Enhancing Cookie Formulations with Combined Dehydrated Peach: A Machine Learning Approach for Technological Quality Assessment and Optimization.

This study focuses on predicting and optimizing the quality parameters of cookies enriched with dehydrated peach through the application of Support Vector Machine (SVM) and Artificial Neural Network (ANN) models. The purpose of the study is to employ advanced machine learning techniques to understand the intricate relationships between input parameters, such as the presence of dehydrated peach and treatment methods (lyophilization and lyophilization with osmotic pretreatment), and output variables representing various quality aspects of cookies. For each of the 32 outputs, including the parameters of the basic chemical compositions of the cookie samples, selected mineral contents, moisture contents, baking characteristics, color properties, sensorial attributes, and antioxidant properties, separate models were constructed using SVMs and ANNs. Results showcase the efficiency of ANN models in predicting a diverse set of quality parameters with r2 up to 1.000, with SVM models exhibiting slightly higher coefficients of determination for specific variables with r2 reaching 0.981. The sensitivity analysis underscores the pivotal role of dehydrated peach and the positive influence of osmotic pretreatment on specific compositional attributes. Utilizing established Artificial Neural Network models, multi-objective optimization was conducted, revealing optimal formulation and factor values in cookie quality optimization. The optimal quantity of lyophilized peach with osmotic pretreatment for the cookie formulation was identified as 15%.

Food grade disinfectants based on hydrogen peroxide/peracetic acid and sodium hypochlorite interfere with the adhesion of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Listeria monocytogenes to stainless steel of differing surface roughness.

This study aimed to evaluate the potential of the bacterium Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Listeria monocytogenes to adhere to stainless steel discs with differing degrees of surface roughness (Ra = 25.20-961.90 nm). Stainless steel is a material commonly used in the food industry for processing equipment, which is regularly exposed to cleaning procedures. The investigation included the commercial disinfectants hydrogen peroxide/peracetic acid and sodium hypochlorite which were evaluated for their antibacterial and anti-adhesion activity. The adhesion was assessed by the standard plate count method, while the broth microdilution method CLSI M07-A10 was used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the disinfectants. Based on the MIC values, both disinfectants exerted significant inhibitory effects with MIC values for hydrogen peroxide/peracetic acid and sodium hypochlorite of 250 µg ml-1 and 500 µg ml-1, respectively. Whereas the MBC values were equal to the MIC for all bacteria except for E. coli with values 2-fold higher than the MIC. Obtained results also revealed that all tested bacteria were able to adhere to stainless steel surfaces, although differences were found for strains and surface roughness. The lowest adhesion rate of each strain was recorded on the roughest stainless steel disc at a Ra of 961.90 nm. Further, at a concentration of 1 MIC, the disinfectant sodium hypochlorite reduced initial bacterial adhesion to stainless steel surfaces to a significantly greater extent than the disinfectant hydrogen peroxide/peracetic acid. These findings are consistent with the results obtained by Scanning Electron Microscopy (SEM) analysis, which indicates the great applicability of the tested disinfectants for the control of bacterial adhesion in the food industry.

Importance of numerical density of tubulointerstitium infiltrates in the prognosis of antineutrophil cytoplasmic antibodies-associated glomerulonephritis.

AIM: To examine the association of the numerical density of the tubulointerstitium infiltrate with pathohistological changes in the glomeruli and the estimated glomerular filtration rate (eGFR) at kidney biopsy and after 18 months. METHODS: This retrospective study enrolled 44 patients (43.2% male) with antineutrophil cytoplasmic antibodies-associated glomerulonephritis treated at the University Clinical Center of Vojvodina between 2017 and 2020. The numerical density of infiltrates in the tubulointerstitium was determined with the Weibel (M-2) system. Data on biochemical, clinical, and pathohistological parameters were obtained. RESULTS: The mean age was 57.7±10.23 years. Global sclerosis in more than 50% of glomeruli and crescents in more than 50% of glomeruli were significantly associated with a mean lower eGFR (17.6±11.78; 32.0±26.13, respectively) at kidney biopsy (P=0.002; P<0.001, respectively), but not after 18 months. The average numerical density of infiltrates was significantly higher in patients with more than 50% of globally sclerotic glomeruli (P<0.001) and with crescents in more than 50% of glomeruli (P<0.001). The average numerical density of infiltrates significantly correlated with eGFR at biopsy (r=-0.614), but not after 18 months. Our results were confirmed by using multiple linear regression. CONCLUSION: Numerical density of infiltrates, and global glomerular sclerosis and crescents in more than 50% of glomeruli significantly affect eGFR at biopsy, but not after 18 months.

