Obvious Cases Research Articles

Creation and development of cyber-physical systems under condition of uncertainty interaction of subsystems

The tasks of creation and development of cyber-physical systems are considered. Cybernetic and physical subsystems can be presented in digital and analog form. The physical subsystem that simulates nature is presented in an analog form. Physical subsystems and processes, both natural, in particular, and technogenic, can behave like “things in themselves.” Therefore, the processes of synchronization of analog processes with cybernetics are often difficult to formalize or are not performed correctly enough. This applies to both obvious cases in problem areas of ecology, mining, energy, and in computers under conditions of inappropriate behavior of programs, ensuring the reliability of testing. This leads to the emergence of uncertainties accompanying the integration of subsystems and control in the system as a whole. The nature of analog-to-digital and digital-to-analog conversion in the known representation requires taking into account the features at the level of this class of systems. These problems are considered at the levels of deterministic, stochastic and uncertainty. The well-known models of monitoring, control of a physical subsystem cannot be directly used for control. The development of correct control actions is considered from the standpoint of transforming such models. These models for dynamical systems are represented by differential equations. It is necessary to develop input-output models for the subsequent synthesis of controls.

Kultuurilisest omastamisest maailmas ja meil: saateks / On cultural appropriation in the world and in Estonia: a preface

The translation article of this volume of Studia Vernacula is an essay on cultural appropriation by the American folklorist Jason Baird Jackson. This is an abridged version of the original article, which the author has reworked for our journal. Cultural appropriation is a phenomenon that can occur whenever there is contact between two (or more) social groups, especially when the balance of power (economic, political, symbolic, etc.) between them is not equal. The group in a position of power appropriates (takes over, essentially robs) the cultural phenomena – both spiritual and material – of the other and misuses them.
 As might be expected, the most obvious cases of cultural appropriation occur in countries and regions with a long colonial heritage, more precisely, in those where the problem has later been thoroughly acknowledged and a voice given to the aggrieved group, often the oppressed indigenous people, but also other (ethno-)cultural minorities. Awareness of cultural appropriation always presupposes some kind of awakened consciousness on the part of the minority group, and the ability to communicate the problem beyond its own inner circle. Cultural appropriation can also be recognised from the outside, as an ethical problem among the dominant group. Nevertheless, some kind of subjectivity on the part of the affected side is indispensable here – so as not to be merely the object of external patronage without any capacity or wish to change the situation itself.
 The Estonian reader might be concerned with the question of whether and to what extent it is possible to speak of cultural appropriation in Estonian ethnography or cultural history. Does the position inherent in American folkloristics, where the question of colonial heritage and the study of “other” peoples is clearly at the forefront, resonate with the (Eastern) European, Herderian approach to heritage, which seems to have been unanimously “ours” all along? In order to answer this question, we should first discuss possible minority groups in Estonia. So far, the Estonian state has been reluctant to grant anyone the legal status of an indigenous people for fear of setting a precedent, also in order to prevent any complications that might arise in connection with this.
 Nevertheless, some ethno-territorial groups in Estonia have at least expressed the wish to consider themselves as indigenous peoples separate from “ordinary Estonians”. In this context, we can also point to instances of cultural appropriation, where material or non-material heritage has been collected from a community and brought to community to museums, probably not always using the most transparent methods. The researcher-collector, as representative of the scientific community, is always in a position of power. Formal and symbolic authority plays a role, so it is possible to manipulate the local people. Similarly, the history of Finno-Ugric research expeditions is not free from selfish or arrogant attitudes towards local communities.
 In Estonia, the widespread use of folk costumes throughout the 20th century is an obvious example of cultural appropriation. The members of hundreds of choirs or dance groups need not have had any meaningful relationship with, or interest in the folk costumes of the parishes that they had to wear during performances. A costume that has lost its personality, torn away from its roots, cheapens and devalues its originality and value, and possibly also its heritage community.
 Alongside the “colonising” attitude of the scientific communities and instances of appropriation born from poor knowledge, we can also speak of the attitude of more emancipated Estonians – distanced from their roots, towards rural life and its representatives, as well as folk culture in general. What to do in these cases, when progressive citizens, tired of city life for one reason or another, are moving to rural places to build a new life? They may feel sympathy for, and even interest in the local community and culture, but their value systems, lifestyle, habits and envisioning often do not coincide with those of the local “natives”. The question arises: at what point does the bona fide exploitation and marketing of local heritage cross the boundary of being disturbing to genuine local people?
 Keywords: cultural appropriation, indigenous peoples, self-colonisation in Estonia

