Enhancing microalgae classification accuracy in marine ecosystems through convolutional neural networks and support vector machines.

Accurately classifying microalgae species is vital for monitoring marine ecosystems and managing the emergence of marine mucilage, which is crucial for monitoring mucilage phenomena in marine environments. Traditional methods have been inadequate due to time-consuming processes and the need for expert knowledge. The purpose of this article is to employ convolutional neural networks (CNNs) and support vector machines (SVMs) to improve classification accuracy and efficiency. By employing advanced computational techniques, including MobileNet and GoogleNet models, alongside SVM classification, the study demonstrates significant advancements over conventional identification methods. In the classification of a dataset consisting of 7820 images using four different SVM kernel functions, the linear kernel achieved the highest success rate at 98.79 %. It is followed by the RBF kernel at 98.73 %, the polynomial kernel at 97.84 %, and the sigmoid kernel at 97.20 %. This research not only provides a methodological framework for future studies in marine biodiversity monitoring but also highlights the potential for real-time applications in ecological conservation and understanding mucilage dynamics amidst climate change and environmental pollution.

Deep learning-based classification of microalgae using light and scanning electron microscopy images.

Microalgae possess diverse applications, such as food production, animal feed, cosmetics, plastics manufacturing, and renewable energy sources. However, uncontrolled proliferation, known as algal bloom, can detrimentally impact ecosystems. Therefore, the accurate detection, monitoring, identification, and tracking of algae are imperative, albeit demanding considerable time, effort, and expertise, as well as financial resources. Deep learning, employing image pattern recognition, emerges as a practical and promising approach for rapid and precise microalgae cell counting and identification. In this study, we processed light microscopy (LM) and scanning electron microscopy (SEM) images of two Cyanobacteria species and three Chlorophyta species to classify them, utilizing state-of-the-art Convolutional Neural Network (CNN) models, including VGG16, MobileNet V2, Xception, NasnetMobile, and EfficientNetV2. In contrast to prior deep learning based identification studies limited to LM images, we, for the first time, incorporated SEM images of microalgae in our analysis. Both LM and SEM microalgae images achieved an exceptional classification accuracy of 99%, representing the highest accuracy attained by the VGG16 and EfficientNetV2 models to date. While NasnetMobile exhibited the lowest accuracy of 87% with SEM images, the remaining models achieved classification accuracies surpassing 93%. Notably, the VGG16 and EfficientNetV2 models achieved the highest accuracy of 99%. Intriguingly, our findings indicate that algal identification using optical microscopes, which are more cost-effective, outperformed electron microscopy techniques.

The ANK nail treatment of lateral malleolar fractures with syndesmosis injury: Clinical outcomes at 10 years of follow-up.

BACKGROUND: Lateral malleolar fractures associated with syndesmotic injuries are common. Various surgical implants may be used for the management of syndesmosis injury. One of these is ANK nail. The aim of the present study was to assess the clinical and radiological outcomes of patients treated with ANK nail. METHODS: Forty-eight patients who were followed up for a minimum of 10 years were reviewed retrospectively using American Orthopedic Foot and Ankle Society (AOFAS) score, radiological evaluation, and development of posttraumatic arthritis. Final data were collected at the last follow-up. RESULTS: The mean age of the patients was 37.3 (17-69) years. The mean follow-up was 129.9 (123-150) months. Twenty-two patients had Weber type B fracture, and their mean AOFAS score was 93.36 points. The remaining 26 patients had Weber type C fracture, and their mean AOFAS score was 97.66 points. There was no relationship between the type of fracture and the clinical outcome. There was a significant correlation between shortening of the fibula and posttraumatic arthritis. CONCLUSION: The ANK nail used for the management of ankle fractures may provide both fracture and syndesmosis stabilities in selected cases and is also a cost effective method as cheap as a cortical screw and a Kirschner wire.

Effectiveness of Four Different Treatment Modalities in the Treatment of Chronic Plantar Fasciitis During a 36-Month Follow-Up Period: A Randomized Controlled Trial.

