Search results for: deep endometriosis

Authors: Jodie Hughes

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Endometriosis affects 1 in 10 individuals that were born female globally. Endometriosis incidence rates peak between 30-40 year of age, in young women and adolescents it is a rarely suspected and often ill-diagnosed. The average cost of endometriosis is €9,579 per woman. More than 75% of women have reported being absent from work due to endometriosis, with 40% of women becoming unemployed due to the disease. 46% of patients with endometriosis need to have appointments with upward of five doctors to gain a correct diagnosis. Quantitative data were collected by way of an online PSS-10 survey that included demographic questions from two sample groups of females, group 1 was females with endometriosis, group 2 were healthy women. The data were scored using Cohens scoring system, overall scores were input to SPSS. A non-parametric Mann-Whitney U test and ANOVA was used to ascertain any differences between the PSS-10 scores of the two groups. A significance level of P<0.05 was adopted. Four women were invited to take part in a semi structured interview that was recorded, transcribed and coded using interpretive phenomenological analysis (IPA) using NVivo 12. Results showed that the PSS-10 scores were significantly higher in women with endometriosis compared to healthy women with a p=<0.005. Endometriosis affects all aspects of a patient’s life, to adequately diagnose and treat the condition and improve HRQoL there needs to be better understanding of the clinical symptoms and how they impact the lives of patients.

Keywords: endometriosis, HRQoL, perceived stress, women

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: Gheorghe Giurgiu, Manole Cojocaru, Mihnea Andrei Nicodin

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Background: Inflammation has the main role in the progression of endometriosis. The mechanisms by which endometriosis induces a chronic pain state remain poorly understood. Unfortunately, there is no known cure for endometriosis. But you can manage it with medication and at-home treatments. Some findings have highlighted the main role of inflammation in endometriosis by acting on proliferation, apoptosis, and angiogenesis. The introduction of new agents can be effective in improving the condition of patients; for example, plants are promising sources of bioactive natural components. Objectives: These natural compounds could be interesting strategies in therapy. While there is no absolute cure for this condition, some home remedies can relieve the pain and discomfort it brings. The purpose of this study is to summarize the potential action of Deniplant nutraceuticals in endometriosis by acting on inflammation. Materials and Methods: The primary symptoms of endometriosis are pelvic pain and infertility. The use of Deniplant nutraceuticals could be interesting in disease management for women. Results: Treating pain-related aspects of endometriosis would contribute to the improvement of mental health and daytime function. Because the microbiome can influence inflammation, new therapies can develop through its natural modulation. There are other options, including natural remedies, herbs like cinnamon twigs or licorice root, or supplements such as thiamine, magnesium, or omega-3 fatty acids. Conclusion: Deniplant nutraceuticals can downregulate inflammation in endometriosis. Nevertheless, the limited number of studies focusing on the different interactions of Deniplant nutraceuticals in endometriosis restricts its clear and immediate use in a therapeutic strategy.

Keywords: endometriosis, diet, Deniplant nutraceuticals, pain

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Authors: Z. Chekini, P. Afsharian, F. Ramezanali, A. A. Akhlaghi, R. Aflatoonian

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Macrophage migration inhibitory factor (MIF) is a key pro-inflammatory cytokine that involves in pathophysiological events of endometriosis. We aimed to evaluate the association between mRNA expression levels and polymorphisms of MIF in endometriosis. Seventy endometriosis patients and 70 volunteer fertile women were recruited. RFLP was applied to determine -173G/C polymorphism. ORF polymorphisms and -794(CATT)5-8 were detected by sequencing. Q-PCR was used for expression study of 14 ectopic tissues of patients. Homozygote of CATT5 was observed only in controls. The CATT5/G haplotype related to controls (p=0.094, OR=0.61). Expression level of MIF with -794(CATT)6,7/-173GC was significantly more than the other haplotypes (p=0.00). We identified four SNPs including: +254rs2096525 (p=0.843), +626rs33958703 (p=0.029), +656rs2070766 (p=0.703) and +509rs182012324 (p=1.00). In conclusion, increased repeat of CATT and presence of C allele in promoter of MIF were significantly associated with mRNA level in patients. It seems that +509rs182012324 and +626rs33958703 SNPs were significantly correlated with susceptibility to endometriosis.