Celery Root Phenols Content, Antioxidant Capacities and Their Correlations after Osmotic Dehydration in Molasses.

The osmotic dehydration (OD) of celery root in sugar beet molasses was studied at three temperatures (20, 35, and 50 °C) and three immersion periods (1, 3, and 5 h) in order to examine the changes in antioxidant potential and phenolic profile of celery root throughout the process. The antioxidant capacity (AOC) of dehydrated samples was evaluated by spectrophotometric and polarographic assays, the total phenolic content by the Folin-Ciocalteu method, and the individual phenolic compounds by HPLC-DAD. As a result of OD in molasses, the AOC and phenols content in samples increased proportionally to the augmentation of temperature and the immersion time. Vanillic acid, syringic acid, and catechin were detected in dehydrated samples as a result of transfer from molasses. Compared to fresh celery root, the content of identified phenols in osmodehydrated samples was improved from 1.5 to 6.2 times. Strong correlations between applied assays were obtained, except for the DPPH. Based on the correlation analysis chlorogenic acid, gallic acid, chrysin, catechin, and kaempferol showed the greatest contribution to the overall AOC of osmodehydrated celery root. Molasses, an agro-industrial waste from sugar production, could be valorized as a valuable osmotic solution.

Gender-specific differences in hemodialysis patients: a multicenter longitudinal study from Serbia.

PURPOSE: The study was undertaken with the aim to determine gender-specific differences in incident hemodialysis (HD) patient and their changes over time. METHODS: The retrospective longitudinal closed cohort study involved 441 incident patients starting HD in 2014 and followed for 1-59 (median 43, IQR 40) months. Demographic, clinical data, treatment characteristics, laboratory findings and outcome were abstracted from the patients' medical records. RESULTS: The relative number of males on HD was about twice that of females throughout the five years investigated. At the beginning of the study, no significant differences were found in the main demographic and clinical characteristics except that diabetes was more often the underlying disease in men than in women. Systolic blood pressure decreased over time significantly more in females than in males. Throughout the study spKt/V was significantly higher in females than in males, but it increased in patients of both genders. There were no gender differences for comorbidities, vascular access and the majority of laboratory findings except for higher serum levels of creatinine and CRP in men than in women. Relatively more females were treated with erythropoiesis stimulating agents and phosphate binders than males. Age and malignancy were selected as significant predictors of mortality for both genders, and, in addition, polycystic kidney disease, serum level of albumin and CRP for men, but spKt/V for women. CONCLUSION: Some significant gender differences were observed throughout, while others appeared during the study but none of them were due to gender inequalities in the applied treatment.

Addition of Combinedly Dehydrated Peach to the Cookies-Technological Quality Testing and Optimization.

Peach dehydrated by a combined method of osmodehydration and lyophilization is characterized by upgraded dehydration effectiveness and enhanced chemical and mineral matter content, and as such, is an interesting material to be applied to the cookies' formulation. Incorporation of this material requires testing and optimization of the addition level from the aspect of overall technological quality in order to obtain a new cookie product. Obtained cookie samples with different levels of dehydrated peach addition were subjected to the nutritive and technology quality parameters testing. Cookies' chemical, mineral matter, and phenolic compounds content, the antioxidative activity of nutritive parameters, and the physical, technological, textural, colour, and sensory characteristics of technological parameters were investigated. Obtained results showed that the addition of especially higher levels of dehydrated peach enhanced all nutritive, while simultaneously decreased most of the technological quality parameters. The statistical method of Z-score analysis was used to calculate the optimal level of dehydrated peach addition to the cookie formulation for obtaining the highest nutritive enrichment without excessive technological quality deterioration. The optimal addition of osmodehydrated and lyophilized peach to the cookie formulation was determined to be 15%.

Association between Hemodialysis Patient Outcomes and Compliance with KDOQI and KDIGO Targets for Mineral and Bone Metabolism.

