Segmentation of orbital and periorbital lesions detected in orbital magnetic resonance imaging by deep learning method

Purpose: Magnetic resonance imaging (MRI) has a special place in the evaluation of orbital and periorbital lesions. Segmentation is one of the deep learning methods. In this study, we aimed to perform segmentation in orbital and periorbital lesions. Material and methods: Contrast-enhanced orbital MRIs performed between 2010 and 2019 were retrospectively screened, and 302 cross-sections of contrast-enhanced, fat-suppressed, T1-weighted, axial MRI images of 95 patients obtained using 3 T and 1.5 T devices were included in the study. The dataset was divided into 3: training, test, and validation. The number of training and validation data was increased 4 times by applying data augmentation (horizontal, vertical, and both). Pytorch UNet was used for training, with 100 epochs. The intersection over union (IOU) statistic (the Jaccard index) was selected as 50%, and the results were calculated. Results: The 77th epoch model provided the best results: true positives, 23; false positives, 4; and false negatives, 8. The precision, sensitivity, and F1 score were determined as 0.85, 0.74, and 0.79, respectively. Conclusions: Our study proved to be successful in segmentation by deep learning method. It is one of the pioneering studies on this subject and will shed light on further segmentation studies to be performed in orbital MR images

Religious Officials' knowledge, attitude, and behavior towards smoking and the new tobacco law in Kahramanmaras, Turkey

<p>Abstract</p> <p>Background</p> <p>Tobacco control effort should be first started in people that are looked upon as role models for the general population. We aimed to determine the knowledge, attitude, and behavior of religious officials towards smoking and the new tobacco law.</p> <p>Method</p> <p>The study group was comprised of 492 Imams and 149 Quran course instructors working in Kahramanmaras city of Turkey, 641 religious officials in total, and our survey form was applied on 406 (63.3%) of those religious officials who agreed to participate in the study.</p> <p>Results</p> <p>Twenty-eight (6.9%) participants were current smokers and 35 (8.6%) were ex-smokers. 99.8% of the religious officials believed that smoking was harmful and/or prohibited in terms of religion. While 43.6% respondents thought smoking was "<it>haram</it>" (forbidden by Islam), 56.2% believed it was "<it>makruh</it>" (something regarded as reprehensible, though not forbidden by God according to Islam). 85.2% of the participants were aware of the recent tobacco law. 55.5% of the respondents, who were aware of the recent tobacco law, evaluated their knowledge level on the law as adequate, whereas 44.5% evaluated it as inadequate 92.4% of the participants noted that religious officials should play active roles in tobacco control effort.</p> <p>Conclusion</p> <p>Smoking rate among religious officials is much lower than that of general public. In order to help religious officials to take a more active role on this issue, they should be trained on the subject and appropriate platforms should be established.</p

Study of the binary system fly ash/sugarcane bagasse ash (FA/SCBA) in SiO2/K2O alkali-activated binders

Due environmental problems related to Portland cement consumption, many studies have been performed to diminish its use. One solution is the development of alkali-activated binders, which can decrease CO2 emissions and energy consumption by 70% when compared to Portland cement production. In addition, an alkali-activated binder presents mechanical properties similar to Portland cement mixtures, which turns into an interesting material in civil construction. Aluminosilicate-based materials are important raw materials to produce the alkali-activated binders. Therefore, two residues are presented as an aluminosilicate source in this study: fly ash (FA) and sugarcane bagasse ash (SCBA). Both residues were obtained from a combustion process to generate energy, the former from coal and the latter from the bagasse of the sugarcane industry. In addition, the alkaline activating solution is an important factor to achieve improved mechanical properties. In this context, this study investigated the influence of four different SiO2/K2O molar ratios (0, 0.36, 0.75 and 1.22) in the activating solution with a constant water content, and three FA/SCBA binder proportions (75/25, 50/50 and 25/75). Microstructural characterization was carried out by X-ray diffraction, Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy, mercury intrusion porosimetry, pH and electrical conductivity measurements to study the evolution of the reaction process. The compressive strength of mortars was assessed in order to determine the optimum SiO2/K2O molar ratio and FA/SCBA ratio. The tests showed that a SiO2/K2O molar ratio of 0.75 and FA/SCBA proportion of 75/25 provided the best mechanical properties.The authors would like to thank the Ministerio de Educacion, Cultura y Deporte of Spain (Cooperacion Interuniversitaria program with Brazil, Project PHB-2011-0016-PC), CAPES Brazil (Project CAPES/DGU No. 266/12) and CNPq (process no 401724/2013-1).Castaldelli, V.; Moraes, J.; Akasaki, JL.; Pinheiro Melges, JL.; Monzó Balbuena, JM.; Borrachero Rosado, MV.; Soriano Martínez, L.... (2016). Study of the binary system fly ash/sugarcane bagasse ash (FA/SCBA) in SiO2/K2O alkali-activated binders. Fuel. 174:307-316. https://doi.org/10.1016/j.fuel.2016.02.020S30731617

