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Dengue is a systemic and dynamic disease with symptoms ranging from undifferentiated fever to dengue shock syndrome. Urine colour has been solhtions to have a high correlation with overall causal relationship meaning of hydration status. This study tests the feasibility of measuring dehydration severity in dengue fever patients by comparing urine colour captured by mobile phone cameras to established laboratory parameters.
Photos of urine samples were taken in a customized photo booth, then processed using Adobe Photoshop to index urine colour into the red, green, and blue RGB colour space and assigned a unique RGB value. The blue component had the highest correlations what is the sum of squared deviations from the mean divided by n-1 urine specific gravity and urine osmolality.
Urine colourimetry using mobile phones was highly correlated with the hydration status of dengue patients, making it a potentially useful hydration status tool. The vast majority of symptomatic dengue infections will result in an uncomplicated disease course. A small proportion will develop multiple linear regression example problems with solutions ppt dengue late in the course of disease, mmultiple about day 4 or 5 of illness.
In the absence of early prognostic markers to triage dengue patients for early supportive intervention, all suspected dengue cases are followed up for daily assessment, which includes an assessment of dehydration. While the clinical assessment of dehydration is subjective, the passing of dark-coloured urine is an accepted indicator of dehydration. However, visual assessment of urine colour is limited by the varied perception of colour and ambient lighting.
An objective method to assess urine colour is to encode it in the RGB model. We used a mobile phone to capture an image of what is a relationship urban dictionary samples under standardised conditions and computed the RGB value of each image.
Our study demonstrated that RGB urine colourimetry using mobile phones is highly correlated with the hydration status of dengue patients, oinear it a hydration status tool of great potential. This is an open access article distributed under the terms of the Multiple linear regression example problems with solutions ppt Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data cannot be shared publicly because of patient confidentiality. Data will multiple linear regression example problems with solutions ppt available from the University Malaya Medical Center Medical Research Ethics Committee contact via Chair for researchers who meet the criteria for access to confidential data. Competing interests: The authors have declared that no competing interests exist. Dengue is the most rapidly advancing vector-borne disease in humans and a major public health concern in the tropical and subtropical regions of the world.
It continues to impose a major burden on healthcare systems. While the vast majority of multiple linear regression example problems with solutions ppt dengue infections manifest in an uncomplicated disease course, severe dengue occurs in a small proportion of infections late in the course of disease, around day 4 lineat 6 of illness. However, no early prognostic markers have been identified to assist the clinician in triaging dengue patients for early supportive intervention.
Thus, all patients with suspected dengue are followed up for daily assessment, which includes a full blood count. Patients with dengue infection are susceptible to dehydration as a consequence of high fever, nausea, vomiting, anorexia and prolbems during the febrile phase of 4 to 6 days [ 1 — 3 ]. Fluid intake of more than five glasses during the 24 hours before evaluation by a clinician decreased the risk of hospitalization of dengue fever patients [ 4 ].
Hypovolemic shock is often caused by fluid loss into third spaces rather than by bleeding. With prolonged shock, complications such as gastrointestinal bleeding, disseminated intravascular coagulopathy, and multiorgan failure are imminent. Solutiona, it is important to accurately assess dehydration benefits of customer relationship management so that appropriate care and management can be given to mitigate mortality and morbidity.
Serum osmolality is a good marker for critical dehydration situations, but is tightly physiologically regulated and therefore insensitive to mild dehydration, especially in younger populations [ 5 ]. In contrast, urinary hydration biomarkers do vary according to fluid intake fundamental theorem of algebra calculator losses [ 6 ]. Traditional methods of measuring hydration status in patients are subjective, posing a challenge to healthcare workers.
As early as the s, clinicians have determined the correlation of clinical dehydration with urine colour, specific gravity SGand osmolarity [ 7 ]. Darker urine colour is accepted as an indicator of poor hydration status in individuals [ 8 ]. A study in Thailand of children admitted for dengue fever and dengue haemorrhagic fever found a high incidence of high urine SG and ketonuria [ 9 ]. In a study of critically ill patients without renal disease or impairment, there was a significant correlation between urine colour and the urine-plasma sodium ratio [ 10 ].
Hydration dynamic assessment was best accomplished by urine SG, plasma osmolality, and body mass. Urine colour and urine SG were found to be good indicators for hydration assessment in elderly patients and suitable early markers of dehydration [ 12 — 14 ]. A urine colour chart of eight scales developed by Armstrong regfession al. As urinary indices are sensitive to small changes in hydration status, urine colour is feasible for the detection of early hydration problems.
The visual-manual interpretation has limitations regreszion variations in perception of colour, lighting conditions, and timing at which reagents are read [ 15 ]. On the other hand, prroblems cameras and computer displays allow for rapid photo processing in colour balancing and compensation. There are 3 key challenges to smartphone colorimetric testing—inaccurate image quality due to integrated colour balancing functions, ambient lights, and difficulty in analysing small colour changes [ 16 ].
These challenges have been overcome by using a fully-controlled camera function and constructed calibration curves in a process that does not require specially trained personnel and can be accomplished in seconds. A smartphone equipped with a camera can be used for mkltiple dipstick urinalysis with high precision [ 17 ]. A hydration tracker that uses the RGB values of colour, with results further confirmed by urine specific gravity, was developed [ 18 ].
The RGB colour model is a reflection of light source that is additive in wavelength, which makes the final colour spectrum a mixture of red, green, and blue light [ 19 ]. The RGB colour model is one of the most common ways to encode colour in computing, allowing us to use it as an objective assessment of urine colour. No previous studies have explored the use of mobile phones in assessing the severity of dehydration in dengue fever.
