Detection of activities in bathrooms through deep learning and environmental data graphics images.

Automatic detection activities in indoor spaces has been and is a matter of great interest. Thus, in the field of health surveillance, one of the spaces frequently studied is the bathroom of homes and specifically the behaviour of users in the said space, since certain pathologies can sometimes be deduced from it. That is why, the objective of this study is to know if it is possible to automatically classify the main activities that occur within the bathroom, using an innovative methodology with respect to the methods used to date, based on environmental parameters and the application of machine learning algorithms, thus allowing privacy to be preserved, which is a notable improvement in relation to other methods. For this, the methodology followed is based on the novel application of a pre-trained convolutional network for classifying graphs resulting from the monitoring of the environmental parameters of a bathroom. The results obtained allow us to conclude that, in addition to being able to check whether environmental data are adequate for health, it is possible to detect a high rate of true positives (around 80%) in some of the most frequent and important activities, thus facilitating its automation in a very simple and economical way.

Cultivable mycoflora on bleached, decaying and healthy Posidonia oceanica leaves in a warm-edge Mediterranean location.

Marine fungi are widely distributed in the ocean, playing an important role in the ecosystems, but only little information is available about their occurrence and activity. Seagrass bleaching is also a neglected phenomenon that seems to be linked to warm environments, even though the causes are still to be defined. In this study, the cultivable mycoflora associated to the leaf conditions (bleached, necrotic and live) and section (from the base to the tip) in the seagrass Posidonia oceanica was investigated in a Mediterranean warm-edge location (Cyprus). A total of 17 Ascomycota species/taxon were identified and results highlighted that mycoflora composition changed significantly in relation to both the leaf condition and section. A few known pathogens of terrestrial plants were detected only on bleached leaves, but it remains unknown whether they have any direct connections with P. oceanica bleaching phenomenon.

Effects of high temperature and marine heat waves on seagrasses: Is warming affecting the nutritional value of Posidonia oceanica?

Primary producers nutritional content affects the entire food web. Here, changes in nutritional value associated with temperature rise and the occurrence of marine heat waves (MHWs) were explored in the endemic Mediterranean seagrass Posidonia oceanica. The variability of fatty acids (FAs) composition and carbon (C) and nitrogen (N) content were examined during summer 2021 from five Mediterranean sites located at the same latitude but under different thermal environments. The results highlighted a decrease in unsaturated FAs and C/N ratio and an increase of monounsaturated FA (MUFA) and N content when a MHW occurred. By contrast, the leaf biochemical composition seems to be adapted to local water temperature since only few significant changes in MUFA were found and N and C/N had an opposite pattern compared to when a MHW occurs. The projected increase in temperature and frequency of MHW suggest future changes in the nutritional value and palatability of leaves.

Status and conservation of coral reefs in Costa Rica.

Costa Rica has coral communities and reefs on the Caribbean coast and on the Pacific along the coast and off-shore islands. The Southern section of the Caribbean coast has fringing and patch reefs, carbonate banks, and an incipient algal ridge. The Pacific coast has coral communities, reefs and isolated coral colonies. Coral reefs have been seriously impacted in the last 30 years, mainly by sediments (Caribbean coast and some Pacific reefs) and by El Niño warming events (both coasts). Monitoring is being carried out at three sites on each coast. Both coasts suffered significant reductions in live coral cover in the 1980's, but coral cover is now increasing in most sites. The government of Costa Rica is aware of the importance of coral reefs and marine environments in general, and in recent years decrees have been implemented (or are in the process of approval) to protect them, but limited resources endanger their proper management and conservation, including proper outreach to reef users and the general public.

Status and conservation of coral reefs in Costa Rica

Costa Rica has coral communities and reefs on the Caribbean coast and on the Pacific along the coast and off-shore islands. The Southern section of the Caribbean coast has fringing and patch reefs, carbonate banks, and an incipient algal ridge. The Pacific coast has coral communities, reefs and isolated coral colonies. Coral reefs have been seriously impacted in the last 30 years, mainly by sediments (Caribbean coast and some Pacific reefs) and by El Niño warming events (both coasts). Monitoring is being carried out at three sites on each coast. Both coasts suffered significant reductions in live coral cover in the 1980’s, but coral cover is now increasing in most sites. The government of Costa Rica is aware of the importance of coral reefs and marine environments in general, and in recent years decrees have been implemented (or are in the process of approval) to protect them, but limited resources endanger their proper management and conservation, including proper outreach to reef users and the general public. Rev. Biol. Trop. 58 (Suppl. 1): 33-50. Epub 2010 May 01.

Costa Rica tiene comunidades coralinas y arrecifes en la costa Caribe y del lado Pacífico a lo largo de la costa y en islas mar afuera). Arrecifes de franja y de parche, bancos carbonatados y una cresta de algas coralinas incipiente están presentes en la sección sur de la costa Caribe. Comunidades coralinas, arrecifes y colonias de coral aisladas se encuentran a lo largo de todo el Pacífico de Costa Rica. Los arrecifes coralinos han sido impactados seriamente en los últimos 30 años, principalmente por sedimentos en el Caribe y algunos arrecifes del Pacífico, y por el calentamiento durante el Fenómeno de El Niño-Oscilación Sureña en el Pacífico. Tres sitios en el Caribe y otros tres en el Pacífico están siendo monitoreados. Después de reducciones significativas en la cobertura de coral vivo en la década de 1980, tanto en el Caribe como en el Pacífico, la mayoría de los arrecifes se está recuperando. El gobierno de Costa Rica es consciente de la importancia de los arrecifes coralinos y de otros ecosistemas marinos, y en años recientes han implementado (o están en proceso de aprobación) varios decretos para la protección de los arrecifes. Pero, hay limitación de fondos y personal para su adecuado manejo y protección. Se necesita más divulgación de información sobre los arrecifes coralinos al público en general y usuarios de los mismos; de nuevo, la limitación de fondos restringe lo que se puede hacer.

