Deep Fishing: Gradient Features from Deep Nets

Convolutional Networks (ConvNets) have recently improved image recognition performance thanks to end-to-end learning of deep feed-forward models from raw pixels. Deep learning is a marked departure from the previous state of the art, the Fisher Vector (FV), which relied on gradient-based encoding of local hand-crafted features. In this paper, we discuss a novel connection between these two approaches. First, we show that one can derive gradient representations from ConvNets in a similar fashion to the FV. Second, we show that this gradient representation actually corresponds to a structured matrix that allows for efficient similarity computation. We experimentally study the benefits of transferring this representation over the outputs of ConvNet layers, and find consistent improvements on the Pascal VOC 2007 and 2012 datasets.Comment: To appear at BMVC 201

Risk factors for deterioration of renal function after coronary artery bypass grafting

Abstract Objective: Various definitions of impairment of renal function after coronary artery bypass grafting (CABG) are used in the literature. Depending on the definition, several risk factors are identified. We analysed our data to determine the risk factors for postoperative deterioration of the creatinine clearance of 10% or more. Methods: All patients undergoing isolated coronary surgery in a single centre between January 1998 and December 2007 are included. Clinical data, including demographics and renal risk factors, were prospectively collected in our database. The most recent preoperative serum creatinine level and the maximum serum creatinine level within the first week postoperatively were used to calculate the creatinine clearance. A deterioration of 10% or more was considered to be an endpoint for this study. Results: In 10 098 out of a total of 10 626 patients, the preoperative as well as the postoperative creatinine clearance could be calculated. In 1053 patients, the deterioration of the creatinine clearance was 10% or more. We could identify the following risk factors: advanced age, diabetes, chronic obstructive pulmonary disease, peripheral vascular disease, emergency operation, previous cardiac surgery, low preoperative haemoglobin level, high preoperative C-reactive protein level, perioperative myocardial infarction, re-exploration and the number of blood transfusions. Conclusions: Risk factors for the deterioration of renal function after revascularisation have been confirmed in this study. In addition, we found peripheral vascular disease, previous cardiac surgery, low preoperative haemoglobin, increased preoperative C-reactive protein level, perioperative myocardial infarction and the number of blood transfusions to be risk factors that have not been described earlier

Transfusion of red blood cells: the impact on short-term and long-term survival after coronary artery bypass grafting, a ten-year follow-up.

Transfusion of red blood cells (RBC) and other blood products in patients undergoing coronary artery bypass grafting (CABG) is associated with increased mortality and morbidity. We retrospectively analyzed data of patients who underwent an isolated coronary bypass graft operation between January 1998 and December 2007. Mean follow-up was 1696±1026 days, with exclusion of 122 patients lost to follow-up and 80 patients who received 10 units of RBC. Of the remaining patients, 8001 (76.7%) received no RBC, 1621 (15.2%) received 1–2 units of RBC, 593 (5.7%) received 3–5 units and 220 (2.1%) received 6–10 units. The number of transfused RBC was a predictor for early but not for late mortality. When compared to expected survival, survival of patients not receiving any blood product was better, while survival of patients receiving >3 units of RBC was worse. Transfusion of RBC is an independent, dose-dependent risk factor for early mortality after revascularization. Compared to expected survival, receiving no RBC improves patient long-term survival, whereas receiving three or more units of RBC significantly decreases patient survival

Epidemic keratoconjunctivitis: efficacy of outbreak management

Purpose Epidemic keratoconjunctivitis (EKC) is one of the most severe ocular viral infections. The aim of this interruptive time series study was to quantitatively evaluate the effectiveness of a hygienic EKC outbreak management concept developed in our ophthalmological department. Methods All patients with suspected EKC in the period from August to November 2018 were included in the study. Data were retrospectively collected from the patient’s medical documents and records. The disease was diagnosed clinically and confirmed by virus detection through polymerase chain reaction (PCR) from conjunctival swabs. With the beginning of the epidemic, an outbreak management plan was implemented to reduce the nosocomial spread. Results The outbreak lasted 77 days (20th August 2018 to 4th November 2018) and affected a total of 120 patients. This corresponds to a mean of 1.5 patients per outbreak day. The median age was 58 [1–92] years. Of all patients, 61 (50.8%) were female. Conjunctival swabs were collected in 100/120 (83.3%) cases, the adenovirus being detected in all positive smears (63/63, 100%). The implementation of our outbreak management plan reduced significantly the number of EKC cases per outbreak day and resulted in a reduction of the basic reproduction number by a factor of 2.2. Conclusion The detection of EKC together with the immediate implementation of hygienic outbreak measures can significantly reduce the spread of infection. The implementation of a strict outbreak management concept can significantly reduce the number of EKC cases, thus avoiding possible complications and therefore unnecessary health-related costs

Biologicals and Fetal Cell Therapy for Wound and Scar Management

Few biopharmaceutical preparations developed from biologicals are available for tissue regeneration and scar management. When developing biological treatments with cellular therapy, selection of cell types and establishment of consistent cell banks are crucial steps in whole-cell bioprocessing. Various cell types have been used in treatment of wounds to reduce scar to date including autolog and allogenic skin cells, platelets, placenta, and amniotic extracts. Experience with fetal cells show that they may provide an interesting cell choice due to facility of outscaling and known properties for wound healing without scar. Differential gene profiling has helped to point to potential indicators of repair which include cell adhesion, extracellular matrix, cytokines, growth factors, and development. Safety has been evidenced in Phase I and II clinical fetal cell use for burn and wound treatments with different cell delivery systems. We present herein that fetal cells present technical and therapeutic advantages compared to other cell types for effective cell-based therapy for wound and scar management

