Pro-Calcitonin and C Reactive Protein as Marker of Infection: Evaluation of Systemic Inflammatory Response Syndrome (SIRS) in Patients with Normal and Impaired Renal Function

Background: To investigate Pro-Calcitonin (PCT) and C reactive protein (CRP) as a predictor of infectious systemic inflammatory response syndrome (SIRS) in patients with normal and impaired renal function.Methods: In this cross-sectional study >18 year old patients with features suggestive of SIRS were included.PCT and CRP were done on the first day of admission. Based on clinical features and results of cultures, patients were divided into non-infection and infection (sepsis) groups. Based on glomerular filtration rate (GFR) patients were further divided to Group A (GFR ≥60ml/min) and Group B (GFR <60ml/min).Receiver operating characteristic (ROC) curve was used for statistical analysis.Results: Out of 740 patients, 48.3% were diagnosed to be suffering from infection (sepsis). GFR of 50.8% patients was ≥ 60 ml/min/1.73m2 (Group A), and GFR of 364 (49.2%) patients was < 60 ml/min/1.73m2(Group B).For prediction of infection in SIRS patients, ROC curve based AUC for PCT in all, Group A, and Group B patients was 0.84, 0.86, and 0.71 respectively. Similarly for CRP AUC was 0.81, 0.78, and 0.83 respectively. Best cut off value of PCT predicting the infectious cause of SIRS in all, Group A, and Group B patients was 0.24, 0.13, and0.93 ng/mL respectively. Similar best cut off value of PCT for all, Group A and B patients were 13.10 and 11.10 mg/L respectively.Conclusion: Initial PCT≥ 0.24ng/mL and CRP ≥ 13.10 mg/L are predictors of sepsis in SIRS patients. PCT is a better predictor for patients with normal and CRP better predictor for patients with deranged renal function

Current Status of the Open Abdomen Treatment for Intra-Abdominal Infection

The open abdomen has become an important approach for critically ill patients who require emergent abdominal surgical interventions. This treatment, originating from the concept of damage control surgery, was first applied in severe traumatic patients. The ultimate goal is to achieve formal abdominal fascial closure by several attempts and adjuvant therapies (fluid management, nutritional support, skin grafting, etc.). Up to the present, open abdomen therapy becomes matured and is multistage-approached in the management of patients with severe trauma. However, its application in patients with intra-abdominal infection still presents great challenges due to critical complications and poor clinical outcomes. This review focuses on the specific use of the open abdomen in such populations and detailedly introduces current concerns and advanced progress about this therapy

Mean platelet volume: A controversial marker of disease activity in Crohn’s disease

Background: We investigated and compared the capacity of mean platelet volume (MPV) and other inflammatory markers in detecting Crohn’s disease (CD) activity and differentiating CD patients from healthy controls. Methods: MPV, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cells were measured in 61 CD patients and 50 healthy subjects. Disease activity was assessed by the Crohn’s Disease Activity Index. Results: A significant decrease in MPV was noted in patients with CD compared with healthy controls (P <0.0001), but statistical difference was not found between active and inactive CD groups. In CD, no significant correlation was found between MPV and other inflammatory markers. The overall accuracy of MPV (cutoff: 10.35 fl), CRP (cutoff: 4.85 mg/dl) and ESR (cutoff: 8.5 mm/hour) in differentiating CD patients from healthy controls was 76.6%, 65.8% and 72.1% respectively. The overall accuracy of CRP (cutoff: 4.95 mg/dl) and ESR (cutoff: 16.5 mm/hour) in determination of active CD was 80.3% and 73.8%. Conclusions: MPV declined in CD patients compared with healthy subjects. MPV had the best accuracy in determination of CD patients and healthy controls. MPV did not show a discriminative value in disease activity