Keywords: endometriosis, haplotype, macrophage migration inhibitory factor, polymorphism

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Authors: A. Zecchin, E. Vallicella, I. Alberi, A. Dalle Carbonare, A. Festi, F. Galeone, S. Garzon, R. Raffaelli, P. Pomini, M. Franchi

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Introduction: Severe endometriosis is a multiorgan disease, that involves bowel in 31% of cases. Disabling symptoms and deep infiltration can lead to bowel obstruction: surgical bowel treatment may be needed. In these cases, colorectal segment resection is usually performed by inferior mesenteric artery ligature, as radically as for oncological surgery. This study was made on surgery based on intestinal vascular axis’ preservation. It was assessed postoperative complications risks (mainly rate of dehiscence of intestinal anastomoses), and results were compared with the ones found in literature about classical colorectal resection. Materials and methods: This was a retrospective study based on 62 patients with deep infiltrating endometriosis of the bowel, which undergo segmental resection with intestinal vascular axis preservation, between 2013 and 2016. It was assessed complications related to the intervention both during hospitalization and 30-60 days after resection. Particular attention was paid to the presence of anastomotic dehiscence. 52 patients were finally telephonically interviewed in order to investigate the presence or absence of intestinal constipation. Results and Conclusion: Segmental intestinal resection performed in this study ensured a more conservative vascular approach, with lower rate of anastomotic dehiscence (1.6%) compared to classical literature data (10.0% to 11.4% ). No complications were observed regarding spontaneous recovery of intestinal motility and bladder emptying. Constipation in some patients, even after years of intervention, is not assessable in the absence of a preoperative constipation state assessment.

Keywords: anastomotic dehiscence, deep infiltrating endometriosis, colorectal resection, vascular axis preservation

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Authors: Freda Halim

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Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

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Authors: Dong-ping Yuan, Lin Gu, Jun Long, Jie Chen, Ni Jie, Ying-Li Shi

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Endometriosis is a common disease in women of reproductive age, whose classic characteristic is mononuclear cell infiltration into lesions. Shikonin is an anti-inflammatory phytocompound from Lithospermum erythrorhizon, whose potential therapeutic effects for the endometriosis remain unclear. The working hypothesis was that shikonin can inhibit the development of endometriosis by the inhibition of chemotactic effect. Shikonin significantly inhibited the growth of human endometrial tissue implanted into mice (P<0.05). No observable adverse effects were found. The mouse regulated upon activation normal T-cell expressed and secreted (mRANTES) level in peritoneal fluid of animal endometriosis model was higher than that in normal SCID mice (P<0.05), and decreased dramatically after shikonin treatment in a dose-dependent manner (P<0.05). Peritoneal fluid from NOD/SCID mice treated with shikonin inhibited monocytes chemotaxis, which could be abolished by mRANTES antibody. In vitro, shikonin significantly inhibited RANTES expression of U937 cells cultured alone or co-cultured with human methothelail cells and endometrial stromal cells, and inhibited RANTES-induced chemotaxis of U937 cells (P<0.05). The present results suggest that shikonin can inhibit the development of endometriosis by mechanisms that at least include the inhibition of RANTES expression and decreased migration of mononuclear cells to lesions. Shikonin may be a useful and safe new approach for treating endometriosis.

Keywords: endometriosis, shikonin, RANTES chemotaxis

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Authors: I. Ramalho, S. Campos, M. Dias

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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.

Keywords: endometriosis, histology, observational study, ovarian cancer

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Authors: Smita Lakhotia, C. Kew, S. H. M. Siraj, B. Chern

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Up to 50% of those with endometriosis may suffer from infertility due to either distorted pelvic anatomy/impaired oocyte release or inhibit ovum pickup and transport, altered peritoneal function, endocrine and anovulatory disorders, including LUF, impaired implantation, progesterone resistance or decreased levels of cellular immunity. The dilemma continues as to whether the surgery or IVF is the optimal management for such recurrent endometriomas. The core question is whether surgery adds anything of value for infertile women with recurrent endometriosis or not. Complete and detailed information on risks and benefits of treatment alternatives must be offered to patients, giving a realistic estimate of chances of success of repetitive surgery and of multiple IVF cycles in order to allow unbiased choices between different possible optionsAn individualized treatment plan should be developed taking into account patient age, duration of infertility, previous pregnancies and specific clinical conditions and wish.

