3079 first-time donors sampled throughout Poland also were screened for antibodies to HEV. HEV RNA and immunoglobulin M-positive donations were confirmed using real-time reverse transcription-polymerase chain reaction and Western blotting, respectively. RESULTS: Ten donors were identified as RNA initial reactive (one of 1266 donors), and six (one of 2109) were identified as repeat reactive and confirmed by real-time reverse transcription-polymerase chain reaction or seroconversion. Sequence analysis identified HEV Genotype 3c in one donor and Genotype 3i in two others. On average, 43.5% of donors were immunoglobulin G-positive. Immunoglobulin G seroprevalence ranged from 22.7% to 60.8% in group ages 18 to 27 years and 48 to 57 years, respectively and differed between administrative regions from 28.9% in Podlasie to 61.3% in Wielkopolska. Thirty-nine of the donors were immunoglobulin M-positive, and seven donors were IgM positive only (0.2%). Of 37 immunoglobulin M-reactive samples tested by Western blot, 24 (64.9%) were confirmed. CONCLUSIONS: The current results indicate a high level of HEV endemicity throughout Poland compared with other countries. There is an urgent need to consider the protection of recipients of blood components against transfusion-transmitted HEV infection.

Hemovigilance survey of pathogen-reduced blood components in the Warsaw Region in the 2009 to 2013 period.

BACKGROUND: In 2009 the Mirasol Pathogen Reduction Technology (PRT) was introduced to the routine blood component production of the Regional Blood Transfusion Center in Warsaw (RBTCW). The goal of this study was to investigate the safety of Mirasol-treated blood components. STUDY DESIGN AND METHODS: The accumulated passive hemovigilance data of Mirasol-treated blood components collected at the RBTCW are presented and compared to historical and contemporary data. Furthermore, active hemovigilance data collected from patients with different hematologic disorders transfused with Mirasol-treated or untreated blood components at the Institute of Hematology and Transfusion Medicine (IHTM) are presented and discussed. RESULTS: The adverse reaction (AR) reporting rate by hospitals to the RBTCW after the implementation of the Mirasol technology was 0.39% for Mirasol-treated platelet concentrates (M-PCs) and 0.05% for Mirasol-treated fresh-frozen plasma. When comparing contemporary rates of ARs recorded by RBTCW in the time period 2011 to 2012, no statistical difference was observed between Mirasol-treated and untreated blood components. No serious AR was attributed to Mirasol-treated components. At the IHTM a lower rate of ARs after transfusion of M-PCs was observed than with untreated PCs. Despite the fact that very large amounts of Mirasol-treated plasma have been transfused to patients with congenital or acquired thrombotic thrombocytopenic purpura, no significant increase in AR rates was observed. CONCLUSION: Treatment of blood components with the Mirasol PRT System has proven to be safe for patients and is not associated with increased rates and grades of adverse events in patients of hospitals in the Warsaw Region.

Laparoscopic splenectomy for hereditary spherocytosis-preliminary report.

Splenectomy is considered standard surgical therapy in hereditary spherocytosis. The procedure is indicated in patients with severe anemia, recurrent hemolytic, and aplastic crises. The aim of the study was to assess treatment outcomes in patients with hereditary spherocytosis who underwent total or partial laparoscopic splenectomy. Fifteen patients aged 4-17 yr underwent laparoscopic splenectomy from 2009 to 2012. Partial and total splenectomies were performed (five and 10 children, respectively). Hematologic parameters, liver function tests, and splenic volume before and after the surgery were analyzed retrospectively. Total follow-up was 1-30 months. Hospitalization and operating time were similar in both groups. In partial splenectomy group, branches of splenic arteries gave better blood supply than short gastric vessels. In both groups, hematologic parameters were improved. Postoperative markedly elevated platelet count was maintained up to 6 months, and after that, platelet count gradually decreased to normal values. Bilirubin level was decreased in early postoperative period; however, it increased later to achieve levels lower than in preoperative period. No severe general infections were observed in both groups. Laboratory parameters (hemoglobin and bilirubin concentrations and RBC) after the surgery improved in all patients, and the effect was maintained during 12 months of follow-up. Platelet count increased significantly after the surgery and was maintained at high levels during the next 6 months. However, it returned to preoperative levels within a year after the surgery. Our study showed that partial splenectomy was not inferior to total splenectomy. However, full assessment requires longer follow-up and larger group of patients.