BACKGROUND: Increased mortality of hemodialysis (HD) patients is associated with chronic kidney disease-mineral and bone disorders (CKD-MBD), and therefore, their correction may improve patient survival. Differences in targets recommended by KDOQI and KDIGO CKD-MBD guidelines directed us to compare the relative numbers of patients achieving these targets and to examine possible associations between compliance with the targets and patient outcome. METHODS: A total of 1,744 patients (61.2% males, aged 58.7 ± 12.5 years) dialyzed in 20 HD centers in Serbia were monitored for 3 years. The number of participants achieving KDOQI/KDIGO guideline targets for serum phosphorus, calcium, and iPTH was determined. The Cox proportional hazards model was used to select variables significantly associated with risk of time to death. RESULTS: A majority of patients were dialyzed thrice weekly for 4 h; 86.3% of them used phosphate binders and 49.3% vitamin D3. Proportions of patients achieving KDOQI and KDIGO targets were 49.5 and 44.4% for phosphorus, 53.2 and 76.7% for calcium, 21 and 42.8% for iPTH. Multivariate Cox analysis selected serum phosphorus level outside the KDIGO target, as well as serum iPTH levels outside KDOQI and KDIGO targets as significant mortality predictors. Areas under the receiver operating characteristic curves showed that achievement of both guideline targets for iPTH had similar survival predictive values. CONCLUSION: Serum phosphorus levels outside KDIGO targets and iPTH levels outside both KDOQI and KDIGO targets were associated with a significantly higher risk of death. These findings may be useful in the management of CKD-MBD and for establishing local guidelines.

Compliance with guidelines and predictors of mortality in hemodialysis. Learning from Serbia patients.

OBJECTIVES: The aims of the study were to determine the percentage of patients on regular hemodialysis (HD) in Serbia failing to meet KDOQI guidelines targets and find out factors associated with the risk of time to death and the association between guidelines adherence and patient outcome. METHODS: A cohort of 2153 patients on regular HD in 24 centers (55.7% of overall HD population) in Serbia were followed from January 2010 to December 2012. The percentage of patients failing to meet KDOQI guidelines targets of dialysis dose (Kt/V>1.2), hemoglobin (>110g/L), serum phosphorus (1.1-1.8mmol/L), calcium (2.1-2.4mmol/L) and iPTH (150-300pg/mL) was determined. Cox proportional hazards analysis was used to select variables significantly associated with the risk of time to death. RESULTS: The patients were on regular HD for 5.3±5.3 years, dialyzed 11.8±1.9h/week. Kt/V<1.2 had 42.4% of patients, hemoglobin <110g/L had 66.1%, s-phosphorus <1.1mmol/L had 21.7% and >1.8mmol/L 28.6%, s-calcium <2.1mmol/L had 11.7% and >2.4mmol/L 25.3%, iPTH <150pg/mL had 40% and >300pg/mL 39.7% of patients. Using Cox model (adjustment for patient age, gender, duration of HD treatment) age, duration of HD treatment, hemoglobin, iPTH and diabetic nephropathy were selected as significant independent predictors of time to death. When targets of five examined parameters were included in Cox model, target for KtV, hemoglobin and iPTH were found to be significant independent predictors of time to death. CONCLUSION: Substantial proportion of patients examined failed to meet KDOQI guidelines targets. The relative risk of time to death was associated with being outside the targets for Kt/V, hemoglobin and iPTH.

Achievement of guideline targets in elderly patients on hemodialysis: a multicenter study.