No consensus has been reached about the best treatment method of plantar fasciitis and the results of the treatment methods have been inconsistent. The objective of the present study was to compare the therapeutic effects of extracorporeal shock wave therapy, platelet-rich plasma injection, local corticosteroid injection, and prolotherapy for the treatment of chronic plantar fasciitis using a randomized, controlled, prospective study. We performed a randomized controlled prospective clinical study of 4 groups. The first group received extracorporeal shock wave therapy, the second group received prolotherapy, the third group received platelet-rich plasma injection, and the fourth group received a local corticosteroid injection. The study included 158 consecutive patients with a diagnosis of chronic plantar fasciitis with a symptomatic heel spur. The clinical outcomes were assessed using the visual analog scale and Revised Foot Function Index. At the end of the follow-up period, the mean visual analog scale scores for all 4 groups were similar to the mean visual analog scale scores before treatment. At the end of the follow-up period, no significant improvement was noted in the Revised Foot Function Index score in any of the groups. The corticosteroid injection was more effective in the first 3 months and extracorporeal shock wave therapy was an effective treatment method in the first 6 months in regard to pain. The corticosteroid injection lost its effectiveness during the follow-up period. The effect of prolotherapy and platelet-rich plasma was seen within 3 to 12 months; however, at the 36-month follow-up point, no differences were found among the 4 treatments.

Comparison of two different vacuum-assisted closure (VAC) treatments of multiple chronic diabetic foot wounds in the same extremity.

BACKGROUND: The aim of the present study is to compare the clinical efficacy and safety of two different vacuum-assisted closure (VAC) applications in one center between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds. METHODS: The study was a randomized-controlled, prospective investigation between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds at single extremity. There were 10 patients in the first group receiving VAC treatment by means of Y-connector and 11 patients in the second group receiving bridge-VAC treatment. RESULTS: There were no significant difference in Revised Foot Function Index scores and total treatment costs between the both groups. The cost of the VAC dressing supplies in one session of the dressings was lower in the bridge-VAC group. CONCLUSIONS: In conclusion, although bridge-VAC treatment seems to be an alternative method to the VAC treatment by means of Y-connector, we found no superiority of one over the other VAC application for chronic diabetic foot wounds.

Intra-articular lipoma of the knee joint located in the posterior compartment: A rare location.

This report presents the case of a 51-year-old woman with intermittent left knee pain, especially during full flexion of the knee, which had been ongoing for 1 year. Magnetic resonance imaging (MRI) showed mild effusion and round mass at the posterior compartment without synovial changes. Computerized tomography (CT) indicated mass had homogeneous low attenuation and density measurement of -99.4±62.3 Hounsfield units (HU), correlated with a lipomatous lesion.

Strategies for Proximal Femoral Nailing of Unstable Intertrochanteric Fractures: Lateral Decubitus Position or Traction Table.

BACKGROUND: The aim of this prospective randomized study was to compare the traction table and lateral decubitus position techniques in the management of unstable intertrochanteric fractures. METHODS: Eighty-two patients with unstable intertrochanteric fractures between 2011 and 2013 were included in this study. All patients were treated surgically with the Proximal Femoral Nail Antirotation implant (DePuy Synthes). Patients were randomized to undergo the procedure in the lateral decubitus position (42 patients) or with the use of a traction table (40 patients). Patients whose procedure was not performed entirely with a semi-invasive method or who required the use of additional fixation materials, such as cables, were excluded from the study. The groups were compared on the basis of the setup time, surgical time, fluoroscopic exposure time, tip-to-apex distance, collodiaphyseal angle, and modified Baumgaertner criteria for radiologic reduction. RESULTS: The setup time, surgical time, and fluoroscopic exposure time were lower and the differences were statistically significant in the lateral decubitus group compared with the traction table group. The collodiaphyseal angles were significantly different between the groups in favor of the lateral decubitus method. The tip-to-apex distance and the classification of reduction according to the modified Baumgaertner criteria did not demonstrate a statistically significant difference between the groups. CONCLUSIONS: The lateral decubitus position is used for most open procedures of the hip. We found that this position facilitates exposure for the surgical treatment of unstable intertrochanteric fractures and has advantages over the traction table in terms of set up time, surgical time and fluoroscopic exposure time.

Bilateral intertrochanteric and femoral diaphyseal fractures with unilateral proximal tibial fracture: A case report and review of the literature.