Keywords: recurrent endometriosis, infertility, oocyte release, pregnancy

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Yuliya Huseva

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To investigate the contents of tears to determine latent blood. Methods: Tear samples from 72 women were studied with the microscopy of tears aspirated with a capillary and stained by Nocht and with a chemical method of test strips with chromogen. Statistical data processing was carried out using statistical packages Statistica 10.0 for Windows, calculation of Pearson's chi-square test, Yule association coefficient, the method of determining sensitivity and specificity. Results:, In 30.6% (22) of tear samples erythrocytes were revealed microscopically. Correlations between the presence of erythrocytes in the tear and the phase of the menstrual cycle has been discovered. In the follicular phase of the cycle, erythrocytes were found in 59.1% (13) people, which is significantly more (x2=4.2, p=0.041) compared to the luteal phase - in 40.9% (9) women. In the first seven days of the follicular phase of the menstrual cycle the erythrocytes were predominanted of in the tears of women examined testifies in favour of the vicarious bleeding from the mucous membranes of extragenital organs in sync with menstruation. Of the other cellular elements in tear samples with latent haemolacria, neutrophils prevailed - in 45.5% (10), while lymphocytes were less common - in 27.3% (6), because neutrophil exudation is accompanied by vasodilatation of the conjunctiva and the release of erythrocytes into the conjunctival cavity. It was found that the prognostic significance of the chemical method was 0.53 of the microscopic method. In contrast to microscopy, which detected blood in tear samples from 30.6% (22) of women, blood was detected chemically in tears of 16.7% (12). An association between latent haemolacria and endometriosis was found (k=0.75, p≤0.05). Microscopically, in the tears of patients with endometriosis, erythrocytes were detected in 70% of cases, while in healthy women without endometriosis - in 25% of cases. The proportion of women with erythrocytes in tears, determined by a chemical method, was 41.7% among patients with endometriosis, which is significantly more (x2=6.5, p=0.011) than 11.7% among women without endometriosis. The data obtained can be explained by the etiopathogenesis of the extragenital endometriosis which is caused by hematogenous spread of endometrial tissue into the orbit. In endometriosis, erythrocytes are found against the background of accumulations of epithelial cells. In the tear samples of 4 women with endometriosis, glandular cuboidal epithelial cells, morphologically similar to endometrial cells, were found, which may indicate a generalization of the disease. Conclusions: Single erythrocytes can normally be found in the tears, their number depends on the phase of the menstrual cycle, increasing in the follicular phase. Erythrocytes found in tears against the background of accumulations of epitheliocytes and their glandular atypia may indicate a manifestation of extragenital endometriosis. Both used methods (microscopic and chemical) are informative in revealing latent haemolacria. The microscopic method is more sensitive, reveals intact erythrocytes, and besides, it provides information about other cells. At the same time, the chemical method is faster and technically simpler, it determines the presence of haemoglobin and its metabolic products, and can be used as a screening.

Keywords: tear, blood, microscopy, epitheliocytes

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Authors: P. Afsharian, S. Mousazadeh, M. Shahhoseini, R. Aflatoonian

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Introduction: Matrix MetalloProteinases (MMPs) degrade extracellular matrix components to provide normal remodeling and contribute to pathological tissue destruction and cell migration in endometriosis. It is accepted that MMPs are resistant to suppression by progesterone in endometriotic tissues. The physiological effects of progesterone are mediated by its two progesterone receptor (PGR) isoforms, namely PGR-A and PGR-B. The capacity of progesterone affect to gene expression is dependent on the PGR-A/PGR-B ratio. The imbalance ratio in endometriotic tissue may be an important mechanism to be resulted in Progesterone resistance and modify progesterone action via differential regulation of specific progesterone response genes and improve endometriosis disease. Material and methods: RNA was extracted from twenty ectopic (endometriotic) and eutopic (endometrial) tissue samples of women undergoing laparoscopy for endometriosis and 20 healthy fertile women at Royan Institute, Tehran, Iran. Analysis of PGR-A, PGR-B, MMP-2 and MMP-9 mRNA expression was performed using Real-time PCR in ectopic and eutopic tissues. Then, Statistical analysis was calculated according to the 2-ΔΔCT equation for all samples. Results: Quantitative RT–PCR analyses of PGR-A and PGR-B mRNA revealed that there were differences in both isoformes of PGRs mRNA expressions between ectopic and control eutopic tissues. We were able to demonstrate low expression levels of PGR-B isoforms in ectopic tissues. Although, PGR-A expression was significantly higher in the same ectopic samples compare to controls.This method permitted us to demonstrate significant overexpression of MMP-2 and MMP-9 in ectopic samples compared to control endometrial tissues, as well. Conclusions: Our data suggest that low expression levels of PGR-B and overexpression of PGR-A can alter PGR-A/PGR-B ratio in endometriotic ectopic tissues. Imbalance ratio of PGRs in endometriotic tissue may be able to consequence MMP-2 and MMP-9 overexpression which can be important in pathogenesis and treatment of disease.

Keywords: endometriosis, matrix metalloproteinases, progesterone receptor -A and -B, PGR-A/PGR-B ratio

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Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio

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Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.

Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery

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Authors: Roxane A. Legaie, Kjiana E. Schwab, Caroline E. Gargett

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Studies looking at the changes in gene expression from RNAseq data often make use of linear models. It is also common practice to focus on a subset of data for a comparison of interest, leaving aside the samples not involved in this particular comparison. This work shows the importance of including all observations in the modeling process to better estimate variance parameters, even when the samples included are not directly used in the comparison under test. The human endometrium is a dynamic tissue, which undergoes cycles of growth and regression with each menstrual cycle. The mesenchymal stem cells (MSCs) present in the endometrium are likely responsible for this remarkable regenerative capacity. However recent studies suggest that MSCs also plays a role in the pathogenesis of endometriosis, one of the most common medical conditions affecting the lower abdomen in women in which the endometrial tissue grows outside the womb. In this study we compared gene expression profiles between MSCs and non-stem cell counterparts (‘non-MSC’) obtained from women with (‘E’) or without (‘noE’) endometriosis from RNAseq. Raw read counts were used for differential expression analysis using a linear model with the limma-voom R package, including either all samples in the study or only the samples belonging to the subset of interest (e.g. for the comparison ‘E vs noE in MSC cells’, including only MSC samples from E and noE patients but not the non-MSC ones). Using the full dataset we identified about 100 differentially expressed (DE) genes between E and noE samples in MSC samples (adj.p-val < 0.05 and |logFC|>1) while only 9 DE genes were identified when using only the subset of data (MSC samples only). Important genes known to be involved in endometriosis such as KLF9 and RND3 were missed in the latter case. When looking at the MSC vs non-MSC cells comparison, the linear model including all samples identified 260 genes for noE samples (including the stem cell marker SUSD2) while the subset analysis did not identify any DE genes. When looking at E samples, 12 genes were identified with the first approach and only 1 with the subset approach. Although the stem cell marker RGS5 was found in both cases, the subset test missed important genes involved in stem cell differentiation such as NOTCH3 and other potentially related genes to be used for further investigation and pathway analysis.

Keywords: differential expression, endometriosis, linear model, RNAseq

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Authors: Y. Heyrani Birak, R. Hizaji, J. Shahkarami

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Reinforced Concrete (RC) deep beams are special structural elements because of their geometry and behavior under loads. For example, assumption of strain- stress distribution is not linear in the cross section. These types of beams may have simple supports or fixed supports. A lot of research works have been conducted on simply supported deep beams, but little study has been done in the fixed-end RC deep beams behavior. Recently, using of fixed-ended deep beams has been widely increased in structures. In this study, the behavior of fixed-ended deep beams is investigated, and the important parameters in capacity of this type of beams are mentioned.

Keywords: deep beam, capacity, reinforced concrete, fixed-ended

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Authors: A. Aarabzadeh, R. Hizaji

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Reinforced Concrete (RC) deep beams are a special type of beams due to their geometry, boundary conditions, and behavior compared to ordinary shallow beams. For example, assumption of a linear strain-stress distribution in the cross section is not valid. Little study has been dedicated to fixed-end RC deep beams. Also, most experimental studies are carried out on simply supported deep beams. Regarding recent tendency for application of deep beams, possibility of using fixed-ended deep beams has been widely increased in structures. Therefore, it seems necessary to investigate the aforementioned structural element in more details. In addition to experimental investigation of a concrete deep beam under cyclic load, different failure mechanisms of fixed-ended deep beams under this type of loading have been evaluated in the present study. The results show that failure mechanisms of deep beams under cyclic loads are quite different from monotonic loads.

Keywords: deep beam, cyclic load, reinforced concrete, fixed-ended

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Authors: Chiara Di Tucci, Giulia Galati, Giulia Mattei, Valentina Bonanni, Oriana Capri, Renzo D'Amelio, Ludovico Muzii, Pierluigi Benedetti Panici

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Objective: Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility. Methods: We performed a search from English literature using the PubMed database with the following keywords: 'female infertility', 'male infertility', 'semen', 'sperm', 'sub-fertile man', 'alpha-lipoic acid', ' alpha lipoic acid', 'lipoid acid', 'endometriosis', 'chronic pelvic pain', 'follicular fluid' and 'oocytes'. We included clinical trials, multicentric studies, and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After the primary and secondary screening, 28 articles were selected. Results: The available literature demonstrates the positive effects of ALA in multiple processes, from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men has been shown to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01), and improve sperm quality (p < .001). Conclusions: ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.

Keywords: alpha lipoic acid, endometriosis, infertility, male factor, polycystic ovary syndrome

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Authors: Yasser F. Hassan

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Deep learning structure is a branch of machine learning science and greet achievement in research and applications. Cellular neural networks are regarded as array of nonlinear analog processors called cells connected in a way allowing parallel computations. The paper discusses how to use deep learning structure for representing neural cellular automata model. The proposed learning technique in cellular automata model will be examined from structure of deep learning. A deep automata neural cellular system modifies each neuron based on the behavior of the individual and its decision as a result of multi-level deep structure learning. The paper will present the architecture of the model and the results of simulation of approach are given. Results from the implementation enrich deep neural cellular automata system and shed a light on concept formulation of the model and the learning in it.

Keywords: cellular automata, neural cellular automata, deep learning, classification

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Authors: Aishrith Rao

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COVID 19 is a pandemic which has resulted in thousands of deaths around the world and a huge impact on the global economy. Testing is a huge issue as the test kits have limited availability and are expensive to manufacture. Using deep learning methods on radiology images in the detection of the coronavirus as these images contain information about the spread of the virus in the lungs is extremely economical and time-saving as it can be used in areas with a lack of testing facilities. This paper focuses on binary classification and multi-class classification of COVID 19 and other diseases such as pneumonia, tuberculosis, etc. Different deep learning methods such as VGG-19, COVID-Net, ResNET+ SVM, Deep CNN, DarkCovidnet, etc., have been used, and their accuracy has been compared using the Chest X-Ray dataset.

Keywords: deep learning, computer vision, radiology, COVID-19, ResNet, VGG-19, deep neural networks

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Authors: Nuntaporn Aukkanit

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The aim of this study was to determine the effect of oils on chemical, physical, and sensory properties of deep-fried dough stick. Five kinds of vegetable oil which were used for addition and frying consist of: palm oil, soybean oil, sunflower oil, rice bran oil, and canola oil. The results of this study showed that using different kinds of oil made significant difference in the quality of deep-fried dough stick. Deep-fried dough stick fried with the rice bran oil had the lowest moisture loss and oil absorption (p≤0.05), but it had some unsatisfactory physical properties (color, specific volume, density, and texture) and sensory characteristics. Nonetheless, deep-fried dough stick fried with the sunflower oil had moisture loss and oil absorption slightly more than the rice bran oil, but it had almost higher physical and sensory properties. Deep-fried dough sticks together with the sunflower oil did not have different sensory score from the palm oil, commonly used for production of deep-fried dough stick. These results indicated that addition and frying with the sunflower oil are appropriate for the production of deep-fried dough stick.

Keywords: deep-fried dough stick, palm oil, sunflower oil, rice bran oil

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Authors: Ashutosh Mishra, Nikhil Goyal

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A 3D facial emotion recognition model based on deep learning is proposed in this paper. Two convolution layers and a pooling layer are employed in the deep learning architecture. After the convolution process, the pooling is finished. The probabilities for various classes of human faces are calculated using the sigmoid activation function. To verify the efficiency of deep learning-based systems, a set of faces. The Kaggle dataset is used to verify the accuracy of a deep learning-based face recognition model. The model's accuracy is about 65 percent, which is lower than that of other facial expression recognition techniques. Despite significant gains in representation precision due to the nonlinearity of profound image representations.

