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Surveillance cameras are commonly used along US highways by State Departments of Transportation (DOT) to monitor the traffic status. State-of-the-art automatic traffic status monitoring requires that the cameras be preset at a predefined zoom level and viewing direction. However, in deployed systems these cameras have zoom, pan, and tilt features. The DOT operators will change the zoom level and camera viewing direction to gather traffic information for analysis. Therefore, the road and lane locations on the camera image cannot be at preset values. It is desirable to develop an intelligent system to automatically detect road and lanes using highway surveillance video with any zoom level and viewing direction. This paper describes a novel lane identification framework based on the Deep Learning starting point: YOLOv4 vehicle detection. This new technique does not use any painted lane markings. We identify the vehicles on the road and then aggregate the detected vehicles at one horizontal line on the image. This salient horizontal line is where the YOLOv4 gives the highest vehicle detection confidence scores. Most vehicles stay within a lane most of the time and change lanes only occasionally. This assumption is used to find the lane center locations according to the relative number of vehicles passing the salient horizontal line. Our method provides robust results in all weather conditions with a lane detection F1-Score above 0.85 compared to human labelled ground truth.

BackgroundIndia has seen a surge in COVID-19 associated mucormycosis (CAM) cases during the second wave of the pandemic. We conducted a study to determine independent risk factors for CAM.MethodsWe performed a retrospective case control study in a tertiary care private hospital in Pune, India. Fifty-two cases of CAM were compared with 166 concurrent controls randomly selected from the COVID-19 admissions during the same time period. Association of demographic factors, comorbidities, cumulative steroid dose used (calculated as dexamethasone equivalent), maximum respiratory support required, use of injectable/oral anticoagulation, and use of aspirin with CAM was assessed by univariate and multivariate logistic regression.ResultsA total of 218 subjects (52 cases; 166 controls) were studied. Any diabetes (pre-existing diabetes and new onset diabetes during COVID-19) was noted in a significantly higher proportion of cases (73·1%, 45·8% P120 mg (OR 9·03, confidence interval 1·75-46·59, P=0·009) and any diabetes (OR 4·78, confidence interval 1·46-15·65, P=0·01) were found to be risk factors for CAM. While use of anticoagulation (OR 0·01, confidence interval 0·00-0·09, PConclusionDiabetes mellitus and cumulative dose of dexamethasone greater than 120 mg (or equivalent dose of other corticosteroid) were associated with an increased risk of CAM while use of aspirin and anticoagulation were associated with a lower risk.

Kidney Disease Quality of Life (KDQOL) instrument w as designed to measure Quality of Life of kidney disease patients. KDQOL has been tested, translated and validated in many countries. KDQOL has not been translated into Marathi language. The primary purpose of this study was to validate Marathi version of KDQOL - SF TM and to evaluate its psychometric properties. This cross sectional study was conducted in two hospitals in Pune from April 2012 to March 2013. Translated Marathi KDQOL - SF TM was evaluated in 93 dialysis patients. Patients’ average age was 57 ±12 y ears and 71% were males. Internal consistency reliability was found to be medium to high ranging from 0.5 to 0.9 except for social interaction. To investigate construct validity, overall health rating scale was correlated with kidney disease targeted scale and with quality of life (SF - 36 scales). Significant (p

The progressive loss of kidney function is accompanied by metabolic acidosis. The relationship between metabolic acidosis, nutritional status, and oral bicarbonate supplementation has not been assessed in the Indian chronic kidney disease (CKD) population who are on maintenance hemodialysis (MHD). This is a single-center prospective study conducted in the Western part of India. Thirty-five patients, who were receiving MHD were assessed for metabolic acidosis along with various nutritional parameters at the baseline and at the follow-up after 3 months, postcorrection of acidosis with oral sodium bicarbonate supplements. The relationship between the correction of metabolic acidosis with oral bicarbonate supplements and changes in dietary and various nutritional parameters were evaluated. Metabolic acidosis at the baseline evaluation was found in 62.86% cases of the cohort with a mean serum bicarbonate value of 20.18 ± 4.93 mmol/L. The correction of acidosis with increment in the mean dosage of oral sodium bicarbonate supplements from 0.69 ± 0.410 mmol/kg/day at baseline to 1.04 ± 0.612 mmol/kg/day, significantly reduced the prevalence of metabolic acidosis to 23.33% cases at the follow-up. Improvement in serum bicarbonate level showed significant dietary, anthropometric, and nutritional improvements in these patients. Hence, we conclude that correction of metabolic acidosis with optimal oral bicarbonate supplementation plays a pivotal role in the treatment of malnourished CKD patients on MHD.

Background: Acute kidney injury (AKI) is common in patients in the pediatric intensive care unit (PICU) and is associated with poor outcome. We conducted the present study to determine the incidence, risk factors and outcomes of AKI in the PICU. Materials and Methods: We collected data retrospectively from case records of children admitted to the PICU during one year. We defined and classified AKI according to modified pRIFLE criteria. We used multivariate logistic regression to determine risk factors of AKI and association of AKI with mortality and morbidity. Results: Of the 252 children included in the study, 103 (40.9%) children developed AKI. Of these 103 patients with AKI, 39 (37.9%) patients reached pRIFLE max of Risk, 37 (35.9%) patients reached Injury, and 27 (26.2%) had Failure. Mean Pediatric Risk of Mortality (PRISM III) score at admission was higher in patients with AKI than in controls ( P < 0.001).