INTRODUCTION: Bilateral intertrochanteric femur fractures are relatively rare injuries. This study aims to present a case of a patient with simultaneous bilateral intertrochanteric femur fractures and femoral diaphyseal fractures and proximal tibial fracture with his twelve years follow-up. PRESENTATION OF CASE: A 44-year-old man presented to emergency department after a motor vehicle accident. Bilateral intertrochanteric femur fractures (OTA classification - 31A.1.2) and bilateral femoral diaphyseal fractures (OTA classification - 32A.2) and nondisplaced right proximal tibial fracture (OTA classification - 41B.1) were determined in radiographs. Following closed reduction, fractures were fixed with intramedullary nails bilaterally. Proximal tibial fracture was fixed with cannulated screws following open reduction. At twelfth year follow-up he was able to do his daily activities with minimal limitation. DISCUSSION: High energy traumas, stress fractures, systemic disorders (osteomalacia, chronic renal failure), steroid treatments, seizures and electric injuries are possible causes for bilateral hip factures. However bilateral femoral diaphyseal fractures are mostly due to high energy traumas. Long-term biphosphonate use may also cause bilateral fractures. Single-stage surgery should be performed in order to avoid secondary damages of surgical interventions. All fractures of our patient were fixed in a single session. This prevented further deterioration of patient's status and made rehabilitation easy. CONCLUSION: Careful evaluation of all systems should be performed in multi-trauma patients to find out concomitant injuries. Single staged surgical treatment may decrease morbidities.

Intramedullary osteosynthesis of instable intertrochanteric femur fractures with Profin® nail in elderly patients.

OBJECTIVE: The aim of this study was to retrospectively analyze the radiologic and functional results of patients with instable intertrochanteric femur fractures treated with Profin® nails. METHODS: This study included 32 patients (24 female, 8 male; mean age: 70.7 years; range: 65 to 96 years) who were treated with Profin® nails for instable intertrochanteric fractures. Fractures were caused by a simple fall in 30 patients and pedestrian accident in two. Eleven patients had Type 31-A2 and 21 patients had Type 31-A3 fractures according to the AO/OTA classification. Results were evaluated clinically and radiologically. Mean follow-up period was 17.3 (range: 12 to 23) months. RESULTS: Good or acceptable reduction was achieved in 93.7% of our patients. Mean surgery duration was 28.2 (range: 22 to 75) minutes and mean blood loss was 215 (range: 150 to 320) cc. Complete union was achieved in all patients at a mean of 17.6 (range: 15 to 22) weeks. Postoperative mean collodiaphyseal angle was 125.5 (range: 122 to 130) degrees and there was no significant difference with follow-up values (p>0.05). Twenty-two patients were able to walk with support and 10 without support after surgery. Mean Oxford hip score was 23.70 (range: 14 to 39) points. One year mortality rate was 18.75%. CONCLUSION: Good functional and radiologic results can be achieved using Profin® nails for unstable intertrochanteric femur fractures in elderly patients.

Accuracy of anterior glenohumeral injections: a cadaver study.

PURPOSE: Intra-articular glenohumeral injections have an important role for therapeutic benefit and diagnostic information. Therefore, it is very important that the injected material should reach its desired target. This study assessed the accuracy of an anterior intra-articular injection in fresh cadavers. METHODS: A total of 50 shoulders of 25 fresh cadavers were included in the study. Anterior placement of a spinal needle using a location just 1 cm lateral to the coracoid, without radiographic assistance were performed. After the needle was placed and estimated to be intra-articular 1 cc of acrylic dye was injected into the joint to determine accuracy of position. RESULTS: Ninety-six percent of injections were accurately administered into the glenohumeral joint and 4% in the surrounding soft tissues and capsule. CONCLUSION: Based on our cadaveric study, an unassisted anterior injection to the glenohumeral joint could be accurately placed.

[A review of malpractice claims concerning orthopedic applications submitted to the Council of Forensic Medicine]. / Adli Tip Kurumu'ndan görüs sorulan ve ortopedi uzmanlik alanina giren tibbi uygulama hatalarinin gözden geçirilmesi.

