Optimizing automated characterization of liver fibrosis histological images by investigating color spaces at different resolutions

Texture analysis (TA) of histological images has recently received attention as an automated method of characterizing liver fibrosis. The colored staining methods used to identify different tissue components reveal various patterns that contribute in different ways to the digital texture of the image. A histological digital image can be represented with various color spaces. The approximation processes of pixel values that are carried out while converting between different color spaces can affect image texture and subsequently could influence the performance of TA. Conventional TA is carried out on grey scale images, which are a luminance approximation to the original RGB (Red, Green, and Blue) space. Currently, grey scale is considered sufficient for characterization of fibrosis but this may not be the case for sophisticated assessment of fibrosis or when resolution conditions vary. This paper investigates the accuracy of TA results on three color spaces, conventional grey scale, RGB, and Hue-Saturation-Intensity (HSI), at different resolutions. The results demonstrate that RGB is the most accurate in texture classification of liver images, producing better results, most notably at low resolution. Furthermore, the green channel, which is dominated by collagen fiber deposition, appears to provide most of the features for characterizing fibrosis images. The HSI space demonstrated a high percentage error for the majority of texture methods at all resolutions, suggesting that this space is insufficient for fibrosis characterization. The grey scale space produced good results at high resolution; however, errors increased as resolution decreased

Different Continuous Training Intensities Improve Echocardiographic Parameters, Quality of Life, and Functional Capacity in Heart Failure Patients with Reduced Ejection Fraction.

BackgroundMultiple comorbidities and physiological changes play a role in a range of heart failure conditions and influence the most effective approach to exercise-based rehabilitation. This research aimed to examine and compare the outcomes of continuous training at three different intensities, focusing on left ventricular (LV) remodeling, functional capacity, and quality of life among patients with heart failure with reduced ejection fraction (HFrEF).MethodsIn this randomized control trial, a total of 60 male patients (average age: 54.33 ±2.35 years) with HFrEF were randomly allocated into three groups: 1) High-intensity continuous training group (HICT), 2) Moderate-intensity continuous training group (MICT), and 3) Low-intensity continuous training group (LICT). All the training was performed on a bicycle ergometer 3 times/week for 12 weeks. Echocardiographic parameters (left ventricular ejection fraction, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, N-terminal pro-B-type natriuretic peptide (NT-proBNP), quality of life (Minnesota Living with Heart Failure Questionnaire), and functional capacity (6-minute walking test) were assessed before and the end of the study.ResultsThe HICT group demonstrated the greatest improvements in all measured variables when compared to the other two groups (P ConclusionIt was determined that HICT appears to yield the most favorable outcomes in enhancing echocardiographic measures, NT-proBNP levels, quality of life, and functional capacity among HFrEF patients

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

COMPARISON OF DIFFERENT THERAPUTIC TECHINQUES ON HAMSTRING FLEXBILITY IN NORMAL ADULTS: RANDOMIZED CONTROLLED TRIAL

Background: Hamstring muscles involve a rate of intense musculoskeletal injuries. Hamstring flexibility, shorting, and exhaustion are hazard variables connected with hamstring strain. Enhanced flexibility has for quite some time been viewed as an imperative part in anticipation of musculotendinous strain. Expanding hamstring flexibility can assume a vital part in counteracting lower furthest point injuries. In any case, few research has been performed on the best technique. This study was conducted to correlate the effect of different therapeutic techniques (active release, muscle energy and Mulligan) on increasing hamstring flexibility. Methods: Fifty seven normal healthy male subjects with hamstring tightness were assigned randomly to one of the four study groups: Group (1)13subjects received active release technique. Group (2)15subjects received muscle energy technique. Group (3) 12subjects received Mulligan’s technique. Group (4)17subjects did not get any intercession. Popliteal angle (active knee extension test) and sit-reach flexibility test were measured pre and post the intervention period. Results: MANOVA test for active knee extension test and sit-reach test among the four groups for post intervention values there was no significant difference between Group 1 and Group 2 in the post values of AKE with both groups showed significant increases than Group 3. Group 1 versus Group 3: p < 0.0001, CI: 3.5-11.8; Group 2 versus Group 3: p < 0.0001, CI: 4.6-12.8). Conclusion: It can be reasoned that both active release and muscle energy techniques have similar impact in enhancing hamstring flexibility than Mulligan technique in normal male adults