3D high-definition manometry in evaluation of children after surgery for Hirschsprung's disease: A pilot study.

PURPOSE: Anorectal 3-dimensional high definition manometry (3D HRM) could be the best tool for postoperative assessment of restorative surgical procedures for Hirschsprung's disease. The aim of our study was to evaluate patients after surgery for Hirschsprung's disease using 3D HRM. MATERIALS AND METHODS: Anorectal function was evaluated using solid state 3D HRM. We measured the length of the anal canal, mean resting squeeze pressures, the presence of rectoanal inhibitory reflex, cough reflex, ano-anal reflex and the bear down manoeuvre. RESULTS: We studied 14 children operated on for Hirschsprung's disease. The mean values of pressure asymmetry were higher in patients after the Duhamel procedure than after the TEPT procedure (29.58% vs. 22.26% during resting and 26.1% vs. 14.01% during squeeze, respectively). No difference between the groups was observed in the measurement of all the manometric parameters except the presence of rectoanal inhibitory reflex (87.5% after TEPT vs. 33% after Duhamel). CONCLUSIONS: Anorectal 3D HRM evaluation of patients with Hirschsprung's disease demonstrated that the asymmetry of the anal canal occurred in a similar percentage after both procedures.

Evaluation of calretinin immunohistochemistry as an additional tool in confirming the diagnosis of Hirschsprung disease.

Hirschsprung disease (HD) is a congenital malformation defined as the absence of myenteric and submucosal ganglion cells (GCs) in the distal rectum and variable length of the contiguous bowel. The aim of this study was to assess the utility of calretinin immunochemistry in comparison with that of standard histology complemented with acetylcholinesterase (AChE) histochemistry routinely employed at our institution to evaluate rectal biopsies carried out for suspicion of HD. Twenty-one rectal biopsies were reviewed, including 14 from patients with suspected HD, 6 from infants with necrotizing enterocolitis (NEC), and 1 from a patient diagnosed with spontaneous intestinal perforation (SIP). Sections stained with hematoxylin-eosin (HE) revealed absence of ganglion cells in 13 cases which included 11 patients with HD and 2 patients with NEC. Among 13 cases of aganglionosis the AChE reaction pattern was consistent with HD in 2 patients. Calretinin positivity was observed in all rectal biopsies showing the presence of GC, and the staining was consistently absent in all cases of aganglionosis. In 6 rectal biopsies in which abnormal acetylcholinesterase (AChE) staining was not seen, loss of calretinin immunoreactivity helped establish the diagnosis of HD.

Head-to-head comparison of two transcription-mediated amplification assay versions for detection of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus Type 1 in blood donors.

BACKGROUND: The second triplex transcription-mediated amplification (TMA) assay version (Ultrio Plus, Novartis Diagnostics) uses an additional reagent enhancing the disruption of hepatitis B virus (HBV) particles and release of DNA for the target capture probe. This study compares the performance of this new assay version with the previous one (Ultrio). STUDY DESIGN AND METHODS: For analytical sensitivity assessment the World Health Organization HBV, hepatitis C virus (HCV), and human immunodeficiency virus (HIV) international standards and various genotype dilution panels were used. Individual donations (IDs) from 9980 first-time donors were screened simultaneously by serology and both TMA assay versions. RESULTS: The 50 and 95% limits of detection (LODs) for HBV using Ultrio Plus were 0.8 (0.6-1.0) and 4.6 (3.2-7.2) IU/mL, respectively, 2.4 (1.4-4.8)-fold more sensitive than Ultrio. The TMA assay versions had comparable LODs for HIV-1 and HCV. The improvement factors on analytical sensitivity panels of HBV Genotypes A to G ranged from 1.3 to 7.3 and 50% LODs (95% confidence interval) reduced from 12.5 (10-15) to 3.8 (3.2-4.4) copies/mL. One Ultrio Plus HBV Genotype D yield sample missed by the Ultrio assay in the donor screening study was detected with ninefold higher sensitivity. The specificities of ID nucleic acid test (ID-NAT) and serologic testing in a similar repeat test algorithm were 100 and 99.41%, respectively. CONCLUSION: More efficient target capture chemistry in the new TMA assay version significantly improved sensitivity and diminished variability in detecting HBV strains of various genotypes. We recommend a triplicate ID-NAT repeat test strategy to eliminate discriminatory tests on false-non-repeat-reactive (anti-HBc-nonreactive) donations.

