Osteomielitis esternal: utilidad de las pruebas de diagnóstico por imágenes con enfoque en medicina nuclear

Introducción: El diagnóstico de osteomielitis esternal post-esternotomía resulta difícil empleando síntomas clínicos o de laboratorio y las imágenes morfológicas orientan a sospecha más que al diagnóstico. Un diagnóstico precoz ofrece calidad de vida y el mejor tratamiento para reducir una mortalidad que oscila entre 14% y 47%. La gammagrafía con leucocitos marcados ofrece el mejor rendimiento diagnóstico para infecciones y se destaca como el patrón de oro diagnóstico. Objetivo: Identificar el desempeño y utilidad de la gammagrafía con leucocitos autólogos marcados con 99mTc-HMPAO en los estudios realizados para la evaluación de osteomielitis esternal. Materiales y métodos: Se realizó un estudio descriptivo, retrospectivo de prueba diagnóstica en la Fundación Cardioinfantil de Bogotá entre enero/2010 y mayo/2015 evaluando gammagrafías con leucocitos marcados ante la sospecha de osteomielitis posterior a esternotomía. Resultados: Se evaluaron 52 pacientes, en los que la gammagrafía con leucocitos mostró 23 pacientes (44,2%) con osteomielitis esternal, logrando una sensibilidad y especificidad del 88,46% y 100% respectivamente. El valor predictivo positivo fue de 100%, y el valor predictivo negativo fue de 89,66%. El impacto de una prueba negativa no modificó el manejo médico inicial en el 93% de los casos mientras que una prueba positiva lo modificó en el 83%. Conclusiones: La gammagrafía con leucocitos autólogos radiomarcados con 99mTc-HMPAO continúa siendo el patrón de oro de referencia no invasiva para el diagnóstico de osteomielitis, y en el caso de osteomielitis esternal se convierte en la prueba de elección pertinente en la selección de pacientes que ameritan una re-intervención quirúrgica.

Image Segmentation Using Information Bottleneck Method

In image processing, segmentation algorithms constitute one of the main focuses of research. In this paper, new image segmentation algorithms based on a hard version of the information bottleneck method are presented. The objective of this method is to extract a compact representation of a variable, considered the input, with minimal loss of mutual information with respect to another variable, considered the output. First, we introduce a split-and-merge algorithm based on the definition of an information channel between a set of regions (input) of the image and the intensity histogram bins (output). From this channel, the maximization of the mutual information gain is used to optimize the image partitioning. Then, the merging process of the regions obtained in the previous phase is carried out by minimizing the loss of mutual information. From the inversion of the above channel, we also present a new histogram clustering algorithm based on the minimization of the mutual information loss, where now the input variable represents the histogram bins and the output is given by the set of regions obtained from the above split-and-merge algorithm. Finally, we introduce two new clustering algorithms which show how the information bottleneck method can be applied to the registration channel obtained when two multimodal images are correctly aligned. Different experiments on 2-D and 3-D images show the behavior of the proposed algorithms

Procés de destintatge del paper per flotació. Avaluació de l'eficàcia de l'eliminació de tinta

