Medical image colorization for better visualization and segmentation

Medical images contain precious anatomical information for clinical procedures. Improved understanding of medical modality may contribute significantly in arena of medical image analysis. This paper investigates enhancement of monochromatic medical modality into colorized images. Improving the contrast of anatomical structures facilitates precise segmentation. The proposed framework starts with pre-processing to remove noise and improve edge information. Then colour information is embedded to each pixel of a subject image. A resulting image has a potential to portray better anatomical information than a conventional monochromatic image. To evaluate the performance of colorized medical modality, the structural similarity index and the peak signal to noise ratio are computed. Supremacy of proposed colorization is validated by segmentation experiments and compared with greyscale monochromatic images

Sanitation and Health

As one article in a four-part PLoS Medicine series on water and sanitation, David Trouba and colleagues discuss the importance of improved sanitation to health and the role that the health sector can play in its advocacy

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Late follow up of autoaugmentation omentocystoplasty in a sheep model

Four male sheep were studied 12 months after an autoaugmentation omentocystoplasty (AAOC). The omentuni was lined with urothelium, but continued inflammation and/or fibrosis were seen within the subepithelial tissues associated with a failure to achieve enlargement of the bladder when compared with a control group of six animals. The median compliance value was 59 mL/cm H 2O for the AAOC animals and 9.8 mL/cm H2O for the control group, indicating that no improvement in bladder dynamic function had been achieved with the AAOC in sheep, and no significant improvement had occurred with time when the results were compared with those seen 6 months earlier.P. A. Dewan, A. J. Owen, W. Stefanek, C. Lorenz and R. W. Byar