A CNN-Based Novel Approach for Classification of Sacral Hiatus with GAN-Powered Tabular Data Set

Caudal epidural anaesthesia is usually the most well-known technique in obstetrics to deal with chronic back pain. Due to variations in the shape and size of the sacral hiatus (SH), its classification is a crucial and challenging task. Clinically, it is required in trauma, where surgeons must make fast and correct selections. Past studies have focused on morphometric and statistical analysis to classify it. Therefore, it is vital to automatically and accurately classify SH types through deep learning methods. To this end, we proposed the Multi-Task Process (MTP), a novel classification approach to classify the SH MTP that initially uses a small medical tabular data set obtained by manual feature extraction on computed tomography scans of the sacrums. Second, it augments the data set synthetically through a Generative Adversarial Network (GAN). In addition, it adapts a two-dimensional (2D) embedding algorithm to convert tabular features into images. Finally, it feeds images into Convolutional Neural Networks (CNNs). The application of MTP to six CNN models achieved remarkable classification success rates of approximately 90 % to 93 %. The proposed MTP approach eliminates the small medical tabular data problem that results in bone classification on deep models

Precisely timed regulation of enhancer activity defines the binary expression pattern of Fushi tarazu in the Drosophila embryo

The genes that drive development each typically have many different enhancers. Properly coordinating the action of these different enhancers is crucial to correctly specifying cell-fate decisions, yet it remains poorly understood how their activity is choregraphed in time. To shed light on this question, we used recently developed single-cell live imaging tools to dissect the regulation of Fushi tarazu (Ftz) in Drosophila melanogaster embryos. Ftz is a transcription factor that is expressed in asymmetric stripes by two distinct enhancers: autoregulatory and zebra. The anterior edge of each stripe needs to be sharply defined to specify essential lineage boundaries. Here, we tracked how boundary cells commit to either a high-Ftz or low-Ftz fate by measuring Ftz protein traces in real time and simultaneously quantifying transcription from the endogenous locus and individual enhancers. This revealed that the autoregulatory enhancer does not establish this fate choice. Instead, it perpetuates the decision defined by zebra. This is contrary to the prevailing view that autoregulation drives the fate decision by causing bi-stable Ftz expression. Furthermore, we showed that the autoregulatory enhancer is not activated based on a Ftz-concentration threshold but through a timing-based mechanism. We hypothesize that this is regulated by several ubiquitously expressed pioneer-like transcription factors, which have recently been shown to act as timers in the embryo. Our work provides new insight into how precisely timed enhancer activity can directly regulate the dynamics of gene regulatory networks, which may be a general mechanism for ensuring that embryogenesis runs like clockwork

Relationship between interleukin-6 levels and ambulatory blood pressure in women with polycystic ovary syndrome

Objective: To determine 24-hour ambulatory blood pressures (ABP) in patients with polycystic ovary syndrome (PCOS) and its relationship with interleukin-6 (IL-6). Design: Prospective controlled study. Setting: University hospital. Patient(s): Fifty-four PCOS patients. Intervention(s): Ambulatory blood pressure monitoring was conducted. Anthropometric, hormonal, metabolic, and inflammatory parameters, including plasma IL-6, C-reactive protein (CRP), fibrinogen, and nitric oxide (NO), were measured in each subject. Main Outcome Measure(s): Ambulatory blood pressure and plasma IL-6, CRP, fibrinogen, and NO. Result(s): Serum IL-6 levels of PCOS women in the highest systolic blood pressure (SBP) quartile were significantly higher than those of women in the lowest SBP quartile. The high serum IL-6 levels (serum IL-6 level R5.1 pg/mL) were associated with a higher probability of raised SBP (R126 mm Hg), with an odds ratio of 2.2 (95% confidence interval 0.8–7.9). The systolic and diastolic (DBP) blood pressures were significantly related to serum IL-6 levels. The IL-6 levels were positively and significantly correlated with serum CRP levels. Interleukin- 6 and CRP were negatively and significantly correlated with serum NO levels. Conlusion(s): The results suggest that raised plasma IL-6 levels may be related to ambulatory SBP and DBP in PCOS

Procalcitonin and other acute phase reactants in patients with chronic obstructive pulmonary disease exacerbation

The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD) acute exacerbations.Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and white blood cell (WBC) counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT.Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27), Mycoplasma-Chlamydia pneumonia (n=11) and the patients with only COPD exacerbation(n=84). Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respectively), whereas the relationship between PCT and ESR was nonsignificant (p=0.55). Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively). The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012).Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients

Conversion in Turkish : an overview

This paper presents an overview of possible cases of conversion in Turkish. I argue that apparent cases of conversion between nouns and adjectives are cases of syntactic transposition, and apparent cases of conversion between nouns/adjectives and verbs are end products of phonological changes in the history of the language, which resulted in pairs of lexemes that are formally identical synchronically, but not historically. This does not mean that no cases of morphological conversion can be traced in the language. I will present two cases of secondary word-class conversion from derived, inflected and uninflected words to toponyms which might be taken as instances of morphological conversion or derivation by zero-affixation

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely