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Ory J, Tradewell MB, Blankstein U, Lima TF, Nackeeran S, Gonzalez DC, Nwefo E, Moryousef J, Madhusoodanan V, Lau S, Jarvi K, Ramasamy R. Artificial Intelligence Based Machine Learning Models Predict Sperm parameter Upgrading after Varicocele Repair: A Multi-Institutional Analysis. World J Mens Health 2022; 40:618-626. [PMID: 35021305 PMCID: PMC9482858 DOI: 10.5534/wjmh.210159] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/17/2021] [Accepted: 09/28/2021] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Varicocele repair is recommended in the presence of a clinical varicocele together with at least one abnormal semen parameter, and male infertility. Unfortunately, up to 50% of men who meet criteria for repair will not see meaningful benefit in outcomes despite successful treatment. We developed an artificial intelligence (AI) model to predict which men with varicocele will benefit from treatment. MATERIALS AND METHODS We identified men with infertility, clinical varicocele, and at least one abnormal semen parameter from two large urology centers in North America (Miami and Toronto) between 2006 and 2020. We collected pre and post-operative clinical and hormonal data following treatment. Clinical upgrading was defined as an increase in sperm concentration that would allow a couple to access previously unavailable reproductive options. The tiers used for upgrading were: 1-5 million/mL (ICSI/IVF), 5-15 million/mL (IUI) and >15 million/mL (natural conception). Thus moving from ICSI/IVF to IUI, or from IUI to natural conception, would be considered an upgrade. AI models were trained and tested using R to predict which patients were likely to upgrade after surgery. The model sorted men into categories that defined how likely they were to upgrade after surgery (likely, equivocal, and unlikely). RESULTS Data from 240 men were included from both centers. A total of 45.6% of men experienced an upgrade in sperm concentration following surgery, 48.1% did not change, and 6.3% downgraded. The data from Miami were used to create a random forest model for predicting upgrade in sperm concentration. On external validation using Toronto data, the model accurately predicted upgrade in 87% of men deemed likely to improve, and in 49% and 36% of men who were equivocal and unlikely to improve, respectively. Overall, the personalized prediction for patients in the validation cohort was accurate (AUC 0.72). CONCLUSIONS A machine learning model performed well in predicting clinically meaningful post-varicocelectomy sperm parameters using pre-operative hormonal, clinical, and semen analysis data. To our knowledge, this is the first prediction model to show the utility of hormonal data, as well as the first to use machine learning models to predict clinically meaningful upgrading. This model will be published online as a clinical calculator that can be used in the preoperative counseling of patients.
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Affiliation(s)
- Jesse Ory
- Department of Urology, University of Miami, Coral Gables, FL, USA.,Department of Urology, Dalhousie University, Halifax, NS, Canada
| | | | - Udi Blankstein
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Thiago F Lima
- Department of Urology, University of Miami, Coral Gables, FL, USA
| | - Sirpi Nackeeran
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | - Elie Nwefo
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | | | | | - Susan Lau
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Keith Jarvi
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Ranjith Ramasamy
- Department of Urology, University of Miami, Coral Gables, FL, USA.
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Garcia-Usó M, Lima TF, Trindade IEK, Pimenta LAF, Trindade-Suedam IK. Three-dimensional tomographic assessment of the upper airway using 2 different imaging software programs: A comparison study. Am J Orthod Dentofacial Orthop 2021; 159:217-223. [PMID: 33483220 DOI: 10.1016/j.ajodo.2020.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Several imaging software programs with different tools are available for upper airway (UAW) analysis by means of cone beam computed tomography. Because of this wide variability, this study aimed to compare the reproducibility of two of the most used software programs on UAW segmentation, that is, Dolphin Imaging (Dolphin Imaging and Management Solutions, Chatsworth, Calif) and Mimics Research (Materialise, Leuven, Belgium). METHODS The sample consisted of 50 scans of adult subjects with Class III malocclusion; pharyngeal volume and minimal cross-sectional area (mCSA) were assessed twice by 2 experienced evaluators using both software programs. Intra- and intersoftware and/or evaluator agreement were calculated using the intraclass correlation coefficient (ICC). Bland-Altman analysis was used to visualize the intersoftware and interevaluator agreement. RESULTS Using Mimics Research and Dolphin Imaging, the respective mean values of volume (cm3) were 27.1 ± 8.4 and 24.7 ± 8.1 (P < 0.05) and of mCSA (mm2) were 167.8 ± 95.5 and 176.5 ± 102.3 (P < 0.05). Although differences between software packages were observed on both the analyzed variables, the results showed a high intersoftware agreement, with ICC of 0.87 (volume) and 0.97 (mCSA) and mean bias of 24.6 (volume) and -8.8 (mCSA). A high intrasoftware agreement was also observed, with values varying from 0.83 to 0.99. Excellent intra- and interevaluator agreement was also obtained, with ICC values from 0.93 to 0.99. CONCLUSIONS Dolphin Imaging and Mimics Research individually provide highly reproducible results, with clinically acceptable agreement between them for UAW segmentation, providing consistent values for volume and mCSA.
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Affiliation(s)
- Michele Garcia-Usó
- Former Post-Graduation Student, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thiago F Lima
- Former Post-Graduation Student, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Inge Elly K Trindade
- Department of Biological Sciences, Bauru School of Dentistry, and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Luiz Andre F Pimenta
- Craniofacial Center, and Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ivy Kiemle Trindade-Suedam
- Department of Biological Sciences, Bauru School of Dentistry, and Laboratory of Physiology, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
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Lima TF, Gamba TO, Zaia AA, Soares AJ. Evaluation of cone beam computed tomography and periapical radiography in the diagnosis of root resorption. Aust Dent J 2016; 61:425-431. [DOI: 10.1111/adj.12407] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2016] [Indexed: 12/15/2022]
Affiliation(s)
- TF Lima
- Endodontics Division; Federal University of Paraíba; João Pessoa Paraíba Brazil
| | - TO Gamba
- State University of Campinas; Piracicaba São Paulo Brazil
| | - AA Zaia
- Endodontics Division; State University of Campinas; Piracicaba São Paulo Brazil
| | - AJ Soares
- Endodontics Division; State University of Campinas; Piracicaba São Paulo Brazil
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Urban VM, Lima TF, Bueno MG, Giannini M, Arioli Filho JN, de Almeida ALPF, Neppelenbroek KH. Effect of the addition of antimicrobial agents on Shore A hardness and roughness of soft lining materials. J Prosthodont 2014; 24:207-14. [PMID: 25082183 DOI: 10.1111/jopr.12205] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2014] [Indexed: 11/27/2022] Open
Abstract
PURPOSE While the incorporation of antimicrobial agents into soft denture liners has been suggested as a reliable alternative treatment for denture stomatitis, it may affect the liner's properties. The effect of addition of antimicrobial agents for the treatment of denture stomatitis on the surface roughness and Shore A hardness of soft lining materials was evaluated. MATERIALS AND METHODS The test groups comprised specimens (36 × 7 × 6 mm(3) ) of soft materials (Softone and Trusoft) without (control) or with incorporation of drugs (nystatin, miconazole, ketoconazole, chlorhexidine diacetate, and itraconazole). Hardness (Shore A) and roughness (Ra) were evaluated after immersion of specimens (n = 10) in distilled water at 37°C for 24 hours, 7 and 14 days. Data were analyzed by 3-way ANOVA/Tukey's test (α = 0.05). RESULTS After 14 days, an increase (p < 0.05) was observed in the hardness of soft materials with time for the modified specimens, except for itraconazole. Addition of drugs increased the Softone roughness only for the addition of miconazole and chlorhexidine (p < 0.05), and did not increase the roughness of Trusoft with time. Only chlorhexidine and itraconazole altered the roughness compared to the control for each material (p < 0.05). CONCLUSIONS The smallest changes of hardness and roughness with time in the modified groups compared to controls were observed for itraconazole groups for both materials.
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Affiliation(s)
- Vanessa M Urban
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil
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Silva EJNL, Herrera DR, Lima TF, Zaia AA. A nonsurgical technique for the removal of overextended gutta-percha. J Contemp Dent Pract 2012; 13:219-221. [PMID: 22665752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The present report describes and discusses a nonsurgical technique for the removal of overextended gutta-percha. BACKGROUND Mechanical irritation results from overextension and the overextended material used during root canal obturation could produce an inflammatory reaction with an area of rarefaction in the periapical tissues. The healing process is not affected by the presence of filling materials as it is well tolerate by the periapical tissues, but it is accepted that a higher failure rate is found in overfilled teeth. CASE REPORT This clinical report describes one case with an overextended gutta-percha cone and a new nonsurgical technique to remove this material. CONCLUSION The technique described is a conservative, safe and plausible option to remove extruded gutta-percha in periapical area. CLINICAL SIGNIFICANCE Overextended gutta-percha cones could increase the failure of endodontic therapy. Commonly surgical procedures are indicated to remove this overextended material, but this nonsurgical technique could be a better treatment alternative and could increase the chances of success.
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Affiliation(s)
- Emmanuel J N L Silva
- Department of Endodontics, Piracicaba Dentistry School, Rua Herotides de Oliveira, Niteroi, Brazil.
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Labruna MB, de Paula CD, Lima TF, Sana DA. Ticks (Acari: Ixodidae) on wild animals from the Porto-Primavera Hydroelectric power station area, Brazil. Mem Inst Oswaldo Cruz 2002; 97:1133-6. [PMID: 12563479 DOI: 10.1590/s0074-02762002000800012] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
From June 2000 to June 2001, a total of 741 ticks were collected from 51 free-living wild animals captured at the Porto-Primavera Hydroelectric power station area, located alongside an approximately 180 km course of the Paran river, between the states of S o Paulo and Mato Grosso do Sul, comprising 9 species of 3 genera: Ambly-omma (7 species), Boophilus (1) and Anocentor (1). A total of 421 immature Amblyomma ticks were reared in laboratory until the adult stage, allowing identification of the species. A. cajennense was the most frequent tick species (mostly immature stages) collected on 9 host species: Myrmecophaga tridactyla, Tamandua tetradactyla,Cerdocyon thous, Puma concolor,Tayassu tajacu, Mazama gouazoubira,Hydrochaeris hydrochaeris,Alouatta caraya, Cebus apella. Other tick species were less common, generally restricted to certain host taxa.
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Affiliation(s)
- Marcelo B Labruna
- Departamento de Medicina Veterinária Preventiva e Saúde Animal, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, 05508-000 São Paulo, SP, Brasil.
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