OBJECTIVES: The aim of this study was to review malpractice claims concerning orthopedic applications that were sent to the Council of Forensic Medicine by public prosecutors and law courts. METHODS: A retrospective review was conducted on 174 malpractice claim files related with orthopedic applications, which had been examined and concluded by the Third Specialized Board of the Council of Forensic Medicine between January 2004 and December 2007. RESULTS: Of 174 files, 129 files were concerned with trauma and 45 files were concerned with orthopedic causes. The types of institutions involved were 82 state hospitals, 56 private hospitals, 17 training and research hospitals, 18 university hospitals, and one military hospital. Orthopedic surgeons were found liable for failure in 61 cases (51 trauma, 10 orthopedic cases). Those who were considered blameworthy were working for 26 private hospitals, 24 state hospitals, seven training and research hospitals, and two university hospitals with the following titles: professor (n=2), chief of clinic (n=1), associate professor (n=2), specialist (n=54), resident (n=3), and nurse (n=1). CONCLUSION: In order to minimize malpractice claims, physicians should steadily improve professional knowledge and skills, give special attention to documenting all information about the patients and applications, and establish a good and intimate physician-patient relationship.

[Osteoid osteoma of the coronoid process causing flexion contracture of the elbow]. / Koronoid çikintida gelisen ve fleksiyon kontraktürüne neden olan osteoid osteoma.

Osteoid osteoma is one of the benign osteoblastic lesions that causes chronic pain. Diagnosis may be delayed in juxta-articular lesions in which characteristic radiographic findings may not be present, resulting in limited joint motion. A 23-year-old patient presented with a complaint of pain in the right elbow of one-year history. He sought medical treatment at another center and was prescribed non-steroidal anti-inflammatory treatment that resulted in significant pain relief; however, limitations of elbow motion ensued. On physical examination, there was pain in the antecubital part of the right elbow on palpation and a flexion contracture of 30 degrees. Findings of computed tomography and magnetic resonance imaging were consistent with osteoid osteoma. The lesion was excised and postoperative controls showed no flexion contracture.

Comparison of carpal tunnel injection techniques: a cadaver study.

The purpose of the study was to evaluate the accuracy of injections into the carpal tunnel using three different portals in cadavers, and to define safe guidelines. In this study, 150 wrists of 75 cadavers (54 male, 21 female) were included. To compare three injection sites, 50 wrists of 25 cadavers were used for each technique; we used 23 gauge needles, and acrylic dye. The first injection technique: the needle was inserted 1cm proximal to the wrist crease and directed distally by roughly 45 in an ulnar direction through the flexor carpi radialis tendon. The second injection technique: the needle was inserted into the carpal tunnel from a point just ulnar to the palmaris longus tendon and 1cm proximal to the wrist crease. The third injection technique: the needle was inserted just distal to the distal skin crease of the wrist in line with the fourth ray. The first injection technique gave the highest accuracy rate, and this was also the safest injection site. Median nerve injuries caused by injection was seen mostly with the second technique. Although a steroid injection may provide symptomatic relief in patients with carpal tunnel syndrome, the median nerve and other structures in the carpal tunnel are at risk of injury. Because of that, the injection should be given using the correct technique by physicians skilled in carpal tunnel surgery.

Comparison of four different intra-articular injection sites in the knee: a cadaver study.

Although intra-articular knee injection is not a complicated procedure, it could be difficult to assess whether the tip of the needle lies free in the joint or is embedded in synovium or other intra-articular soft tissues. The purpose of this study was to evaluate the accuracy rate of intra-articular injection using anteromedial (AM), anterolateral (AL), lateral midpatellar (LMP), and medial midpatellar (MMP) portals in cadavers. In this study 156 knees of 78 fresh cadavers were included. Anterolateral and AM injection to both knees of 39 cadavers (78 knees) were performed. MMP and LMP injection to both knees of other 39 cadavers were also performed. Accuracy rate was the highest (85%) in the AL injection portal and lowest in the MMP portal (56%). In conclusion, the accuracy obtained with use of the MMP portal was significantly lower than that obtained with the use of either the AM (P < 0.05), AL (P < 0.0001), or LMP (P < 0.05) portal. Although AL injection site resulted in good intra-articular delivery with 85% accuracy rate and with a lower incidence of soft tissue infiltration, the results were not statistically significant when compared to AM and LMP portals. Therefore, any of these three portals might be preferred depending on the experience of the physician. On the other hand, 100% accuracy could not be obtained through any portals in the study, which should be kept in mind when treating knee problems with intra-articular medications.