Sit-to-Stand Analysis in the Wild using Silhouettes for Longitudinal Health Monitoring

We present the first fully automated Sit-to-Stand or Stand-to-Sit (StS) analysis framework for long-term monitoring of patients in free-living environments using video silhouettes. Our method adopts a coarse-to-fine time localisation approach, where a deep learning classifier identifies possible StS sequences from silhouettes, and a smart peak detection stage provides fine localisation based on 3D bounding boxes. We tested our method on data from real homes of participants and monitored patients undergoing total hip or knee replacement. Our results show 94.4% overall accuracy in the coarse localisation and an error of 0.026 m/s in the speed of ascent measurement, highlighting important trends in the recuperation of patients who underwent surgery

Prevention of acute kidney injury and protection of renal function in the intensive care unit

Acute renal failure on the intensive care unit is associated with significant mortality and morbidity. To determine recommendations for the prevention of acute kidney injury (AKI), focusing on the role of potential preventative maneuvers including volume expansion, diuretics, use of inotropes, vasopressors/vasodilators, hormonal interventions, nutrition, and extracorporeal techniques. A systematic search of the literature was performed for studies using these potential protective agents in adult patients at risk for acute renal failure/kidney injury between 1966 and 2009. The following clinical conditions were considered: major surgery, critical illness, sepsis, shock, and use of potentially nephrotoxic drugs and radiocontrast media. Where possible the following endpoints were extracted: creatinine clearance, glomerular filtration rate, increase in serum creatinine, urine output, and markers of tubular injury. Clinical endpoints included the need for renal replacement therapy, length of stay, and mortality. Studies are graded according to the international Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) group system Several measures are recommended, though none carries grade 1A. We recommend prompt resuscitation of the circulation with special attention to providing adequate hydration whilst avoiding high-molecular-weight hydroxy-ethyl starch (HES) preparations, maintaining adequate blood pressure using vasopressors in vasodilatory shock. We suggest using vasopressors in vasodilatory hypotension, specific vasodilators under strict hemodynamic control, sodium bicarbonate for emergency procedures administering contrast media, and periprocedural hemofiltration in severe chronic renal insufficiency undergoing coronary intervention