The Weierstrass–Durand–Kerner root finder is not generally convergent

Finding roots of univariate polynomials is one of the fundamental tasks of numerics, and there is still a wide gap between root finders that are well understood in theory and those that perform well in practice. We investigate the root-finding method of Weierstrass, also known as the Durand–Kerner-method: this is a root finder that tries to approximate all roots of a given polynomial in parallel. This method has been introduced 130 years ago and has since then a good reputation for finding all roots in practice except in obvious cases of symmetry. Nonetheless, very little is known about its global dynamics and convergence properties. We show that the Weierstrass method, like the well-known Newton method, is not generally convergent: there are open sets of polynomials p p of every degree d ≥ 3 d \ge 3 such that the dynamics of the Weierstrass method applied to p p exhibits attracting periodic orbits. Specifically, all polynomials sufficiently close to Z 3 + Z + 175 Z^3 + Z + 175 have attracting cycles of period 4 4 . Here, period 4 4 is minimal: we show that for cubic polynomials, there are no periodic orbits of length 2 2 or 3 3 that attract open sets of starting points. We also establish another convergence problem for the Weierstrass method: for almost every polynomial of degree d ≥ 3 d\ge 3 there are orbits that are defined for all iterates but converge to ∞ \infty ; this is a problem that does not occur for Newton’s method. Our results are obtained by first interpreting the original problem coming from numerical mathematics in terms of higher-dimensional complex dynamics, then phrasing the question in algebraic terms in such a way that we could finally answer it by applying methods from computer algebra. The main innovation here is the translation into an algebraic question, which is amenable to (exact) computational methods close to the limits of current computer algebra systems.

College Students’ Perceptions of Ambiguous Hook-ups Involving Alcohol Intoxication

Alcohol intoxication is a prevalent feature of university life and campus sexual assault cases. While previous research has examined how students perceive obvious cases of assault, less is known about how students evaluate more ambiguous sexual scenarios—such as those including two intoxicated individuals. In three survey experiments with college students (N = 990), we examined how manipulating the intoxication (sober vs. drunk) of a man accused of assault (the respondent) influenced perceptions of a hook-up scenario involving an intoxicated woman. Although university policies indicate that respondent intoxication should not influence evaluations of these scenarios, we hypothesized that students would be influenced by cues of respondent intoxication when making judgments of the hook-up and the individuals involved. Students reported that the hook-up was a sexual assault more often when the respondent was sober compared to when he was drunk, and they found sober respondents more responsible for the encounter than drunk respondents. Although effect sizes fluctuated across studies, an internal meta-analysis found evidence of significant (but modest) aggregate effects. Furthermore, perceptions of the respondent’s agency mediated the effects of intoxication on perceptions of respondent responsibility (Studies 2 & 3). We also manipulated whether the respondent should have reasonably known the complainant was drunk (Studies 1 & 2) and whether the complainant or the complainant’s friend reported the incident (Study 3), but these manipulations had little effect on students’ perceptions of the vignettes. We discuss how our findings can guide future research and consider implications of our results for university stakeholders.

What Inspiring Elements from Natural Services of Water Quality Regulation Could Be Applied to Water Management?

