Oocyte retrieval difficulties in women with ovarian endometriomas

Research question: What are the frequency, characteristics and consequences of technical diffiiculties encountered by physicians when carrying out oocyte retrieval in women with ovarian endometriomas? Design: We prospectively recruited women undergoing IVF and compared technical difficulties between women with (n = 56) and without (n = 227) endometriomas. Results: In exposed women, the cyst had to be transfixed in eight cases (14%, 95% CI 7 to 25%) and accidental contamination of the follicular fluid with the endometrioma content was recorded in nine women (16%, 95% CI 8 to 27%). Moreover, follicular aspiration was more frequently incomplete (OR 3.6, 95% CI 1.4 to 9.6). In contrast, the retrievals were not deemed to be more technically difficult by the physicians and the rate of oocytes retrieved per developed follicle did not differ. No pelvic infections or cyst ruptures were recorded (0%, 95% CI 0 to 5%). Conclusions: Oocyte retrieval in women with ovarian endometriomas is more problematic but the magnitude of these increased difficulties is modest

Qalb ta’ Tifel

Ġabra ta’ poeżiji u proża li tinkludi: Lil Malta ta’ Dun Karm – Fuq il-Fruntiera ta’ Dun Karm – Jum li jibqa’ jissemma ta’ Ġużè Chetcuti – Xbihet Malta ta’ Arthur V. Vassallo – Għanja ta’ Mħabba ta’ Ġużè Chetcuti – Żewġ Poeżijiet tal-kittieb Malti Antonio Calleja ta’ A. C. – Twettiqa ta’ Calleja – Lil Ħabib Għeluq Sninu ta’ Calleja – Taħt is-Salib ta’ R. M. B. – Lil Dun Karm ta’ Fran. Camilleri – Frak mill-weraq ta’ Byron ta’ A. C. – Irrid Immur Ta’ Xbiex ta’ Fran. Camilleri – Il-Cottonera fil-Ħamrun ta’ N. Biancardi – Qalb ta’ Tifel ta’ R. M. B.N/

Mainstreaming nature-based solutions for climate resilient infrastructure in peri-urban sub-Saharan Africa

Despite a growing recognition of the importance of designing, rehabilitating, and maintaining green infrastructure to provide essential ecosystem services and adapt to climate change, many decision makers in sub-Saharan Africa continue to favour engineered solutions and short term economic growth at the expense of natural landscapes and longer term sustainability agendas. Existing green infrastructure is typically maintained in more affluent suburbs, inadvertently perpetuating historic inequalities. This is in part because there remains a lack of fine-grained, comparative evidence on the barriers and enablers to mainstreaming green infrastructure in peri-urban areas. Here, we developed an analytical framework based on a review of 155 studies, screened to include 29 studies in 24 countries. Results suggest eight overarching categories of interconnected barriers to green infrastructure in peri-urban areas. Using a combinatorial mixed method approach, we then surveyed households in nine settlements in drought-prone Windhoek (n=330) and seven settlements in flood-prone Dar es Salaam (n=502) and conducted key informant interviews (n=118). Peri-urban residents in Windhoek and Dar es Salaam indicated 18 forms of green infrastructure and 47 derived ecosystem services. The most frequently reported barriers were financial (40.8%), legal and institutional barriers (35.8%) followed by land use change and spatial trade-offs (33%) and finally ecosystem disservices (30.6%). The most significant barriers in Dar es Salaam were legal and institutional (22.7%) and in Windhoek were land use change and spatial trade-offs (24.4%). At the household level, the principal barrier was financial; at community and municipal levels the main barriers were related to design, performance, and maintenance; while at the national level, the main barriers were legal and institutional. Embracing institutional cultures of adaptive policymaking, equitable partnerships, co-designing futures, integrated landscape management and experimental innovation have potential to scale long term maintenance for urban green infrastructure and foster agency, creativity and more transformative relationships and outcomes