[The analysis of patients with body traumas treated in the Military Medical Academy's Second Clinical Hospital of the Medical University of Lodz]. / Analiza pacjentów z obrazeniami ciala, leczonych w Uniwersyteckim Szpitalu Klinicznym nr 2 (USK 2) im. Wojskowej Akademii Medycznej Uniwersytetu Medycznego w Lodzi.

According to recent WHO reports, body traumas are ranked third with respect of frequency of occurrence right after cardiovascular diseases and tumours, and are considered one of the major medical problems. Trauma is a kind of energy (mechanical, thermal or chemical) affecting the human body. After crossing the threshold of tissue endurance, an injury or damage occurs. A common problem of all the centres that treat traumas is a reliable and comparable assessment of injury severity. Constant improvement of the trauma scores, contributes to increased objectivity of the assessment of injury severity and makes trauma research easier. To a large extent, commonness of the scores enables the exchange of experiences with respect to treating patients after trauma. An ideal scale should be reliable, easy to use, and most of all commonly used, thus enabling the employment of a common "traumatologic" language. In the following research, the test group was comprised of 137 adult patients including 113 men (82%) and 24 women (18%). Most patients were aged from 20 to 60 years, that is, in the productive age. Appropriate trauma treatment results in the reduction of the costs of hospitalisation time of those patients and their recovery. An accident or worse still death of a young person is not only a personal tragedy for the family. It is also a big economic loss for the society which results from "lost years of life" and thus "lost years of work". Quick and appropriate treatment, done in a proper centre with appropriately trained staff and highest quality equipment will allow not only to reduce the victim's suffering and return to their daily life, but also minimise the social costs connected with disability pensions, benefits and compensations. Most injuries happened at work--61% were probably due to haste but most of all not complying with occupational health and safety regulations, which all employees should know and comply with. It involves doctors writing a sick note for the injured which undoubtedly involves much bigger losses for the employer and social costs in a form of increased premiums for healthcare plans. The most common mechanism of the injuries was self-injury (66.7%). In the study population, even 87% of the victims suffered from isolated body injuries. As is apparent from the analysed data, one should provide money for short-term health care, i.e. up to 2 days. The average treatment time for the study population was 4 days, with the maximum of 23 days. Most patients (60%) were brought by emergency medical services.

[Inflammatory cytokines and long-term prognosis after cardiac arrest]. / Rokownicza wartosc stezenia cytokin u chorych po naglym zatrzymaniu krazenia.