Calciphylaxis, also known as calcific uremic arteriolopathy, is a rare, life-threatening complication of end-stage renal disease. However, it may also occur in patients without renal failure, the nonuremic calciphylaxis. Most patients present with painful skin ulcers. Delayed diagnosis can lead to sepsis-related morbidity and mortality. Aberrations in calcium, phosphate, and parathyroid hormone physiology are common and biopsy is diagnostic. Early diagnosis and correction of vascular and metabolic aberrations may assist in healing as may the use of sodium thiosulfate and hyperbaric oxygen therapy. We report on successful treatment of a case of calciphylaxis in a renal transplant recipient with normal allograft function.

Aim. This study seeks to review the psychosocial factors affecting patients with end-stage kidney disease (ESKD) from a tertiary hospital in Australia.Methods. We audited patients with ESKD, referred to social work services from January 2012 to December 2014. All patients underwent psychosocial assessments by one, full-time renal social worker. Patient demographics, cumulative social issues, and subsequent interventions were recorded directly into a database.Results. Of the 244 patients referred, the majority were >60 years (58.6%), male (60.7%), born in Australia (62.3%), on haemodialysis (51.6%), and reliant on government financial assistance (88%). Adjustment issues (41%), financial concerns (38.5%), domestic assistance (35.2%), and treatment nonadherence (21.3%) were the predominant reasons for social work consultation. Younger age, referral prior to start of dialysis, and unemployment were significant independent predictors of increased risk of adjustment issues (p=0.004, p=0.041, 0.052, and 0.008, resp.).Conclusion. Psychosocial and demographic factors were associated with treatment nonadherence and adjustment difficulties. Additional social work support and counselling, in addition to financial assistance from government and nongovernment agencies, may help to improve adjustment to the diagnosis and treatment plans as patients approach ESKD.

Background and Purpose: Intracorporeal lithotripsy is an important modality used for stone pulverization. To improve the pulverization properties of intracorporeal lithotriptors, a novel intracorporeal “spearheaded lithotriptor” was designed by our institute. It was compared in vitro with the conventional lithotriptor. Materials and Methods: The pulverization and propulsion dynamics were evaluated at various pressure settings on an in vitro bench arrangement with phantom stones. Lateral displacement during pulverization was also compared. Results: The spearheaded lithotriptor had a better first hit (P

An intracorporeal lithotripsy probe tip was designed with a paraboloid shaped tip and compared with holmium laser for stone pulverization.The paraboloid tip concept was developed and designed using computer aided design (CAD), fabricated, and patented. CAD analysis and in vitro comparison (with laser) of pulverization and propulsion dynamics were performed in an underwater hands-free bench arrangement using phantom stones. SPSS analysis for different energy cohorts was performed.CAD analysis: At "point contact" with the tip, the paraboloid lithotripter generated 3590 bars at generator settings of 4 bars. During "follow-up impacts," the tip pressure exponentially decreased (graduated tip pressure) and the lateral/centrifugal forces increased, converting the probe into a side-firing energy source. Bench analysis: At point contact, the paraboloid lithotripter at 2, 3, and 4 bars was comparable to that of a 6, 10, and 15 W laser, respectively (P0.005). The paraboloid lithotripter showed a statistically significant advantage in breaking the phantoms, as against a laser that always bored through the phantom. Stone propulsion was comparable within all energy cohorts (P0.05).The paraboloid lithotripter generates highly focused impact force with low propulsion, at point contact. As stone pulverization progresses, the tip forces exponentially decrease and the probe converts into a lateral firing energy source resulting in pulverization into larger fragments. Thus, the paraboloid lithotripter has all the advantages of laser at point contact and advantages of pneumatic lithotripter at follow-up hits, akin to being a bimodal energy source.

Aim: Metabolic acidosis is a feature of chronic kidney disease (CKD) due to the reduced capacity of the kidney to synthesize ammonia and excrete hydrogen ions. Among the many goals of hemodialysis (HD), the role in correction of metabolic acidosis is an important one. To assess the prevalence and severity of metabolic acidosis in the Indian patients of CKD, who are on maintenance HD (MHD). Methods: This is a cross-sectional study on 35 patients conducted at two centers in Western part of India. The demographic, clinical, and laboratory assessments were done on chronic stable patients receiving MHD. The prevalence and severity of metabolic acidosis were evaluated. Results: Metabolic acidosis was found in 22 out of 35 patients (62.85%), with mean predialysis serum pH and HCO 3 of 7.32 ± 0.083 and 20.37 ± 4.94 mmol/L, respectively. Conclusion: Metabolic acidosis is significantly prevalent in patients on MHD in India.