Multi-Modal Convolutional Parameterisation Network for Guided Image Inverse Problems.

There are several image inverse tasks, such as inpainting or super-resolution, which can be solved using deep internal learning, a paradigm that involves employing deep neural networks to find a solution by learning from the sample itself rather than a dataset. For example, Deep Image Prior is a technique based on fitting a convolutional neural network to output the known parts of the image (such as non-inpainted regions or a low-resolution version of the image). However, this approach is not well adjusted for samples composed of multiple modalities. In some domains, such as satellite image processing, accommodating multi-modal representations could be beneficial or even essential. In this work, Multi-Modal Convolutional Parameterisation Network (MCPN) is proposed, where a convolutional neural network approximates shared information between multiple modes by combining a core shared network with modality-specific head networks. The results demonstrate that these approaches can significantly outperform the single-mode adoption of a convolutional parameterisation network on guided image inverse problems of inpainting and super-resolution.

Irritable Bowel Syndrome Patient Experience: A Survey of Patient-Reported Symptoms by Irritable Bowel Syndrome Subtype and Impact on Quality of Life.

Objectives: Irritable bowel syndrome (IBS) is a chronic, debilitating, functional gastrointestinal disorder with symptoms of abdominal pain, bloating, and altered bowel behaviours of constipation (IBS-C), diarrhea (IBS-D), or a mixture of both (IBS-M). There is limited information published on the impact of symptoms on everyday life in the Canadian population. Methods: An online survey was conducted with individuals diagnosed with IBS to capture the severity and frequency of patient-reported symptoms, including impact on productivity, quality of life, healthcare utilization, treatment access, and corresponding symptom relief. Responses from the three subtypes of IBS were categorized to illustrate differences among these. Results: There were 2,470 qualified respondents (filtered from 2,981, which included nonspecific IBS). IBS-M was the most common subtype, at 44 percent. Most individuals from all three IBS subtypes reported experiencing moderate to severe abdominal pain (63-70 percent) and bloating (59-75 percent) over the previous 3 months. Persons living with IBS-C reported severe bloating (32 percent), straining (72 percent), and tenesmus (78 percent) whereas those with IBS-D experienced severe urgency (63 percent) and incontinence (29 percent). Symptoms interfered in daily life, sometimes in 46 percent and often in 23 percent of respondents. Patients reported mood and anxiety disorders as common comorbidities with IBS (mood disorders: 30-34 percent; anxiety disorders: 25-30 percent). Conclusions: This study focuses on the differences among the IBS subtypes. IBS impacts productivity and healthcare utilization, which requires further investigation on approaches to improve treatment. The frequency and severity of symptoms in IBS are high and only a few respondents reported that their symptoms are under control.

Índice frágil-VIG: Validez convergente y discriminativa respecto a la Short Physical Performance Battery en población general / Frail-VIG index: Convergent and discriminatory validity with respect to Short Physical Performance Battery in general population

Antecedentes y objetivo: El estudio de la fragilidad en atención primaria (AP) mediante índices de fragilidad (IF) es escaso. El índice frágil-VIG evalúa el grado de fragilidad con un enfoque multidimensional. El objetivo principal fue investigar la validez convergente y discriminativa del índice frágil-VIG respecto a la Short Physical Performance Battery (SPPB) en población general ≥ 70 años. Población, materiales y métodos: Estudio descriptivo transversal. Se incluyeron 416 participantes no institucionalizados ≥ 70 años de dos cupos de un centro de salud semiurbano. Las variables principales fueron el índice frágil-VIG y la SPPB. Resultados: El valor bajo la curva ROC del índice frágil-VIG respecto a la SPPB < 7 fue de 0,81 (IC 95% 0,76-0,86). La correlación fue -0,59 (IC 95% -0,524 a -0,649). La media del índice frágil-VIG en los participantes clasificados como no frágiles por SPPB < 7 fue 0,103 (IC 95% 0,094-0,112) y en los clasificados como frágiles, 0,242 (IC 95% 0,215-0,269). Se obtuvieron diferencias significativas en la media y distribución de la SPPB, según las categorías del índice frágil-VIG. La prevalencia de fragilidad según el índice frágil-VIG fue de 29,3% (IC 95% 25,2-33,9), inicial 19%, intermedia 7,5%, avanzada 2,9%. Se clasificaron como participantes frágiles según el índice frágil-VIG y no según la SPPB < 7, 10,4%, y al contrario 9,6%, siendo la media de dominios del índice frágil-VIG afectados 3,9 y 2,2, respectivamente. Conclusiones: El índice frágil-VIG presenta una adecuada validez convergente y discriminativa respecto a la SPPB, lo cual avala su uso en AP. Hay un 20% de participantes clasificados como frágiles de manera discordante, con distinto perfil. (AU)