Theoretical and functional ecology is a source of useful knowledge for ecological engineering. The better understanding of the natural service of water quality regulation is now inspiring for optimization of water resource management, restoration and bioremediation practices. This transfer with a biomimicry approach applies particularly well in the urban, rural and agricultural areas, but is yet underexplored for water quality purposes. This natural service intensely involves the benthic boundary layer as a biogeochemical hot spot with living communities. A selection of processes related to the bioturbation phenomena is explored because of their influence on properties of the aquatic environment. The applications are valuable in a range of fields, from water treatment technology to management of ecosystems such as constructed and natural wetlands, streams, rivers, lagoons and coastal ecosystems. This paper gathers the more obvious cases of potential applications of bioturbation research findings on the biomimicry of natural services to water practices. These include pollution pumping by bioturbated sediment, water column oxygen saving during early diagenesis of deposits under conveyors transport and conservation of macroporous as well as fine sediment. Some applications for constructed devices are also emerging, including infiltration optimization and sewage reduction based on cross-biological community involvement.

An increased potential for organ donors may be found among patients with out-of-hospital cardiac arrest

IntroductionA prehospital system where obvious futile cases may be terminated prehospitally by physicians may reduce unethical treatment of dying patients. Withholding treatment in futile cases may seem ethically sound but may keep dying patients from becoming organ donors. The objective of this study was to characterise the prehospital patients who underwent organ donation. The aim was to alert prehospital physicians to a potential for an increase in the organ donor pool by considering continued treatment even in some prehospital patients with obvious fatal lesions or illness.MethodsThis is a retrospective register-based study from the Region of Southern Denmark. The prehospital medical records from patients who underwent organ donation after prehospital care from 1st of January 2016–31st of December 2020 were screened for inclusion. The outcome measures were prehospital diagnosis, vital parameters, and critical interventions.ResultsIn the five year period, one-hundred-and-fifty-one patients were entered into a donation process in the health region following prehospital care. Sixteen patients were excluded due to limitations in data availability. Of the 135 patients included, 36.3% had a stroke. 36.7% of these patients were intubated prehospitally. 15.6% had subarachnoideal haemorrhage. 66.7% of these were intubated prehospitally. 10.4% suffered from head trauma. 64.3% of these patients were intubated at the scene. In 21.5% of the patients, the prehospitally assigned tentative diagnosis was missing or included a diverse spectrum of medical and surgical emergencies. Twenty-two patients (16.3%) were resuscitated from cardiac arrest. 81.8% were intubated at the scene.ConclusionThe majority of the patients who became organ donors presented prehospitally with intracranial pathology. However, 30% of the patients that later underwent an organ donation process had other prehospital diagnoses. Among these, one patient in six had out-of-hospital cardiac arrest. Termination of treatment in patients with cardiac arrest is not uncommon in physician-manned prehospital emergency medical systems. An organ donation process cannot be initiated prehospitally but can be shut down if treatment is withheld or terminated. We contend that there is a potential for enlarging the donor pool if the decision processes in out-of-hospital cardiac arrest include considerations concerning future procurement of organ donors.

The “Worst Dinner Guest Ever”

In 2012, a Venn diagram appeared on the blog The Kitchn detailing the characteristics of what it called the “worst dinner guest ever.” This maligned guest is not only vegan but also gluten and lactose intolerant and allergic to nuts and eggs. While a few commenters agreed with the implication that dietary constraints indicate a failure of appropriate guest behavior, most echoed what Lisa Heldke and Raymond Boisvert (2016) suggest is the dominant American view: hosts are generally obliged to accommodate the dietary restrictions of their guests. For Heldke and Boisvert, this is most obviously true when guests have food allergies and serious harm can be easily avoided by a change in menu. In this essay I argue that epistemic barriers can obscure hosts’ perception of these ostensibly obvious cases, preventing them from fulfilling their obligations. Specifically, I argue that guests with food allergies and other “gut issues” can be subject to testimonial injustice that undermines their credibility, leading hosts to doubt or disbelieve their need for accommodation. Such guests may also be subject to testimonial smothering, discouraging them from disclosing their dietary restrictions in the first place. I argue that these forms of epistemic injustice raise multiple moral concerns and that hosts have a responsibility to practice epistemic humility regarding guests’ reports of gut issues. Overall, this paper aims to enable hosts and guests with gut issues alike to recognize and overcome epistemic obstacles to good hospitality—the importance of which extends far beyond the dinner table.