La tesi doctoral presentada té com a objectius principals l'estudi de les etapes fonamentals de desintegració i flotació en un procés de destintatge de papers vell de qualitats elevades per a poder millorar l'eficàcia d'aquestes etapes clau. Conté una revisió teòrica completa i molt actualitzada del procés de desintegració i flotació tant a nivell macroscòpic com microscòpic. La metodologia de treball en el laboratori, la posada a punt dels aparells, així com les anàlisis efectuades per a valorar la resposta del procés (anàlisi de blancor, anàlisi d'imatge i anàlisi de la concentració efectiva de tinta residual) estan descrites en el capítol de material i mètodes. La posada en marxa permet obtenir unes primeres conclusions respecte la necessitat de treballar amb una matèria primera homogènia i respecte la no significació de la temperatura de desintegració dins l'interval de treball permès al laboratori (20-50°C). L'anàlisi de les variables mecàniques de desintegració: consistència de desintegració (c), velocitat d'agitació en la desintegració (N) i temps de desintegració (t), permet de discernir que la consistència de desintegració és una variable fonamental. El valor de consistència igual al 10% marca el límit d'existència de les forces d'impacte mecànic en la suspensió fibrosa. A consistències superiors, les forces viscoses i d'acceleració dominen l'etapa de desintegració. Existeix una interacció entre la consistència i el temps de desintegració, optimitzant-se aquesta darrera variable en funció del valor de la consistència. La velocitat d'agitació és significativa només per a valors de consistència de desintegració inferiors al 10%. En aquests casos, incrementar el valor de N de 800 a 1400 rpm representa una disminució de 14 punts en el factor de destintabilitat. L'anàlisi de les variables químiques de desintegració: concentració de silicat sòdic (% Na2SiO3), peròxid d'hidrogen (% H2O2) i hidròxid sòdic (% Na2OH), proporciona resultats força significatius. El silicat sòdic presenta un efecte altament dispersant corroborat per les corbes de distribució dels diàmetres de partícula de tinta obtingudes mitjançant anàlisi d'imatges. L'hidròxid sòdic també presenta un efecte dispersant tot i que no és tant important com el del silicat sòdic. Aquests efectes dispersants són deguts principalment a l'increment de les repulsions electrostàtiques que aporten a la suspensió fibrosa aquests reactius químics fent disminuir l'eficàcia d'eliminació de l'etapa de flotació. El peròxid d'hidrogen utilitzat generalment com agent blanquejant, actua en aquests casos com a neutralitzador dels grups hidroxil provinents tant del silicat sòdic com de l'hidròxid sòdic, disminuint la repulsió electrostàtica dins la suspensió. Amb l'anàlisi de les variables hidrodinàmiques de flotació: consistència de flotació (c), velocitat d'agitació durant la flotació (N) i cabal d'aire aplicat (q), s'aconsegueix la seva optimització dins el rang de treball permès al laboratori. Valors elevats tant de la velocitat d'agitació com del cabal d'aire aplicat durant la flotació permeten eliminar majors quantitats de tinta. La consistència de flotació assoleix valors òptims depenent de les condicions de flux dins la cel·la de flotació. Les metodologies d'anàlisi emprades permeten obtenir diferents factors de destintabilitat. Entre aquests factors existeix una correlació important (determinada pels coeficients de correlació de Pearson) que permet assegurar la utilització de la blancor com a paràmetre fonamental en l'anàlisi del destintatge de papers vells, sempre i quan es complementi amb anàlisis d'imatge o bé amb anàlisi de la concentració efectiva de tinta residual. S'aconsegueixen expressions empíriques tipus exponencial que relacionen aquests factors de destintabilitat amb les variables experimentals. L' estudi de les cinètiques de flotació permet calcular les constants cinètiques (kBlancor, kERIC, kSupimp) en funció de les variables experimentals, obtenint un model empíric de flotació que relacionant-lo amb els paràmetres microscòpics que afecten realment l'eliminació de partícules de tinta, deriva en un model fonamental molt més difícil d'interpretar. Mitjançant l'estudi d'aquestes cinètiques separades per classes, també s'aconsegueix determinar que l'eficàcia d'eliminació de partícules de tinta és màxima si el seu diàmetre equivalent és superior a 50 μm. Les partícules amb diàmetres equivalents inferiors a 15 μm no són eliminades en les condicions de flotació analitzades. Es pot dir que és físicament impossible eliminar partícules de tinta de diàmetres molt diferents amb la mateixa eficiència i sota les mateixes condicions de treball. El rendiment del procés analitzat en funció de l'eliminació de sòlids per l'etapa de flotació no ha presentat relacions significatives amb cap de les variables experimentals analitzades. Únicament es pot concloure que addicionar quantitats elevades de silicat sòdic provoca una disminució tant de sòlids com de matèria inorgànica presents en les escumes de flotació.

Qualidade de vida do cuidador de enfermagem e sua relação com o cuidar; Quality of life of the nursing caregiver and its relationship with care

Objective:To identify aspects that affect the quality of life of nursing caregivers and their relationship with care in an Intensive Care Unit for Adults (A-ICU). Methods:This was a descriptive study with qualitative approach, taking as subjects 21 professionals who constitute the nursing staff of the A-ICU of a school hospital in Maringá-PR. Unstructured interview was used as a strategy to collect data, conducted between May and June 2009. Data analysis was based on the method of content analysis. The categories identified were: overlooking improvement in quality of life related to the resources in an A-ICU; the quality of life influencing the form of care; interpersonal relationships into the health team reflecting on the quality of life and care. Results:The analysis of caregivers’ speech and the results of the observation showed that there is correlation between the aspects they consider influential in their quality of life and the way of caring for patients in an A-ICU.Conclusion: The findings indicate that, among the influential aspects, the stressful factors overlap the enhancing ones. From this perspective, dealing with caregiver’s suffering might be the starting point for the improvement in quality of care in an A-ICU.