Background and objective: Studies of frailty in primary health care (PHC) using frailty indexes are scarce. Frail-VIG index assesses the level of frailty through a multidimensional approach. The main objective was to investigate the convergent and discriminative validity of the frail-VIG index with respect to Short Physical Performance Battery (SPPB) in general population ≥ 70 years. Population, materials and methods: Descriptive cross-sectional study. We included 416 non-institutionalized patients aged 70 years or over from two lists of general practitioners in a semi-urban healthcare center. Main variables were: frail-VIG index and SPPB. Results: The value of the area under the ROC curve of frail-VIG index respect SPPB < 7 was 0.81 (95% CI: 0.76–0.86). Pearson's correlation coefficient was −0.59 (95% CI: −0.524 to −0.649). The mean of frail-VIG index in those classified as not frail by SPPB < 7 was 0.103 (95% CI: 0.094–0.112) and in the frail was 0.242 (95% CI: 0.215–0.269). We obtained significant differences in the mean and distribution of the SPPB according to the frail-VIG index categories. The frailty prevalence according to the frail-VIG index was 29.3% (95% CI: 25.2–33.9), initial 19%, intermediate 7.5% and advanced 2.9%. There were frailty people by frail-VIG index and not by SPPB < 7 the 10.4%; on the contrary the 9.6%, the mean of affected domains of frail-VIG index was 3.9 and 2.2, respectively. Conclusions: The frail-VIG index presents adequate convergent and discriminative validity with respect to the SPPB that supports the use in PHC. There is a 20% of participants classified as frail in a discordant way, who presents a different profile. (AU)

[Frail-VIG index: Convergent and discriminatory validity with respect to Short Physical Performance Battery in general population]. / Índice frágil-VIG: Validez convergente y discriminativa respecto a la Short Physical Performance Battery en población general.

BACKGROUND AND OBJECTIVE: Studies of frailty in primary health care (PHC) using frailty indexes are scarce. Frail-VIG index assesses the level of frailty through a multidimensional approach. The main objective was to investigate the convergent and discriminative validity of the frail-VIG index with respect to Short Physical Performance Battery (SPPB) in general population ≥ 70 years. POPULATION, MATERIALS AND METHODS: Descriptive cross-sectional study. We included 416 non-institutionalized patients aged 70 years or over from two lists of general practitioners in a semi-urban healthcare center. Main variables were: frail-VIG index and SPPB. RESULTS: The value of the area under the ROC curve of frail-VIG index respect SPPB < 7 was 0.81 (95% CI: 0.76-0.86). Pearson's correlation coefficient was -0.59 (95% CI: -0.524 to -0.649). The mean of frail-VIG index in those classified as not frail by SPPB < 7 was 0.103 (95% CI: 0.094-0.112) and in the frail was 0.242 (95% CI: 0.215-0.269). We obtained significant differences in the mean and distribution of the SPPB according to the frail-VIG index categories. The frailty prevalence according to the frail-VIG index was 29.3% (95% CI: 25.2-33.9), initial 19%, intermediate 7.5% and advanced 2.9%. There were frailty people by frail-VIG index and not by SPPB < 7 the 10.4%; on the contrary the 9.6%, the mean of affected domains of frail-VIG index was 3.9 and 2.2, respectively. CONCLUSIONS: The frail-VIG index presents adequate convergent and discriminative validity with respect to the SPPB that supports the use in PHC. There is a 20% of participants classified as frail in a discordant way, who presents a different profile.