“DNA Evidence and the Islamic Law of Paternity in Light of Maqāṣid al‐Sharīʿa”

AbstractThe protection of progeny (nasl) is one of the five universal ends (al‐maqāṣid al‐kulliyya al‐khams) of Islamic law. Despite this principle, classical Islamic law (fiqh), with very limited exceptions, barred affiliating a child conceived through illicit intercourse to the child’s biological father, even if his identity was known. Was this based on a pragmatic recognition of the impossibility of identifying the “true” biological father of any child or a commitment to a deeper principle? If the former, the reliability of DNA testing would require a change in the rule, but if the latter, DNA’s reliability would be irrelevant. Using primarily examples drawn from the Mālikī school of law, this paper argues, based on a purposive reading of those rules, that biological paternity, while important to Islamic law’s juridical conception of paternity, was not always the most important legal value at stake. Rather, preserving a child’s presumptive affiliation to the mother’s legitimate sexual partner was also a crucial legal value that could carry greater weight than biological paternity when the two conflicted. The tendency to entrench the biological mother’s legitimate sexual partner as the child’s lawful father in all but the most obvious cases of adulterous conception suggests that for pre‐modern Islamic law, the best interests of the child weighed heavily in the law of paternity. In modern circumstances, therefore, DNA evidence of biological paternity, while it should be admissible to establish paternity of illegitimate children born to unmarried women, should not be admissible in cases involving children born to married women. Muslim states could also use DNA evidence of paternity to establish the monetary responsibility of adulterous fathers for their illegitimate children while denying them the benefits of legal paternity. Muslim states, in recognition of the importance of the well‐being of the child, might also reconsider their laws on adoption, by introducing distinctions between adoptive parents and children, on the one hand, and parents and children related by nasab, on the other hand.

Probabilistic Pocket Druggability Prediction via One-Class Learning.

The choice of target pocket is a key step in a drug discovery campaign. This step can be supported by in silico druggability prediction. In the literature, druggability prediction is often approached as a two-class classification task that distinguishes between druggable and non-druggable (or less druggable) pockets (or voxels). Apart from obvious cases, however, the non-druggable class is conceptually ambiguous. This is because any pocket (or target) is only non-druggable until a drug is found for it. It is therefore more appropriate to adopt a one-class approach, which uses only unambiguous information, namely, druggable pockets. Here, we propose using the import vector domain description (IVDD) algorithm to support this task. IVDD is a one-class probabilistic kernel machine that we previously introduced. To feed the algorithm, we use customized DrugPred descriptors computed via NanoShaper. Our results demonstrate the feasibility and effectiveness of the approach. In particular, we can remove or mitigate biases chiefly due to the labeling.

Micronutrients as Adjunctive Treatment for Bipolar Disorder: A Randomized, Double-Blinded, Controlled Trial