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: a global survey, current guidelines, and expert recommendations

PURPOSE: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. MATERIALS AND METHODS: An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. RESULTS: A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4-6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. CONCLUSIONS: This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Reactive arthritis due to zoophilic (canine) sexual intercourse

PubMedID: 17509183Reactive arthritis (ReA) is defined as a joint inflammation triggered by a distant infection, with no cultivable microbes in the joints. Although efforts have been made to characterize the microorganism linked to ReA, no definite common feature has so far emerged. Here we present a case of ReA which occurred after a zoophilic (canine genus) sexual intercourse

Orbital restoration surgery in the zygomaticotemporal and zygomaticofacial nerves and important anatomic landmarks

PubMed ID: 19305251A variety of etiologies may result in functional and aesthetic deficiencies requiring orbital reconstruction. Fractures of the zygomaticomaxillary complex in the acute stage are frequently accompanied by sensory disturbances of the zygomatic nerve (ZN). The purpose of the current study was to describe the anatomic and topographic landmarks of the ZN in 18 adult human cadavers regarding the localization and dimensions in the orbit. The zygomaticotemporal (ZTN) and zygomaticofacial nerves (ZFN) along the lateral wall of the orbit passed through the zygomaticotemporal and zygomaticofacial foramens, respectively. The angle between the ZTN and the ZFN within the orbit was approximately 42.21 degrees. The mean (SD) distance between the orbital opening of the ZTN and the meeting point of the ZTN was measured as 9.21 (5.18) mm. The mean (SD) distance between the orbital opening of the ZFN and the meeting point of the ZTN was calculated as 11.22 (4.25) mm. The mean (SD) distance between the orbital opening of the ZFN and the infraorbital margin of the orbit was 13.04. (3.21) mm. A detailed knowledge of the ZN's passage in the orbit is necessary for a surgeon while performing maxillofacial surgery. If these measurements are taken into account, there will be little surgical risk, and this will be helpful in identifying the extent of the operative field. © 2009 Lippincott Williams & Wilkins, Inc

A morphometric study of the inferior orbital fissure using three-dimensional anatomical landmarks: Application to orbital surgery

PubMed ID: 19670289The inferior orbital fissure (IOF) is an important structure during orbital surgery, however, neither its anatomical features nor the procedures necessary to expose the IOF have been examined in detail. A morphometric analysis of the IOF was performed on 232 orbits using computer software. The longest and shortest borders of the IOF were 18.2 ± 4.9 and 1.9 ± 1.3 mm, respectively. The outer and the inner angles were 138.9 ± 32.7° and 38.4 ± 24.7°, respectively. The perimeter of the IOF was 50.6 ± 13.5 mm and its area was 61.3 ± 39.1 mm2. Eight types of IOF were observed. Type 1 IOF was observed in 42.2% and the Type 2 IOF was identified in 15.9%. A statistically significant relation was found between the longest edge and area and the widest edge and area of the IOF. The findings of our study suggest that the removal of the lateral wall should begin inferiorly, just lateral to the IOF and extended superolaterally. These data may be useful during surgical approaches to the orbit. © 2009 Wiley-Liss, Inc