Crop cultivation planning with fuzzy estimation using water wave optimization.

In a complex agricultural region, determine the appropriate crop for each plot of land to maximize the expected total profit is the key problem in cultivation management. However, many factors such as cost, yield, and selling price are typically uncertain, which causes an exact programming method impractical. In this paper, we present a problem of crop cultivation planning, where the uncertain factors are estimated as fuzzy parameters. We adapt an efficient evolutionary algorithm, water wave optimization (WWO), to solve this problem, where each solution is evaluated based on three metrics including the expected, optimistic and pessimistic values, the combination of which enables the algorithm to search credible solutions under uncertain conditions. Test results on a set of agricultural regions in East China showed that the solutions of our fuzzy optimization approach obtained significantly higher profits than those of non-fuzzy optimization methods based on only the expected values.

IgG4-related kidney disease complicated with retroperitoneal fibrosis: A case report.

BACKGROUND: IgG4-related disease (IgG4-RD) is a chronic fibrotic disease mediated by immunity recognized by clinicians in recent years. When the kidney is involved, it is called IgG4-related kidney disease (IgG4-RKD). IgG4-related tubulointerstitial nephritis (IgG4-TIN) is a representative manifestation of IgG4-RKD. IgG4-TIN can cause obstructive nephropathy complicated by retroperitoneal fibrosis (RPF). Cases of IgG4-TIN complicated with RPF are rare. Glucocorticoids are the first-line therapeutic medication for IgG4-RD and can significantly improve renal function. CASE SUMMARY: Herein, we report the case of a 56-year-old man with IgG4-RKD complicated with RPF. The patient presented to the hospital with complaints of elevated serum creatinine (Cr), nausea, and vomiting. During hospitalization, Cr was 1448.6 µmol/L, and serum IgG4 was increased. A total abdominal computed tomography (CT) scan and enhanced CT scan obviously indicated RPF. Although this patient had a long course and renal insufficiency, we performed a kidney biopsy. Renal biopsy showed that the renal tubulointerstitium had focal plasma cell infiltration and increased lymphocyte infiltration accompanied by fibrosis. After combining the biopsy results with immunohistochemistry, it was found that the absolute number of positive IgG4+ cells per high power field exceeded 10, and the ratio of IgG4/IgG was over 40%. Finally, the patient was diagnosed with IgG4-TIN complicated with RPF and given glucocorticoids as long-term maintenance therapy, helping him keep out of dialysis. After a follow-up of 19 mo, the patient had recovered well. Previous literature on IgG4-RKD and RPF was retrieved from PubMed to characterize the clinical and pathological features and to identify the diagnosis and treatment of IgG4-RKD. CONCLUSION: Our case report demonstrates the clinical characteristics of IgG4-RKD complicated with RPF. Serum IgG4 is a favorable indicator for screening. Performing renal biopsy actively plays a vital role in diagnosis and treatment, even if the patient has a long course and manifests with renal insufficiency. It is remarkable to treat IgG4-RKD with glucocorticoids. Hence, early diagnosis and targeted therapy are essential for reversing renal function and improving extrarenal manifestations in patients with IgG4-RKD.

Self-management program for patients with chronic kidney disease (SMP-CKD) in Southern China: protocol for an ambispective cohort study.

BACKGROUND: Chronic kidney disease (CKD) is a major global health problem. Short-term self-management has been considered to effect some renal and psychological endpoints. However, there are currently very few studies about self-management for CKD that a) have been scientifically designed by a theory-based framework and b) that evaluate the long-term effects and working mechanism. This study presents the rationale and design of a theory-based cohort study to explore how this self-management intervention works and its effectiveness on the Chinese CKD population. METHODS: In this ambispective intervention cohort study,1,200 patients with CKD stages 1-5 will be recruited from July 2015 to July 2024 in 3 branches of Guangdong Provincial Hospital of Chinese Medicine (GPHCM) in Guangdong province, China. The patients in the self-management cohort will choose to receive an intervention that consists of education, nutrition/diet modification, lifestyle change recommendation, medication review, and psychology support based on Social Cognition Theory (SCT). The patients in the control cohort will do regular follow-ups based on the clinic rules. All the patients will be followed up for 5 years, or until the occurrence of a primary outcome. Detailed clinical, laboratory markers, nutritional status, psychological exposures and outcome questionaries will be collected semiannually in CKD stage 1-2 and trimonthly in stage 3-5 patients. The primary outcome is the occurrence of composite clinical endpoints (doubling of serum creatinine level, ESKD, loss of renal function (≥ 40% decline in GFR from baseline), death, major cardiovascular or cerebrovascular events). The main secondary outcomes include the absolute change and slope of eGFR, absolute changes of urinary protein creatinine ratio, 24-h urine proteinuria, intact parathyroid hormone level, and self-management adherence rate and quality of life from baseline to end of the study. The effectiveness of self-management will be analyzed and the association between longitudinal trajectories of self-management and renal outcomes will be evaluated. DISCUSSION: This study aims to provide further evidence for the effectiveness of theory-based self-management in CKD patients and to improve the lives of patients with CKD by slowing progression, improving psychological well-being and overall quality of life. TRIAL REGISTRATION: Chinese Clinical Trial Register (ChiCTR1900024633). 19 July, 2019. http://www.chictr.org.cn/showproj.aspx?proj=38378.

Long noncoding RNAs: Important participants and potential therapeutic targets for myocardial ischaemia reperfusion injury.