ObjectivesAn open label trial had suggested that a comprehensive micronutrient supplement, Empower Plus Advanced, in combination with Fish Oil, would be helpful in reducing symptom burden in adults diagnosed with bipolar disorder.MethodsWe designed a double-blinded, randomized, controlled feasibility trial to explore the parameters necessary to mount a large-scale clinical trial. We aimed to enroll 97 participants and randomize in a 3:2 ratio to Vitamins or Placebo. We recruited patients from a family medicine residency clinic in Maine who were diagnosed in the electronic health record as having bipolar disorder. Diagnoses were confirmed via psychiatric interview or chart review (for obvious cases). The primary outcome measures were changes on the clinical global impressions scale (CGI), changes on the UKU Side Effects Scale, and changes in medications doses.ResultsA total of 69 patients were actually randomized and data were analyzed for 49 patients. The cost per participant was higher than expected due to increased regulatory requirements imposed by our Institutional Review Board (IRB) related to concerns about the hazards of micronutrient supplementation for psychiatric patients. In non-parametric chi-square analysis, significantly more patients in the Vitamin group improved on the CGI over the course of their participation in the study (p = 0.04). However, in parametric analysis the average improvement was not statistically significant between the two groups. All patients showed significant improvement over time in CGI (p = 0.0001) with statistically significant reductions in medication doses and side effects. The only adverse events occurring more among the Intervention group were nausea and loose stools but were not statistically significant.ConclusionsWe suspect the benefits of closer surveillance, medication adjustment (mostly reduction), and human contact overshadowed the potential benefits of micronutrients. Future studies would do well to use a four-month lead-in period during which medications can be adjusted and participants can decide if they are willing to take vitamins for an extended time. Our data suggest that primary care patients with bipolar disorder would fare better on lower medications doses and more frequent visits. Further clinical trials are warranted.Funding SourcesThe Foundation for Excellence in Mental Health.

Origami-Based Design for 4D Printing of 3D Support-Free Hollow Structures

The integration of additive manufacturing (AM) in design and engineering has prompted a wide spectrum of research efforts, involving topologically optimized solid/lattice structures, multimaterial structures, bioinspired organic structures, and multiscale structures, to name a few. However, except for obvious cases, very little attention has been given to the design and printing of more complex three-dimensional (3D) hollow structures or folded/creased structures. One of the main reasons is that such complex open or closed 3D cavities and regular/freeform folds generally lead to printing difficulties from support-structure-related issues. To address this barrier, this paper aims to investigate four-dimensional (4D) printing as well as origami-based design as an original research direction to design and build 3D support-free hollow structures. This work consists of describing the rough 3D hollow structures in terms of two-dimensional (2D) printed origami precursor layouts without any support structure. Such origami-based definitions are then embodied with folding functions that can be actuated and fulfilled by 3D printed smart materials. The desired 3D shape is then built once an external stimulus is applied to the active materials, therefore ensuring the transformation of the 2D origami layout to 3D structures. To demonstrate the relevance of the proposal, some illustrative cases are introduced.

Brak wątpliwości co do okoliczności czynu i winy oskarżonego jako przesłanka postępowania nakazowego w polskim procesie karnym. Uwagi na tle wyroku Sądu Najwyższego z dnia 27 kwietnia 2021 r., V KK 374/20

The publication concerns the lack of doubts as to the circumstances of the act and guilt of the accused as premises for the injunction proceedings in the Polish criminal trial. The starting point for the author’s considerations is the view expressed by the Supreme Court in the judgment of 27 April 2021, V KK 374/20, that the injunction proceedings are a special institution of procedural law, the application of which has been provided for the most obvious cases, when the evidence submitted with the act of the accusation is so unequivocal that it does not raise any doubts as to the guilt of the accused and the circumstances of the alleged act. It also expressed the opinion that the absence of these doubts means that they do not exist as regards the perpetration of a given act, the defendant’s guilt, and the fulfillment of all the features of this act listed in the provisions of substantive criminal law, taking into account all the evidence on which the indictment was based. Otherwise, it is necessary to consider the case at the main hearing