Cases of albinism and leucism in amphibians in Italy : new reports

Findings of abnormally pigmented amphibian individuals provide interesting insights on intraspecific phenotypic variability as well as on variation among populations inhabiting different habitats. Amphibian coloration is determined by chromatophores (specific epidermal cells), and a variety of abnormalities related to them have been reported. In this study we reported cases of albinism and leucism in six species of Italian amphibians, including some endemic species. For some taxa, like Hydromantes sarrabusensis, H. flavus, H. supramontis and Bufo viridis, we describe the first observations of albinism and leucism

Implementable Deep Learning for Multi-sequence Proton MRI Lung Segmentation:A Multi-center, Multi-vendor, and Multi-disease Study

Background: Recently, deep learning via convolutional neural networks (CNNs) has largely superseded conventional methods for proton (1H)-MRI lung segmentation. However, previous deep learning studies have utilized single-center data and limited acquisition parameters.Purpose: Develop a generalizable CNN for lung segmentation in 1H-MRI, robust to pathology, acquisition protocol, vendor, and center.Study type: Retrospective.Population: A total of 809 1H-MRI scans from 258 participants with various pulmonary pathologies (median age (range): 57 (6–85); 42% females) and 31 healthy participants (median age (range): 34 (23–76); 34% females) that were split into training (593 scans (74%); 157 participants (55%)), testing (50 scans (6%); 50 participants (17%)) and external validation (164 scans (20%); 82 participants (28%)) sets.Field Strength/Sequence: 1.5-T and 3-T/3D spoiled-gradient recalled and ultrashort echo-time 1H-MRI.Assessment: 2D and 3D CNNs, trained on single-center, multi-sequence data, and the conventional spatial fuzzy c-means (SFCM) method were compared to manually delineated expert segmentations. Each method was validated on external data originating from several centers. Dice similarity coefficient (DSC), average boundary Hausdorff distance (Average HD), and relative error (XOR) metrics to assess segmentation performance.Statistical Tests: Kruskal–Wallis tests assessed significances of differences between acquisitions in the testing set. Friedman tests with post hoc multiple comparisons assessed differences between the 2D CNN, 3D CNN, and SFCM. Bland–Altman analyses assessed agreement with manually derived lung volumes. A P value of &lt;0.05 was considered statistically significant.Results: The 3D CNN significantly outperformed its 2D analog and SFCM, yielding a median (range) DSC of 0.961 (0.880–0.987), Average HD of 1.63 mm (0.65–5.45) and XOR of 0.079 (0.025–0.240) on the testing set and a DSC of 0.973 (0.866–0.987), Average HD of 1.11 mm (0.47–8.13) and XOR of 0.054 (0.026–0.255) on external validation data.Data Conclusion: The 3D CNN generated accurate 1H-MRI lung segmentations on a heterogenous dataset, demonstrating robustness to disease pathology, sequence, vendor, and center.Evidence Level: 4.Technical Efficacy: Stage 1.</p

Factors Affecting Infestation by Triatoma infestans in a Rural Area of the Humid Chaco in Argentina: A Multi-Model Inference Approach

Vector-borne transmission of Chagas disease remains a major public health problem in parts of Latin America. Triatoma infestans is the main vector in the countries located in the South American Cone, particularly in the Gran Chaco ecoregion where residual insecticide control has achieved only a moderate, irregular impact. To contribute to improved control strategies, we analyzed the factors associated with the presence and abundance of T. infestans in 327 inhabited houses in a well-defined rural area with no recent vector control interventions in the humid Argentine Chaco. Bugs were found mainly in domiciles, kitchens, storerooms, and chicken coops and nests, particularly where adequate refuge and animal hosts (humans, dogs, cats or poultry) were available. Domiciles constructed from mud were the most often infested, but brick-and-cement domiciles, even in good conditions, were also found infested. Availability of refuge and hosts for T. infestans are key targets for vector control. Ten-fold variations in domestic infestation observed across neighboring villages, and differences in the relevant factors for T. infestans presence with respect to other areas of the Gran Chaco region suggest that host management, building techniques and insecticide use need to be tailored to the local environment, socio-economic characteristics, and climatic conditions