Position statement on the use of albumin in liver cirrhosis.

Cirrhosis is characterised by a prolonged asymptomatic period in which the inflammation persists, increasing as the disease progresses. Characteristic of this is the increase in pro-inflammatory cytokines and pro-oxidant molecules which are determining factors in the development of multiple organ dysfunction. In the early development of cirrhosis, splanchnic arterial vasodilation, activation of vasoconstrictor systems (renin-angiotensin-aldosterone) and the sympathetic nervous system (noradrenaline) bring about bacterial translocation and systemic dissemination via portal circulation of bacterial products, and molecular patterns associated with damage, which exacerbate the systemic inflammation present in the patient with cirrhosis. Albumin is a molecule that undergoes structural and functional changes as liver damage progresses, affecting its antioxidant, immunomodulatory, oncotic and endothelial stabilising properties. Our knowledge of the properties of albumin reveals a molecule with multiple treatment options in patients with cirrhosis, from the compensated then decompensated phases to multiple organ dysfunction. Its recognised uses in spontaneous bacterial peritonitis, post-paracentesis circulatory dysfunction, acute kidney injury and hepatorenal syndrome are fully validated, and a treatment option has opened up in decompensated cirrhosis and in acute-on-chronic liver disease.

Simple corrections for the static dielectric constant of liquid mixtures from model force fields.

Pair-wise additive force fields provide fairly accurate predictions, through classical molecular simulations, for a wide range of structural, thermodynamic, and dynamical properties of many materials. However, one key property that has not been well captured is the static dielectric constant, which characterizes the response of a system to an applied electric field and is important in determining the screening of electrostatic interactions through a system. A simple correction has been found to provide a relatively robust method to improve the estimate of the static dielectric constant from molecular simulations for a broad range of compounds. This approach accounts for the electronic contribution to molecular polarizability and assumes that the charges that couple a molecule to an applied electric field are proportional to the effective force field charges. In this work, we examine how this correction performs for systems at different temperatures and for binary mixtures. Using a value for the electronic polarizability, based on the experimental index of refraction, and a charge scaling factor, determined at a single temperature, we find that the static dielectric constant can be predicted remarkably well, in comparison to the experimentally measured values. This provides good evidence that the effective charges that appear in pair-wise additive force fields developed to reproduce the potential energy surface of a system are not the same as those that determine the static dielectric constant; however, they can be captured in a relatively simple manner, which is dependent on the particular force field.

Utilización de datos administrativos y el volumen de cirugía coronaria. Una nota de precaución / Administrative data and volume of surgical revascularization. A note of caution

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Automatic Annotation of Subsea Pipelines using Deep Learning.

Regulatory requirements for sub-sea oil and gas operators mandates the frequent inspection of pipeline assets to ensure that their degradation and damage are maintained at acceptable levels. The inspection process is usually sub-contracted to surveyors who utilize sub-sea Remotely Operated Vehicles (ROVs), launched from a surface vessel and piloted over the pipeline. ROVs capture data from various sensors/instruments which are subsequently reviewed and interpreted by human operators, creating a log of event annotations; a slow, labor-intensive and costly process. The paper presents an automatic image annotation framework that identifies/classifies key events of interest in the video footage viz. exposure, burial, field joints, anodes, and free spans. The reported methodology utilizes transfer learning with a Deep Convolutional Neural Network (ResNet-50), fine-tuned on real-life, representative data from challenging sub-sea environments with low lighting conditions, sand agitation, sea-life and vegetation. The network outputs are configured to perform multi-label image classifications for critical events. The annotation performance varies between 95.1% and 99.7% in terms of accuracy and 90.4% and 99.4% in terms of F1-Score depending on event type. The performance results are on a per-frame basis and corroborate the potential of the algorithm to be the foundation for an intelligent decision support framework that automates the annotation process. The solution can execute annotations in real-time and is significantly more cost-effective than human-only approaches.