62 The Impact of ICD10 on the Incidence of Abuse in the National Burn Repository

IntroductionPreviously, cases of abuse may only have been coded as such when the investigation was complete, thus skewing the data available in the National Burn Repository (NBR) toward more severe or obvious cases of abuse. The introduction of the ICD10 coding system in 2015 brought with it the concept of “confirmed” and “suspected” cases of abuse. We hypothesized that the creation of these two categories might shift our understanding of non-accidental pediatric burn injuries.MethodsWe queried the NBR, a retrospective database maintained by the American Burn Association (ABA) which contains data submitted by all ABA-verified burn centers as well as some non-verified centers, for all children under the age of 18. Data were cleaned using e-codes where appropriate. To create equal samples, we created two cohorts: the ICD-9 sample comprises all children treated from 2012-2014, and the ICD-10 sample includes all children treated from 2016 to 2018. Data from 2015 were omitted as the ICD-10 coding system was introduced part way through the year.ResultsA total of 34,456 patients are included in the sample, including 18,783 (54.5%) in the ICD-9 group and 15,673 in the ICD-10 group. The most common causes of injury in both eras was scald (48.7% in ICD-9 and 55.2% in ICD-10), followed by fire/ flame (20.3% in ICD-9 and 20.9% in ICD-10). The overall rate of abuse (including both suspected and confirmed abuse in the ICD-10 group) was higher in the ICD-9 era than the ICD-10 era (4.2 vs 3.2%, p< 0.001). As seen in previous studies, children with injuries due to abuse were younger (median age 2.0 vs 3.0 years, p< 0.001), had a larger median burn size (3.0 vs 5.0%, p< 0.001), a longer hospital length of stay (2.0 vs 4.0 days, p< 0.001), and a higher rate of mortality (0.8 vs 0.5%, p< 0.001). In the ICD-10 cohort, only 17 cases were coded as “confirmed” abuse (0.1%) and 478 were coded as “suspected” (3.0%). In contrast, in the ICD-9 group, 789 patients (4.2%) were coded as being victims of abuse.ConclusionsWe expected that adoption of ICD-10, with its ability to yield increased data granularity, would yield a higher overall incidence of injury. Specifically, we expected more patients with smaller injuries to be included in the new “suspected” category, given the lower threshold to apply that diagnosis. However, this was not demonstrated in the NBR dataset, and in fact the overall incidence of abuse decreased. Given the added layers of complexity within the ICD-10 system, it is possible that the differences reflect challenges in coding cases of abuse rather than actual epidemiological changes.

Magnum Opus: The Cycle Plays of Eugene O'neill

Magnum Opus: The Cycle Plays of Eugene O'neill

Forensic Accounting: A Novel Paradigm and Relevant Knowledge in Fraud Detection and Prevention

ABSTRACT Forensic accounting is a new trend that goes beyond normal audit approaches and procedures for fraud identification. The practice applies reliable principles and methods to obtain sufficient facts or data that provide basis for prosecution in the law court. Forensic accountants characteristically need adequate know-how and skills for investigation and proactive audit to control fraud. With globalization of the economy, fraudsters can be found in any organization. These criminals take advantage of loopholes such as suspicious financial statement, defective internal controls, and poor corporate governance. Hence, there is a great need for skilled forensic accountants to detect, prevent and expose the weak system. The professionals can exercise their mandate by reporting the obvious cases of fraud committed to a law court for prosecution.

Letters From Our Readers.