Estudo preliminar- descalcificação de tecido ósseo de origem animal em micro-ondas

A análise histopatológica de tecido ósseo exige uma etapa de descalcificação. O método usual consiste na imersão das amostras em ácidos, mas para além de provocarem danos tecidulares, o processo é prolongado. A utilização de micro-ondas acelera a descalcificação, mas não deve comprometer a imagem microscópica. Objetivo: Diminuir a duração da descalcificação, mantendo a qualidade da imagem microscópica. Metodologia: Foram testadas amostras de osso compacto e esponjoso. Realizou-se a descalcificação pelo método convencional e pelo método em micro-ondas, através da adaptação de um protocolo conhecido. Utilizou-se ácido nítrico a 5% e 10%. Resultados: Nos fragmentos de maiores dimensões, após 4 horas com ácido nítrico a 10% em micro-ondas, não se conseguiu uma descalcificação completa, apesar da imagem histológica ser razoável. Nos fragmentos de osso esponjoso, verificou-se uma redução de cerca de 25 horas relativamente ao método convencional. Nas biópsias, houve uma redução de aproximadamente 10 horas, utilizando ácido nítrico a 5%. Com ácido nítrico a 10% houve destruição tecidular. Nos casos em que se obteve uma descalcificação completa, a imagem microscópica apresenta fraca qualidade. Conclusão: A utilização de micro-ondas com ácido nítrico a 5%/10%, aplicando o protocolo deste estudo, reduz a duração da descalcificação, mas compromete a imagem microscópica.

Effect of dietary supplementation with selenium-enriched yeast or sodium selenite on selenium tissue distribution and meat quality in beef cattle

The objective was to determine the concentration of total selenium (Se) and the proportion of total Se comprised as selenomethionine (SeMet) and selenocysteine (SeCys) in post mortem tissues of beef cattle offered diets containing graded additions of selenized enriched yeast (SY) [Saccharomyces cerevisae CNCM I-3060]), or sodium selenite (SS). Oxidative stability and tissue glutathione peroxidase (GSH-Px) activity of edible muscle tissue were assessed 10 d post-mortem. Thirty two beef cattle were offered, for a period of 112 d, a total mixed ration which had either been supplemented with SY (0, 0.15 or 0.35 mg Se/kg DM) or SS (0.15 mg Se/kg DM). At enrollment (0 d) and at 28, 56, 84 and 112 d following enrollment, blood samples were taken for Se and Se species determination, as well as whole blood GSH-Px activity. At the end of the study beef cattle were euthanized and samples of heart, liver, kidney, and skeletal muscle (LM and psoas major) were retained for Se and Se species determination. Tissue GSH-Px activity and thiobarbituric acid reactive substances (TBARS) were determined in skeletal muscle tissue (LM only). The incorporation into the diet of ascending concentrations of Se as SY increased whole blood total Se and the proportion of total Se comprised as SeMet, as well as GSH-Px activity. There was also a dose dependant response to the graded addition of SY on total Se and proportion of total Se as SeMet in all tissues and GSH-Px activity in skeletal muscle tissue. Furthermore, total Se concentration of whole blood and tissues was greater in those animals offered SY when compared with those receiving a comparable dose of SS, indicating an improvement in Se availability and tissue Se retention. Likewise, GSH-Px activity in whole blood and LM was greater in those animals offered SY when compared with those receiving a comparable dose of SS. However, these increases in tissue total Se and GSH-Px activity appeared to have little or no effect in meat oxidative stability.

