A Low-Cost Test for Anemia Using an Artificial Neural Network.

BACKGROUND: Anemia during pregnancy can complicate maternal and neonatal health and even lead to fatal consequences if not diagnosed early on. Around 99% of women who face maternal mortality are from middle or low-income countries. Early screening of anemia could facilitate improved health outcomes in pregnant women. Point of care techniques are preferred due to their ability to provide results rapidly and because they can be used by personnel with minimal or no training. Such techniques are especially useful in resource-constrained settings like rural parts of developing countries. OBJECTIVES: The aim of the study was to develop a tool using an Artificial Neural Network (ANN) to estimate hemoglobin values using color information recorded from blood sample images. Our method utilizes inexpensive consumables and a simple image acquisition setup that can be assembled easily. METHODS: This study explores a neural network model to estimate the hemoglobin content in an individual's blood sample. Blood samples were collected from 86 volunteers and the images of blood drops were obtained using an image acquisition setup designed by the team. The color intensity values calculated from the blood drop images were used as feature descriptors for the samples. The features obtained from our samples were consequently fed to the Artificial Neural Network. RESULTS: Our neural network that gives the best result has the architecture of 11 neurons in each of the 5 layers. The best model gave estimated hemoglobin levels by analyzing color of blood samples with an accuracy of ±1.8 g/dl Limits of agreement (LOA) and bias 0.03 g/dl (with mean error of 0.75 g/dl). The model was subsequently tested with a validation set prepared from an additional 65 samples. The estimated hemoglobin levels gave an accuracy of +2 g/dl to -1.9 g/dl Limits of agreement (LOA) and bias 0.06 g/dl (with mean error of 0.78 g/dl). CONCLUSION: Optimization of sensitivity and specificity has been able to achieve the sensitivity and specificity values as 95.5% and 52% respectively. These results are at par with the contemporary measurement techniques indicating that our method can be used as a workable screening technique itself.

Taxonomy Classification using Genomic Footprint of Mitochondrial Sequences.

BACKGROUND: Advancement in sequencing technology yields a huge number of genomes from a multitude of organisms on our planet. One of the fundamental tasks for processing and analyzing these sequences is to organize them in the existing taxonomic orders. METHODS: Recently, we proposed a novel approach, GenFooT, for taxonomy classification using the concept of genomic footprint (GFP). The technique is further refined and enhanced in this work leading to improved accuracies in the task of taxonomic classification based on various benchmark datasets. GenFooT maps a genome sequence in a 2D coordinate space and extracts features from that representation. It uses two hyper-parameters, namely block size and number of fragments of genomic sequence while computing the feature. In this work, we propose an analysis of choosing values of those parameters adaptively from the sequences. The enhanced version of GenFooT is named GenFooT2. RESULTS: We have tested GenFooT2 on ten different biological datasets of genomic sequences of various organisms belonging to different taxonomy ranks. Our experimental results indicate a 3% improved classification performance of the proposed GenFooT2 featured with a Logistic regression classifier as compared to GenFooT. We also performed the statistical test to compare the performance of GenFooT2 to the state-of-the-art methods including our previous method, GenFooT. CONCLUSION: The experimental results as well as the statistical test exhibit that the performance of the proposed GenFooT2 is significantly better.

Assessment of serum calcium in -patients referred for suspected lung cancer: A quality -improvement project to enhance patient safety in clinical practice.

BACKGROUND: Hypercalcaemia is a serious complication of lung cancer. A quality improvement project (QIP) was designed based on guidance from the American College of Chest Physician and the European Respiratory Society who recommend measuring serum calcium for patients referred with suspected lung cancer. METHOD: Seventy-two patients were included in the initial data to ascertain the delay between referral to the lung cancer pathway and obtaining serum calcium levels as part of the initial work-up. New data were then collected after each intervention (including presentations at weekly respiratory multidisciplinary team meetings, posters within clinical areas and a hospital trust screensaver) to evaluate the delay. RESULTS: Initially, 11.1% (n=8) did not have serum calcium measured at any point; two of which had lung cancer (including one metastatic malignancy). Of those who had serum calcium measured, there was a median delay of 13 days between first suspicion and obtaining serum calcium. After all the interventions were put in place, patients had a median of 7 days' delay (p=0.001). CONCLUSION: This QIP design was based on continued feedback to improve the care of patients suspected of lung cancer. Although there was a significant reduction in delays post-intervention, increasing awareness in the community is suggested to maintain these improvements.