Keywords: facial recognition, computational intelligence, convolutional neural network, depth map

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Authors: Debneil Saha Roy

Abstract:

Weather forecasting is a complex topic and is well suited for analysis by deep learning approaches. With the wide availability of weather observation data nowadays, these approaches can be utilized to identify immediate comparisons between historical weather forecasts and current observations. This work explores the application of deep learning techniques to weather forecasting in order to accurately predict the weather over a given forecast hori­zon. Three deep neural networks are used in this study, namely, Multi-Layer Perceptron (MLP), Long Short Tunn Memory Network (LSTM) and a combination of Convolutional Neural Network (CNN) and LSTM. The predictive performance of these models is compared using two evaluation metrics. The results show that forecasting accuracy increases with an increase in the complexity of deep neural networks.

Keywords: convolutional neural network, deep learning, long short term memory, multi-layer perceptron

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Authors: Basiliyos Tilahun Betru, Charles Awono Onana, Bernabe Batchakui

Abstract:

Recommender systems have become increasingly popular in recent years, and are utilized in numerous areas. Nowadays many web services provide several information for users and recommender systems have been developed as critical element of these web applications to predict choice of preference and provide significant recommendations. With the help of the advantage of deep learning in modeling different types of data and due to the dynamic change of user preference, building a deep model can better understand users demand and further improve quality of recommendation. In this paper, deep neural network models for recommender system are evaluated. Most of deep neural network models in recommender system focus on the classical collaborative filtering user-item setting. Deep learning models demonstrated high level features of complex data can be learned instead of using metadata which can significantly improve accuracy of recommendation. Even though deep learning poses a great impact in various areas, applying the model to a recommender system have not been fully exploited and still a lot of improvements can be done both in collaborative and content-based approach while considering different contextual factors.

Keywords: big data, decision making, deep learning, recommender system

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Authors: M. Abdallah

Abstract:

Urban development requires deep excavations near buildings and other structures. Deep excavation has become more a necessity for better utilization of space as the population of the world has dramatically increased. In Lebanon, some urban areas are very crowded and lack spaces for new buildings and underground projects, which makes the usage of underground space indispensable. In this paper, a numerical modeling is performed using the finite element method to study the deep excavation-diaphragm wall soil-structure interaction in the case of nonlinear soil behavior. The study is focused on a comparison of the results obtained using different support systems. Furthermore, a parametric study is performed according to the remoteness of the structure.

Keywords: deep excavation, ground anchors, interaction soil-structure, struts

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Authors: Shuen-Tai Wang, Fang-An Kuo, Chau-Yi Chou, Yu-Bin Fang

Abstract:

2016 has become the year of the Artificial Intelligence explosion. AI technologies are getting more and more matured that most world well-known tech giants are making large investment to increase the capabilities in AI. Machine learning is the science of getting computers to act without being explicitly programmed, and deep learning is a subset of machine learning that uses deep neural network to train a machine to learn  features directly from data. Deep learning realizes many machine learning applications which expand the field of AI. At the present time, deep learning frameworks have been widely deployed on servers for deep learning applications in both academia and industry. In training deep neural networks, there are many standard processes or algorithms, but the performance of different frameworks might be different. In this paper we evaluate the running performance of two state-of-the-art distributed deep learning frameworks that are running training calculation in parallel over multi GPU and multi nodes in our cloud environment. We evaluate the training performance of the frameworks with ResNet-50 convolutional neural network, and we analyze what factors that result in the performance among both distributed frameworks as well. Through the experimental analysis, we identify the overheads which could be further optimized. The main contribution is that the evaluation results provide further optimization directions in both performance tuning and algorithmic design.

Keywords: artificial intelligence, machine learning, deep learning, convolutional neural networks

Procedia PDF Downloads 171

Authors: Jiaqi Huang, Yuheng Wang

Abstract:

Premises selection, the task of selecting a set of axioms for proving a given conjecture, is a major bottleneck in automated theorem proving. An array of deep-learning-based methods has been established for premises selection, but a perfect performance remains challenging. Our study examines the inaccuracy of deep neural networks in premises selection. Through training network models using encoded conjecture and axiom pairs from the Mizar Mathematical Library, two potential biases are found: the network models classify more premises as necessary than unnecessary, referred to as the ‘positive bias’, and the network models perform better in proving conjectures that paired with more axioms, referred to as ‘length bias’. The ‘positive bias’ and ‘length bias’ discovered could inform the limitation of existing deep neural networks.

