Various risk scores such as COVID‐GRAM Critical Illness Risk Score (COVID‐GRAM), quick COVID‐19 Severity Index (qCSI), and systemic immune‐inflammation index (SII) have been developed to determine critical illness in hospitalized patients. None of these risk scoring systems was evaluated in HD patients who indeed carry the highest risk of developing critical illnesses. We aimed to evaluate, in hemodialysis (HD) patients with COVID‐19, the performance of these scoring systems for the need of intensive care unit (ICU) and mortality. The qCSI, COVID‐GRAM, and SII scores of the patients at admission to hospital were calculated and grouped according to the scoring results. The primary outcome of the study was mortality and need of ICU. Critical illness was described as a composition of admission to the ICU, invasive ventilation, or death. It was determined that when the qCSI is over 6.5, the need for ICU increased 13.8 times and mortality increased 21.3 times. When the COVID‐GRAM score is >157, the ICU need increased 14.7 times and the mortality increased 33.7 times. We found that the need for ICU increased 4.2 times and mortality increased 3.1 times when the SII score was >1145. These tests, which can be easily calculated, could be used to estimate the risk of developing critical illness among COVID‐19 HD patients. Estimating the risk of critical illness could help to reduce mortality in HD patients.
The aim of the present study was to measure full epidermal thickness, stratum corneum thickness, rete length, dermal papilla widening and suprapapillary epidermal thickness in psoriasis patients using a light microscope and computer-supported image analysis. The data obtained were analyzed in terms of patient age, type of psoriasis, total body surface area involvement, scalp and nail involvement, duration of psoriasis, and family history of the disease. The study was conducted on 64 patients and 57 controls whose skin biopsies were examined by light microscopy. The acquired microscopic images were transferred to a computer and measurements were made using image analysis. The skin biopsies, taken from different body areas, were examined for different parameters such as epidermal, corneal and suprapapillary epidermal thickness. The most prominent increase in thickness was detected in the palmar region. Corneal thickness was more pronounced in patients with scalp involvement than in patients without scalp involvement (t = -2.651, P = 0.008). The most prominent increase in rete length was observed in the knees (median: 491 µm, t = 10.117, P = 0.000). The difference in rete length between patients with a positive and a negative family history was significant (t = -3.334, P = 0.03), being 27% greater in psoriasis patients without a family history. The differences in dermal papilla distances among patients were very small. We conclude that microscope-supported thickness measurements provide objective results.
Abstract:In image clustering, it is desired that pixels assigned in the same class must be the same or similar. In other words, the homogeneity of a cluster must be high. In gray scale image segmentation, the specified goal is achieved by increasing the number of thresholds. However, the determination of multiple thresholds is a typical issue. Moreover, the conventional thresholding algorithms could not be used in color image segmentation. In this study, a new color image clustering algorithm with multilevel thresholding has been presented and, it has been shown how to use the multilevel thresholding techniques for color image clustering. Thus, initially, threshold selection techniques such as the Otsu and Kapur methods were employed for each color channel separately. The objective functions of both approaches have been integrated with the forest optimization algorithm (FOA) and particle swarm optimization (PSO) algorithm. In the next stage, thresholds determined by optimization algorithms were used to divide color space into small cubes or prisms. Each sub-cube or prism created in the color space was evaluated as a cluster. As the volume of prisms affects the homogeneity of the clusters created, multiple thresholds were employed to reduce the sizes of the sub-cubes. The performance of the proposed method was tested with different images. It was observed that the results obtained were more efficient than conventional methods.
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