Exploring Vision Transformers as Diffusion Learners

Score-based diffusion models have captured widespread attention and funded fast progress of recent vision generative tasks. In this paper, we focus on diffusion model backbone which has been much neglected before. We systematically explore vision Transformers as diffusion learners for various generative tasks. With our improvements the performance of vanilla ViT-based backbone (IU-ViT) is boosted to be on par with traditional U-Net-based methods. We further provide a hypothesis on the implication of disentangling the generative backbone as an encoder-decoder structure and show proof-of-concept experiments verifying the effectiveness of a stronger encoder for generative tasks with ASymmetriC ENcoder Decoder (ASCEND). Our improvements achieve competitive results on CIFAR-10, CelebA, LSUN, CUB Bird and large-resolution text-to-image tasks. To the best of our knowledge, we are the first to successfully train a single diffusion model on text-to-image task beyond 64x64 resolution. We hope this will motivate people to rethink the modeling choices and the training pipelines for diffusion-based generative models

Morphology and Mechanical Properties of Plantar Fascia in Flexible Flatfoot: A Noninvasive In Vivo Study

From Frontiers via Jisc Publications RouterHistory: collection 2021, received 2021-06-20, accepted 2021-08-16, epub 2021-09-15Publication status: PublishedPlantar fascia plays an important role in human foot biomechanics; however, the morphology and mechanical properties of plantar fascia in patients with flexible flatfoot are unknown. In this study, 15 flexible flatfeet were studied, each plantar fascia was divided into 12 positions, and the morphologies and mechanical properties in the 12 positions were measured in vivo with B-mode ultrasound and shear wave elastography (SWE). Peak pressures under the first to fifth metatarsal heads (MH) were measured with FreeStep. Statistical analysis included 95% confidence interval, intragroup correlation coefficient (ICC1,1), one-way analysis of variance (one-way ANOVA), and least significant difference. The results showed that thickness and Young’s modulus of plantar fascia were the largest at the proximal fascia (PF) and decreased gradually from the proximal end to the distal end. Among the five distal branches (DB) of the fascia, the thickness and Young’s modulus of the second and third DB were larger. The peak pressures were also higher under the second and third MH. This study found a gradient distribution in that the thickness and Young’s modulus gradient decreased from the proximal end to the distal end of plantar fascia in the longitudinal arch of flexible flatfeet. In the transverse arch, the thickness and Young’s modulus under the second and third DB were larger than those under the other three DB in flexible flatfoot, and the peak pressures under the second and third MH were also larger than those under the other three MH in patients with flexible flatfoot. These findings deepen our understanding of the changes of biomechanical properties and may be meaningful for the study of pathological mechanisms and therapy for flexible flatfoot

An Evil Backstage Manipulator: Psychological Factors Correlated with Health-Related Quality of Life in Chinese Patients with Crohn's Disease

Health-related quality of life (HRQoL) is recommended as one of essential parameters to evaluate treatment effect and clinical outcome in patients with Crohn's disease (CD). Recent studies reported that psychological factors might play a role in HRQoL in Western and American CD patients. Sufficient evidences in Chinese CD patients are still unavailable. This study is dedicated to investigate the correlation of various psychological factors with HRQoL in Chinese CD patients. We prospectively collected 40 active and 40 quiescent CD patients in China and found that psychological factors, especially neuroticism and anxiety, significantly correlate with and affect HRQoL in both active and quiescent CD groups. This is the first report revealing correlation between psychological factors and HRQoL in Chinese CD patients. Therefore, we assume that our results can contribute to a better understanding of etiology and tailoring of management in Chinese patients with Crohn's disease and are beneficial to our colleagues to compare the heterogeneous characteristics of Crohn's disease in different ethnic groups