Deformity Index: A Semi-Reference Clade-Based Quality Metric of Phylogenetic Trees.

Measuring the dissimilarity of a phylogenetic tree with respect to a reference tree or the hypotheses is a fundamental task in the phylogenetic study. A large number of methods have been proposed to compute the distance between the reference tree and the target tree. Due to the presence of unresolved relationships among the species, it is challenging to obtain a precise and an accurate reference tree for a selected dataset. As a result, the existing tree comparison methods may behave unexpectedly in various scenarios. In this paper, we introduce a novel scoring function, called the deformity index, to quantify the dissimilarity of a tree based on the list of clades of a reference tree. The strength of our proposed method is that it depends on the list of clades that can be acquired either from the reference tree or from the hypotheses. We investigate the distributions of different modules of the deformity index and perform different goodness-of-fit tests to understand the cumulative distribution. Then, we examine, in detail, the robustness as well as the scalability of our measure by performing different statistical tests under various models. Finally, we experiment on different biological datasets and show that our proposed scoring function overcomes the limitations of the conventional methods.

Prediction of survival outcome based on clinical features and pretreatment 18FDG-PET/CT for HNSCC patients.

BACKGROUND AND OBJECTIVE: In this study, we have analysed pretreatment positron-emission tomography/ computed tomography (PET/CT) images of head and neck squamous cell carcinoma (HNSCC) patients. We have used a publicly available dataset for our analysis. The clinical features of the patient, PET quantitative parameters, and textural indices from pretreatment PET-CT images are selected for the study. The main objective of the study is to use classifiers to predict the outcome for HNSCC patients and compare the performance of the model with the conventional statistical model (CoxPH). METHODS: We have applied a 40% fixed SUV threshold method for tumour delineation. Clinical features of each patient are provided in the dataset, and other features are calculated using LIFEx software. For predicting the outcome, we have implemented three classifiers - Random Forest classifier, Gradient Boosted Decision tree (GBDT) and Decision tree classifier. We have trained each model using 93 data points and test the model performance using 39 data points. The best model - GBDT is chosen based on the performance metrics. RESULTS: It is observed that typically three features: MTV (Metabolic tumour Volume), primary tumour site and GLCM_correlation are significant for prediction of survival outcome. For testing cohort, GBDT achieves a balanced accuracy of 88%, where conventional statistical model reported a balanced accuracy of 81.5%. CONCLUSIONS: The proposed classifier achieves higher accuracy than the state of the art technique. Using this classifier we can estimate the HNSCC patient's outcome, and depending upon the outcome treatment policy can be selected.

Estradiol reverses excitatory synapse loss in a cellular model of neuropsychiatric disorders.

Loss of glutamatergic synapses is thought to be a key cellular pathology associated with neuropsychiatric disorders including schizophrenia (SCZ) and major depressive disorder (MDD). Genetic and cellular studies of SCZ and MDD using in vivo and in vitro systems have supported a key role for dysfunction of excitatory synapses in the pathophysiology of these disorders. Recent clinical studies have demonstrated that the estrogen, 17ß-estradiol can ameliorate many of the symptoms experienced by patients. Yet, to date, our understanding of how 17ß-estradiol exerted these beneficial effects is limited. In this study, we have tested the hypothesis that 17ß-estradiol can restore dendritic spine number in a cellular model that recapitulates the loss of synapses associated with SCZ and MDD. Ectopic expression of wildtype, mutant or shRNA-mediated knockdown of Disrupted in Schizophrenia 1 (DISC1) reduced dendritic spine density in primary cortical neurons. Acute or chronic treatment with 17ß-estradiol increased spine density to control levels in neurons with altered DISC1 levels. In addition, 17ß-estradiol reduced the extent to which ectopic wildtype and mutant DISC1 aggregated. Furthermore, 17ß-estradiol also caused the enrichment of synaptic proteins at synapses and increased the number of dendritic spines containing PSD-95 or that overlapped with the pre-synaptic marker bassoon. Taken together, our data indicates that estrogens can restore lost excitatory synapses caused by altered DISC1 expression, potentially through the trafficking of DISC1 and its interacting partners. These data highlight the possibility that estrogens exert their beneficial effects in SCZ and MDD in part by modulating dendritic spine number.

