In cosmetic surgery, bridging the anticipation gap between the patients and the physicians can be challenging if there lacks objective and transparent information exchange during the decision-making and surgical process. Among all factors, facial symmetry is the most important for assessing facial attractiveness. The aim of this work is to promote communications between the two parties by providing a quadruple of quantitative measurements: overall asymmetry index (oAI), asymmetry vector, classification, and confidence vector, using an artificial neural network classifier to model people’s perception acquired from visual questionnaires concerning facial asymmetry. The questionnaire results exhibit a Cronbach’s Alpha value of 0.94 and categorize the respondents’ perception of each stimulus face into perceived normal (PN), perceived asymmetrically normal (PAN), and perceived abnormal (PA) categories. The trained classifier yields an overall root mean squared error < 0.01, and its result shows that the oAI is, in general, proportional to the degree of perceived asymmetry. However, there exist faces that are difficult to classify as either PN or PAN or either PAN or PA with competing confidence values. In such cases, oAI alone is not sufficient to articulate facial asymmetry. Assisting surgeon–patient conversations with the proposed asymmetry quadruple is advised to avoid or to mitigate potential medical disputes.
Introduction . Nonalcoholic fatty liver disease (NAFLD) is becoming more common around the world and it may progress to cirrhosis and liver failure, increasing mortality risk. In hemodialysis (HD) patients, NAFLD may be a novel risk factor for their high cardiovascular mortality. Heightened oxidative stress is highly prevalent in HD patients. However, the relationship between oxidative stress and NAFLD in HD patients is not well defined. Methods . We studied seventy-one stable nondiabetic HD patients. Nineteen patients had the diagnosis of NAFLD by ultrasonography. Blood levels of oxidative stress markers were measured in each patient, including thiobarbituric acid reactive substances (TBARS), free thiols, superoxide dismutase (SOD) activities, and glutathione peroxidase (GPx) activity. The copy numbers of mitochondrial DNA (mtDNA) in peripheral leukocytes were also determined. Demographic, biochemistry, and hemogram data were recorded. The two groups of patients were compared in order to determine the factors associated with NAFLD in HD patients. Findings . Compared to those without NAFLD, nondiabetic HD patients with NAFLD had significantly higher mtDNA copy number and GPx levels. The two groups did not differ significantly in dialysis adequacy, hemoglobin, serum calcium, phosphorus, albumin, liver function tests, or lipid profiles. Regression analysis confirmed mtDNA copy numbers and GPx levels as two independent factors associated with NAFLD. Compared to those with polysulfone, patients dialyzed with cellulose membrane have significantly higher levels of TBARS. However, patients with or without NAFLD did not differ in their use of either dialysis membrane. Discussion . Oxidative stress (represented by antioxidant defense, GPx) and mitochondrial DNA copy numbers are independently associated with fatty liver disease in nondiabetic HD patients. The diagnostic and therapeutic implications of this key observation warrant further exploration.
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