70 research outputs found
Acute kidney injury in patients with COVID-19 compared to those with influenza: a systematic review and meta-analysis
BackgroundCOVID-19 and influenza can both lead to acute kidney injury (AKI) as a common complication. However, no meta-analysis has been conducted to directly compare the incidence of AKI between hospitalized patients with COVID-19 and influenza. The objective of our study aims to investigate the incidence and outcomes of AKI among hospitalized patients between these two groups.Materials and methodsA systematic search of PubMed, Embase, and Cochrane databases was conducted from December 2019 to August 2023 to identify studies examining AKI and clinical outcomes among hospitalized patients with COVID-19 and influenza. The primary outcome of interest was the incidence of AKI, while secondary outcomes included in-hospital mortality, recovery from AKI, hospital and ICU stay duration. The quality of evidence was evaluated using Cochrane and GRADE methods.ResultsTwelve retrospective cohort studies, involving 17,618 hospitalized patients with COVID-19 and influenza, were analyzed. COVID-19 patients showed higher AKI incidence (29.37% vs. 20.98%, OR: 1.67, 95% CI 1.56–1.80, p < 0.01, I2 = 92.42%), and in-hospital mortality (30.95% vs. 5.51%, OR: 8.16, 95% CI 6.17–10.80, p < 0.01, I2 = 84.92%) compared to influenza patients with AKI. Recovery from AKI was lower in COVID-19 patients (57.02% vs., 80.23%, OR: 0.33, 95% CI 0.27–0.40, p < 0.01, I2 = 85.17%). COVID-19 patients also had a longer hospital stay (SMD: 0.69, 95% CI 0.65–0.72, p < 0.01, I2 = 98.94%) and longer ICU stay (SMD: 0.61, 95% CI 0.50–0.73, p < 0.01, I2 = 94.80%) than influenza patients. In our study, evidence quality was high (NOS score 7–9), with low certainty for AKI incidence and moderate certainty for recovery form AKI by GRADE assessment.ConclusionCOVID-19 patients had higher risk of developing AKI, experiencing in-hospital mortality, and enduring prolonged hospital/ICU stays in comparison to influenza patients. Additionally, the likelihood of AKI recovery was lower among COVID-19 patients
View-sharing PROPELLER with pixel-based optimal blade selection: Application on dynamic contrast-enhanced imaging
Purpose: To achieve better spatial and temporal resolution of dynamic contrast-enhanced MR imaging, the concept of k-space data sharing, or view sharing, can be implemented for PROPELLER acquisition. As found in other view-sharing methods, the loss of high-resolution dynamics is possible for view-sharing PROPELLER (VS-Prop) due to the temporal smoothing effect. The degradation can be more severe when a narrow blade with less phase encoding steps is chosen in the acquisition for higher frame rate. In this study, an iterative algorithm termed pixel-based optimal blade selection (POBS) is proposed to allow spatially dependent selection of the rotating blades, to generate high-resolution dynamic images with minimal reconstruction artifacts. Methods: In the reconstruction of VS-Prop, the central k-space which dominates the image contrast is only provided by the target blade with the peripheral k-space contributed by a minimal number of consecutive rotating blades. To reduce the reconstruction artifacts, the set of neighboring blades exhibiting the closest image contrast with the target blade is picked by POBS algorithm. Numerical simulations and phantom experiments were conducted in this study to investigate the dynamic response and spatial profiles of images generated using our proposed method. In addition, dynamic contrast-enhanced cardiovascular imaging of healthy subjects was performed to demonstrate the feasibility and advantages. Results: The simulation results show that POBS VS-Prop can provide timely dynamic response to rapid signal change, especially for a small region of interest or with the use of narrow blades. The POBS algorithm also demonstrates its capability to capture nonsimultaneous signal changes over the entire FOV. In addition, both phantom andin vivo experiments show that the temporal smoothing effect can be avoided by means of POBS, leading to higher wash-in slope of contrast enhancement after the bolus injection. Conclusions: With the satisfactory reconstruction quality provided by the POBS algorithm, VS-Prop acquisition technique may find useful clinical applications in DCE MR imaging studies where both spatial and temporal resolutions play important roles. © 2014 American Association of Physicists in Medicine.Link_to_subscribed_fulltex
Post-hospital care of stroke patients in Taipei: Use of services and policy implications
Impact of type of dialyzable beta-blockers on subsequent risk of mortality in patients receiving dialysis: A systematic review and meta-analysis.