OBJECTIVES: Advanced age is associated with shorter survival on dialysis. The aim of the present study was to compare the adherence with KDOQI guideline targets and the association between mortality and satisfying the guidelines targets between hemodialysis patients aged 65 years and over and those younger than 65 years. METHODS: Data were collected using a questionnaire sent to all 46 HD centers in Serbia with totally 3868 HD patients. The 24 centers responded and sent the data on all patients aged 18 years or older that were on regular HD for more than 3 months (2153 patients, 1320 males, aged 18-90 years). Data are presented in two groups: a group of patients younger than 65 years (1438, 66.8 %) and a group of patients aged 65 years and over (715, 33.2 %). The percentage of patients whose values failed to meet the targets recommended by KDOQI Clinical Practice Guidelines was calculated for dialysis dose (spKt/V), hemoglobin, serum phosphorus, serum calcium and plasma iPTH (150-300 pg/mL). Patients were followed from enrollment until their death, kidney transplantation, departure from the center or the end of the study. RESULTS: Elderly patients were more likely to have hypertension, significantly lower systolic and diastolic blood pressure and smaller dialysis vintage than younger patients. They were less frequently treated with high-flux membranes and hemodiafiltration and they had significantly lower number of dialysis hours per week and significantly lower interdialytic weight gain. They used ESA and phosphate binders less frequently than younger patients (p < 0.001 and p = 0.002). Older patients had similar Kt/V as younger ones but they had significantly more frequent Hb level outside the target range than younger patients. During the year follow-up period, by using a Cox proportional hazards model it has been confirmed that age, dialysis vintage, weekly dialysis time and target values for Kt/V were significant independent predictors of time to death for younger patients and gender, dialysis vintage and iPTH were independent predictor of time to death for older patients. CONCLUSION: Despite less favorable dialysis prescription, older patients had similar Kt/V and less frequent deviations from the target values proposed by KDOQI for serum phosphorus and iPTH but more frequent deviation for Hb value as compared with younger patients. Risk factors for mortality differ between older and younger patients; out of five KDOQI targets, only Kt/V proved to be a significant risk factor for mortality for younger and iPTH for older patients.

An experience with colistin applied in treatment of imunocompromised patients with peritonitis on peritoneal dialysis.

INTRODUCTION: Immunocompromised patients, such as those with multiple myeloma on peritoneal dialysis, are particularly susceptible to the occurrence of peritonitis. CASE REPORT: We presented a 56-year-old female patient with a 10-year history of multiple myeloma. The patient was on peritoneal dialysis since 2010. During 2012 the patient had the first episode of peritonitis that was successfully managed, but in 2013 the second episode of peritonitis occured. Analysis of dialysate culture and exit site swab revealed the presence of multiresistant Acinetobacter spp., which was susceptible only to colistin. Prompt colistin therapy was administered at the doses of 100,000 units/day during six days, which resulted in complete recovery of the patient, as well as improvement of local abdominal findings. Gram-negative bacteria (genus Acinetobacter) are common causative agents in hospital-acquired infections. Studies confirmed susceptibility of Acinetobacter to colistin, which was also the case with the presented patient. Intravenous administration of colistin resulted in a complete remission of this severe, life-threatening peritonitis. CONCLUSION: Patients with multiple myeloma and renal failure are highly prone to severe life-threatening infections.

Blunt trauma of the thoracic aortic isthmus.

Blunt trauma of the thoracic aorta is the second leading cause of death in traffic accidents, after head injuries. A polytraumatized patient, aged 40, was admitted, with trauma of the thoracic aortic isthmus, after a traffic accident. Adequate resuscitation and intensive therapy, angiographic and MSCT diagnostics enabled the urgent surgical treatment. On the sixty-seventh day of surgery, the patient was successfully transferred to a regional health center in good general condition. Blunt aortic injury occurs in 1% of casualties in traffic and causes 16% mortality. More than 80% of patients die before arrival to hospital. In conclusion, we point out with satisfaction the successful surgical treatment and survival of injured patients admitted to our hospital.

A surgical thread as a nidus for the common bile duct stone formation.

A 68-year old patient, who had had cholecistectomy when he was 30 years old and had been hospitalized in several occasions, with clinical presentation of recidivant cholangitis was admitted to county hospital. Computed tomography was performed, where a bile duct dilatation was noted, with suspected 12 mm concrement. After that the patient was referred to the hospital in order to undergo therapeutic endoscopic retrograde cholangiopancreatography. After performing the procedure, the presence of the concrement, 12x25mm in size was confirmed. It was evacuated during mechanical lithotripsy along with a part of surgical thread, which could not have been extracted entirely. A surgery had to be performed because the patient developed cholestasis. Forming of choledocholith most likely developed on the matrix of surgical thread, which is a rare cause of choledocholithiasis.

[Early continuous dialysis in acute glyphosate-surfactant poisoning].