Keywords: automated theorem proving, premises selection, deep learning, interpreting deep learning

Procedia PDF Downloads 136

Authors: Mannal Tariq

Abstract:

Construction industry is making progress at a high pace. The trend of the world is getting more biased towards the high rise buildings. Deep beams are one of the most common elements in modern construction having small span to depth ratio. Deep beams are mostly used as transfer girders. This experimental study consists of 16 reinforced concrete (RC) deep beams. These beams were divided into two groups; A and B. Groups A and B consist of eight beams each, having 381 mm (15 in) and 457 mm (18 in) depth respectively. Each group was further subdivided into four sub groups each consisting of two identical beams. Each subgroup was comprised of solid/control beam (without opening), opening above neutral axis (NA), at NA and below NA. Except for control beams, all beams with openings were strengthened with carbon fibre reinforced polymer (CFRP) vertical strips. These eight groups differ from each other based on depth and location of openings. For testing sake, all beams have been loaded with two symmetrical point loads. All beams have been designed based on strut and tie model concept. The outcome of experimental investigation elaborates the difference in the shear behaviour of deep beams based on depth and location of circular openings variation. 457 mm (18 in) deep beam with openings above NA show the highest strength and 381 mm (15 in) deep beam with openings below NA show the least strength. CFRP sheets played a vital role in increasing the shear capacity of beams.

Keywords: CFRP, deep beams, openings in deep beams, strut and tie modal, shear behaviour

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Authors: Seyed Abolhasan Naeini, Saeideh Mohammadi

Abstract:

Embankment settlement on soft clays has always been problematic due to the high compaction and low shear strength of the soil. Deep soil mixing and geosynthetics are two soil improvement methods in such fields. Here, a numerical study is conducted on the embankment performance on the soft ground improved by deep soil mixing columns and geosynthetics based on the data of a real project. For this purpose, the finite element method is used in the Plaxis 2D software. The Soft Soil Creep model considers the creep phenomenon in the soft clay layer while the Mohr-Columb model simulates other soil layers. Results are verified using the data of an experimental embankment built on deep mixing columns. The effect of depth and diameter of deep mixing columns and the stiffness of geogrid on the vertical and horizontal movements of embankment on clay subsoil will be investigated in the following.

Keywords: PLAXIS 2D, embankment settlement, horizontal movement, deep soil mixing column, geogrid

Procedia PDF Downloads 136

Authors: Ruqaya H. Aljabery

Abstract:

Reinforced Concrete (RC) deep beams are one of the main critical structural elements in terms of safety since significant loads are carried in a short span. The shear capacity of these sections cannot be predicted accurately by the current design codes like ACI and EC2; thus, they must be investigated. In this research, non-linear behavior of RC deep beams strengthened in shear with Fiber Reinforced Polymer (FRP) strips, and the efficiency of FRP in terms of enhancing the shear capacity in RC deep beams are examined using Finite Element Analysis (FEA), which is conducted using the software ABAQUS. The effect of several parameters on the shear capacity of the RC deep beam are studied in this paper as well including the effect of the cross-sectional area of the FRP strip and the shear reinforcement area to the spacing ratio (As/S), and it was found that FRP enhances the shear capacity significantly and can be a substitution of steel stirrups resulting in a more economical design.

Keywords: Abaqus, concrete, deep beam, finite element analysis, FRP, shear strengthening, strut-and-tie

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Authors: Nitin Shravan, Sudarsun Santhiappan, B. Sivaselvan

Abstract:

Subsection identification, in the context of Electronic Health Records (EHRs), is identifying the important sections for down-stream tasks like auto-coding. In this work, we classify the text present in EHRs according to their information, using machine learning and deep learning techniques. We initially describe briefly about the problem and formulate it as a text classification problem. Then, we discuss upon the methods from the literature. We try two approaches - traditional feature extraction based machine learning methods and deep learning methods. Through experiments on a private dataset, we establish that the deep learning methods perform better than the feature extraction based Machine Learning Models.

Keywords: deep learning, machine learning, semantic clinical classification, subsection identification, text classification

Procedia PDF Downloads 180