A Novel Method for Lip Movement Detection using Deep Neural Network

Recognition of Lip movements has become one of the most challenging tasks and has crucial applications in the contemporary scenario. It is the recognition of the speech uttered by individual using visual cues. Visual interpretation of lip movement is especially useful in scenarios like video surveillance, where auditory signals are either not available or too noisy for interpretation. It is also useful for hearing-impaired individuals where audio signal is of no use. Many developments have taken place in this nascent field using various deep learning-based techniques. This research does analysis over various state-of-the-art deep-learning models on MIRACL-VC1 dataset. This study also aims to find out the optimal baseline architecture suitable for building a new model with high accuracy for lip movement detection. The models are trained from scratch over the pre-processed MIRACL-VC1 dataset consisting of small-size images. Experimental observations with state-of-the-art deep learning models indicate that EfficientNet B0 architecture yielded an accuracy of 80.13%. Thus, EfficientNet B0 is further utilized as baseline deep architecture to design a customized model for effective detection. This research proposes an attention based deep learning model combined with Long Short-Term Memory (LSTM) layer having EfficientNet B0 as the backbone architecture. The proposed model yielded an accuracy of 91.13%

Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction: Pathophysiology, Assessment, Prevalence and Prognosis.

Heart failure with preserved ejection fraction (HFpEF) currently accounts for approximately half of all new heart failure cases in the community. HFpEF is closely associated with chronic lifestyle-related diseases, such as obesity and type 2 diabetes, and clinical outcomes are worse in those with than without comorbidities. HFpEF is pathophysiologically distinct from heart failure with reduced ejection fraction, which may explain, in part, the disparity of treatment options available between the two heart failure phenotypes. The mechanisms underlying HFpEF are complex, with coronary microvascular dysfunction (MVD) being proposed as a potential key driver in its pathophysiology. In this review, the authors highlight the evidence implicating MVD in HFpEF pathophysiology, the diagnostic approaches for identifying MVD (both invasive and non-invasive) and the prevalence and prognostic significance of MVD

Heart failure specialist nurse-led day case ambulatory management with intravenous diuretics reduces hospitalisations for acute decompensated heart failure irrespective of ejection fraction

Conocer las ventajas de la cirugía ambulatoria con anestesia local de hernia de pared abdominal en el Hospital Carlos Lanfranco la Hoz 2012-2015. El estudio fue de tipo descriptivo, analítico y retrospectivo. Paciente portador de hernia de la pared abdominal que cumple los criterios de inclusión y que recibieron las charlas preoperatorias del Hospital Carlos Lanfranco La Hoz. Se confeccionó una ficha de recolección de datos con base en el registro de historia clínica. El total fue 354 pacientes de los cuales se manejaron en forma de cirugía ambulatoria en 340 (96%) y mayor de 24 horas 14 (4%), con una mortalidad de 0 y morbilidad de 2,8%. Se aprecia una ligera predominancia en varones 50,56%. Predominio de adultos 45,2%. De 354 pacientes, 135 (38%) fueron intervenidos bajo anestesia local pura, 22 (6%) se utilizó anestesia local más analgesia ev. y 32 (9%) con anestesia local y sedación, un total de 189 (53%) de pacientes operados con anestesia local, adultos en 58,7%, no presentando complicaciones, y manejo ambulatorio al 100%. Si sumamos a las hernias inguino escrotales, las bilaterales, inguinal + umbilical e incisional sería la hernia inguinal la más frecuente 163(46%). Con anestesia local predominaron por igual las hernias umbilical e inguinal (83 cada una). El total de complicaciones fueron ocho (2,25%): tres hematomas (37%), inguinodinia tres casos (38%), fiebre postoperatoria uno (12%) y un caso de orquitis (13%), no se apreciaron seromas ni infección del sitio operatorio. Se concluye que es un método seguro, económico y de calidad para pacientes electivos y seleccionados. La morbilidad es baja. La anestesia local para hernia de pared abdominal es una técnica depurada, segura e inocua que permite una pronta recuperación

A minimum dataset for a standard adult transthoracic echocardiogram: a guideline protocol from the British Society of Echocardiography.

There have been significant advances in the field of echocardiography with the introduction of a number of new techniques into standard clinical practice. Consequently, a 'standard' echocardiographic examination has evolved to become a more detailed and time-consuming examination that requires a high level of expertise. This Guideline produced by the British Society of Echocardiography (BSE) Education Committee aims to provide a minimum dataset that should be obtained in a comprehensive standard echocardiogram. In addition, the layout proposes a recommended sequence in which to acquire the images. If abnormal pathology is detected, additional views and measurements should be obtained with reference to other BSE protocols when appropriate. Adherence to these recommendations will promote an increased quality of echocardiography and facilitate accurate comparison of studies performed either by different operators or at different departments

Characterizing heart failure with preserved and reduced ejection fraction: An imaging and plasma biomarker approach.

