RESUMEN
Anemia is a significant global health issue, affecting over a billion people worldwide, according to the World Health Organization. Generally, the gold standard for diagnosing anemia relies on laboratory measurements of hemoglobin. To meet the need in clinical practice, physicians often rely on visual examination of specific areas, such as conjunctiva, to assess pallor. However, this method is subjective and relies on the physician's experience. Therefore, we proposed a deep learning prediction model based on three input images from different body parts, namely, conjunctiva, palm, and fingernail. By incorporating additional body part labels and employing a fusion attention mechanism, the model learns and enhances the salient features of each body part during training, enabling it to produce reliable results. Additionally, we employ a dual loss function that allows the regression model to benefit from well-established classification methods, thereby achieving stable handling of minority samples. We used a retrospective data set (EYES-DEFY-ANEMIA) to develop this model called Body-Part-Anemia Network (BPANet). The BPANet showed excellent performance in detecting anemia, with accuracy of 0.849 and an F1-score of 0.828. Our multi-body-part model has been validated on a prospectively collected data set of 101 patients in National Taiwan University Hospital. The prediction accuracy as well as F1-score can achieve as high as 0.716 and 0.788, respectively. To sum up, we have developed and validated a novel non-invasive hemoglobin prediction model based on image input from multiple body parts, with the potential of real-time use at home and in clinical settings.
RESUMEN
In adult mammals, wound healing predominantly follows a fibrotic pathway, culminating in scar formation. However, cutaneous microwounds generated through fractional photothermolysis, a modality that produces a constellation of microthermal zones, exhibit a markedly different healing trajectory. Our study delineates the cellular attributes of these microthermal zones, underscoring a temporally limited, subclinical inflammatory milieu concomitant with rapid re-epithelialization within 24 hours. This wound closure is facilitated by the activation of genes associated with keratinocyte migration and differentiation. In contrast to macrothermal wounds, which predominantly heal through a robust myofibroblast-mediated collagen deposition, microthermal zones are characterized by absence of wound contraction and feature delayed collagen remodeling, initiating 5-6 weeks after injury. This distinct wound healing is characterized by a rapid re-epithelialization process and a muted inflammatory response, which collectively serve to mitigate excessive myofibroblast activation. Furthermore, we identify an initial reparative phase characterized by a heterogeneous extracellular matrix protein composition, which precedes the delayed collagen remodeling. These findings extend our understanding of cutaneous wound healing and may have significant implications for the optimization of therapeutic strategies aimed at mitigating scar formation.
RESUMEN
BACKGROUND: Proteinuria, a marker of kidney injury, may be related to skeletal muscle loss. Whether the severity of proteinuria is associated with physical performance is unclear. METHODS: We examined the association of proteinuria severity with physical performance cross-sectionally in 3357 military young males, free of chronic kidney disease, from the cardiorespiratory fitness and hospitalization events in armed Forces (CHIEF) study in Taiwan. The grades of proteinuria were classified according to one dipstick urinalysis which were collected at morning after an 8-h fast as unremarkable (0, +/-, and 1+), moderate (2+) and severe (3+ and 4+). Aerobic physical performance was evaluated by time for a 3000-m run and anaerobic physical performance was evaluated by numbers of 2-min sit-ups and 2-min push-ups, separately. Multiple linear regressions were used to determine the relationship. RESULTS: As compared with unremarkable proteinuria, moderate and severe proteinuria were dose-dependently correlated with 3000-m running time (ß: 4.74 (95% confidence intervals (CI): - 0.55, 10.02) and 7.63 (95% CI: 3.21, 12.05), respectively), and inversely with numbers of 2-min push-ups (ß = - 1.13 (- 1.97, - 0.29), and - 1.00 (- 1.71, - 0.28), respectively) with adjustments for age, service specialty, body mass index, blood pressure, alcohol intake, smoking, fasting plasma glucose, blood urea nitrogen, serum creatinine and physical activity. However, there was no association between proteinuria severity and 2-min sit-ups. CONCLUSIONS: Our findings show a relationship of dipstick proteinuria with aerobic physical performance and parts of anaerobic physical performance in military healthy males. This mechanism is not fully understood and requires further investigations.