Prevalence of Minimal Hepatic Encephalopathy in Patients With Liver Cirrhosis: A Cross-Sectional, Clinicoepidemiological, Multicenter, Nationwide Study in India: The PREDICT Study.

BACKGROUND: The study aimed at assessing the prevalence and clinical profile of minimal hepatic encephalopathy (MHE) in patients with cirrhosis using neuropsychological assessment and at understanding the management practices of MHE in the Indian clinical setting. METHODS: This cross-sectional, clinicoepidemiological study conducted at 20 sites enrolled liver cirrhosis patients with Grade 0 hepatic encephalopathy according to West-Haven Criteria. Patients were subjected to mini-mental state examination and those with a score of ≥24 were assessed using psychometric hepatic encephalopathy score. Short Form-36 questionnaire was administered to assess the impact on health-related quality of life. RESULTS: Of the 1260 enrolled patients, 1114 were included in the analysis. The mean age was 49.5 years and majority were males (901 [81%]). The prevalence of MHE was found to be 59.7% (665/1114) based on the psychometric hepatic encephalopathy score of ≤-5. Alcohol-related liver disease was the most common etiology (482 [43.27%]) followed by viral infection (239 [21.45%]). Past smokers as well as those currently smoking were more likely to have MHE than nonsmokers. A significant association was found between tobacco chewing, smoking, alcohol consumption, diabetes, and the presence of MHE. Multivariable analysis revealed smoking as the only parameter associated with MHE. A total of 300 (26.9%) patients were on prophylaxis with lactulose/lactitol or rifaximin. These patients were less likely to have MHE as compared to those not on prophylaxis (odds ratio, 0.67; 95% confidence interval, 0.50-0.88; P = 0.005). CONCLUSION: The disease burden of MHE is quite substantial in patients with cirrhosis with no apparent cognitive defect. Smoking, whether past or current, has significant association with the presence of MHE. Although MHE has been shown to adversely affect quality of life, prophylaxis for MHE is not routinely practiced in the Indian setting.The study has been registered under clinical trials registry of India (CTRI/2014/01/004306).

Estimation of echocardiogram parameters with the aid of impedance cardiography and artificial neural networks.

The advent of cardiovascular diseases as a disease of mass catastrophy, in recent years is alarming. It is expected to spread as an epidemic by 2030. Present methods of determining the health of one's heart include doppler based echocardiogram, MDCT (Multi Detector Computed Tomography), among various other invasive and non-invasive hemodynamic monitoring techniques. These methods require expert supervision and costly clinical set-ups, and cannot be employed by a common individual to perform a self diagnosis of one's cardiac health, unassisted. In this work, the authors propose a novel methodology using impedance cardiography (ICG), for the determination of a person's cardio-vascular health. The recorded ICG signal helps in extraction of features which are used for estimating parameters for cardiac health monitoring. The proposed methodology with the aid of artificial neural network is able to determine Stroke Volume (SV), Left Ventricular End Systolic Volume (LVESV), Left Ventricular End Diastolic Volume (LVEDV), Left Ventricular Ejection Fraction (LVEF), Iso Volumetric Contraction Time (IVCT), Iso Volumetric Relaxation Time (IVRT), Left Ventricular Ejection Time (LVET), Total Systolic Time (TST), Total Diastolic Time (TDT), and Myocardial Performance Index (MPI), with error margins of ±8.9%, ±3.8%, ±1.4%, ±7.8%, ±16.0%, ±9.0%, ±9.7%, ±6.9%, ±6.2%, and ±0.9%, respectively. The proposed methodology could be used in screening of precursors to cardiac ailments, and to keep a check on the cardio-vascular health.

Tool inhibitors and assays to interrogate the biology of the TRAF2 and NCK interacting kinase.

The TRAF2 and NCK interacting kinase (TNIK) has been proposed to play a role in cytoskeletal organization and synaptic plasticity and has been linked, among others, to neurological disorders. However, target validation efforts for TNIK have been hampered by the limited kinase selectivity of small molecule probes and possible functional compensation in mouse models. Both issues are at least in part due to its close homology to the kinases MINK1 (or MAP4K6) and MAP4K4 (or HGK). As part of our interest in validating TNIK as a therapeutic target for neurological diseases, we set up a panel of biochemical and cellular assays, which are described herein. We then examined the activity of known amino-pyridine-based TNIK inhibitors (1, 3) and prepared structurally very close analogs that lack the ability to inhibit the target. We also developed a structurally orthogonal, naphthyridine-based TNIK inhibitor (9) and an inactive control molecule of the same chemical series. These validated small-molecule probes will enable dissection of the function of TNIK family in the context of human disease biology.

Potential of growth factor incorporated mesoporous bioactive glass for in vivo bone regeneration.

Mesoporous bioactive glass (MBG) has drawn much attention due to its superior surface texture, porosity and bioactive characteristics. Aim of the present study is to synthesize MBG using different surfactants, viz., hexadecyltrimethylamonium(CTAB) (M1), poly-ethylene glycol (PEG) (M2) and pluronic P123 (M3); bioactivity study; and to understand their bone regeneration efficacy in combination with insulin-like growth factors (IGF-1) in animal bone defect model. SBF study revealed the formation of calcium carbonate (CaCO3) and hydroxyapatite (HAp) phase over 14 days. Formation of apatite layer was further confirmed by FTIR, FESEM and EDX analysis. M1 and M2 showed improved crystallinity, while M3 showed slightly decrease in crystalline peak of CaCO3 and enhanced HAp phase. More Ca-P layer formed in M1 and M2 supported the in vivo experiments subsequently. Degree of new bone formation for all MBGs were high, i.e., M1 (80.7 ±â€¯2.9%), M2 (74.4 ±â€¯2.4%) and M3 (70.1 ±â€¯1.9%) compared to BG (66.9 ±â€¯1.8%). In vivo results indicated that the materials were non-toxic, biodegradable, biocompatible, and is suitable as bone replacement materials. Thus, we concluded that growth factor loaded MBG is a promising candidate for bone tissue engineering application.

Ro-positive interstitial lung disease treated with cyclophosphamide.

Interstitial lung disease (ILD) comprises a spectrum of conditions involving inflammation and/or fibrosis of the alveolar wall causing limitation in gaseous exchange. Treatment varies depending on the underlying ILD. We describe the case of a woman presenting with a productive cough who was diagnosed with community-acquired pneumonia. While on the ward she developed type-1 respiratory failure requiring continuous positive airway pressure and intensive care unit admission. Failing to respond to targeted antimicrobials she was investigated by chest high-resolution CT and autoantibody screen to identify non-infective causes of her respiratory signs and symptoms. These demonstrated diffuse ground-glass change with peripheral honeycombing in keeping with fibrosis and alveolitis alongside high titres of anti-SS-A/Ro antibodies. She was managed with reducing course of steroids and immunosuppression with cyclophosphamide. The rational of long-term immunosuppression was based on a presumed diagnosis of lung-dominant connective tissue disease, a disease concept proposed in contemporary medical literature.

Estradiol modulates the efficacy of synaptic inhibition by decreasing the dwell time of GABAA receptors at inhibitory synapses.

Estrogen plays a critical role in many physiological processes and exerts profound effects on behavior by regulating neuronal excitability. While estrogen has been established to exert effects on dendritic morphology and excitatory neurotransmission its role in regulating neuronal inhibition is poorly understood. Fast synaptic inhibition in the adult brain is mediated by specialized populations of γ-c aA receptors (GABAARs) that are selectively enriched at synapses, a process dependent upon their interaction with the inhibitory scaffold protein gephyrin. Here we have assessed the role that estradiol (E2) plays in regulating the dynamics of GABAARs and stability of inhibitory synapses. Treatment of cultured cortical neurons with E2 reduced the accumulation of GABAARs and gephyrin at inhibitory synapses. However, E2 exposure did not modify the expression of either the total or the plasma membrane GABAARs or gephyrin. Mechanistically, single-particle tracking revealed that E2 treatment selectively reduced the dwell time and thereby decreased the confinement of GABAARs at inhibitory synapses. Consistent with our cell biology measurements, we observed a significant reduction in amplitude of inhibitory synaptic currents in both cultured neurons and hippocampal slices exposed to E2, while their frequency was unaffected. Collectively, our results suggest that acute exposure of neurons to E2 leads to destabilization of GABAARs and gephyrin at inhibitory synapses, leading to reductions in the efficacy of GABAergic inhibition via a postsynaptic mechanism.

