Evaluation of an Area-Based matching algorithm with advanced shape models

Nowadays, the scientific institutions involved in planetary mapping are working on new strategies to produce accurate high resolution DTMs from space images at planetary scale, usually dealing with extremely large data volumes. From a methodological point of view, despite the introduction of a series of new algorithms for image matching (e.g. the Semi Global Matching) that yield superior results (especially because they produce usually smooth and continuous surfaces) with lower processing times, the preference in this field still goes to well established area-based matching techniques. Many efforts are consequently directed to improve each phase of the photogrammetric process, from image pre-processing to DTM interpolation. In this context, the Dense Matcher software (DM) developed at the University of Parma has been recently optimized to cope with very high resolution images provided by the most recent missions (LROC NAC and HiRISE) focusing the efforts mainly to the improvement of the correlation phase and the process automation. Important changes have been made to the correlation algorithm, still maintaining its high performance in terms of precision and accuracy, by implementing an advanced version of the Least Squares Matching (LSM) algorithm. In particular, an iterative algorithm has been developed to adapt the geometric transformation in image resampling using different shape functions as originally proposed by other authors in different applications

A standard ballroom and Latin dance program to improve fitness and adherence to physical activity in individuals with type 2 diabetes and in obesity

Objective: To test the effectiveness of a dance program to improve fitness and adherence to physical activity in subjects with type 2 diabetes and obesity.Research Design and Methods: Following a motivational interviewing session, 100 subjects with diabetes and/or obesity were enrolled either in a dance program (DP, n = 42) or in a self-selected physical activity program (SSP, n = 58), according to their preferences. Outcome measures were reduced BMI/waist circumference, improved metabolic control in type 2 diabetes ( 120.3% reduction of HbA1c) and improved fitness (activity expenditure >10 MET-hour/week; 10% increase in 6-min walk test (6MWT)). Target achievement was tested at 3 and 6 months, after adjustment for baseline data (propensity score). Results: Attrition was lower in DP. Both programs significantly decreased body weight (on average, 122.6 kg; P < 0.001) and waist circumference (DP, 123.2 cm; SSP, 122.2; P < 0.01) at 3 months, and the results were maintained at 6 months. In DP, the activity-related energy expenditure averaged 13.5 \ub1 1.8 MET-hour/week in the first three months and 14.1 \ub1 3.0 in the second three-month period. In SSP, activity energy expenditure was higher but highly variable in the first three-month period (16.5 \ub1 13.9 MET-hour/week), and decreased in the following three months (14.2 \ub1 12.3; P vs. first period < 0.001). At three months, no differences in target achievement were observed between groups. After six months the odds to attain the MET, 6MWT and A1c targets were all significantly associated with DP. Conclusion: Dance may be an effective strategy to implement physical activity in motivated subjects with type 2 diabetes or obesity (Clinical trial reg. no. NCT02021890, clinicaltrials.gov)

The Burden of NAFLD and Its Characteristics in a Nationwide Population with Type 2 Diabetes

Objective. We studied the prevalence of nonalcoholic fatty liver disease (NAFLD) and its clinical correlates in a population of patients with type 2 diabetes mellitus (T2DM). Methods. Clinical data of 94,577 T2DM patients were retrieved from 160 diabetes clinics in Italy in a standardized format and centrally analyzed anonymously. After exclusion of 5967 cases (high or uncertain alcohol intake), in 38,880 the Fatty Liver Index (FLI) was used as a proxy for the diagnosis of NAFLD. Factors associated with FLI assessed NAFLD (FLI-NAFLD) were evaluated through multivariate analysis. Results. FLI-NAFLD was present in 59.6% of patients. Compared to non-NAFLD, FLI-NAFLD was associated with impairment in renal function, higher albumin excretion, HbA1c and blood pressure, lower HDL cholesterol, and poorer quality of care. ALT was within normal limits in 73.6% of FLI-NAFLD patients (45.6% if the updated reference values were used). The prevalence of FLI-NAFLD did not differ if the whole sample (94,577 cases) was examined, irrespective of alcohol intake. Conclusions. FLI-NAFLD was present in the majority of T2DM patients of our sample and metabolic derangement, not alcohol consumption, was mainly associated with the disease. FLI-NAFLD patients have a worse metabolic profile. ALT levels are not predictive of NAFLD

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The management of severe hypoglycemia by the emergency system: The HYPOTHESIS study

