Saliency-Enhanced Content-Based Image Retrieval for Diagnosis Support in Dermatology Consultation: Reader Study.

Background: Previous research studies have demonstrated that medical content image retrieval can play an important role by assisting dermatologists in skin lesion diagnosis. However, current state-of-the-art approaches have not been adopted in routine consultation, partly due to the lack of interpretability limiting trust by clinical users.

Objective: This study developed a new image retrieval architecture for polarized or dermoscopic imaging guided by interpretable saliency maps.

Suspicious Skin Lesion Detection in Wide-Field Body Images using Deep Learning Outlier Detection.

During consultation dermatologists have to address hundreds of lesions in a limited amount of time. They will not only evaluate the single lesion of interest but more importantly the context of it. Visually comparing the similarity of the majority of lesions within the same patient provides a strong indication for lesions with significantly differing aspects.

Comparison of pediatric scoring systems for mortality in septic patients and the impact of missing information on their predictive power: a retrospective analysis.

Background: Scores can assess the severity and course of disease and predict outcome in an objective manner. This information is needed for proper risk assessment and stratification. Furthermore, scoring systems support optimal patient care, resource management and are gaining in importance in terms of artificial intelligence.

Nucleated red blood cells as predictors of mortality in patients with acute respiratory distress syndrome (ARDS): an observational study.

Background: Nucleated red blood cells (NRBCs) in critically ill patients are associated with increased mortality and poor outcome. The aim of the present study was to evaluate the predictive value of NRBCs in patients with acute respiratory distress syndrome (ARDS).

Methods: This observational study was conducted at an ARDS referral center and included patients from 2007 to 2014.

Efficacy and safety of argatroban in patients with acute respiratory distress syndrome and extracorporeal lung support.

Background: Extracorporeal membrane oxygenation (ECMO) or pumpless extracorporeal lung assist (pECLA) requires effective anticoagulation. Knowledge on the use of argatroban in patients with acute respiratory distress syndrome (ARDS) undergoing ECMO or pECLA is limited. Therefore, this study assessed the feasibility, efficacy and safety of argatroban in critically ill ARDS patients undergoing extracorporeal lung support.

Gliogenic LTP spreads widely in nociceptive pathways.

Learning and memory formation involve long-term potentiation (LTP) of synaptic strength. A fundamental feature of LTP induction in the brain is the need for coincident pre- and postsynaptic activity. This restricts LTP expression to activated synapses only (homosynaptic LTP) and leads to its input specificity.

Taxonomist's Nightmare … Evolutionist's Delight : An Integrative Approach Resolves Species Limits in Jumping Bristletails Despite Widespread Hybridization and Parthenogenesis.

Accurate species delimitation is fundamental to biology. Traditionally, species were delimited based on morphological characters, sometimes leading to taxonomic uncertainty in morphologically conserved taxa. Recently, multiple taxonomically challenging cases have benefited from integrative taxonomy-an approach that highlights congruence among different disciplines and invokes evolutionary explanations for incongruence, acknowledging that different methods can mirror different stages of the speciation continuum.

Inferior vena cava collapsibility loses correlation with internal jugular vein collapsibility during increased thoracic or intra-abdominal pressure.

Purpose: Point-of-care ultrasound evaluates inferior vena cava (IVC) and internal jugular vein (IJV) measurements to estimate intravascular volume status. The reliability of the IVC and IJV collapsibility index during increased thoracic or intra-abdominal pressure remains unclear.

Methods: Three phases of sonographic scanning were performed: spontaneous breathing phase, increased thoracic pressure phase via positive pressure ventilation (PPV) phase, and increased intra-abdominal pressure (IAP) phase via laparoscopic insufflation to 15 mmHg.

Lung Injury Prediction Score Is Useful in Predicting Acute Respiratory Distress Syndrome and Mortality in Surgical Critical Care Patients.

Background. Lung injury prediction score (LIPS) is valuable for early recognition of ventilated patients at high risk for developing acute respiratory distress syndrome (ARDS). This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients.

Feasibility of common carotid artery point of care ultrasound in cardiac output measurements compared to invasive methods.

Background: Cardiac output (CO) measurement in the intensive care unit (ICU) requires invasive devices such as the pulmonary artery (PA) catheter or arterial waveform pulse contour analysis (PCA). This study tests the accuracy and feasibility of point of care ultrasound (POCUS) of the common carotid artery to estimate the CO non-invasively and compare it to existing invasive CO measurement modalities.

Methods: Patients admitted to the surgical and cardiothoracic ICU in a tertiary university-affiliated academic center during a 4-month period, with invasive hemodynamic monitoring devices for management, were included in this cohort study.

Recovery rate of adrenal function after surgery in patients with acromegaly is higher than in those with non-functioning pituitary tumors: a large single center study.

Purpose: To compare hypothalamus-pituitary-adrenal (HPA) axis integrity at diagnosis and recovery after transsphenoidal surgery (TSS), in acromegaly patients, compared with tumor size matched non-functioning adenoma (NFA) patients.

Methods: A retrospective 7-year evaluation of acromegaly patients, who underwent TSS with 52 weeks follow-up at a single institution, was undertaken. 50 acromegaly with complete follow-up data at all points and 50 NFA patients were matched for tumor size; HPA axis was similarly assessed pre-operatively and at 6, 12 and 52 weeks post-operatively.