IntroductionThe pathophysiology of heart failure with preserved ejection fraction (HFpEF) remains incompletely defined. We aimed to characterize HFpEF compared to heart failure with reduced ejection fraction (HFrEF) and asymptomatic hypertensive or non-hypertensive controls.Materials and methodsProspective, observational study of 234 subjects (HFpEF n = 140; HFrEF n = 46, controls n = 48, age 73±8, males 49%) who underwent echocardiography, cardiovascular magnetic resonance imaging (CMR), plasma biomarker analysis (panel of 22) and 6-minute walk testing (6MWT). The primary end-point was the composite of all-cause mortality and/or HF hospitalization.ResultsCompared to controls both HF groups had lower exercise capacity, lower left ventricular (LV) EF, higher LV filling pressures (E/E', B-type natriuretic peptide [BNP], left atrial [LA] volumes), more right ventricular (RV) systolic dysfunction, more focal and diffuse fibrosis and higher levels of all plasma markers. LV remodeling (mass/volume) was different between HFpEF (concentric, 0.68±0.16) and HFrEF (eccentric, 0.47±0.15); pConclusionsHFpEF is a distinct pathophysiological entity compared to age- and sex-matched HFrEF and controls. HFpEF and HFrEF are associated with similar adverse outcomes. Inflammation is common in both HF phenotypes but cardiomyocyte stretch/stress is greater in HFrEF

Rationale and design of the United Kingdom Heart Failure with Preserved Ejection Fraction Registry

\ua9 Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.Objective: Heart failure with preserved ejection fraction (HFpEF) is a common heterogeneous syndrome that remains imprecisely defined and consequently has limited treatment options and poor outcomes. Methods: The UK Heart Failure with Preserved Ejection Fraction Registry (UK HFpEF) is a prospective data-enabled cohort and platform study. The study will develop a large, highly characterised cohort of patients with HFpEF. A biobank will be established. Deep clinical phenotyping, imaging, multiomics and centrally held national electronic health record data will be integrated at scale, in order to reclassify HFpEF into distinct subgroups, improve understanding of disease mechanisms and identify new biological pathways and molecular targets. Together, these will form the basis for developing diagnostics and targeted therapeutics specific to subgroups. It will be a platform for more effective and efficient trials, focusing on subgroups in whom targeted interventions are expected to be effective, with consent in place to facilitate rapid recruitment, and linkage for follow-up. Patients with a diagnosis of HFpEF made by a heart failure specialist, who have had natriuretic peptide levels measured and a left ventricular ejection fraction >40% are eligible. Patients with an ejection fraction between 40% and 49% will be limited to no more than 25% of the cohort. Conclusions: UK HFpEF will develop a rich, multimodal data resource to enable the identification of disease endotypes and develop more effective diagnostic strategies, precise risk stratification and targeted therapeutics. Trial registration number: NCT05441839

Clinical Significance of Myocardial Injury in Patients Hospitalized for COVID-19: A Prospective, Multicenter, Cohort Study

\ua9 2024 The AuthorsBackground: Hospitalized COVID-19 patients with troponin elevation have a higher prevalence of cardiac abnormalities than control individuals. However, the progression and impact of myocardial injury on COVID-19 survivors remain unclear. Objectives: This study sought to evaluate myocardial injury in COVID-19 survivors with troponin elevation with baseline and follow-up imaging and to assess medium-term outcomes. Methods: This was a prospective, longitudinal cohort study in 25 United Kingdom centers (June 2020 to March 2021). Hospitalized COVID-19 patients with myocardial injury underwent cardiac magnetic resonance (CMR) scans within 28 days and 6 months postdischarge. Outcomes were tracked for 12 months, with quality of life surveys (EuroQol-5 Dimension and 36-Item Short Form surveys) taken at discharge and 6 months. Results: Of 342 participants (median age: 61.3 years; 71.1% male) with baseline CMR, 338 had a 12-month follow-up, 235 had a 6-month CMR, and 215 has baseline and follow-up quality of life surveys. Of 338 participants, within 12 months, 1.2% died; 1.8% had new myocardial infarction, acute coronary syndrome, or coronary revascularization; 0.8% had new myopericarditis; and 3.3% had other cardiovascular events requiring hospitalization. At 6 months, there was a minor improvement in left ventricular ejection fraction (1.8% \ub1 1.0%; P < 0.001), stable right ventricular ejection fraction (0.4% \ub1 0.8%; P = 0.50), no change in myocardial scar pattern or volume (P = 0.26), and no imaging evidence of continued myocardial inflammation. All pericardial effusions (26 of 26) resolved, and most pneumonitis resolved (95 of 101). EuroQol-5 Dimension scores indicated an overall improvement in quality of life (P < 0.001). Conclusions: Myocardial injury in severe hospitalized COVID-19 survivors is nonprogressive. Medium-term outcomes show a low incidence of major adverse cardiovascular events and improved quality of life. (COVID-19 Effects on the Heart; ISRCTN58667920