Effects of dietary supplementation with selenium enriched yeast or sodium selenite on selenium tissue distribution and meat quality in lambs

The objective was to determine the concentration of total selenium (Se) and the proportion of total Se comprised as selenomethionine (SeMet) and selenocysteine (SeCys), as well as meat quality in terms of oxidative stability in post mortem tissues of lambs offered diets with an increasing dose rate of selenized enriched yeast (SY), or sodium selenite (SS). Fifty lambs were offered, for a period of 112 d, a total mixed ration which had either been supplemented with SY (0, 0.11, 0.21 or 0.31 mg/kg DM to give total Se contents of 0.19, 0.3, 0.4 and 0.5 mg Se/kg DM for treatments T1, T2, T3 and T4, respectively) or SS (0.11 mg/kg DM to give 0.3 mg Se/kg DM total Se [T5]). At enrolment and at 28, 56, 84 and 112 d following enrolment, blood samples were taken for Se and Se species determination, as well as glutathione peroxidase (GSH-Px) activity. At the end of the study lambs were euthanased and samples of heart, liver, kidney, and skeletal muscle were retained for Se and Se species determination. Tissue GSH-Px activity and thiobarbituric acid reactive substances (TBARS) were determined in Longissimus Thoracis. The incorporation into the diet of ascending concentrations of Se as SY increased whole blood total Se and the proportion of total Se comprised as SeMet, and erythrocyte GSH-Px activity. Comparable doses of SS supplementation did not result in significant differences between these parameters. With the exception of kidney tissue, all other tissues showed a dose dependant response to increasing concentrations of dietary SY, such that total Se and SeMet increased. Selenium content of Psoas Major was higher in animals fed SY when compared to a similar dose of SS, indicating improvements in Se availability and retention. There were no significant treatment effects on meat quality assessments GHS-Px and TBARS, reflecting the lack of difference in the proportion of total Se that was comprised as SeCys. However, oxidative stability improved marginally with ascending tissue Se content, providing an indication of a linear dose response whereby TBARS improved with ascending SY inclusion.

Quality of medicines stored together in multi-compartment compliance aids

Background and Objective: Dispensing medicines into compliance aids is a common practice in pharmacy contrary to manufacturers’ advice and studies have shown the appearance of light-sensitive tablets is compromised by such storage; we previously found evidence of reduced bioavailability at elevated temperature and humidity. Our objective was to examine the physicochemical stability of two generic atenolol tablets in different compliance aids and with aspirin co-storage at room temperature and at 40 °C/75% relative humidity. Methods: The physicochemical stability of atenolol tablets was evaluated after 28 days of storage and compared with controls by examining visual appearance, weight, disintegration, dissolution, friability and hardness to accepted standards and using a previously validated HPLC method for chemical assay. Results and Discussion: The response to storage was brand-dependent and not straightforward. With one make of atenolol (Alpharma), storage in compliance aids even at room temperature impacted on physical stability, reducing tablet hardness, with storage in Dosett® exerting a greater impact than storage in Medidos® (t-test P < 0·001). Co-storage at elevated temperature and humidity also impacted on the appearance of non-coated aspirin tablets (Angette™). The chemical stability of atenolol was not affected and we did not find evidence of changes to bioavailability with either make. Certainly data for one atenolol make (CP Pharmaceuticals) co-stored with aspirin (Angette™ and Nu-Seals) in both compliance aids at room temperature provided evidence of short-term stability. But medicines are dispensed into compliance aids in multi-factorial ways so our study highlights not only the lack of evidence but also a realization that evidence to support real practice may not be accomplished through research. Conclusion: Reassuring practitioners of the continued stability of medicines in compliance aids under the countless condition in which they are dispensed in practice may requires a different approach involving medical device regulators and more definitive professional guidance.

Variation in the ovarian reserve Is linked to alterations in intrafollicular estradiol production and ovarian biomarkers of follicular differentiation and oocyte quality in cattle

The mechanisms whereby the high variation in numbers of morphologically healthy oocytes and follicles in ovaries (ovarian reserve) may have an impact onovarian function, oocyte quality, and fertility are poorly understood. The objective was to determine whether previously validated biomarkers for follicular differentiation and function, as well as oocyte quality differed between cattle with low versus a high antral follicle count (AFC). Ovaries were removed (n = 5 per group) near the beginning of the nonovulatory follicular wave, before follicles could be identified via ultrasonography as being dominant, from heifers with high versus a low AFC. The F1, F2, and F3 follicles were dissected and diameters determined. Follicular fluid and thecal, granulosal, and cumulus cells and the oocyte were isolated and subjected to biomarker analyses. Although the size and numerous biomarkers of differentiation, such as mRNAs for the gonadotropin receptors, were similar, intrafollicular concentrations of estradiol and the abundance of mRNAs for CYP19A1 in granulosal cells and ESR1, ESR2, and CTSB in cumulus cells were greater, whereas mRNAs for AMH in granulosal cells and TBC1D1 in thecal cells were lower for animals with low versus a high AFC during follicle waves. Hence, variation in the ovarian reserve may have an impact on follicular function and oocyte quality via alterations in intrafollicular estradiol production and expression of key genes involved in follicle-stimulating hormone action (AMH) and estradiol (CYP19A1) production by granulosal cells, function and survival of thecal cells (TBC1D1), responsiveness of cumulus cells to estradiol (ESR1, ESR2), and cumulus cell determinants of oocyte quality (CTSB).

