An artificial intelligence approach to predict infants' health status at birth.

BACKGROUND: Machine learning could be used for prognosis/diagnosis of maternal and neonates' diseases by analyzing the data sets and profiles obtained from a pregnant mother. PURPOSE: We aimed to develop a prediction model based on machine learning algorithms to determine important maternal characteristics and neonates' anthropometric profiles as the predictors of neonates' health status. METHODS: This study was conducted among 1280 pregnant women referred to healthcare centers to receive antenatal care. We evaluated several machine learning methods, including support vector machine (SVM), Ensemble, K-Nearest Neighbor (KNN), Naïve Bayes (NB), and Decision tree classifiers, to predict newborn health state. RESULTS: The minimum redundancy-maximum relevance (MRMR) algorithm revealed that variables, including head circumference of neonates, pregnancy intention, and drug consumption history during pregnancy, were top-scored features for classifying normal and unhealthy infants. Among the different classification methods, the SVM classifier had the best performance. The average values of accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) in the test group were 75%, 75%, 76%, 76%, and 65%, respectively, for SVM model. CONCLUSION: Machine learning methods can efficiently forecast the neonate's health status among pregnant women. This study proposed a new approach toward the integration of maternal data and neonate profiles to facilitate the prediction of neonates' health status.

The use of diffusion-weighted MR imaging in the functional assessment of the testes of patients with clinical varicocele.

We aimed to evaluate the use of diffusion-weighted imaging (DWI) in the assessment of the varicocele effect on testicular parenchyma and spermatogenesis, with estimation of apparent diffusion coefficient (ADC) value changes in the testicular parenchyma. We prospectively evaluated 30 consecutive patients (18 patients with bilateral varicocele and 12 patients with unilateral varicocele) and 10 healthy controls. US and DWI were performed to all patients. A total of 80 testes were included, which divided into three groups: group A: testes ipsilateral to the varicocele (n = 48, 60%); group B: testes contralateral to the varicocele (n = 12, 15%); and group C: normal testes of the control (n = 20, 25%). There was a statistically significant difference in mean ADC value between all groups (p-value < 0.001). In groups A and B, there was a negative correlation between mean ADC values and varicocele grade as well as pampiniformis venous diameter. In group A, there was a significant positive correlation between mean ADC value and sperm count (p-value = 0.01, r-value = 0.48) as well as sperm motility (p-value = 0.04, r-value = 0.33). DWI sequence can be used to evaluate the sequel of varicocele, with decreased ADC values that are significantly correlated with abnormal semen parameters. Thus, ADC values may be considered as an ancillary indicator of testicular parenchyma changes.

p53, MAPKAPK-2 and caspases regulate nickel oxide nanoparticles induce cell death and cytogenetic anomalies in rats.

The unique properties of nickel oxide nanoparticles (NiO-NPs) distinguish it from traditional nickel containing materials, and enable its industrial application as an advanced nanomaterial. Despite the benefits, the in vivo toxicological studies on NiO-NPs have been mainly focused on its pulmonary pathology. However, NiO-NPs exposure via oral route and its subsequent toxic effects in exposed animals are still lacking. Hence, we evaluated the NiO-NPs oral toxicity in male Wistar rats. NiO-NPs induced significant increase in chromosomal aberrations (CAs), micronuclei (MN) formation and, DNA damage in rats. Flow cytometric analysis showed apoptosis, ROS generation and dysfunction of mitochondrial membrane potential (ΔΨm). Imbalance of antioxidant enzymes, along with histological alterations was found in liver. Taking together, these results unequivocally suggested that NiO-NPs induced toxicity was through cyto-genetic alterations, oxidative stress, apoptosis and liver toxicity. The western blotting data validated the interplay of p53 and MAPKAPK-2 signalling via activation of caspases 8, 3, cyto c, pro-apoptotic bax and anti-apoptotic bcl-2 proteins.

Protective Efficacy of Recombinant Turkey Herpes Virus (rHVT-H5) and Inactivated H5N1 Vaccines in Commercial Mulard Ducks against the Highly Pathogenic Avian Influenza (HPAI) H5N1 Clade 2.2.1 Virus.

In Egypt, ducks kept for commercial purposes constitute the second highest poultry population, at 150 million ducks/year. Hence, ducks play an important role in the introduction and transmission of avian influenza (AI) in the Egyptian poultry population. Attempts to control outbreaks include the use of vaccines, which have varying levels of efficacy and failure. To date, the effects of vaccine efficacy has rarely been determined in ducks. In this study, we evaluated the protective efficacy of a live recombinant vector vaccine based on a turkey Herpes Virus (HVT) expressing the H5 gene from a clade 2.2 H5N1 HPAIV strain (A/Swan/Hungary/499/2006) (rHVT-H5) and a bivalent inactivated H5N1 vaccine prepared from clade 2.2.1 and 2.2.1.1 H5N1 seeds in Mulard ducks. A 0.3ml/dose subcutaneous injection of rHVT-H5 vaccine was administered to one-day-old ducklings (D1) and another 0.5ml/dose subcutaneous injection of the inactivated MEFLUVAC was administered at 7 days (D7). Four separate challenge experiments were conducted at Days 21, 28, 35 and 42, in which all the vaccinated ducks were challenged with 106EID50/duck of H5N1 HPAI virus (A/chicken/Egypt/128s/2012(H5N1) (clade 2.2.1) via intranasal inoculation. Maternal-derived antibody regression and post-vaccination antibody immune responses were monitored weekly. Ducks vaccinated at 21, 28, 35 and 42 days with the rHVT-H5 and MEFLUVAC vaccines were protected against mortality (80%, 80%, 90% and 90%) and (50%, 70%, 80% and 90%) respectively, against challenges with the H5N1 HPAI virus. The amount of viral shedding and shedding rates were lower in the rHVT-H5 vaccine groups than in the MEFLUVAC groups only in the first two challenge experiments. However, the non-vaccinated groups shed significantly more of the virus than the vaccinated groups. Both rHVT-H5 and MEFLUVAC provide early protection, and rHVT-H5 vaccine in particular provides protection against HPAI challenge.