Incidence and prognostic implications of late bleeding events after percutaneous mitral valve repair.

OBJECTIVES: MitraClip is an established therapy for patients with mitral regurgitation (MR) that are considered of high-risk or inoperable. However, late bleeding events (BE) after hospital discharge and their impact on prognosis in this cohort of patients have been poorly investigated. Our purpose is to address the incidence, related factors and clinical implications of BE after hospital discharge in patients treated with MitraClip. METHODS: Prospective registry of all consecutive patients (n = 80) who underwent MitraClip implantation in our Institution between June 2014 and December 2017. BE were defined according to MVARC definitions. A combined clinical end-point including admission for heart failure (HF) and all-cause mortality was established to analyze prognostic implications of BE. RESULTS: During a median follow up of 523.5 days, 41 BE were reported in 21 patients. Atrial fibrillation (AF, HR 4.54, CI95% 1.20-17.10) and combined antithrombotic therapy at discharge (HR 3.52, CI95% 1.03-11.34) were independently associated with BE. In the study period, 15 (18.8%) patients died, 20 (25%) were admitted for HF and 29 (36.3%) presented the combined end-point. After multivariable adjustment BE remained independently associated with an adverse outcome (HR 3.80, CI 95% 1.66-8.72). In the subgroup of patients with AF, HAS-BLED score was higher among subjects with BE (3.1 ±â€¯1.3 vs 2.1 ±â€¯0.9, p = 0.003). HAS-BLED score had a significant discrimination power for the occurrence BE (AUC: 0.677 [0.507-0.848]) in this subgroup. CONCLUSIONS: BE are common after MitraClip and are associated with an impaired outcome. Strategies to reduce bleeding events are paramount in this cohort of patients.

Molecular Dynamics Investigation of the Influence of the Hydrogen Bond Networks in Ethanol/Water Mixtures on Dielectric Spectra.

The dielectric response of fluids to electromagnetic radiation in the microwave region originates from processes occurring at the molecular level. Understanding these processes in more detail is relevant to many fields, such as microwave heating, fluid mixing, and separation technologies. In this work, we use molecular dynamics (MD) simulations to study the dielectric spectra of ethanol/water mixtures. We compare our predictions with experimental results at different compositions. We show how the dielectric response can be estimated to a high level of accuracy using three dielectric relaxations: a dominant and slower process at microwave frequencies and two faster processes. A deeper study of the dynamics of the hydrogen bond network formed in these systems reveals how collective processes between the individual species are the origin of the final dielectric response. Our results agree with the "wait-and-switch" mechanism, which describes the dynamics of the hydrogen bond network as the combination of two processes: the fast breakage and formation of individual hydrogen bonds and the subsequent reorganization of the entire network once this process becomes energetically favorable. Since the dielectric response is related to dipole reorientations in the system, it is directly linked to these mechanisms.

Crystal Shape Modification via Cycles of Growth and Dissolution in a Tubular Crystallizer.

Besides size and polymorphic form, crystal shape takes a central role in engineering advanced solid materials for the pharmaceutical and chemical industries. This work demonstrates how multiple cycles of growth and dissolution can manipulate the habit of an acetylsalicylic acid crystal population. Considerable changes of the crystal habit could be achieved within minutes due to rapid cycling, i.e., up to 25 cycles within <10 min. The required fast heating and cooling rates were facilitated using a tubular reactor design allowing for superior temperature control. The face-specific interactions between solvent and the crystals' surface result in face-specific growth and dissolution rates and hence alterations of the final shape of the crystals in solution. Accurate quantification of the crystal shapes was essential for this work, but is everything except simple. A commercial size and shape analyzer had to be adapted to achieve the required accuracy. Online size, and most important shape, analysis was achieved using an automated microscope equipped with a flow-through cell, in combination with a dedicated image analysis routine for particle tracking and shape analysis. Due to the implementation of this analyzer, capable of obtaining statistics on the crystals' shape while still in solution (no sampling and manipulation required), the dynamic behavior of the size shape distribution could be studied. This enabled a detailed analysis of the solvent's effect on the change in crystal habit.