Recombinant human granulocyte-macrophage colony stimulating factor (sargramostim) as an alternative therapy for fistulizing Crohn's disease.

BACKGROUND: Impaired neutrophil function has been proposed in the pathogenesis of Inflammatory Bowel Disease. Failure to control the response to bacteria and bacterial products triggers the inflammatory cascade. Genetic disorders of neutrophil dysfunction exhibit gastrointestinal manifestations similar to Crohn's disease. Treatments that enhance neutrophil and macrophage function with colony-stimulating factors have been successful in these conditions. Some studies using sargramostin in patients with Crohn's disease have suggested a beneficial effect in disease activity, including fistulizing disease. The goal of the study was to evaluate the safety and efficacy of sargramostin in patients with fistulizing Crohn's disease who had not responded to conventional therapy or had developed adverse reaction to infliximab requiring discontinuation of the drug. METHODS: Patients with fistulizing Crohn's disease who had failed conventional therapy were recruited. Sargramostin 6 microg/kg subcutaneously daily for 8 weeks was prescribed. Follow-up included clinical evaluation, exam of the fistulas, laboratories, CDAI score, adverse events, compliance with therapy, quality of life assessment, and baseline and post-treatment abdomino-pelvic MRI. RESULTS: Three patients were enrolled. There were 4 perianal, 7 enterocutaneous and multiple enteroenteric fistulas. Two completed 8 weeks of treatment and 1 was discontinued at week 5 for a hypersensitivity reaction. Sargramostin was ineffective in all three. CONCLUSIONS: The small number of patients and the severity of their disease do not allow any conclusions about the drug effectiveness. Placebo-controlled studies, perhaps with less complicated patients, are needed to define a role, if any, of this therapy in fistulizing Crohn's disease.

Septic shock of early or late onset: does it matter?

STUDY OBJECTIVES: To determine possible differences in morbidity and mortality between early and late onset of septic shock in ICU patients. DESIGN: Systematic data collection. SETTING: Thirty-one-bed, mixed, medicosurgical ICU in a university hospital. PATIENTS: All 65 patients who acquired septic shock after admission to the ICU between February 1999 and April 2000. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Forty-one of the 65 patients presented with septic shock within 24 h of admission to the ICU (early septic shock [ESS]); the other 21 patients acquired septic shock > 24 h after ICU admission (late septic shock [LSS]). Eleven patients had a second episode (7 patients in the ESS group, and 4 patients in the LSS group), and 1 patient in the LSS group had a third episode of septic shock. Patients with ESS had higher APACHE (acute physiology and chronic health evaluation) II (mean +/- SD, 26 +/- 6 vs 20 +/- 6; p = 0.002) and sequential organ failure assessment (SOFA) scores (11 +/- 3 vs 7 +/- 3, p < 0.001) on ICU admission, and a higher blood lactate concentration at the onset of shock (median 3.70 mEq/L; interquartile range, 2.6 to 6.6 mEq/L; vs median, 2.50 mEq/L [interquartile range, 1.8 to 4.0 mEq/L], p = 0.03) than patients with LSS. However, the duration of septic shock (median, 42 h [interquartile range, 21 to 97 h] vs median, 93 h [interquartile range, 32 to 241 h], p = 0.058) and the length of ICU stay after the onset of septic shock (median, 75 h; [interquartile range, 38 to 203 h] vs median, 321 h [interquartile range, 96 to 438 h], p = 0.018), was shorter in patients with ESS than patients with LSS. The ICU mortality rate was 63% (26 patients) in the ESS group, and 88% (21 patients) in the LSS group (p = 0.071). At the onset of the first episode of shock, patients with ESS had higher SOFA scores (11 +/- 3 vs 9 +/- 3, p = 0.045), lower pH (7.24 +/- 0.15 vs 7.33 +/- 0.12, p = 0.01), and were treated with higher doses of dopamine (median, 20 microg/kg/min [interquartile range, 14 to 20 microg/kg/min] vs median, 12 microg/kg/min [interquartile range, 8 to 20 microg/kg/min], p = 0.028) than patients with LSS. CONCLUSIONS: Septic shock is more severe when of early onset, as reflected by more severe organ dysfunction, greater lactic acidosis, and higher vasopressor requirements, yet the outcome is better, as reflected by a shorter duration of the shock episode, shorter ICU stay, and slightly lower mortality rates. These differences may influence clinical trials of therapeutic agents for sepsis, and should be taken into account when analyzing the results.

Preparing active patients for international travel.

The risk of acquiring an illness when traveling internationally depends mostly on the area of the world to be visited. Today, with so many transportation options, increasing numbers of athletes are traveling abroad for training and competition, and leisure travelers are enjoying physically challenging adventure vacations-thus exposing themselves to potential medical problems. Primary care, sports medicine, and team physicians must be able to provide travelers with up-to-date information on immunization and chemoprophylaxis requirements, as well as other preventive medicine recommendations.

Pearls.

'Pearls' enables sports medicine professionals to share their practical tips for treating patients. We invite you to send your contributions to Pearls Editor, THE PHYSICIAN AND SPORTSMEDICINE, 4530 W 77th St, Minneapolis, MN 55435. Address electronic submissions to psm@mill2.millcomm.com. Illustrations or photos are encouraged. Selected pearls will be published, accompanied by the author's name.