Divergent evolution of terrestrial locomotor abilities in extant Crocodylia

Extant Crocodylia are exceptional because they employ almost the full range of quadrupedal footfall patterns (“gaits”) used by mammals; including asymmetrical gaits such as galloping and bounding. Perhaps this capacity evolved in stem Crocodylomorpha, during the Triassic when taxa were smaller, terrestrial, and long-legged. However, confusion about which Crocodylia use asymmetrical gaits and why persists, impeding reconstructions of locomotor evolution. Our experimental gait analysis of locomotor kinematics across 42 individuals from 15 species of Crocodylia obtained 184 data points for a wide velocity range (0.15–4.35 ms−1). Our results suggest either that asymmetrical gaits are ancestral for Crocodylia and lost in the alligator lineage, or that asymmetrical gaits evolved within Crocodylia at the base of the crocodile line. Regardless, we recorded usage of asymmetrical gaits in 7 species of Crocodyloidea (crocodiles); including novel documentation of these behaviours in 5 species (3 critically endangered). Larger Crocodylia use relatively less extreme gait kinematics consistent with steeply decreasing athletic ability with size. We found differences between asymmetrical and symmetrical gaits in Crocodylia: asymmetrical gaits involved greater size-normalized stride frequencies and smaller duty factors (relative ground contact times), consistent with increased mechanical demands. Remarkably, these gaits did not differ in maximal velocities obtained: whether in Alligatoroidea or Crocodyloidea, trotting or bounding achieved similar velocities, revealing that the alligator lineage is capable of hitherto unappreciated extreme locomotor performance despite a lack of asymmetrical gait usage. Hence asymmetrical gaits have benefits other than velocity capacity that explain their prevalence in Crocodyloidea and absence in Alligatoroidea—and their broader evolution

The Lung Image Database Consortium (LIDC):A comparison of different size metrics for pulmonary nodule measurements

RATIONALE AND OBJECTIVES: To investigate the effects of choosing between different metrics in estimating the size of pulmonary nodules as a factor both of nodule characterization and of performance of computer aided detection systems, since the latters are always qualified with respect to a given size range of nodules. MATERIALS AND METHODS: This study used 265 whole-lung CT scans documented by the Lung Image Database Consortium using their protocol for nodule evaluation. Each inspected lesion was reviewed independently by four experienced radiologists who provided boundary markings for nodules larger than 3 mm. Four size metrics, based on the boundary markings, were considered: a uni-dimensional and two bi-dimensional measures on a single image slice and a volumetric measurement based on all the image slices. The radiologist boundaries were processed and those with four markings were analyzed to characterize the inter-radiologist variation, while those with at least one marking were used to examine the difference between the metrics. RESULTS: The processing of the annotations found 127 nodules marked by all of the four radiologists and an extended set of 518 nodules each having at least one observation with three-dimensional sizes ranging from 2.03 to 29.4 mm (average 7.05 mm, median 5.71 mm). A very high inter-observer variation was observed for all these metrics: 95% of estimated standard deviations were in the following ranges [0.49, 1.25], [0.67, 2.55], [0.78, 2.11], and [0.96, 2.69] for the three-dimensional, the uni-dimensional, and the two bi-dimensional size metrics respectively (in mm). Also a very large difference among the metrics was observed: 0.95 probability-coverage region widths for the volume estimation conditional on uni-dimensional, and the two bi-dimensional size measurements of 10mm were 7.32, 7.72, and 6.29 mm respectively. CONCLUSIONS: The selection of data subsets for performance evaluation is highly impacted by the size metric choice. The LIDC plans to include a single size measure for each nodule in its database. This metric is not intended as a gold standard for nodule size; rather, it is intended to facilitate the selection of unique repeatable size limited nodule subsets