To: Editor, The Angle OrthodontistRe: Response to: Value-addition of lateral cephalometric radiographs in orthodontic diagnosis and treatment planning by Anjali Dinesh, Sunil Mutalik, Jonathan Feldman, and Aditya Tadinada. Angle Orthod. 2020;90:665-671.Thank you for reading our work and for your comments on the study. We fully recognize the value of a lateral cephalometric exam and agree with your list of observations. Please recognize that our conclusions are based on the study we conducted and the readers must appreciate the context as well as the limitations of the study. The key point our study was trying to convey to the reader is to alert the clinician to stop and consider the risk vs benefit analogy for exposing vulnerable population groups to ionizing radiation. The most important principle of radiation safety is “As Low as Reasonably Achievable” (ALARA). This is of particular importance in orthodontic patients who are more vulnerable to ionizing radiation than older individuals.The topic we studied is not a particularly new one but the timing of the study is valuable especially since it comes at a time when CBCT is being increasingly used for complex cases. Some of the studies that have asked a similar question, like the study by Silling et al1 dates back to 1979 where they found that, for obvious cases, lateral cephalometric exams were not necessary but might be necessary for complicated cases. At the time of that study, the option of using CBCT for challenging cases did not exist. Today, if we had a complicated case, it might require extensive analysis with the help of digital models and 3-D images and we typically plan the treatment roadmap during clinical evaluation. But the studies done by Devereux et al2 in 2011 showed that the lateral cephalometric image did not have a significant impact on treatment. Similarly, Stupar et al3 in 2016 showed that lateral cephalometric images had no influence on their extraction treatment planning decisions. These variations in literature show that every case is unique in its own way where a lateral cephalometric exam or a CBCT exam could be helpful based on the case and a case-specific imaging decision spares individuals from unnecessary radiation exposure.We particularly appreciate your observation regarding incidental findings and would like to take the opportunity to emphasize the value of adequately evaluating the entire image if 2-D, and the entire volume of data if 3D, for identifying and diagnosing incidental findings for appropriately triaging the condition.

Is Anyone Representing Non-resident Finnish Citizens in the Legislative Process of Finland?

This research paper examines the instances of representation of the expatriate Finnish citizen in the different stages of the legislative process in Finland: the preparation of law bills, the process in the Parliamentary committees and in the plenary sessions of the Finnish Parliament Eduskunta. The aim is to answer the questions how many and what kind of expatriate Finns issues there has been on the political agenda, when those issues were there, and who acted for the expatriates then. Here, the research approach is descriptive. Newly digitalized collections of legislative documents create novel opportunities to seek efficiently through a large number of records and find topics that have not gained much attention, in addition to the more obvious cases such as the dual citizenship or recently the postal voting. In Finland, the Finnish diaspora has not been a fervently debated issue and it is only rarely mentioned in the plenary debates of the Parliament. The data includes two kinds of sources, actions by the MPs and Government bills. In the Finnish case, the number of relevant documents is small. Therefore, including different types of text into a single study is necessary to find out the political forces that have influence on the issues concerning the Finnish citizen abroad.

A Myocardial Segmentation Method Based on Adversarial Learning.

Congenital heart defects (CHD) are structural imperfections of the heart or large blood vessels that are detected around birth and their symptoms vary wildly, with mild case patients having no obvious symptoms and serious cases being potentially life-threatening. Using cardiovascular magnetic resonance imaging (CMRI) technology to create a patient-specific 3D heart model is an important prerequisite for surgical planning in children with CHD. Manually segmenting 3D images using existing tools is time-consuming and laborious, which greatly hinders the routine clinical application of 3D heart models. Therefore, automatic myocardial segmentation algorithms and related computer-aided diagnosis systems have emerged. Currently, the conventional methods for automatic myocardium segmentation are based on deep learning, rather than on the traditional machine learning method. Better results have been achieved, however, difficulties still exist such as CMRI often has, inconsistent signal strength, low contrast, and indistinguishable thin-walled structures near the atrium, valves, and large blood vessels, leading to challenges in automatic myocardium segmentation. Additionally, the labeling of 3D CMR images is time-consuming and laborious, causing problems in obtaining enough accurately labeled data. To solve the above problems, we proposed to apply the idea of adversarial learning to the problem of myocardial segmentation. Through a discriminant model, some additional supervision information is provided as a guide to further improve the performance of the segmentation model. Experiment results on real-world datasets show that our proposed adversarial learning-based method had improved performance compared with the baseline segmentation model and achieved better results on the automatic myocardium segmentation problem.

Can Epicardial Adipose Tissue be Defined as an Early Marker of Treatment Decisions of Subclinical Hypothyroidism in Childhood?

