Laparoscopic versus Open Appendectomy: Where Are We Now?

Rezumat Apendicectomia prin abord laparoscopic versus abord deschis: pentru ce optãm? Scop: Deaei avantajele procedurilor laparoscopice au fost intens studiate pe parcursul ultimelor douã decenii, apendicectomia laparoscopicã nu a putut fi desemnatã ca procedurã standard de tratament din cauza unor dezavantaje de tipul timpilor operatori aei al costurilor crescute. Obiectivul studiului nostru este de a reevalua rezultatele pe termen lung ale abordului laparoscopic versus cel chirurgical deschis pentru aceastã patologie pe baza datelor actuale. Metode: Datele pacienåilor supuaei apendicectomiei între ianuarie 2012 aei iulie 2012 au fost analizate prospectiv. Datele demografice ale pacienåilor, durata procedurii, perioada de internare, nevoia de analgezice, scorul VAS aei rata mortalitãåii au fost înregistrate. Rezultate: Din 241 de pacienåi, 120 (49.8%) au suferit intervenåie deschisã aei 121 (50.2%) au fost operaåi laparoscopic. Perioada intervenåiei a fost similarã între cele douã grupuri (p=0.855). Scorurile VAS dupã prima orã (p=0.001), dupã 6 (p=0.001) aei dupã 12 ore de la operaåie (p=0.028) au fost mai mari în grupul de apendicectomii prin abord deschis (p=0.001). Nu au existat diferenåe statistice vizând ratele de morbiditate între grupul prin abord deschis aei cel prin abord laparoscopic (p=0.617). Concluzii: Cele douã tehnici operatorii sunt similare în ceea ce priveaete perioada de internare, durata operaåiei aei complicaåiile postoperatorii. Apendicectomia laparoscopicã reduce nevoia de analgezice aei scorurile VAS; aceasta ar trebui prin urmare luatã în considerare ca standard de aur în tratamentul chirurgical al apendicitei acute. Cuvinte cheie: apendicitã, apendicectomie, procedurã laparoscopicã, abces abdominal, infecåia plãgii chirurgicale Abstract Purpose: Although the advantages of laparoscopic procedures has been well studied over the last two decade, laparoscopic appendectomy could not to be a standard therapy due to some disadvantages such as longer operative time and higher cost. The objective of our study is to re-evaluate the outcomes of laparoscopic versus open appendectomy with current data. Methods: Between January 2012 and July 2012, the data of the patients who had appendectomy were recorded prospectively. Patients' demographics, duration of procedure, length of hospital stay, need of analgesics, postoperative visual analogue scale scores and morbidity were assessed

Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

PURPOSE: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians

Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

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

Evaluation of Wind Field Predictions by Atmospheric Models Over the Marmara Sea

Data collected from meteorological stations in the Turkish Straits System (TSS) around the Marmara Sea are used to assess the performance of atmospheric models in predicting the winds. The Coupled Ocean/Atmosphere Mesoscale Prediction System (COAMPS) is applied using different spatial resolutions ranging between 1 km and 27 km to investigate the effect of model spatial grid resolution on the accuracy of the computed wind field. The influence of ocean dynamics on atmospheric winds also is investigated by comparing wind field predictions from a fully coupled COAMPS with those from an uncoupled (stand-alone atmospheric) COAMPS. Following an examination of the wind products, the importance of using high resolution wind forcing for ocean circulation predictions is evaluated

SARS-CoV-2 Pneumonia Affects Male Reproductive Hormone Levels: A Prospective, Cohort Study

Background: SARS-CoV-2 which causes coronavirus disease 2019 (COVID-19) binds to angiotensinconverting enyzme 2 (ACE2) and enters the host cell. ACE2 protein is expressed highly in the testis

Grain size and heavy mineral distribution as related to hinterland and environmental conditions for modern beach sediments from the Gulfs of Antalya and Finike, eastern Mediterranean

WOS: 000247233200013Backshore sediment samples from 22 beaches along the Antalya and Finike Gulfs have been studied for their grain size, chemical and heavy mineral composition. Data presented here suggest that well- to moderately-sorted (0.41 Phi-0.92 Phi) medium sand (1 Phi-2 Phi) represents dominant mean grain size in most beaches. In contrast, some beaches from the western part of the Gulf of Antalya (Goynuk, Kemer-Kiris and Beldibi) are composed of pebble- to boulder-size grained beaches which are located close to mouths of short and steep-gradient ephemeral rivers entering the sea from the Western Taurus Mountains. The heavy mineral assemblages are dominated by detrital opaque minerals (14-58% magnetite, chromite, and hematite), pyroxene (8-65% augite), amphibole (3-15% tremolite and actinolite), epidote (3-25%), garnet (2-9% pyrope and almandine) and micas (3-20 biotite, muscovite and chlorite). The very high concentrations of heavy minerals (up to 86% of bulk sediment) together with the significant concentrations of some elements found in beach sediments from the Gulf of Finike and western Gulf of Antalya (Fe: 18.40%; Cr: 10.00%; and Ti: 1.32%) are indicative of ultramafic origin, mainly derived from the ophiolitic rocks of the Antalya-Tekirova nappe on coastal hinterland. (c) 2007 Elsevier B.V. All rights reserved

How to Affect the Number of Images on the Success Rate for Detection of Weeds with Deep Learning

The detection of weeds with computer vision without the help of an expert is important for scientific studies and other purposes. The images used for the detection of weeds are recorded under controlled conditions and used in image processing-deep learning methods. In this study, the images of 3-4-leaf (true-leaf) periods of the wild mustard (Sinapis arvensis) plant, which is the critical process for chemical control, were recorded from its natural environment by a drone. The datasets were included 50-100-250-500 and 1 000 raw images and were augmented by image preprocessing methods. Totally 12 different augmentation methods used and datasets were examined for understand how to affects the numbers of images on training-validation performance. YOLOv5 was used as a deep learning method and results of the datasets were evaluated with the Confusion Matrix, Metrics-Precision, and Train-Object Loss. For results of Confusion Matrix where 1 000 images gave the highest results with TP (True Positive) 80% and FP (False Positive) 20%. The TP-FP ratios of 500, 250, 100 and 50 image numbers were respectively; 65%-35%, 43%-57%, 0%-100% and 0%-100%. With 100 and 50 images, the system did not show any TP success. The highest metrics-precision ratio was found 92.52% for 1 000 images set and for 500 and 250 image sets respectively; 88.34% and 79.87%. The 100 and 50 images datasets did not show any metrics-precision ratio. The minimum object loss ratio was 5% at 50th epochs in the 100 images dataset. This dataset was followed by other 50, 250, 500, and 1 000 images respectively; 5.4%, 6.14%, 6.16%, and 8.07%.</jats:p