Elite Wellness

IntroductionClassifications are helpful for surgeons as they can be a resource for decision-making, often providing the individual indicators that may deem a case necessary for surgery. However, when there are multiple classifications, the decision-making might be compromised. That is the case with C2 fractures. For this reason, this study was designed to review the different classifications of axis fractures. Research questionWhat are the most commonly used classifications for C2 fractures, and how do these classifications compare in terms of clinical utility? MethodsA systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines was performed. Three different Pub-med searches (https://pubmed.ncbi.nlm.nih.gov/) were done to isolate the most common C2 fracture classifications of odontoid process fractures, the posterior element of the axis and axis body fractures. ResultsThe search isolated 530 papers. Applying the inclusion and exclusion criteria yielded seven papers on axis body fractures, six on odontoid fractures, and ten on “hangman's fractures.” Most of the classifications proposed are modified versions of the classic ones: Benzel's for body fractures, Anderson and D'Alonzo's for odontoid fractures, and Effendi's for “hangman's fractures.” The proposal by AO Spine of a different classification seems promising and had good early results of interobserver and intraobserver agreement. Discussion and conclusionCurrently, no classification is universally accepted or widely used. The emergence of the AO Spine Upper Cervical Injury Classification system seems promising as it encompasses radiological and clinical elements.

The worldwide prevalence of "sensitive skin" group is estimated at being close to 40%. The main trigger for sensitive skin is the misuse of cosmetics products. Majority of the in vitro studies on cosmetic ingredients developed for topical application to the skin are not able to describe sensory irritation, such as stinging, burning, itching, and tingling. Besides, most of the in vivo tests often encounter problems such as limited number of subjects and usage scenarios deviate from reality. A gradient boosting algorithm is adopted in our context to integrate multisource of information including skin types, sensory response, and cosmetics ingredients to predict sensory irritation. In this study, online comments were preprocessed to construct a multi-dimensional structured data including skin types, sensory response, and cosmetics ingredients. A gradient boosting regression model was developed where sensory response was predicted based on the abovementioned structured input. The predictions were validated by in vivo test and were shown favorably when comparing with the state-of-the-art results from related works. 46007 samples were collected after data cleaning and were used in model developing. Results showed that the model was capable to predict the sensory response of 16 skin types to different ingredients (R=0.71, P<10-10 ). In addition, this model was validated using data from in vivo studies and presented a value of 75% on specificity, 88.9% on sensitivity, and 82.4% on accuracy. Our approach that is based on a variant of the gradient boosting algorithm provided an adequate solution for understanding the sensory irritation of cosmetic ingredients.

Aim: To evaluate the effects of combined treatment approaches on endometriosis-associated infertility in different stages of endometriosis using laparoscopy, gonadotropin-releasing hormone (GnRH) agonist (GnRHa) therapy and in vitro fertilization (IVF). Methods: This retrospective study was carried out on 179 women with surgically confirmed endometriosis. Patients were divided into subgroups: group 1 (stage I-II, n = 121) and group 2 (stage III-IV, n = 58). Patients eligible for IVF, who were found to have adenomyosis or moderate to severe endometriosis, were also given postoperative GnRHa. Pregnancy and delivery rates were cumulatively calculated during 5 years according to the severity of the disease. Results: The overall pregnancy, delivery and miscarriage rates were 66.5, 56.4 and 15.1%, respectively, for all patients following spontaneous and assisted conception. There were no significant differences in reproductive outcomes between the study groups. The pregnancy and delivery rates were also comparable within group 1 between the patients with and without GnRHa treatment. Conclusion: Pregnancy and delivery rates at different stages of endometriosis were not affected by the different approaches used for infertility treatment, with >60 and >50% of patients having conceived and delivered a baby, respectively, in both groups. The usefulness of GnRHa treatment for endometriosis patients with minimal to mild forms is questionable and deserves further studies.