IDXL: Species Tree Inference Using Internode Distance and Excess Gene Leaf Count.

We propose an extension of the distance matrix methods NJst and ASTRID to infer species trees from incongruent gene trees having Incomplete Lineage Sorting. Both approaches consider the average internode distance (ID) between individual taxa pairs as the distance measure. The measure ID does not use the root of a tree, and thus may not always infer the relative position of a taxon with respect to the root. We define a novel distance measure excess gene leaf count (XL) between individual couplets. The XL measure is computed using the root of a tree. It is proved to be additive, and is shown to infer the relative order of divergence among individual couplets better. We propose a novel method IDXL which uses both the XL and ID measures for species tree construction. IDXL is shown to perform better than NJst and other distance matrix approaches for most of the biological and simulated datasets. Having the same computational complexity as NJst, IDXL can be applied for species tree inference on large-scale biological datasets.

Cytoplasmic Relocalization of TAR DNA-Binding Protein 43 Is Not Sufficient to Reproduce Cellular Pathologies Associated with ALS In vitro.

Mutations in the gene TARDBP, which encodes TAR DNA-binding protein 43 (TDP-43), are a rare cause of familial forms of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). While the majority of mutations are found in the C-terminal glycine-rich domain, an alanine to valine amino acid change at position 90 (A90V) in the bipartite nuclear localization signal (NLS) of TDP-43 has been described. This sequence variant has previously been shown to cause cytoplasmic mislocalization of TDP-43 and decrease protein solubility, leading to the formation of insoluble aggregates. Since the A90V mutation has been described both in patients as well as healthy controls, its pathogenic potential in ALS and FTD remains unclear. Here we compare properties of overexpressed A90V to the highly pathogenic M337V mutation. Though both mutations drive mislocalization of the protein to the cytoplasm to the same extent, M337V produces more significant damage in terms of protein solubility, levels of pathogenic phosphorylation, and formation of C-terminal truncated protein species. Furthermore, the M337V, but not the A90V mutant, leads to a downregulation of histone deacetylase 6 and Ras GTPase-activating protein-binding protein. We conclude that in the absence of another genetic or environmental 'hit' the A90V variant is not sufficient to cause the deleterious phenotypes associated with ALS and FTD, despite prominent cytoplasmic protein relocalization of TDP-43.

Influence of single and binary doping of strontium and lithium on in vivo biological properties of bioactive glass scaffolds.

Effects of strontium and lithium ion doping on the biological properties of bioactive glass (BAG) porous scaffolds have been checked in vitro and in vivo. BAG scaffolds were prepared by conventional glass melting route and subsequently, scaffolds were produced by evaporation of fugitive pore formers. After thorough physico-chemical and in vitro cell characterization, scaffolds were used for pre-clinical study. Soft and hard tissue formation in a rabbit femoral defect model after 2 and 4 months, were assessed using different tools. Histological observations showed excellent osseous tissue formation in Sr and Li + Sr scaffolds and moderate bone regeneration in Li scaffolds. Fluorochrome labeling studies showed wide regions of new bone formation in Sr and Li + Sr doped samples as compared to Li doped samples. SEM revealed abundant collagenous network and minimal or no interfacial gap between bone and implant in Sr and Li + Sr doped samples compared to Li doped samples. Micro CT of Li + Sr samples showed highest degree of peripheral cancellous tissue formation on periphery and cortical tissues inside implanted samples and vascularity among four compositions. Our findings suggest that addition of Sr and/or Li alters physico-chemical properties of BAG and promotes early stage in vivo osseointegration and bone remodeling that may offer new insight in bone tissue engineering.

Image Inpainting Through Metric Labeling via Guided Patch Mixing.

In this paper, we present a novel formulation of exemplar-based image inpainting as a metric labeling problem, and solve it through the simulated annealing algorithm. Due to their greedy nature, exemplar-based methods sometimes produce inpainted images, which are visually inconsistent. These methods are highly dependent upon the initialization. To solve these problems, we generate five images with a different initialization. A suitable mixture of these five images produces a good inpainted image. The cost function of the proposed metric labeling problem consists of three components, namely, neighbor cost, total variation cost, and structure cost. A linear combination among these components is used to maintain better visual consistency in the inpainted region having smooth transition from the bordering regions of the source image. We use a quality measure to this end. Our experiments on a wide variety of images demonstrate that the proposed technique produces better inpainting images as compared with some other state-of-the-art techniques.