Minimally Invasive Treatment of Liver Hydatidosis.

BACKGROUND AND OBJECTIVES: Open surgery has been the mainstay treatment for liver hydatidosis in the past. Today, for treatment of simple and uncomplicated cysts, we have a variety of choices: antihelmintic therapy, the PAIR (puncture, aspiration, injection, and respiration) technique, and the laparoscopic approach. We reviewed our series of 267 cases of hepatic hydatidosis submitted to surgery over a period of 20 years, from 1995 through 2014, comparing the results of these minimally invasive treatments. METHODS: In 92 patients (25.7% of cases) who presented with complicated liver hydatid cysts, we performed open surgery. In 16.4% of cases (59 patients), we used a laparoscopic approach, and in 208 patients (57.9% of cases), we used the PAIR technique. All patients were monitored after surgery for a mean of 61.7 months (range, 16-127). Postoperative follow-up consisted of clinical examination, laboratory investigation, abdominal ultrasound, and magnetic resonance imaging. RESULTS: Almost all patients (198, 95.2%) treated with the PAIR technique and 55 patients (93.2%) treated with the laparoscopic approach were cured. Six patients (2.8%) from the echo-guided puncture group had to undergo a repeat of the procedure because the cavity did not disappear after 2 years. In 4 patients (2%), we performed open surgery for 2 biliary fistulas and 2 hepatic abscesses. Four patients from the laparoscopic group needed additional procedures. Open surgery was necessary in 2 patients for a recurrence after 2 years; 1 patient had developed a liver abscess and the other had a biliary fistula. CONCLUSIONS: In conclusion, open surgery remains the viable option for complicated cysts, with biliary communication, with multiple daughter vesicles, or with calcified walls. For simple, uncomplicated hydatid cysts, both methods (the PAIR technique and laparoscopic procedure) are safe and efficient, with very good results and low morbidity rates.

Hazards of low dose flame-retardants (BDE-47 and BDE-32): Influence on transcriptome regulation and cell death in human liver cells.

We have evaluated the in vitro low dose hepatotoxic effects of two flame-retardants (BDE-47 and BDE-32) in HepG2 cells. Both congeners declined the viability of cells in MTT and NRU cell viability assays. Higher level of intracellular reactive oxygen species (ROS) and dysfunction of mitochondrial membrane potential (ΔΨm) were observed in the treated cells. Comet assay data confirmed the DNA damaging potential of both congeners. BDE-47 exposure results in the appearance of subG1 apoptotic peak (30.1%) at 100 nM, while BDE-32 arrested the cells in G2/M phase. Among the set of 84 genes, BDE-47 induces downregulation of majority of mRNA transcripts, whilst BDE-32 showed differential expression of transcripts in HepG2. The ultrastructural analysis revealed mitochondrial swelling and degeneration of cristae in BDE-47 and BDE-32 treated cells. Overall our data demonstrated the hepatotoxic potential of both congeners via alteration of vital cellular pathways.

Efficacy of 48-hour post-operative antibiotics prophylaxis for patients undergoing percutaneous endoscopic gastrostomy tube in preventing site infection.

BACKGROUND: Percutaneous Endoscopic Gastrostomy (PEG) is an endoscopic procedure for placing a feeding tube into the stomach through the skin, primarily to avoid malnutrition. Malnutrition can increase the risk of wound infection, whose incidence can be decreased by using antibiotic prophylaxis. AIM: The purpose of our study was to evaluate the efficacy of a new antibiotic regimen in preventing acute post-PEG procedure complications. PATIENTS AND METHODS: Ninety-seven consecutive patients were put on combined antibiotic therapy of clindamycin 600 mg and cefotaxime 1,000 mg every eight hours, starting with the insertion of the PEG tube and maintained for 48 hours. Pain/tenderness, leakage/drainage, bleeding fever, maximum white blood cells (WBC) count, pus/discharge, and PEG tube function were evaluated within 48 hours and 1 week from PEG insertion. RESULTS: Infection at the site of PEG insertion occurred in 3 cases (3.1%) within 48 hours and in 1 case (1.0%) within 7 days. Within 48 hours from the procedure, incidence of fever and increased WBC count was 10.3% and 9.3%, respectively, though at 7 days all were resolved. Pain, leak, and bleeding at the site of PEG placement were prevalently mild within 48 hours (74.2%, 12.4%,13.4% of patients, respectively) and subsided within 7 days (2.1%, 0%, 0%). One case (1.0%) of minor antibiotic side effect occurred. Two patients died due to complications not related to the procedure. CONCLUSION: The combined use of short-term cefotaxime and clindamycin seems to be effective in reducing incidence of acute complications due to PEG placement without increasing side-effects.