Extensive variation in chromosome number and genome size in sexual and parthenogenetic species of the jumping-bristletail genus Machilis (Archaeognatha).

Parthenogenesis in animals is often associated with polyploidy and restriction to extreme habitats or recently deglaciated areas. It has been hypothesized that benefits conferred by asexual reproduction and polyploidy are essential for colonizing these habitats. However, while evolutionary routes to parthenogenesis are manifold, study systems including polyploids are scarce in arthropods.

Farmers and their environment: protective influences of the farming environment against the development of allergies.

Compared with other population groups, the way of life of farmers can be viewed as being similar to that of our ancestors. The settled continuation of generations within certain critical geographical and environmental conditions requires a special local network of knowledge and experience. The immune system provides protection against microbes and their toxins.

Hemodynamic changes in patients undergoing carotid endarterectomy under cervical block and general anesthesia.

Background: The objective of this study was to assess differences in hemodynamic stability for patients undergoing carotid endarterectomy (CEA) under general anesthesia (GA) as compared with cervical block anesthesia (CBA).

Methods: An institutional review board-approved, retrospective review of 651 patients from 1998 to 2012 undergoing CEA was performed: 254 patients underwent CEA under CBA and 397 under GA. Comprehensive chart review including preoperative, postoperative, and 30-day follow-up was conducted.

Racial differences in vasopressor requirements for septic shock.

Objective: The objective of this study was to compare vasopressor requirements between African American (AA) patients and white patients in septic shock.

Methods: This was a retrospective cohort review conducted over a 2-year period measuring total and mean dosage of various vasopressors used between two racial groups during the treatment of patients admitted with septic shock. The study included patients admitted to the intensive care unit with septic shock at an 805-bed tertiary, academic center.

Induction of thermal hyperalgesia and synaptic long-term potentiation in the spinal cord lamina I by TNF-α and IL-1β is mediated by glial cells.

Long-term potentiation (LTP) of synaptic strength in nociceptive pathways is a cellular model of hyperalgesia. The emerging literature suggests a role for cytokines released by spinal glial cells for both LTP and hyperalgesia. However, the underlying mechanisms are still not fully understood.

Properties of spinal lamina III GABAergic neurons in naïve and in neuropathic mice.

Background: Nerve injury leads to Aβ-fibre-mediated mechanical allodynia that is in part due to an impaired GABAergic inhibition in the spinal cord dorsal horn. The properties and function of GABAergic neurons in spinal cord lamina III, an area where low-threshold mechanosensitive Aβ-fibres terminate are, however, largely unknown.

Methods: We used transgenic mice, which express enhanced green fluorescent protein (EGFP) under control of the promoter GAD67.

Antimycotic-antibiotic amphotericin B promotes influenza virus replication in cell culture.

In general, antibiotics are not rated as substances that inhibit or support influenza virus replication. We describe here the enhancing effect of the polyene antibiotic amphotericin B (AmB) on influenza virus growth in Vero cells. We show that isolation rates of influenza A and B viruses from clinical samples can be dramatically enhanced by adding AmB to the culture medium.

Normal hypothalamic-pituitary-adrenal axis by high-dose cosyntropin testing in patients with abnormal response to low-dose cosyntropin stimulation: a retrospective review.

Objective: To analyze the interpretation of the 1-microg low-dose adrenocorticotropic hormone (ACTH) test (LDT) for assessment of the presence of adrenal insufficiency (AI) in comparison with the 250-microg or standard high-dose ACTH test (HDT), which uses the same cutoff cortisol value of 18 microg/dL (500 nmol/L) as the lower limit of normal.

Methods: We present a retrospective review of 26 patients referred to the Pituitary Clinic who underwent both the LDT and the HDT for evaluation of the function of the hypothalamic-pituitary-adrenal axis.

Results: Of the 26 study patients, 23 had discordant findings--abnormal LDT and normal HDT results with use of the empiric cortisol cutoff of 18 microg/dL at 30 minutes in response to the ACTH dose.

Direct excitation of spinal GABAergic interneurons by noradrenaline.

Endogenous pain control is, in part, mediated by descending inhibition of spinal nociception via spinal release of noradrenaline. Antinociception by activation of descending noradrenergic fibres has partially been attributed to the direct inhibition of nociceptive spinal neurons. Here, we tested the alternative hypothesis: the direct excitation of inhibitory spinal interneurons by noradrenaline.

Induction of synaptic long-term potentiation after opioid withdrawal.

mu-Opioid receptor (MOR) agonists represent the gold standard for the treatment of severe pain but may paradoxically also enhance pain sensitivity, that is, lead to opioid-induced hyperalgesia (OIH). We show that abrupt withdrawal from MOR agonists induces long-term potentiation (LTP) at the first synapse in pain pathways. Induction of opioid withdrawal LTP requires postsynaptic activation of heterotrimeric guanine nucleotide-binding proteins and N-methyl-d-aspartate receptors and a rise of postsynaptic calcium concentrations.

Analysis of the relationship between pollinosis and date of birth in Switzerland.

Background: The first months of life may represent a vulnerable period in the development of atopic diseases. The objective of this study was to examine the relationship between the month of birth and the development of birch and grass pollen allergy in the Swiss population.

Methods: Data from the Swiss Study on Air Pollution and Lung Diseases in Adults(SAPALDIA) as well as the Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution and Climate (SCARPOL) were used.