The use of image analysis to estimate population growth rate in Daphnia magna

1. Population growth rate (PGR) is central to the theory of population ecology and is crucial for projecting population trends in conservation biology, pest management and wildlife harvesting. Furthermore, PGR is increasingly used to assess the effects of stressors. Image analysis that can automatically count and measure photographed individuals offers a potential methodology for estimating PGR. 2. This study evaluated two ways in which the PGR of Daphnia magna, exposed to different stressors, can be estimated using an image analysis system. The first method estimated PGR as the ratio of counts of individuals obtained at two different times, while the second method estimated PGR as the ratio of population sizes at two different times, where size is measured by the sum of the individuals' surface areas, i.e. total population surface area. This method is attractive if surface area is correlated with reproductive value (RV), as it is for D. magna, because of the theoretical result that PGR is the rate at which the population RV increases. 3. The image analysis system proved reliable and reproducible in counting populations of up to 440 individuals in 5 L of water. Image counts correlated well with manual counts but with a systematic underestimate of about 30%. This does not affect accuracy when estimating PGR as the ratio of two counts. Area estimates of PGR correlated well with count estimates, but were systematically higher, possibly reflecting their greater accuracy in the study situation. 4. Analysis of relevant scenarios suggested the correlation between RV and body size will generally be good for organisms in which fecundity correlates with body size. In these circumstances, area estimation of PGR is theoretically better than count estimation. 5. Synthesis and applications. There are both theoretical and practical advantages to area estimation of population growth rate when individuals' reproductive values are consistently well correlated with their surface areas. Because stressors may affect both the number and quality of individuals, area estimation of population growth rate should improve the accuracy of predicting stress impacts at the population level.

The graduate teacher programme in England: mentor training, quality assurance and the findings of inspection

In its recent report on the Graduate Teacher Programme (GTP), an employment-based route to Qualified Teacher Status (QTS) in England, the Government's Office for Standards in Education found that, although almost all trainees meet the standards required to qualify, too often they do so at an adequate level, rather than achieving the high levels of which they should be capable. The underlying reason for this is the quality of mentoring provided in the schools. The inspectors concluded that schoolbased trainers are often not adequately prepared for their role in implementing wide-ranging training programmes for trainee teachers. Despite this generally bleak picture, Ofsted concluded that 'the minority of cases of good practice in the training programmes and of high quality teaching by trainees indicate that the GTP can be an effective alternative route for training teachers'™. This article considers the strengths and weaknesses of the Graduate Teacher Programme, introduced in January 1998, and also reports on a small-scale project, funded by the Teacher Training Agency (TTA), the key objective of which was to strengthen the existing partnerships by improving the quality of school-based tutor training and continuous professional development of staff.

A novel method for measuring lag times in division of individual bacterial cells using image analysis

A method is presented for determining the time to first division of individual bacterial cells growing on agar media. Bacteria were inoculated onto agar-coated slides and viewed by phase-contrast microscopy. Digital images of the growing bacteria were captured at intervals and the time to first division estimated by calculating the "box area ratio". This is the area of the smallest rectangle that can be drawn around an object, divided by the area of the object itself. The box area ratios of cells were found to increase suddenly during growth at a time that correlated with cell division as estimated by visual inspection of the digital images. This was caused by a change in the orientation of the two daughter cells that occurred when sufficient flexibility arose at their point of attachment. This method was used successfully to generate lag time distributions for populations of Escherichia coli, Listeria monocytogenes and Pseudomonas aeruginosa, but did not work with the coccoid organism Staphylococcus aureus. This method provides an objective measure of the time to first cell division, whilst automation of the data processing allows a large number of cells to be examined per experiment. (c) 2005 Elsevier B.V. All rights reserved.