Interplay between Vacuum-Grown Monolayers of Alkylphosphonic Acids and the Performance of Organic Transistors Based on Dinaphtho[2,3-b:2',3'-f]thieno[3,2-b]thiophene.

Monolayers of six alkylphosphonic acids ranging from C8 to C18 were prepared by vacuum evaporation and incorporated into low-voltage organic field-effect transistors based on dinaphtho[2,3-b:2',3'-f]thieno[3,2-b]thiophene (DNTT). Similar to solution-assembled monolayers, the molecular order for vacuum-deposited monolayers improved with increasing length of the aliphatic tail. At the same time, Fourier transform infrared (FTIR) measurements suggested lower molecular coverage for longer phosphonic acids. The comparison of FTIR and vibration frequencies calculated by density functional theory indicated that monodentate bonding does not occur for any phosphonic acid. All monolayers exhibited low surface energy of ∼17.5 mJ/m(2) with a dominating Lifshitz-van der Waals component. Their surface roughness was comparable, while the nanomechanical properties were varied but not correlated to the length of the molecule. However, large improvement in transistor performance was observed with increasing length of the aliphatic tail. Upon going from C8 to C18, the mean threshold voltage decreased from -1.37 to -1.24 V, the field-effect mobility increased from 0.03 to 0.33 cm(2)/(V·s), the off-current decreased from ∼8 × 10(-13) to ∼3 × 10(-13) A, and for transistors with L = 30 µm the on-current increased from ∼3 × 10(-8) to ∼2 × 10(-6) A, and the on/off-current ratio increased from ∼3 × 10(4) to ∼4 × 10(6). Similarly, transistors with longer phosphonic acids exhibited much better air and bias-stress stability. The achieved transistor performance opens up a completely "dry" fabrication route for ultrathin dielectrics and low-voltage organic transistors.

Factors that Influence Health-Related Quality of Life in Patients with Primary Sclerosing Cholangitis.

BACKGROUND: Primary sclerosing cholangitis (PSC) is an incurable, cholestatic liver disease often coincident with inflammatory bowel disease (IBD). AIMS: To evaluate the impact of liver disease and IBD on health-related quality of life (HRQoL) in PSC. METHODS: A mixed-methods, cross-sectional study was performed at a tertiary center. Short Form-36 (SF-36) scores were compared between PSC, Canadian normative data, and disease controls. Disease-specific instruments scores [PBC-40, Short IBD questionnaire, Liver Disease Quality of Life Questionnaire (LDQOL)] were compared between PSC and disease controls. Multivariable regression identified factors independently associated with final SF-36 component scores. Qualitative evaluation of patient questionnaires was performed using a content analysis framework. RESULTS: One hundred and sixty-two surveys were completed (99 PSC, 26 primary biliary cirrhosis, 16 non-autoimmune cholestatic liver disease, and 21 IBD). PSC patients had significantly lower SF-36 scores than Canadian controls, but similar scores to disease controls. LDQOL most accurately predicted HRQoL. Factors negatively associated with physical HRQoL included shorter IBD duration, liver disease symptoms, and decompensated cirrhosis. Mental HRQoL was influenced by liver disease and IBD symptoms, pruritus, social isolation, and depression. Nearly 75 % expressed existential anxiety regarding disease progression and diminished life expectancy, with 25 % disclosing social isolation. CONCLUSIONS: Patients with PSC have significantly lower HRQoL than healthy controls. Both symptoms of IBD and chronic liver disease impact HRQoL in patients with PSC, which lead to significant psychologic burden that is expressed by existential anxieties and social isolation. A PSC-specific HRQoL tool is critical to adequately quantify the distinct impact of IBD and cholestatic liver disease.

