Spectrum of Skin Manifestations in CKD: A Tertiary Care Center Experience from North India

Introduction: Dermal manifestations in chronic kidney disease (CKD) patients may range from mild ones, like xerosis, skin pallor, pruritus, coated tongue, superficial infections and hair and nail changes, to severe life-threatening ones, like nephrogenic systemic fibrosis, which is a rare entity in current times. The present study was done to evaluate the spectrum of mucocutaneous manifestations in patients with CKD and to look for an association between them and various biochemical parameters and inflammatory markers. Material and methods: This study was a 1 year prospective, observational study conducted on adult patients with CKD who presented to the Nephrology clinic in Pt. BD Sharma PGIMS, Rohtak. Patients between the ages of 17 and 75 years with CKD stages II or more with dermatological conditions were included in this study. Each participant was subjected to detailed clinical, biochemical, radiological and dermatological examination by same consultants in order to avoid interpersonal variations. Various skin, mucosal, nail and hair manifestations along with cutaneous infections were analyzed across the spectrum of CKD. Results: Among cutaneous infections, fungal infections predominated, amongst which, onychomycosis was the most common. Xerosis was the most common dermatological disease and the prevalence of xerosis, skin pallor and pruritus was found to increase significantly from Stage II to Stage V and VD of CKD in a statistically significant manner. An association was found between xerosis and decreasing levels of hemoglobin and while ferritin was not different between patients with and without xerosis, high-sensitivity C-reactive protein (hs-CRP) was significantly higher in patients with xerosis. Similarly, hs-CRP levels were significantly elevated in patients with xerostomia and nail pallor as compared with those who did not have these conditions. Lastly, patients with nail pallor had significantly lower albumin. Conclusion: It was observed in our study that in CKD patients on hemodialysis and on conservative management, xerosis, pruritus, pigmentation, nail changes, oral mucosa changes and cutaneous infections were the predominant cutaneous manifestations. In patients with CKD, mucocutaneous manifestations progressively worsened as renal function deteriorated

Steady-state Flow Solutions for Delta Wing Configurations at High Angle of Attack using Implicit Schemes

Finding fully converged, steady-state solutions of the compressible Reynolds Averaged Navier-Stokes (RANS) equations for aerodynamic configurations on the border of the flight envelope often poses serious challenges to solution algorithms that have proven robust and successful for configurations at cruise conditions. Examples of such cases are agile configurations at high angles of attack. When trying to compute solutions in these scenarios, one often observes that the solution process breaks down after few iterations or that a steady-state RANS solution, although it may exist, cannot be reached with the employed solution algorithm. While, in general, no clear reason for this behavior can be identified, the complexity of these flows seems to be significantly greater compared to flows around transport aircraft in cruise flight. The flow fields are dominated by the interaction of shock waves with a system of vortices emanating from the leading edges on the upper surface of the wing, leading to massive flow separation. These flow features tend to be inherently unsteady and can be assumed to cause problems in computing a converged solution using an algorithm designed to find steady-state solutions of the RANS equations. To avoid these problems, it is not uncommon to calculate such configurations in an unsteady mode, which often comes at a rather high computational cost. This article demonstrates the necessity for implicit smoothers to approximate fully converged solutions of these challenging simulations. A numerical example is given to confirm that convergence is only possible using an exact derivative together with a suited preconditioner

Gangotri glacier dynamics from multi-sensor SAR and optical data

The present study has analyzed dynamics of Gangotri glacier using multiple remote sensing (RS) datasets and ground based observations. Interferometric Synthetic Aperture Radar (InSAR) data pairs from European Remote Sensing satellite (ERS 1/2) tandem pair for spring of 1996, Sentinel-1 SAR pairs and Japanese's Advance Land Observation System (ALOS) PALSAR-2 SAR data for Spring of 2015 were used to derive glacier-surface velocity at seasonal time scale using Differential InSAR (DInSAR) techniques. Bi-static TanDEM-X (Experimental) data was used for the 1st time to estimate glacier surface elevation changes for a period of 22, 44, 88 days during summer of 2012 using InSAR techniques in this study. Annual glacier velocity was also estimated using temporal panchromatic data of LANDSAT-5 (30 m), LANDSAT-7/8 (15 m), Sentinel-2 (10 m) and Indian Remote Sensing Satellite IRS-1C/1D panchromatic (5 m) data during 1998–2019 with feature tracking approach. This study has estimated glacier surface velocity and surface elevation changes for the major parts of Gangotri glacier and its tributary glaciers using medium to high resolution optical and SAR datasets, at annual and seasonal time scale, which is an improvement over earlier studies, wherein snout based glacier recession or only main glacier velocities were reported. The velocity and slope were used to assess glacier-ice thickness distribution using Glabtop-2, slope dependent and laminar flow based methods over the Gangotri group of glaciers. The estimated ice thickness was estimated in the range of 58–550 m for the complete glacier while few small areas in middle &amp; upper regions carry higher thickness of about 607 m. The estimated glacier-ice thickness was found in the range of 58–67 m at the snout region. The estimation was validated using 2014 field measurements from Terrestrial Laser Scanner (TLS) for the first time and correlation was found to be 0.799 at snout of the glacier.</p