Dual Semantic Fusion Network for Video Object Detection

Video object detection is a tough task due to the deteriorated quality of video sequences captured under complex environments. Currently, this area is dominated by a series of feature enhancement based methods, which distill beneficial semantic information from multiple frames and generate enhanced features through fusing the distilled information. However, the distillation and fusion operations are usually performed at either frame level or instance level with external guidance using additional information, such as optical flow and feature memory. In this work, we propose a dual semantic fusion network (abbreviated as DSFNet) to fully exploit both frame-level and instance-level semantics in a unified fusion framework without external guidance. Moreover, we introduce a geometric similarity measure into the fusion process to alleviate the influence of information distortion caused by noise. As a result, the proposed DSFNet can generate more robust features through the multi-granularity fusion and avoid being affected by the instability of external guidance. To evaluate the proposed DSFNet, we conduct extensive experiments on the ImageNet VID dataset. Notably, the proposed dual semantic fusion network achieves, to the best of our knowledge, the best performance of 84.1\% mAP among the current state-of-the-art video object detectors with ResNet-101 and 85.4\% mAP with ResNeXt-101 without using any post-processing steps.Comment: 9 pages,6 figure

Design of Reconfigurable Intelligent Surfaces for Wireless Communication: A Review

Existing literature reviews predominantly focus on the theoretical aspects of reconfigurable intelligent surfaces (RISs), such as algorithms and models, while neglecting a thorough examination of the associated hardware components. To bridge this gap, this research paper presents a comprehensive overview of the hardware structure of RISs. The paper provides a classification of RIS cell designs and prototype systems, offering insights into the diverse configurations and functionalities. Moreover, the study explores potential future directions for RIS development. Notably, a novel RIS prototype design is introduced, which integrates seamlessly with a communication system for performance evaluation through signal gain and image formation experiments. The results demonstrate the significant potential of RISs in enhancing communication quality within signal blind zones and facilitating effective radio wave imaging

Effects of Changes in the Levels of Damage-Associated Molecular Patterns Following Continuous Veno–Venous Hemofiltration Therapy on Outcomes in Acute Kidney Injury Patients With Sepsis

Background: We investigated the association of damage-associated molecular pattern (DAMP) removal with mortality in sepsis patients undergoing continuous veno–venous hemofiltration (CVVH).Methods: Circulating levels of DAMPs [mitochondrial DNA (mtDNA); nuclear DNA (nDNA); heat shock protein 70 (HSP70); and high mobility group box 1 (HMGB1)] and cytokines were measured at baseline, 6 and 12 h after initiation of CVVH. Urinary DNA levels were analyzed at baseline and end of CVVH. The expression of human leukocyte antigen (HLA)-DR was assayed at 0, 3, and 7 days after initiation of CVVH. Moreover, the effects of HSP70 and HMGB1 clearance on survival were analyzed.Results: We evaluated 43 patients with acute kidney injury (AKI) (33 sepsis patients). Twenty-two sepsis patients (67%) and three non-sepsis patients (30%) expired (P = 0.046). Significant reductions in the levels of circulating interleukin-6 (P = 0.046) and tumor necrosis factor-α (P = 0.008) were found in the sepsis group. The levels of mtDNA were increased (ND2, P = 0.035; D-loop, P = 0.003), whereas that of HSP70 was reduced (P = 0.000) in all patients during the first 12 h. The levels of DAMPs in the plasma were markedly increased after blood passage from the inlet through the dialyzer in survivor sepsis patients. The clearance rates of HSP70 and HMGB1 were good predictors of mortality [area under the curve (AUC) = 0.937, P = 0.000; AUC = 0.90, P = 0.001, respectively]. The level of HLA-DR was increased in response to higher HSP70 clearance (P = 0.006). Survival was significantly worse in groups with higher clearance rates of HSP70 and HMGB1 than the cut-off value (log-rank test: P = 0.000 for both). Higher HSP70 clearance was a significant independent predictor of mortality (odds ratio = 1.025, 95% confidence interval [CI]: 1.012–1.039, P = 0.000). The urinary nDNA (β-globin) level before CVVH was an independent risk factor for the duration of CVVH in patients with sepsis (sRE = 0.460, 95% CI: 1.720–8.857, P = 0.005).Conclusion: CVVH removes inflammatory factors, reduces urinary DAMPs, and removes plasma DAMPs. However, survival decreases in response to higher HSP70 clearance