Psychometric properties of the Barkley Deficits in Executive Functioning Scale: A Spanish-Language Version in a community sample of puerto rican adults.

Performance-based measures have shown some limitation in the assessment of executive functioning (EF) and rating scales have been proposed as an alternative. Our aim was to conduct a comprehensive psychometric evaluation of the Barkley Deficits in Executive Functioning Scale (BDEFS), as administered in 452 Latino community adults (65.5% female). The BDEFS was back-translated into Spanish. We performed exploratory factor analysis (EFA) to assess the structure of the translated BDEFS and to compare it with the original five-factor structure based on the English-language version. Confirmatory factor analysis (CFA) was performed to test the original language structure of the instrument, and also a modified version with items that loaded equally in both versions. The Adult Self-Report Scale was used to screen for ADHD symptoms. We assessed invariance on the latent factor's mean by age and gender, and to estimate associations with ADHD symptom dimensions. The five-factor structure of the BDEFS was partially supported by EFA/CFA, in which 78 out of 89 items loaded similar to the original English-language structure. Factor scores were significantly associated with ADHD symptom dimensions. Model-based contrasts revealed that inattention was primarily associated with disorganization, time-management and motivational aspects of EF; hyperactivity was predominantly related to self-restraint and self-regulation factors. The BDEFS seemingly assesses similar dimensions of the EF construct in English and in the present Spanish-language versions. Factor scores were differentially associated with ADHD subtypes. Replication and confirmation of the Spanish-language BDEFS in a larger sample is advised. (PsycINFO Database Record

¿Seguimos las recomendaciones de las guías de revascularización coronaria? Otro punto de vista / Are we following the recommendations of the clinical guidelines? Another point of view

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[Hereditary angioedema: strange cause of abdominal pain]. / Angioedema hereditario: causa rara de dolor abdominal.

BACKGROUND: Hereditary angioedema is an episodic swelling disorder with autosomal dominant inheritance characterized by sudden attacks of peripheral swelling. Patients also commonly have episodic swelling of the wall of hollow viscera, including the bowel. CLINICAL CASE: We present a 33-year-old previously healthy male with a complaint of acute-onset intense abdominal pain localized in the epigastrium. Pain irradiated to the right lower quadrant and was associated with five episodes of vomiting. Computed tomography showed thickening of the duodenal wall with liquid in the subphrenic space. Complementary laboratory tests showed low C4 complement levels (5.5 mg/dl) and 30% complement C1 inhibitor activity. CONCLUSIONS: Hereditary angioedema is caused by a deficiency (type I) or dysfunction (type II) in complement C1 inhibitor. Abdominal associated with angioedema may manifest as severe acute-onset abdominal pain or as moderately severe chronic recurrent abdominal pain. Two medications are currently FDA-approved for the treatment of these patients.

Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.

[Utility of omentoplasty for poststernotomy mediastinitis secondary to myocardial revascularization surgery]. / Utilidad de la omentoplastia en el tratamiento de la esternomediastinitis secundaria a cirugía de revascularización miocárdica.

Acute poststernotomy mediastinitis is a serious complication of cardiac surgery and is associated with high mortality. Conservative treatment with local debridement, irrigating-suction systems, and specific antibiotic therapy is sometimes inadequate. Omentoplasty is occasionally used for reconstruction and the treatment of various chest diseases. This useful procedure is most often indicated for suppurative processes and radionecrosis, to complement myoplasty, or to cover a chest wall prosthesis. When used to treat poststernotomy mediastinitis secondary to cardiac surgery, omentoplasty improves control of infection and prognosis. We describe 2 cases of poststernotomy mediastinitis secondary to cardiac revascularization surgery in which omentoplasty was an effective treatment. Excellent control of infection was achieved.