Predicting the Progression of Chronic Kidney Disease: A Systematic Review of Artificial Intelligence and Machine Learning Approaches.

Chronic kidney disease (CKD) is a progressive condition characterized by gradual loss of kidney function, necessitating timely monitoring and interventions. This systematic review comprehensively evaluates the application of artificial intelligence (AI) and machine learning (ML) techniques for predicting CKD progression. A rigorous literature search identified 13 relevant studies employing diverse AI/ML algorithms, including logistic regression, support vector machines, random forests, neural networks, and deep learning approaches. These studies primarily aimed to predict CKD progression to end-stage renal disease (ESRD) or the need for renal replacement therapy, with some focusing on diabetic kidney disease progression, proteinuria, or estimated glomerular filtration rate (GFR) decline. The findings highlight the promising predictive performance of AI/ML models, with several achieving high accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve scores. Key factors contributing to enhanced prediction included incorporating longitudinal data, baseline characteristics, and specific biomarkers such as estimated GFR, proteinuria, serum albumin, and hemoglobin levels. Integration of these predictive models with electronic health records and clinical decision support systems offers opportunities for timely risk identification, early interventions, and personalized management strategies. While challenges related to data quality, bias, and ethical considerations exist, the reviewed studies underscore the potential of AI/ML techniques to facilitate early detection, risk stratification, and targeted interventions for CKD patients. Ongoing research, external validation, and careful implementation are crucial to leveraging these advanced analytical approaches in clinical practice, ultimately improving outcomes and reducing the burden of CKD.

Preparation and application of hydroxypropyl methylcellulose blended with beeswax and essential oil edible coating to enhance the shelf life of sweet cherries.

The study involved preparing and applying edible nano-emulsion coatings containing hydroxypropyl methylcellulose (HPMC), beeswax (BW), and essential oils (thyme, cinnamon, clove, and peppermint) onto sweet cherries. The application was conducted at 4 °C, and the coated cherries were stored for 36 days. This research examines synthesized nano-emulsions physicochemical properties and antibacterial and antifungal activities (C1, C2, and C3). Additionally, it evaluates the quality parameters of control and coated sweet cherry samples. The features of the three edible coatings were assessed, and the findings from the zeta sizer, zeta potential, FTIR, and SEM analyses were deemed satisfactory. It was observed that the application of nano-emulsion coating C1 yielded positive results in maintaining quality attributes such as total suspended solids (TSS), total solids (TS), color, weight loss, respiration rate, firmness, total phenolic contents, and sensory evaluations. Nano-emulsion coating C1 demonstrated efficacy as an antibacterial and antifungal agent against foodborne pathogens E. coli and A. niger, respectively. The current research results are promising and applicable in food industries. The implications suggest that composite nano-emulsion, specifically nano-emulsion edible coatings, can be extensively and effectively used to preserve the quality and shelf life of fruits and vegetables. Furthermore, the environmental waste from conventional food packaging will be minimized using edible packaging applications.

Durability and Accelerated Ageing of Natural Fibers in Concrete as a Sustainable Construction Material.

This paper presents an experimental study on the influence of alkaline environments on natural fibers of plant and mineral origin in concretes. The durability of concrete-based composite materials is influenced by the properties of the reinforcing fiber, and the serviceability of concrete is dependent on its durability. The aim of the present study is to investigate the strength, weight loss %, and surface degradation of jute, sugarcane, coconut, sisal, as well as basalt fibers through an accelerated aging method when used as reinforcements in concrete. The samples were immersed in an alkaline environment of sodium and calcium hydroxide at two different levels of pH for one week. Further, the fibers were immersed in NaOH and Ca(OH)2 solutions of 1 M, 2 M, 4 M, and 6 M concentrations for 48 h in order to investigate the gradual effect of an alkaline environment on the mechanical properties of the fiber. It was concluded that the weight loss % was greatest for jute fibers when used in concrete composite, while there was no significant effect on the basalt fiber samples. The strength of jute fiber in the concrete sample was also most severely affected by the aging process, compared to other fibers. The strength of basalt fibers in a concrete composite was least affected by the aging process. In some cases, the sisal fiber sample showed an increase in fiber tenacity after the aging process due to fibrillation, which might have increased the interfacial area. The fiber microstructure before and after the aging was evaluated through the use of scanning electron microscopy (SEM). SEM analyses of different fibers were carried out to investigate surface degradation. The fiber pull-out strength was found to be the greatest for basalt fiber, followed by jute and sisal. This is indicative of the excellent adhesion of such fibers with cement in a concrete composite. In these cases, the use of sisal fiber results in defibrillation and increased specific surface area. Sugarcane and coconut fibers ruptured due to their inherent weakness and provided only a small increment in the mechanical performance of the concrete. Basalt fiber-reinforced concrete offered the greatest compressive strength, followed by jute and sisal. These observations provide crucial information regarding the durability and aging of natural fiber-reinforced concrete.