Detection of Splenic Tissue Using Tc-99m-Labelled Denatured Red Blood Cells Scintigraphy-A Quantitative Single Center Analysis

Background: Red blood cells (RBC) scintigraphy can be used not only for detection of bleeding sites, but also of spleen tissue. However, there is no established quantitative readout. Therefore, we investigated uptake in suspected splenic lesions in direct quantitative correlation to sites of physiologic uptake in order to objectify the readout. Methods: 20 patients with Tc-99m-labelled RBC scintigraphy and SPECT/low-dose CT for assessment of suspected splenic tissue were included. Lesions were rated as vital splenic or non-splenic tissue, and uptake and physiologic uptake of bone marrow, pancreas, and spleen were then quantified using a volume-of-interest based approach. Hepatic uptake served as a reference. Results: The median uptake ratio was significantly higher in splenic (2.82 (range, 0.58-24.10), n = 47) compared to other lesions (0.49 (0.01-0.83), n = 7), p < 0.001, and 5 lesions were newly discovered. The median pancreatic uptake was 0.09 (range 0.03-0.67), bone marrow 0.17 (0.03-0.45), and orthotopic spleen 14.45 (3.04-29.82). Compared to orthotopic spleens, the pancreas showed lowest uptake (0.09 vs. 14.45, p = 0.004). Based on pancreatic uptake we defined a cutoff (0.75) to distinguish splenic from other tissues. Conclusion: As the uptake in extra-splenic regions is invariably low compared to splenules, it can be used as comparator for evaluating suspected splenic tissues

A krónikus bőrgyógyászati betegségek pszichológiai megközelítése – a pszichodermatológia szerepe, fő kihívásai és feladatai

A bőrbetegségeket világszerte a negyedik legnagyobb terhet jelentő, nem végzetes népegészségügyi problémákként azonosították, amelyek mind az érintettek, mind pedig az egészségügyi ellátórendszer számára komoly kihívást jelentenek. A bőrbetegségek kialakulásában és lefolyásában a pszichoszociális tényezők, a megterhelő életesemények és a stressz sok esetben komoly szerepet játszanak, elszenvedőit gyakran romló életminőség jellemzi, és igen gyakoriak a komorbid pszichoszociális zavarok. Az utóbbi időben növekszik a száma azoknak a szakirodalmi tanulmányoknak, amelyek a pszichodermatológiai betegségek osztályozásának egységesítése mellett érvelnek, a klinikai praxis színvonalának javítása, a bőrbetegséggel élők jobb megértése, valamint a különböző szakmák (bőrgyógyászok, háziorvosok, pszichiáterek, pszichológusok) közös fogalmi rendszerének kialakítása érdekében. E tanulmányok a pszichodermatológiai megbetegedéseket négy fő csoport és további alcsoportok szerint osztályozzák. Cikkünkben bemutatjuk az új osztályozási rendszerre tett javaslatokat, valamint a pszichodermatológia, vagy pszichokután medicina tudományterületét, interdiszciplináris szemléletmódját, amely célul tűzte ki, hogy egyaránt figyelmet fordít a bőrgyógyászati megbetegedések biológiai, pszichés, valamint szociális komponenseire. A klinikai praxis során a pszichodermatológiai szemléletmód és az interdiszciplináris – azaz komplex – kezelés hiányában sok esetben az érintett populáció állapotának stagnálását vagy romlását figyelhetjük meg. Ám a szakirodalmi eredmények alapján a pszichodermatológiai szemléletmód pszichoszociális tényezőinek integrálásával, például pszichoszociális állapotfelméréssel, és a hagyományos kezelést kiegészítő pszichoszociális kezelések segítségével a bőrgyógyászati megbetegedéssel küzdők állapota javítható. A bőrbetegséggel élők ellátásának javítására tett irány elvek szakirodalmi áttekintése alapján javasoljuk az egészségügyi ellátó személyzet és a szakemberek pszichodermatológiai edukációját, valamint a komplex ellátáshoz szükséges feltételek megteremtését

Prediction of TERTp-mutation status in IDH-wildtype high-grade gliomas using pre-treatment dynamic 18FFET PET radiomics

PURPOSE To evaluate radiomic features extracted from standard static images (20-40~min p.i.), early summation images (5-15~min p.i.), and dynamic 18FFET PET images for the prediction of TERTp-mutation status in patients with IDH-wildtype high-grade glioma. METHODS A total of 159 patients (median age 60.2~years, range 19-82~years) with newly diagnosed IDH-wildtype diffuse astrocytic glioma (WHO grade III or IV) and dynamic 18FFET PET prior to surgical intervention were enrolled and divided into a training (n = 112) and a testing cohort (n = 47) randomly. First-order, shape, and texture radiomic features were extracted from standard static (20-40~min summation images; TBR20-40), early static (5-15~min summation images; TBR5-15), and dynamic (time-to-peak; TTP) images, respectively. Recursive feature elimination was used for feature selection by 10-fold cross-validation in the training cohort after normalization, and logistic regression models were generated using the radiomic features extracted from each image to differentiate TERTp-mutation status. The areas under the ROC curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive value were calculated to illustrate diagnostic power in both the training and testing cohort. RESULTS The TTP model comprised nine selected features and achieved highest predictability of TERTp-mutation with an AUC of 0.82 (95{\%} confidence interval 0.71-0.92) and sensitivity of 92.1{\%} in the independent testing cohort. Weak predictive capability was obtained in the TBR5-15 model, with an AUC of 0.61 (95{\%} CI 0.42-0.80) in the testing cohort, while no predictive power was observed in the TBR20-40 model. CONCLUSIONS Radiomics based on TTP images extracted from dynamic 18FFET PET can predict the TERTp-mutation status of IDH-wildtype diffuse astrocytic high-grade gliomas with high accuracy preoperatively