Breast Cancer Immunohistochemical Image Generation: a Benchmark Dataset and Challenge Review

For invasive breast cancer, immunohistochemical (IHC) techniques are often used to detect the expression level of human epidermal growth factor receptor-2 (HER2) in breast tissue to formulate a precise treatment plan. From the perspective of saving manpower, material and time costs, directly generating IHC-stained images from hematoxylin and eosin (H&E) stained images is a valuable research direction. Therefore, we held the breast cancer immunohistochemical image generation challenge, aiming to explore novel ideas of deep learning technology in pathological image generation and promote research in this field. The challenge provided registered H&E and IHC-stained image pairs, and participants were required to use these images to train a model that can directly generate IHC-stained images from corresponding H&E-stained images. We selected and reviewed the five highest-ranking methods based on their PSNR and SSIM metrics, while also providing overviews of the corresponding pipelines and implementations. In this paper, we further analyze the current limitations in the field of breast cancer immunohistochemical image generation and forecast the future development of this field. We hope that the released dataset and the challenge will inspire more scholars to jointly study higher-quality IHC-stained image generation.Comment: 13 pages, 11 figures, 2table

Exposure, hazard and risk mapping during a flood event using open source geospatial technology

After a flood event there is a need to delineate the hazard footprint as quickly as possible in order to assess the magnitude of losses and to plan for the relief operations. Delineation of such hazard footprint is generally hindered by the lack of geospatial data, technology and related software packages. This paper demonstrates the use of open source data and software packages which can be used to implement most recent technology available for flood hazard footprint delineation. This study utilizes open source software packages and web applications like Geographic Resource Analysis Support System, Quantum geographic information system and Google Earth to implement a complete process of hazard mapping using remotely sensed data which include pre-processing, mapping (both hazard and exposure) and accuracy assessment. In this study, Brisbane flood event of 2011 has been taken as a case study. For built-up extraction, the Landsat 7-band image has been transformed to a stack of 3-band image using vegetation, water and built-up indices. It has been observed by scattergram analysis that these transformations make vegetation, water and built-up classes more separable. Built-up area has been delineated using supervised maximum likelihood classification on the new 3-band image. For flood hazard mapping, thresholding of near-infrared band has been utilized along with the assistance of mid-infrared band to discriminate water from built-up classes. After delineating both exposure and hazard map, final risk map due to flood event has been generated to assess the urban exposure under the flood hazard impact

Moleshare (Spring 2018) - Interface Mockup Design

Moleshare mobile application uses crowd sourcing for the identification of suspicious moles in a "Hot or Not" swipe-style app. Users can review and flag posts and submit their own images. The app provides information about mole identification and gives users peace of mind about concerning moles. Our Problem: An estimated 178,560 cases of melanoma will be diagnosed in the U.S. in 2018 and melanoma is the deadliest form of skin cancer, killing around 10,000 annually. On average, a person's risk of melanoma doubles after five sunburns. However, the five-year survival rate when detected early is about 99% in the U.S. Our Solution: Crowd sourcing the identification of suspicious moles in a "Hot or Not" swipe-style app where users can review and flag posts as well as submit their own, and to provide information about mole identification to give users peace of mind about concerning moles. Audience: Young adults who do not visit a dermatologist regularly; People in rural areas without easy access to dermatologists or information; Anyone with a potentially cancerous mole

Moleshare (Spring 2018) - Powerpoint Demonstration

Moleshare mobile application uses crowd sourcing for the identification of suspicious moles in a "Hot or Not" swipe-style app. Users can review and flag posts and submit their own images. The app provides information about mole identification and gives users peace of mind about concerning moles. Our Problem: An estimated 178,560 cases of melanoma will be diagnosed in the U.S. in 2018 and melanoma is the deadliest form of skin cancer, killing around 10,000 annually. On average, a person's risk of melanoma doubles after five sunburns. However, the five-year survival rate when detected early is about 99% in the U.S. Our Solution: Crowd sourcing the identification of suspicious moles in a "Hot or Not" swipe-style app where users can review and flag posts as well as submit their own, and to provide information about mole identification to give users peace of mind about concerning moles. Audience: Young adults who do not visit a dermatologist regularly; People in rural areas without easy access to dermatologists or information; Anyone with a potentially cancerous mole

Moleshare (Spring 2018) - One Sheet

Moleshare mobile application uses crowd sourcing for the identification of suspicious moles in a "Hot or Not" swipe-style app. Users can review and flag posts and submit their own images. The app provides information about mole identification and gives users peace of mind about concerning moles. Our Problem: An estimated 178,560 cases of melanoma will be diagnosed in the U.S. in 2018 and melanoma is the deadliest form of skin cancer, killing around 10,000 annually. On average, a person's risk of melanoma doubles after five sunburns. However, the five-year survival rate when detected early is about 99% in the U.S. Our Solution: Crowd sourcing the identification of suspicious moles in a "Hot or Not" swipe-style app where users can review and flag posts as well as submit their own, and to provide information about mole identification to give users peace of mind about concerning moles. Audience: Young adults who do not visit a dermatologist regularly; People in rural areas without easy access to dermatologists or information; Anyone with a potentially cancerous mole