IgG4 Autoimmune Disease Masquerading As Oroantral Fistula.

IgG4-related disease (IgG4-RD) is an immune-mediated disorder that involves multiple organs and is characterized by the infiltration of lymphoplasmacytic cells, including IgG4-positive plasma cells, along with storiform fibrosis and obliterative phlebitis in the inflamed organs. The primary sites affected by this condition include the pancreas, bile ducts, salivary glands, aorta, lungs, kidneys, meninges, lacrimal glands, mediastinal lymph nodes, and retroperitoneum. The pathogenesis is linked to a type 2 T-helper-cell cytokine profile and the involvement of regulatory T cells. However, the exact mechanism is still unknown. Patients with IgG4-related disease are frequently misdiagnosed as having malignancies due to the resemblance of the lesions to infections or other immune-mediated diseases and certain tumors, such as pancreatic cancer and pseudo-renal pelvis tumor. Prompt identification of IgG4-related disease is essential as a delayed diagnosis until advanced stages can result in severe organ damage and potentially fatal outcomes, despite the disease being highly responsive to treatment. This report presents a highly unusual case of IgG4-related disease (IgG4-RD) with an atypical presentation in a 38-year-old female patient. The patient sought medical attention in the emergency department due to nasal septal erosions and an oral-antral fistula. Nasal cultures were conducted and indicated the presence of Klebsiella ozaena. Subsequent investigations, including a nasal biopsy, confirmed the diagnosis of IgG4-related autoimmune disease.

Optimization of seismic performance in waste fibre reinforced concrete by TOPSIS method.

For a sustainable environment and to tackle the pollution problem, industrial wastes can be used in concrete composite materials. This is especially beneficial in places prone to earth quack and lower temperature. In this study, five different types of waste fibres such as polyester waste, rubber waste, rock wool waste, glass fibre waste and coconut fibre waste were used as an additive in 0.5% 1%, and 1.5% by mass in concrete mix. Seismic performance related properties of the samples were examined through evaluation of compressive strength, flexural strength, impact strength, split tensile strength, and thermal conductivity. Results showed that, impact strength of the concrete significantly improved by the addition of fibre reinforcement in concrete. Split tensile strength and flexural strength were significantly reduced. Thermal conductivity was also influenced by addition of polymeric fibrous waste. Microscopic analysis was performed to examine the fractured surfaces. In order to get the optimum mix ratio, multi response optimization technique was used to determine the desired level of impact strength at an acceptable level of other properties. Rubber waste was found to be the most attractive option followed by coconut fibre waste for the seismic application of concrete. The significance and percentage contribution of each factor was obtained by Analysis of variance ANOVA (α = 0.05) and pie chart which showed that Factor A (waste fibre type) is the main contributor. Confirmatory test was done on optimized waste material and their percentage. The order preference similarity to ideal solution (TOPSIS) technique was used for developed samples to obtain solution (sample) which is closest to ideal as per given weightage and preference for the decision making. The confirmatory test gives satisfactory results with error of 6.68%. Cost of reference sample and waste rubber reinforced concrete sample was estimated, which showed that 8% higher volume was achieved with waste fibre reinforced concrete at approximately same cost as pure concrete. Concrete reinforced with recycled fibre content is potentially beneficial in terms of minimizing resource depletion and waste. The addition of polymeric fibre waste in concrete composite not only improves seismic performance related properties but also reduces the environmental pollution from waste material which has no other end use.

Multiscale Principal Component Analysis-Signed Directed Graph Based Process Monitoring and Fault Diagnosis.

The chemical process industry has become the backbone of the global economy. The complexities of chemical process systems have been increased in the last two decades due to online sensor technology, plant-wide automation, and computerized measurement devices. Principal component analysis (PCA) and signed directed graph (SDG) are some of the quantitative and qualitative monitoring techniques that have been widely applied for chemical fault detection and diagnosis (FDD). The conventional PCA-SDG algorithm is a single-scale FDD representation origin, which cannot effectively solve multiple FDD representation origins. The multiscale PCA-SDG wavelet-based monitoring technique has potential because it easily distinguishes between deterministic and stochastic characteristics. This study uses multiscale PCA-SDG to detect, diagnose the root cause and identify the fault propagation path. The proposed method is applied to a continuous stirred tank reactor system to validate its effectiveness. The propagation route of most process failures is detected, identified, and diagnosed, which is well-aligned with the fault description, demonstrating a satisfactory performance of the suggested technique for monitoring the process failures.