Introduction and Aim: Childhood overt hypothyroidism is a chronic disease that affect many system adversely and requires treatment. However, Subclinical Hypothyroidism (SH), defined obvious cases, impacts on other systems are unknown and there is no common approach to be treated. Moreover, SH may continue for many years, before they become overt hypothyroidism. Cardiovascular System (CVS) is one of the host system, which hypothyroidism adversely affects. Epicardial Adipose Tissue Thickness (EAT) is known to be an important marker in terms of the cardiovascular risks. We aimed to determine the effects on CVS in children with SH. Material and Methods: The study included were 100 cases, which are 1-18 years had categorized in two groups; control group (50 children), who had no signs of thyroidal dysfunction and case group (50 children) who had diagnosed with SH, are recruited in the study. SH was diagnosed according to the slightly higher TSH than the upper limit (4.2M/L), normal free T4 and T3 levels. Medical treatment (LT4) was decided according to the levels of TSH, sT3, sT4 and clinical status. EAT was determined by transthoracic echocardiographic measurements in millimeters. The SH cases were classified into two groups in terms of medical treatment. EAT thickness was measured in patients with treated group (SH1) and non-treated group (SH2) at admission (EAT0) and at 6 months (EAT 6). Results: Epicardial adipose tissue thickness was significantly higher in SH children, than the children without thyroid dysfunction. The mean value of the EAT in control group was 2,11±0,52 mm. Mean of EAT0 was 4,08±1,41 in group SH1, mean of EAT0 was 4,31±1,09 mm in group SH2. In addition, mean of EAT6 was 3.65±1,27 mm in group SH1 and mean of EAT6 was 4,16±1,10 in group SH2. Although there were a decrease in both group SH1 and SH2, at EAT6 compared to the EAT0, and this decrease was more significant in group SH1.

Can Epicardial Adipose Tissue be Defined as an Early Marker of Treatment Decisions of Subclinical Hypothyroidism in Childhood?

Introduction and Aim: Childhood overt hypothyroidism is a chronic disease that affect many system adversely and requires treatment. However, Subclinical Hypothyroidism (SH) ,defined obvious cases, impacts on other systems are unknown and there is no common approach to be treated. Moreover, SH may continue for many years, before they become overt hypothyroidism. Cardiovascular System (CVS) is one of the host system, which hypothyroidism adversely affects. Epicardial Adipose Tissue thickness (EAT) is known to be an important marker in terms of the cardiovascular risks. We aimed to determine the effects on CVS in children with SH. Material and Methods: The study included were 100 cases, which are 1-18 years had categorized in two groups; control group (50 children), who had no signs of thyroidal dysfunction and case group (50 children) who had diagnosed with SH, are recruited in the study. SH was diagnosed according to the slightly higher TSH than the upper limit (4.2M/L), normal free T4 and T3 levels. Medical Treatment (LT4) was decided according to the levels of TSH, sT3, sT4 and clinical status. EAT was determined by transthoracic echocardiographic measurements in millimeters. The SH cases were classified into two groups in terms of medical treatment. EAT thickness was measured in patients with treated group (SH1) and non-treated group (SH2) at admission (EAT0) and at 6. months (EAT 6). Results: Epicardial adipose tissue thickness was significantly higher in SH children, than the children without thyroid dysfunction. The mean value of the EAT in control group was 2,11 ± 0,52mm. Mean of EAT0 was 4,08 ± 1,41 in group SH1, mean of EAT0 was 4,31 ± 1,09mm in group SH2. In addition, mean of EAT6 was 3.65 ± 1,27mm in group SH1 and mean of EAT6 was 4,16 ± 1,10 in group SH2. Although there were a decrease in both group SH1 and SH2, at EAT6 compared to the EAT0, and this decrease was more significant in group SH1. Discussion: This study suggests that subclinical hypothyroidism effects adversly the cardiovascular system in children before hypothyroidism become overt. In future this data may be marker at the begining of LT4 treatment in children with SH.