Abstract Background and aims: Severe hypoglycemia is not rare in diabetes and markedly im-pacts onhealthresourceuse.We aimed to describe the characteristics of patients attending emergency departments (EDs) following a severe episode of hypoglycemia, the factors associated with the management of events and the \ufb01nal outcome. Methods and results: We carried out a retrospective analysis of cases attending 46 Italian EDs for hypoglycemia from January 2011 to June 2012. A total of 3753 records were retrieved from the databases of the participating centers, part of a network repeatedly involved in collaborative studies; 3516 episodes occurred in subjects with diabetes (median age, 76 years; range, 1 e102). Comorbidities were recorded in 2320 (65.9%) diabetes cases; association with trauma or road accidents in 287 (8.2%) and 47 (1.3%), respectively. Patients were treated with insulin (49.8%), oral agents (31.4%), or combination treatment (15.1%). The event required assistance by the out-of-hospital Emergency services in 1821 cases (51.8%). Following the ED visit, admis-sion to hospital departments was deemed necessary in 1161 cases (33.1%). Diabetes treatment (oral agents: OR, 1.63; 95% con\ufb01dence interval (CI), 1.37e1.94), increasing age (OR, 1.39; 95%CI, 1.31e1.48) and the number of comorbidities (OR, 1.51; 95% CI, 1.38e1.66) were the main drivers of admission. The in-hospital death rate was 10%, associated with the number of comor-bidities (OR, 1.28; 95%CI, 1.01e1.63). Conclusion: Severe hypoglycemia requiring referral to EDs is associated with a signi\ufb01cant work-up of the Emergency services and a remarkable in-hospital death rate in frail individuals with diabetes

Weight loss for a healthy liver

Overweight and obesity undoubtedly drive the prevalence of nonalcoholic fatty liver disease (NAFLD) in the population, promoting liver fat accumulation. There is also evidence that obesity may increase disease progression to nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis and eventually to hepatocellular carcinoma. Hence, weight loss is considered essential in overweight/obese patients with NAFLD to reduce the burden of the disease; even a limited amount of weight loss is associated with decreased hepatic triglyceride content, measured by proton magnetic resonance spectroscopy, and remission of ultrasound-assessed steatosis, in a dose-dependent manner. The possibility to reduce hepatic necroinflammation and fibrosis is less proven, although evidence is rapidly accumulating. A small randomized, controlled trial (RCT), carried out along the principles of cognitive-behavioral therapy, showed that the adoption of healthy lifestyles was accompanied by a significant improvement of necroinflammation and resolution of NASH, compared to a control population (Table 1). Notably, the improvement was driven by weight loss of >7%, irrespective of treatment arm, not by participation in the experimental lifestyle treatment group. Similarly, studies in morbidly obese subjects undergoing bariatric (metabolic) surgery reported histological improvement during follow-up. In summary, there is evidence from the literature that no matter how you lose weight, weight loss improves liver health. In this issue of Gastroenterology, large prospective cohort studies strengthen this evidence

Performance evaluation of DTM area-based matching reconstruction of Moon and Mars

High resolution DTMs, suitable for geomorphological studies of planets and asteroids, are today among the main scientific goals of space missions. In the framework of the BepiColombo mission, we are experimenting the use of different matching algorithms as well as the use of different geometric transformation models between stereo pairs, assessing their performances in terms of accuracy and computational efforts. Results obtained with our matching software are compared with those of established software. The comparison of the performance of image matching being the main objective of this work, all other steps of the DTM generation procedure have been made independent of the matching software by using a common framework. Tests with different transformation models have been performed using computer generated images as well as real HiRISE and LROC NAC images. The matching accuracy for real images has been checked in terms of reconstruction error against DTMs of Mars and the Moon published online and produced by the University of Arizona

Estimating the risk of severe hypoglycemic event related to glucose-lowering treatment among Italian patients with diabetes: the HYPOTHESIS database

The primary objective of this study was to estimate 1) the annual risk of undergoing a severe hypoglycemic event in Italian patients with diabetes and 2) the risk of hospitalization following such event. From the HYPOTHESIS database, powered by 46 emergency departments covering a 12-million-odd population, data were extracted of 1,922 hypoglycemic events occurring in patients with diabetes in 2011. The mean age was 71.5 (standard deviation 16.8) years, 50.1% were men, and blood glucose at the time of the event was 44.2 (26.5) mg/dL. Patients were being treated with insulin alone (55%) or in combination with oral hypoglycemic agents (OHA, 15%), or with OHA alone, either in monotherapy (14%) or in multiple therapy (16%). Comorbidities were recorded in 71.8% of the patients. Based on the rates of glucose-lowering drug use in Italian patients with diabetes, the annual risk of undergoing a serious hypoglycemic event was estimated at 1.27% for subjects treated with insulin alone, the highest (p<0.00001) as compared with insulin + OHA (0.41%) or OHA alone, either in monotherapy or in multiple therapy (0.1% and 0.17%, respectively). The risk of being hospitalized following the hypoglycemic event was the least (27.6%) for subjects treated with insulin alone (p<0.0083). Subjects treated with insulin + OHA showed a lower risk (34.2%) as compared with that for subjects treated with OHA (p<0.02). Death occurs in 7% of hospitalized patients. Older age (p<0.0001) and comorbidities (p<0.0001) were risk factors for hypoglycemia-related hospitalization. Treatments with insulin alone (p<0.005) or in combination (p<0.049) were negatively associated with hospital admission. Severe hypoglycemic events associated with the use of oral glucose-lowering agents carry the highest risk of hospital treatment. As such, they are also likely to generate higher tangible and intangible costs