Successful manipulation of the quality and quantity of fat and carbohydrate consumed by free-living individuals using a food exchange model

Our objective in this study was to develop and implement an effective intervention strategy to manipulate the amount and composition of dietary fat and carbohydrate (CHO) in free-living individuals in the RISCK study. The study was a randomized, controlled dietary intervention study that was conducted in 720 participants identified as higher risk for or with metabolic syndrome. All followed a 4-wk run-in reference diet [high saturated fatty acids (SF)/high glycemic index (GI)]. Volunteers were randomized to continue this diet for a further 24 wk or to I of 4 isoenergetic prescriptions [high monounsaturated fatty acids (MUFA)/high GI; high MUFA/low GI; low fat (LF)/high GI; and LF/low GI]. We developed a food exchange model to implement each diet. Dietary records and plasma phospholipid fatty acids were used to assess the effectiveness of the intervention strategy. Reported fat intake from the LF diets was significantly reduced to 28% of energy (%E) compared with 38% E from the HM and LF diets. SF intake was successfully decreased in the HM and LF diets was similar to 10% E compared with 17% E in the reference diet (P = 0.001). Dietary MUFA in the HIM diets was similar to 17% E, significantly higher than in the reference (12% E) and LF diets (10% E) (P = 0.001). Changes in plasma phospholipid fatty acids provided further evidence for the successful manipulation of fat intake. The GI of the HGI and LGI arms differed by similar to 9 points (P = 0.001). The food exchange model provided an effective dietary strategy for the design and implementation across multiple sites of 5 experimental diets with specific targets for the proportion of fat and CHO. J. Nutr. 139: 1534-1540, 2009.

Improving quality of mother-infant relationship and infant attachment in socioeconomically deprived community in South Africa: randomised controlled trial

Objective To assess the efficacy of an intervention designed to improve the mother-infant relationship and security of infant attachment in a South African peri-urban settlement with marked adverse socioeconomic circumstances. Design Randomised controlled trial. Setting Khayelitsha, a peri-urban settlement in South Africa. Participants 449 pregnant women. Interventions The intervention was delivered from late pregnancy and for six months postpartum. Women were visited in their homes by previously untrained lay community workers who provided support and guidance in parenting. The purpose of the intervention was to promote sensitive and responsive parenting and secure infant attachment to the mother. Women in the control group received no therapeutic input from the research team. Main outcome measures Primary outcomes: quality of mother-infant interactions at six and 12 months postpartum; infant attachment security at 18 months. Secondary outcome: maternal depression at six and 12 months. Results The intervention was associated with significant benefit to the mother-infant relationship. At both six and 12 months, compared with control mothers, mothers in the intervention group were significantly more sensitive (6 months: mean difference=0.77 (SD 0.37), t=2.10, P<0.05, d=0.24; 12 months: mean difference=0.42 (0.18), t=-2.04, P<0.05, d=0.26) and less intrusive (6 months: mean difference=0.68 (0.36), t=2.28, P<0.05, d=0.26; 12 months: mean difference=-1.76 (0.86), t=2.28, P<0.05, d=0.24) in their interactions with their infants. The intervention was also associated with a higher rate of secure infant attachments at 18 months (116/156 (74%) v 102/162 (63%); Wald=4.74, odds ratio=1.70, P<0.05). Although the prevalence of maternal depressive disorder was not significantly reduced, the intervention had a benefit in terms of maternal depressed mood at six months (z=2.05, P=0.04) on the Edinburgh postnatal depression scale). Conclusions The intervention, delivered by local lay women, had a significant positive impact on the quality of the mother-infant relationship and on security of infant attachment, factors known to predict favourable child development. If these effects persist, and if they are replicated, this intervention holds considerable promise for use in the developing world. Trial registration Current Controlled Trials ISRCTN25664149.

Enhancing change detection in low-quality surveillance footage using markov random fields

Urban surveillance footage can be of poor quality, partly due to the low quality of the camera and partly due to harsh lighting and heavily reflective scenes. For some computer surveillance tasks very simple change detection is adequate, but sometimes a more detailed change detection mask is desirable, eg, for accurately tracking identity when faced with multiple interacting individuals and in pose-based behaviour recognition. We present a novel technique for enhancing a low-quality change detection into a better segmentation using an image combing estimator in an MRF based model.