Asunto(s)
Personal Militar , Rendimiento Físico Funcional , Proteinuria/orina , Adulto , Humanos , Masculino , Taiwán , Adulto JovenRESUMEN
Myopia has been linked to body weight and sedentary status, but the association with quantitatively measured physical fitness in adults has not been examined. Cross-sectional analyses were performed to investigate the association between physical fitness and myopia in 3,669 military men (aged 29.4 years) in Taiwan. The severity of myopia obtained from the left eye was classified as mild (-0.5 to -3.0 diopters; n = 544), moderate -3.1 to -6.0 diopters; n = 563), and high (<-6.0 diopters; n =150); others were defined as nonmyopia (n = 2,412). Aerobic fitness was evaluated by time for a 3000-meter run test, and muscular endurance was evaluated by numbers of 2-min sit-ups and 2-min push-ups. A value of p < .0125 was considered significant. A multiple linear regression analysis was used to determine the relationship. Individuals who were less physically fit had higher risk of myopia. The associations were dose-dependently significant with mild, moderate, and high myopia for 3000-meter running time (ß = 9.64; 95% confidence intervals [3.22, 16.05], ß = 12.41; 95% CI [6.05, 18.76], and ß = 20.87; 95% CI [9.22, 32.51], respectively) after controlling for the potential covariates. There tended to be an inverse association with moderate and high myopia for numbers of 2-min push-ups (ß = -1.38; 95% CI [-2.43, -0.34] and ß = -2.10; 95% CI [- 3.97, -0.22], respectively) and 2-min sit-ups (ß = -0.83; 95% CI [-1.54, -0.12] and ß = -1.29; 95% CI [-2.56, -0.02], respectively), respectively. This study suggested that physical fitness, particularly aerobic fitness of the military males who received regular training, is inversely associated with myopia severity, independent of service specialty, body mass index, and educational level.
Asunto(s)
Ejercicio Físico/fisiología , Personal Militar/estadística & datos numéricos , Miopía/prevención & control , Aptitud Física/fisiología , Índice de Severidad de la Enfermedad , Adulto , Índice de Masa Corporal , Estudios Transversales , Humanos , Masculino , Carrera/fisiología , TaiwánRESUMEN
Acute stroke patients commonly suffer from hyperglycemia. However, the relationship between hyperglycemia and poor outcome after discharge of patients with acute cerebellar hemorrhage (CH) had not been hitherto investigated.Sixty-two patients with acute spontaneous CH were retrospectively analyzed. The consciousness level, blood glucose/sugar (BS) on arrival and maximum diameter of hematoma, etc., were obtained. Patient prognosis was scored by the Glasgow Outcome Scale (GOS) at discharge and we divided them into good outcome (GOS score of 4 or 5) and poor outcome (GOS score of 1 or 2 or 3) groups. The association between early outcome and clinical characteristics were investigated by multivariate logistic regression. There were 33 (53.4%) patients in the poor outcome group and 29(46.6%) in the good outcome group. The initial BS was significantly higher in the poor outcome group (186.4±57 mg/dl) compared with good outcome group (136.6±31.1 mg/dl)(p<0.001). BS≥140 mg/dl (OR=25.217, p=0.008) and maximum diameter of hematoma ≥3 cm (OR=216.422, p<0.001) were independently correlated with poor outcome. We report the first study that hyperglycemia (BS≥140 mg/dl) on arrival and maximum diameter of hematoma ≥3 cm were found to be strong predictive factors of poor outcome at discharge in patients with acute spontaneous CH.
Asunto(s)
Glucemia/análisis , Enfermedades Cerebelosas/sangre , Enfermedades Cerebelosas/terapia , Hemorragia Cerebral/sangre , Hemorragia Cerebral/terapia , Hiperglucemia/sangre , Adulto , Anciano , Anciano de 80 o más Años , Presión Sanguínea/fisiología , Tronco Encefálico/patología , Enfermedades Cerebelosas/patología , Hemorragia Cerebral/patología , Ventrículos Cerebrales/patología , Trastornos de la Conciencia/etiología , Femenino , Escala de Consecuencias de Glasgow , Humanos , Hidrocefalia/etiología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento , Adulto JovenRESUMEN
We report a case of cerebellar hemorrhage (CH) that recurred in other hemisphere after 4 months of the first attack. A 58-year-old man presented with general weakness and computerized tomography (CT) of the brain showed a 41 mm hematoma in the right cerebellum with intraventricular extension. The satisfactory outcome was obtained after emergency surgical intervention and intensive rehabilitation. However, the patient irregularly took the prescribed anti-hypertensive medication. Four months after first attack, the recurrent CH in left side showed by brain CT. Only 2 cases of recurrent CH have been published thus far. The patient is the third reported case of recurrent CH and the second case in which CH recurred in the other hemisphere. Further, no patient has been reported to develop recurrence of CH in such a short period after the first onset. We discuss the possible pathophysiology, clinical course, treatment outcome, risk factors associated with such events and the importance of blood pressure control for preventing recurrence.