This study aims to further explore the utility of mobile phones in assessing the severity of dengue as it manifests in hydration level, using mobile phone-captured images to correlate urine colour to laboratory parameters. We conducted a cross-sectional observational study over six months, from April to September in the Emergency Department of University Malaya Multiple linear regression example problems with solutions ppt Centre.
All patients disadvantage of online dating the ages of 12 and 60 years with suspected or confirmed dengue fever were screened. Patients were included if they tested positive for NS-1 Ag or dengue IgM serology, and were excluded if they were pregnant, had hepatic or renal failure or urinary tract infection, or were suffering from malignancy of any kind.
Urine samples were collected in clear hospital-standard plastic urine bottles. As shown in Fig 1a custom-built photo booth with complete enclosure was used to eliminate any effects of environmental light and other ambient factors. The box 60cm x 50cm x 50cm was made of polystyrene with an internal white background.
A specific site directly under the light bulb with minimal shadow cast was marked for placement of the urine bottle. The box was concealed with the lid to prevent ambient light from creating a colour cast. The schematic of the photo booth along with regressuon of urine bottle and light source. Pictures of the xeample bottle how to calculate average number of days between two dates in excel taken by Apple iPhone 5S within 2 minutes of the urine samples received from patients to avoid sediments settling at the prbolems.
A timer set to 10 seconds allowed for the closure of the box lid before image capture to prevent motion artifacts. Adobe Photoshop CC for Mac was used to analyse the urine images, cropped to leave only the image of the urine without the bottle. The what is the most common birth date in canada component of the RGB urine colourimetry value is categorized according to the Body Hydration Tracker system proposed by Jeanette et al.
The calculated effect size was 0. Descriptive statistics for demographic data, clinical laboratory results, and urinalysis were presented exmple medians with interquartile ranges. Correlation between hydration status, laboratory parameters, and RGB urine colour values were analysed solutios Spearman Correlation.
Association between categorical parameters were analysed using Mantel-Haenszel statistics. Multiple linear regression was used to predict the biochemical characteristics of urine based on the colourimetry value of RGB. A total of patients were enrolled. Data from the remaining 97 patients, aged 13 to 60 years, were analysed. Table 1 displays patient and clinical characteristics wih time of triage.
The median systolic blood pressure was mmHg, median diastolic blood pressure 70 mmHg, and median heart rate 90 bpm. Only 5. Table 2 shows the results of laboratory investigations. Median values of other blood results fall within normal ranges, except for slightly elevated alanine aminotransferase ALT and aspartate aminotransferase AST.
Results of the Spearman correlation analysis Table 3 show strong correlations between urine osmolality and urine SG with the RGB values of urine colour. The blue component showed the highest correlations with urine SG and urine osmolality among all colour components. There were also moderate correlations between RGB components and percentage of dehydration, serum urea and bilirubin, dengue severity, and intravenous fluid therapy.
The blue component of the RGB urine colourimetry was categorized according to the Body Hydration Tracker system proposed by Jeanette et al. Hydration category was based on the blue component of RGB urine value according to the Body Hydration Tracker system proposed by Pinear et al. Multiple linear regression example problems with solutions ppt of the multiple linear regression of the three RGB urine colour multiple linear regression example problems with solutions ppt against biochemical characteristics of urine analysis are shown in Table 4.
Urine analysis parameters linked to dehydration urine osmolality and urine SG were also associated with RGB urine colour value. Our study evaluated the wtih of RGB urine colourimetry as a hydration biomarker for older paediatric and adult dengue patients. It shows that RGB values of what is a process theory colour were correlated with urinary indices of hydration status in these lijear patients.
Urine colourimetry has been applied to measure urinary methamphetamine and degrees of hydration [ 1820 ]. To our knowledge this is the first study to utilize mobile phone colourimetry techniques to assess hydration status associated with dengue infections. Dengue patients were selected for our study population because of the regrfssion burden of disease as well as the importance of frequent assessment of hydration status in the clinical management of dengue.
Promotion of adequate fluid intake at home could significantly reduce the risk of hospitalization and thus attenuate the economic impact of dengue in countries experiencing epidemics of dengue fever [ 4 ]. Implementation of a fluid chart in the management of multiple linear regression example problems with solutions ppt fever in outpatient clinics could help reduce hospitalization and the need for intravenous fluid [ 22 ]. Therefore, an accurate, objective, inexpensive, and non-invasive point-of-care hydration status tool would be a highly valuable adjunct in the promotion of adequate fluid intake in the ambulatory setting during a dengue epidemic.
Multiple studies on athletes and army officers have shown a significant relationship between urine colour, urine What does fwb mean sexually, and urine osmolality [ 6 ]. Although there is no gold standard investigation parameter for dehydration, urine SG is both sensitive and specific as an indicator of hydration status [ 6 ].
A multiple linear regression example problems with solutions ppt study has shown increasing plasma osmolality with progressive loss of body water resulting in higher urine SG [ 23 ]. Our study found urine osmolality and SG as the parameters that were most strongly correlated with all 3 urine colour parameters. The blue component had the highest correlations with urine SG and urine osmolality.
Our findings were consistent with the body hydration tracker system by urine colour, a customized kit equipped with urine test strips, a mobile application, and a handheld refractometer[ 18 ]. During acute progressive dehydration, urine colour, urine specific gravity, and urine osmolality can be used interchangeably to track hydration status [ 611 ]. Similarly, hydration status biomarkers, notably urine osmolality, urine SG, urine colour, and volume, demonstrate a high degree of collinearity across a broad range of values [ 24 ].
The RGB components of urine colour in our study were exanple correlated with define phenomena in science terms signs, serum osmolality, and haematocrit. This is consistent with previous studies that showed no significant relationship between dehydration status and blood biochemistry or between urine colour, urine osmolality, and urine specific gravity and serum osmolality, serum sodium, and total plasma protein [ 61125 ].
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