BACKGROUND: The long-term survival rate after sudden cardiac arrest remains low despite progress in resuscitation, possibly due to acute ischemia of vital organs and subsequent general inflammatory reaction. We investigated a possible relationship between inflammatory cytokine concentrations and cardiac arrest (CA) survival. METHODS: Fifty one adult acute coronary syndrome patients, 35 males and 16 females, aged 62 +/- 12 years, who survived out-of-hospital CA (45%) and in-hospital CA (55%) were enrolled in the study. Twenty four of the patients died (D-CA); the other 27 survived and were discharged from the hospital (S-CA). Clinical conditions were rated by the Simplified Acute Physiology Score II (SAPS II) and Multiple Organ Dysfunction Score (MODS). Blood samples were obtained immediately after cardiac arrest. Serum concentrations of IL-6, IL-10 and TNF-alpha were analysed and rated against survival rates. RESULTS: Higher mean concentrations of all cytokines were found in the D-CA group, when compared to the S-CA group. The mean concentration of IL-6 was 225 +/- 178 IU mL(-1) in the D-CA patients and 88 +/- 120 IU mL(-1) in the S-CA group (p = 0.006), and correlated inversely with survival (p = 0.018). The higher concentrations of IL-10 and TNF-alpha in non-survivors were not significant and bore no relation to survival rates. We also found significantly higher SAPS II and MODS scores, which correlated with both IL-6 levels and survival rates. CONCLUSIONS: The relationship between the concentration of inflammatory cytokines and survival has been reported by others and should be regarded as a marker of generalized inflammatory response. A concentration of IL-6 is of high prognostic value.

Boussignac CPAP in the postoperative period in morbidly obese patients.

BACKGROUND: In the postoperative period hypoventilation and hypoxia with hypercarbia may occur in morbidly obese patients due to the residual influence of general anesthesia drugs, postoperative atelectasis and postoperative pain. Non-Invasive Ventilation (NIV) is a method of improvement of respiratory efficiency in patients not requiring mechanical ventilation. The aim of the study was to compare NIV (Boussignac) CPAP and traditional oxygen delivery via nasal catheter in the postoperative acute care unit (PACU) in morbidly obese patients after open Roux-en-Y gastric bypass (RYGBP). METHODS: 19 morbidly obese patients scheduled for elective open RYGBP, were randomly divided into 2 groups: CPAP (10 patients) or control (nasal catheter - 9 patients). Patients consisted of: 8 male and 11 female, mean weight 127.76 +/- 18.5 kg, height 173.41 +/- 9.41 cm, BMI 42.43 +/- 3.3 kg/m2, age 35.84 +/- 9.05 years. In the PACU, capillary blood gas measurements were taken at 3 Time Points: T1 - 30 min, T2 - 4 hours and T3 - 8 hours after admission. Sample T0 was taken before surgery. For management of postoperative pain, patients received morphine 2 mg/h intravenously and tramadol 100 mg. RESULTS: Mean blood gas measurements of all postoperative time points were: pO2 81.0+/-16.0 (range 78.1-85.7) mmHg vs 65.9+/-4.9 (range 63.8-68.1) mmHg (P<0.05); pCO2 40.6+/-2.4 (range 39.4-41.8) mmHg vs 41.5+/-4.0 (range 39.6-43.4) mmHg (P>0.05), in the CPAP and control groups respectively. In every case, pulse-oxymetry oxygenation was >94%. CONCLUSION: Boussignac CPAP improved blood oxygenation compared to passive oxygenation with a nasal catheter but had no influence on CO2 elimination in non-CO2 retaining morbidly obese patients.

[Resuscitation of a pregnant woman]. / Resuscytacja krqzeniowo-oddechowa kobiety ciezarnej.

Most pregnant women have little interest in thinking about the prospect of death. Mortality related to the pregnancy itself is rare, occurring in an estimated 1 of every 30 000 deliveries. Although cardiopulmonary arrest rarely occurs in pregnant women, it is important that the health care team knows the appropriate actions to take in such an event, to promote positive outcomes for both mother and fetus. We discuss important pathophysiological alterations during pregnancy and, including recommendations in the available literature, we present a standardized protocol for life support for mother. Perimortem cesarean section is rarely required, but it is important topic for two reasons. First, there is a clear imperative to promptly decide and act when PMCD is indicated. As in all emergency care, knowledge must precede the crisis rather than await it. Second, indications for PMCD have broadened considerably since 1980s, and the procedure may attain a more prominent role in the future. We believe that prompt cesarean delivery is the key to maternal and infant survival in such cases.