Myocardial ischaemia reperfusion (I/R) injury is one of the leading causes of coronary artery disease-associated morbidity and mortality. While different strategies have been used to limit I/R injuries, cardiac functions often do not recover to the normal level as anticipated. Recent studies have pointed to important roles of long noncoding RNAs (lncRNAs) in the development of myocardial I/R injury. LncRNA is a class of RNA molecules of more than 200 nucleotides in length which are not translated into proteins. I/R causes dysregulation of lncRNA expression in cardiomyocytes, thereby affecting multiple cellular functions including mitochondrial homeostasis, apoptosis, necrosis and autophagy, suggesting that manipulating lncRNAs may be of great potential in counteracting I/R injury-induced myocardial dysfunctions. In this review, we provide an updated summary on our knowledge about contributions of lncRNAs to the development of I/R injury, with an emphasis on the functional links between several well established cardiac lncRNAs and regulation of cellular outcomes post I/R.

Preventable Deaths in Multiple Trauma Patients: The Importance of Auditing and Continuous Quality Improvement.

BACKGROUND: Management errors during pre-hospital care, triage process and resuscitation have been widely reported as the major source of preventable and potentially preventable deaths in multiple trauma patients. Common tools for defining whether it is a preventable, potentially preventable or non-preventable death include the Advanced Trauma Life Support (ATLS®) clinical guideline, the Injury Severity Score (ISS) and the Trauma and Injury Severity Score (TRISS). Therefore, these surrogated scores were utilized in reviewing the study's trauma services. METHODS: Trauma data were prospectively collected and retrospectively reviewed from January 1, 2018, to December 31, 2018. All cases of trauma death were discussed and audited by the Hospital Trauma Committee on a regular basis. Standardized form was used to document the patient's management flow and details in every case during the meeting, and the final verdict (whether death was preventable or not) was agreed and signed by every member of the team. The reasons for the death of the patients were further classified into severe injuries, inappropriate/delayed examination, inappropriate/delayed treatment, wrong decision, insufficient supervision/guidance or lack of appropriate guidance. RESULTS: A total of 1913 trauma patients were admitted during the study period, 82 of whom were identified as major trauma (either ISS > 15 or trauma team was activated). Among the 82 patients with major trauma, eight were trauma-related deaths, one of which was considered a preventable death and the other 7 were considered unpreventable. The decision from the hospital's performance improvement and patient safety program indicates that for every trauma patient, basic life support principles must be followed in the course of primary investigations for bedside trauma series X-ray (chest and pelvis) and FAST scan in the resuscitation room by a person who meets the criteria for trauma team activation recommended by ATLS®. CONCLUSION: Mechanisms to rectify errors in the management of multiple trauma patients are essential for improving the quality of trauma care. Regular auditing in the trauma service is one of the most important parts of performance improvement and patient safety program, and it should be well established by every major trauma center in Mainland China. It can enhance the trauma management processes, decision-making skills and practical skills, thereby continuously improving quality and reducing mortality of this group of patients.

The application of the movement classification system in the diagnosis of children with Cerebral Palsy.

Cerebral Palsy is mean damage to the brain, causing non-progressive brain injury, such as hemiplegia, limbs palsy, epilepsy, involuntary movements, poor coordination. This paper proposes a movement evaluation and classification system, in view Cerebral Palsy children hand movement smoothness evaluation. In addition, the application of the movement classification system in the diagnosis of children with cerebral palsy is also discussed. The system contains: image capture, image segmentation, and information classification processing. Momentum analysis parameters and coordination neural network are used to conduct the data classification. The experimental results are shown that the proposed system has the higher accurate diagnostic rate of children are divided into cerebral palsy groups or normal groups.

An Adaptive-Tabu GA for Registration of CT and Surface Laser Scan.

An adaptive-tabu GA (Genetic Algorithm) method is proposed to improve some traditional GA methods in the registration of computer tomography (CT) and surface laser scan. In this method, the adaptive memory structure and search strategy of Tabu Search (TS) with the modified chromosome crossover and adaptive mutation are proposed to increase the convergence speed and accuracy of the fitness function. This registration method can be used on non-fiducial stereo-tactic brain surgeries to assist surgeons to diagnose and treat brain diseases.

An upper-limb-movement classification system of cerebral palsy children based on arm motion detection.

The researches about upper limb palsy patients are the minority areas among the researches about cerebral palsy (CP) patients. This paper presents an upper-limb-movement classification system of cerebral palsy children based on their arm motion information to judge their impairment degree. The system contains three parts: image capture, image segmentation, and information classification processing. Momentum analysis parameters and coordination neural network are used to conduct the data classification. The experimental results are shown that the proposed system has the higher accurate rate of tracking compared with Normalized Cross Correlation and Otsu methods, and the patients are divided into the slight impairment grade or the serious impairment grade.

A Segmentation Scheme of Brainstem and Cerebellum using Scale-Based Fuzzy Connectedness and Deformable Contour Model.

A semi-automatic multiple-stage segmentation scheme of brainstem and cerebellum is proposed in this paper. This proposed scheme contains a modified Scale-based Fuzzy Connectedness (FC) algorithm, a morphology operator, Chain code, and Active Contour Mode (ACM). A modified Scale-based FC is utilized to delivery a rough segmentation, a morphology operator and Chain code are used to compensate the uncompleted small regions and derive an initial contour, and ACM is employed to obtain the final object boundary with the aid of the initial contour from the previous stages. The experimental results verify that the segmentation results using the proposed scheme are more accurate than using a single algorithm based on a Scale-Based FC method.