IMMEDIATE AND LATE EFFECT OF CRYOTHERAPY ON BALANCE IN HEALTHY SUBJECTS

Background: cryotherapy application is commonly used as a physical therapy tools with many advantages, however numerous researchers have stated decrease in subject balance which affects quality of movement following cryotherapy application, thus the purpose of study was to investigate the immediate and late effect of cryotherapy on ankle dominant joint on static balance and test the difference in static balance change between both sexes. Methods: Thirty healthy subjects, Subjects had their static balance tested during two conditions: (1) an experimental condition where the subject received the cryotherapy application by using cooled gel pack to the dominant ankle joint for 15 minutes immediately before static balance testing and (2) a control condition finished at room temperature. Using coin flip for randomization the order of examining condition. Biodex balance system was used to measure static balance. Results: analysis of data using ANOVA and unpaired test, show insignificantly statistically effect in all aspect of static balance within female group and within male group with p-value of overall stability index for female=0.669, for male =0.382, Anterior/posterior stability index for female =0.196, for male=0.552 and medial/lateral stability index for female =0.989, for male=0.46 and insignificant statistically difference between male and female in all aspect of static balance. Conclusion: the result of the study suggest that using cold gel pack for fifteen minutes of cold gel pack on dominant ankle extremity have no effect on static balance on both sexes

Exercise-based gaming in patients with multiple sclerosis: A systematic review and meta-analysis

Background: Multiple sclerosis presents a significant burden, with balance disturbances impacting patients’ daily living. Conventional therapies have been supplemented with technological advancements like virtual reality (VR) and exergaming, providing engaging, multisensory rehabilitation options. Objective: This study aimed to synthesize evidence on exergaming’s role in multiple sclerosis treatment, particularly to evaluate the impact of exergaming on cognitive, motor, and psychological outcomes in patients with multiple sclerosis. Methods: A systematic review and subsequent meta-analysis design were employed. An extensive search was conducted up to June 2023 across five electronic databases - Web of Science, Scopus, PubMed, Cochrane, and EMBASE. The data extraction process from the selected studies was conducted independently. The risk of bias was assessed using the Cochrane Risk of Bias Assessment Tool 1 (ROB1) and the National Institutes of Health (NIH) assessment tool. Continuous outcomes were consolidated as mean differences (MD) with 95% confidence intervals (CIs). Meta-analyses were performed using RevMan ver. 5.4. Results: Out of 1,029 studies, 27 were included for meta-analysis. There were no significant differences in cognitive outcomes between the exergaming and the no-intervention group or the Conventional Physiotherapy and Rehabilitation interventions (CPRh) subgroups. However, the Symbol Digit Modalities Test (SDMT) showed a statistically significant difference in favor of exergaming in the no-intervention subgroup (MD = 5.40, 95% CI [0.08, 10.72], p = 0.05). In motor outcomes, exergaming only demonstrated better results in the 6-minute walking test compared to the no-intervention group (MD = 25.53, 95% CI [6.87, 44.19], p = 0.007). The Berg Balance Scale score in both studied subgroups and the Timed Up and Go (TUG) test in the no-intervention group favored exergaming. In terms of psychological outcomes, the Beck Depression Inventory did not reveal any significant differences, while the Modified Fatigue Impact Scale (MFIS) score favored exergaming in the CPRh subgroup. Conclusion: Exergaming shows promise for enhancing cognitive and motor functions, motivation, adherence, and quality of life in MS patients, which is beneficial for nurses. It can be tailored to individual preferences and easily conducted at home, potentially serving as a viable alternative to traditional rehab programs, especially during relapses. However, further research is necessary to fully understand its optimal and lasting benefits