Importance Of Clinical Risk Index For Babies Score For Predicting Mortality Among Neonates.

BACKGROUND: High mortality among premature and very low birth weight (VLBW) babies necessitates the need to formulate and use scoring systems like CRIB score to predict the mortality in this vulnerable group. Objective of the study was to determine the strength of Clinical Risk Index For Babies (CRIB) score in detecting neonatal mortality in babies presenting with very low birth weight so that timely intervention can be done. It was a cross-sectional study, conducted at NICU, Children Hospital, Pakistan Institute of Medical Sciences Islamabad (PIMS) in nine months starting from First July 2017. METHODS: A total of two hundred and fifty-four (n=254) new-borns with birth weight of between 500-1500 grams and gestational age lesser than 35 weeks were included in the study. CRIB score was calculated in all neonates and its association was assessed with mortality during NICU stay. Recorded data was analysed for demographic variables. Means and standard deviation was calculated for numeric variables. Chi-square test was applied to find p-value for the correlation between the main variables. RESULTS: 54.3% (n=138) patients were males and 45.7% (n=116) were females. Mean gestational age was 33.3 weeks±1.04 SD and mean birth weight of study population was 1129.9 grams±210.6 SD. Mean CRIB score among the study population was 6.3±3.1SD and overall mortality was found to be 54.7% (n=139). Mean CRIB score was found to be 8.27±2.1 SD among mortality group and it was 3.87±3.4 SD among newborns who were discharged (p<0.05). Mortality was present in 4.3% (n=4) of neonates with CRIB score between 1 to 5, 87.1% (n=121) who had CRIB score between 6 to 10 and 100% (n=14) of neonates who had CRIB score level 11-15 (p<0.05), so a significantly higher percentage mortality was noted among neonates with higher CRIB scores. CONCLUSIONS: According to our study mean CRIB score is a significant predictor of neonatal mortality.

Sensitivity Profiles of Human Prostate Cancer Cell Lines to an 80 Kinase Inhibitor Panel.

BACKGROUND: Taxanes and anti-androgen therapies are routinely used for the treatment of metastatic prostate cancer, however the majority of patients eventually develop resistance. MATERIALS AND METHODS: Eighty kinase inhibitors were screened regarding their ability to inhibit cell viability in CWR22, 22Rv1, PC-3 and DU145 prostate cancer cells using automated toxicity assays. Four kinase inhibitors were selected for further investigation. RESULTS: No significant difference in sensitivity patterns was found between the androgen receptor wild-type CWR22 and its androgen receptor mutant variant 22Rv1, indicating that androgen receptor mutation did not impact on kinase inhibitor sensitivity in this model. Metastatic PC-3 and DU145 prostate cancer cell lines were less sensitive to kinase inhibitors than the non-metastatic CWR22 and 22Rv1. All four cell lines responded to GSK-3 inhibitor BIO, and MEK inhibitor PD198306. DU145 cells were resistant to p75NTR/TrkA and CHK4 inhibitors, RO-082750 and Ryuvidine. CONCLUSION: Kinase inhibition may be an appropriate strategy for the treatment of prostate cancer.

Cranial meningioma co-localised with Langerhans cell histiocytosis.

We present a case in which a patient was initially diagnosed and treated for a para-cavernous meningioma with radiotherapy. An accompanying lesion overlying the left frontal convexity was surgically removed several months later to provide a histological diagnosis. Surprisingly, meningioma and Langherhans cell histiocytosis were found in the same lesion.

Beliefs and perceptions of acne among a sample of students from Sindh Medical College, Karachi.

OBJECTIVE: To determine the beliefs of undergraduate medical students regarding acne. METHOD: A cross-sectional study in 630 medical students (aged 16-29 years) was conducted. A voluntary self administered questionnaire was used to collect data regarding their beliefs and perceptions about acne. Both acne and non-acne sufferers were included in the study. RESULT: Of the 630 respondents, 55.9% were sufferers while 44.1% were non-sufferers. Of all, 67.0% of the affected believed it to be relieved by frequent face washing and that they should seek treatment, whereas 79.84% students believed in seeking dermatologist's advice regarding treatment. Mass media was the most common source of information. As to the cause, 21.7% students believed that hereditary factors and 20.1% thought environmental factors are the major cause of acne. In diet, soft drinks (29.2%) were considered the major exacerbating factor. The most significant emotional impact of acne on medical students was embarrassment (26.2%). CONCLUSION: The results of this study pointed out that misconceptions and false beliefs on acne are widespread and enduring among Medical students' too. Health education programme on acne is needed to improve their understanding of the condition.