BackgroundBeta-blockers has been reported to improve all-cause mortality and cardiovascular mortality in patients receiving dialysis, but type of beta-blockers (i.e., high vs. low dialyzable) on patient outcomes remains unknown. This study aimed at assessing the outcomes of patients receiving dialyzable beta-blockers (DBBs) compared to those receiving non-dialyzable beta-blockers (NDBBs).MethodsWe searched the databases including PubMed, Embase, Cochrane, and ClinicalTrials.gov until 28 February 2022 to identify articles investigating the impact of DBBs/NDBBs among patients with renal failure receiving hemodialysis/peritoneal dialysis (HD/PD). The primary outcome was risks of all-cause mortality, while the secondary outcomes included risk of overall major adverse cardiac event (MACE), acute myocardial infarction (AMI) and heart failure (HF). We rated the certainty of evidence (COE) by Cochrane methods and the GRADE approach.ResultsAnalysis of four observational studies including 75,193 individuals undergoing dialysis in hospital and community settings after a follow-up from 180 days to six years showed an overall all-cause mortality rate of 11.56% (DBBs and NDBBs: 12.32% and 10.7%, respectively) without significant differences in risks of mortality between the two groups [random effect, aHR 0.91 (95% CI, 0.81-1.02), p = 0.11], overall MACE [OR 1.03 (95% CI, 0.78-1.38), p = 0.82], and AMI [OR 1.02 (95% CI, 0.94-1.1), p = 0.66]. Nevertheless, the pooled odds ratio of HF among patients receiving DBBs was lower than those receiving NDBB [random effect, OR 0.87 (95% CI, 0.82-0.93), pConclusionsThe use of dialyzable and non-dialyzable beta-blockers had no impact on the risk of all-cause mortality, overall MACE, and AMI among dialysis patients. However, DBBs were associated with significant reduction in risk of HF compared with NDBBs. The limited number of available studies warranted further large-scale clinical investigations to support our findings
A Data-Driven Autonomous Driving System for Overtaking Bicyclists
This research aims to develop data-driven models for suggesting the initiation of an automated car-to-bicycle overtaking process that will be assessed subjectively by human drivers and bicyclists in a driving simulator environment. A naturalistic driving dataset with 102 vehicles involved served as the data source for model development. The models were implemented to a CarSim software as the driving simulator platform for an experiment. Thirty-two participants were recruited to evaluate the models from driver and bicyclist’s perspectives on the aspects of satisfaction and perceived risk of collision. It was found that both drivers and bicyclists felt less satisfied and perceived higher risk if the overtaking was engaged with a faster speed and the presence of incoming traffic. However, the effect to bicyclists could be mitigated with the application of a dedicated bicycle lane. Bicyclists also sought more lateral room to the vehicle when being overtaking, although drivers were satisfied with the current settings without perceiving any significant risk. Therefore, the developed models should be adjusted in the future by considering the perceptions by bicyclists and other road users. Stakeholders, such as automated feature developers and policymakers, should referto the models carefully with paying attention to the inconsistency between driver’s and bicyclist’s perspectives.http://deepblue.lib.umich.edu/bitstream/2027.42/192315/1/A Data-Driven Autonomous Driving System for Overtaking Bicyclists Final Report.pdf-1Description of A Data-Driven Autonomous Driving System for Overtaking Bicyclists Final Report.pdf : Final Repor
Separation of Two-Dimensional Mixed Circular Fringe Patterns Based on Spectral Projection Property in Fractional Fourier Transform Domain
In this paper, a method for automatically separating the mixed circular fringe patterns based on the fractional Fourier transform (FrFT) analysis is proposed. Considering the mixed two-dimensional (2-D) Gaussian-based circular fringe patterns, detected by using an image sensor, we propose a method that can efficiently determine the number and parameters of each separated fringe patterns by using the FrFT due to the observed higher sparsity in the frequency domain than that in the spatial domain. First, we review the theory of FrFT and the properties of the 2-D circular fringe patterns. By searching the spectral intensities of the various fractional orders in the FrFT projected along both the frequency axes, the proposed method can automatically determine the total fringe number, the central position, binary phase, and the maximum fringe width of each 2-D circular fringe pattern. In the experimental results, both the computer-simulated and optically mixed fringe patterns are used to verify the proposed method. In addition, the additive Gaussian noise effects on the proposed method are investigated. The proposed method can still successfully separate the mixed fringe pattern when the signal-to-noise ratio is higher than 7 dB
Separation of Two-Dimensional Mixed Circular Fringe Patterns Based on Spectral Projection Property in Fractional Fourier Transform Domain
In this paper, a method for automatically separating the mixed circular fringe patterns based on the fractional Fourier transform (FrFT) analysis is proposed. Considering the mixed two-dimensional (2-D) Gaussian-based circular fringe patterns, detected by using an image sensor, we propose a method that can efficiently determine the number and parameters of each separated fringe patterns by using the FrFT due to the observed higher sparsity in the frequency domain than that in the spatial domain. First, we review the theory of FrFT and the properties of the 2-D circular fringe patterns. By searching the spectral intensities of the various fractional orders in the FrFT projected along both the frequency axes, the proposed method can automatically determine the total fringe number, the central position, binary phase, and the maximum fringe width of each 2-D circular fringe pattern. In the experimental results, both the computer-simulated and optically mixed fringe patterns are used to verify the proposed method. In addition, the additive Gaussian noise effects on the proposed method are investigated. The proposed method can still successfully separate the mixed fringe pattern when the signal-to-noise ratio is higher than 7 dB
Ambient Cumulative PM2.5 Exposure and the Risk of Lung Cancer Incidence and Mortality: A Retrospective Cohort Study
Smoking, sex, air pollution, lifestyle, and diet may act independently or in concert with each other to contribute to the different outcomes of lung cancer (LC). This study aims to explore their associations with the carcinogenesis of LC, which will be useful for formulating further preventive strategies. This retrospective, longitudinal follow-up cohort study was carried out by connecting to the MJ Health Database, Taiwan Cancer Registry database, and Taiwan cause of death database from 2000 to 2015. The studied subjects were persons attending the health check-ups, distributed throughout the main island of Taiwan. Cox proportional hazards regression models were used to investigate the risk factors associated with LC development and mortality after stratifying by smoking status, with a special emphasis on ambient two-year average PM2.5 exposure, using a satellite-based spatiotemporal model at a resolution of 1 km2, and on dietary habit including consumption of fruits and vegetables. After a median follow-up of 12.3 years, 736 people developed LC, and 401 people died of LC-related causes. For never smokers, the risk of developing LC (aHR: 1.32, 95%CI: 1.12–1.56) and dying from LC-related causes (aHR: 1.28, 95%CI: 1.01–1.63) rises significantly with every 10 μg/m3 increment of PM2.5 exposure, but not for ever smokers. Daily consumption of more than two servings of vegetables and fruits is associated with lowering LC risk in ever smokers (aHR: 0.68, 95%CI: 0.47–0.97), and preventing PM2.5 exposure is associated with lowering LC risk for never smokers
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