In-hospital measurement of left ventricular ejection fraction and one-year outcomes in acute coronary syndromes: results from the IMMEDIATE Trial.

BACKGROUND: In patients with acute coronary syndrome (ACS), reduced left ventricular ejection fraction (LVEF) is a known marker for increased mortality. However, the relationship between LVEF measured during index ACS hospitalization and mortality and heart failure (HF) within 1 year are less well-defined. METHODS: We performed a retrospective analysis of 445 participants in the IMMEDIATE Trial who had LVEF measured by left ventriculography or echocardiogram during hospitalization. RESULTS: Adjusting for age and coronary artery disease (CAD) history, lower LVEF was significantly associated with 1-year mortality or hospitalization for HF. For every 5 % LVEF reduction, the hazard ratio [HR] was 1.26 (95 % CI 1.15, 1.38, P < 0.001). Participants with LVEF < 40 % had higher hazard of 1-year mortality or HF hospitalization than those with LVEF > 40 (HR 3.59; 95 % CI 2.05, 6.27, P < 0.001). The HRs for the association of LVEF with the study outcomes were similar whether measured by left ventriculography or by echocardiography, (respectively, HR 1.32; 95 % CI 1.15, 1.51 and 1.21; 95 % CI 1.106, 1.35, interaction P = 0.32) and whether done within 24 h or not within 24 h (respectively, HR 1.28; 95 % CI 1.10, 1.50 and 1.23; 95 % CI 1.10, 1.38, interaction P = 0.67). CONCLUSIONS: Among patients with ACS, lower in-hospital LVEF is associated with increased 1-year mortality or hospitalization for HF, regardless of the method or timing of the LVEF assessment. This has prognostic implications for clinical practice and suggests the possibility of using various methods of LVEF determination in clinical research.

Laryngeal leishmaniasis in a patient taking inhaled corticosteroids.

We present a case of a man in his late 60s, who had spent 3-4 months of the year in rural Spain, presenting with intermittent hoarseness of voice. He had a background of asthma and bronchiectasis, and was taking inhaled corticosteroids. His dysphonia was initially managed as bronchiectasis with little improvement. Bronchoscopy revealed a cystic lesion on his left vocal fold, and tissue biopsy revealed Leishmania amastigotes. This confirmed a diagnosis of laryngeal leishmaniasis. We propose that this is likely secondary to his inhaled corticosteroid therapy. The infection was treated with a 30-day course of miltefosine, and at most recent follow-up the patient was deemed free from leishmanial infection.

C-Reactive protein reactions to glucose-insulin-potassium infusion and relations to infarct size in patients with acute coronary syndromes.

BACKGROUND: Some benefits of glucose-insulin-potassium (GIK) in patients with acute coronary syndromes (ACS) may be from an anti-inflammatory effect. The primary aim of this study was to assess the impact of GIK administration early in the course of ACS on inflammatory marker C-reactive protein (CRP) levels. A secondary aim was to investigate the association between CRP and 30-day infarct size. METHODS AND RESULTS: Retrospective analysis of participants with ACS randomly assigned to GIK or placebo for at least 8 h in the IMMEDIATE Trial biological mechanism cohort (n = 143). High sensitivity CRP (hs-CRP) was measured at emergency department presentation, and 6 and 12 h into infusion. Logarithmically transformed hs-CRP values at 12-hours were lower with GIK vs. placebo (mean =0.65 mg/L in GIK, 0.84 mg/L in placebo), with a marginal trend toward significance (P = 0.053). Furthermore, using mixed models of hs-CRP, time, and study group, there was a significant increase in hs-CRP levels over time, but the rate of change did not differ between treatment arms (P = 0.3). Multivariable analysis showed that an elevation in hs-CRP, measured at 12 h, was an independent predictor of 30-day infarct size (ß coefficient, 6.80; P = 0.04) using sestamibi SPECT imaging. CONCLUSIONS: The results of this study show no significant effect of GIK on hs-CRP. In addition our results show that in patients with ACS, hs-CRP measured as early as 12 h can predict 30-day infarct size.