INTRODUCTION: Treating severe acute glyphosate-surfactant poisoning requires intensive therapy including dialysis. Cases of hemoperfusion and hemodialysis use in renal failure induced by herbicide ingestion have been reported in the current medical literature. We present a case report of successful patient treatment with continuous venovenous hemodiafiltration in acute glyphosate-surfactant poisoning. CASE OUTLINE: A 36-year-old male patient attempted suicide by drinking approximately 300 ml of glyphosate-surfactant about an hour before coming to our Clinic. On admittance the patient was somnolent, normotensive, acidotic and hyperkalemic. Six hours after poison ingestion there was no positive response to symptomatic and supportive therapy measures. The patient became hypotensive, hypoxic with oliguric acute renal failure, so that post-dilution continuous veno-venous hemodiafiltration was started. During the treatment the patient became hemodinamically stabile, diuresis was established along with electrolyte and acid-base status correction and a gradual decrease of blood urea nitrogen and creatinine levels. After a single 27.5-hour treatment, clinical condition and renal function parameters did not require further dialysis. Complete recovery of renal function was achieved on the fifth day. CONCLUSION: Early introduction of continuous veno-venous hemodiafiltration with other intensive therapy measures led to complete recovery in a hemodinamically instable patient.

[Influence of hemoglobin level and dose of administered recombinant human beta erythropoietin on survival of hemodialysis patients].

BACKGROUND/AIM: In patients with end-stage renal disease, treatment with erythropoietin lowers cardiovascular morbidity, improves quality of life and patient survival. The aim of this study was to determine the difference in survival of hemodialysis patients treated with recombinant human beta erythropoietin and patients without this treatment, and to determine the influence of hemoglobin level and erythropoietin dose on the survival of these patients. METHOD: The study included 291 patients undergoing maintenance hemodialysis, 122 were on erythropoietin therapy, 169 patients formed control group. The study was performed at the Clinic for Nephrology and Clinical Immunology, Clinical Center of Vojvodina, during a 69-month period. We analyzed basic demographic parameters, dialysis duration, underlying disease, comorbidities, death causes, blood-work parameters and erythropoietin dosage. Descriptive statistics, Anova, Manova, discriminant function analysis, Cox regressional model and Kaplan Meier survival curves were used as statistical methods. RESULTS: Average age and dialysis duration in the experimental group were 47.88 +/- 13.32 years, and 45.76 +/- 46.73 months, respectively and in the control group 58.73 +/- 12.67 years and 62.80 +/- 55.23 months, respectively. Average level of hemoglobin and hematocrit in the group in which erythropoietin had been administered was 11.40 +/- 8.39 g/dL and 0.35 +/- 0.04/L, while the control group these values were 8.52 +/- 7.73 g/dL and 0.26 +/- 0.04/L, respectively. Average monthly dosage of erythropoietin was 21 587 +/- 10 183.36 IJ/month. Significant difference in survival was determined (p < 0.05) between the stated patient groups. A significant difference (p < 0.05) was found in survival of the patients in which erythropoietin was administered regarding hemoglobin level (< 100 g/L/100-110 g/L/110-120 g/L/ > 120 g/L), as well as in regard of erythropoietin dose applied (< 20 000 IJ/20 000-40 000 IJ/ > 40 000 IJ/month). CONCLUSION: Best survival was noted in patients with hemoglobin > 120 g/L and erythropoietin dose < 20 000 IJ/month.

[Goodpasture's syndrome--case report]. / Goodpastureov sindrom--prikaz slucaja.

INTRODUCTION: Goodpasture's syndrome is a rare, autoimmune disease characterized by pulmonary hemorrhage, glomerulonephritis and production of anti-GBM (glomerular basement membrane) antibodies. The etiology of this syndrome is still unknown. Goodpasture's syndrome usually starts with pulmonary hemorrhage, which is followed by symptoms of kidney disease. Laboratory findings often include: anemia, microhematuria, proteinuria, increased levels of urea and creatinine and anti-GBM antibodies. Diagnosis of this syndrome can be established by presence of pulmonary hemorrhage, pulmonary radiography, kidney biopsy and positive result of circulating anti-GBM antibodies. Treatment of this syndrome should be initiated as soon as possible using a combination of corticosteroids, cytostatics and plasmapheresis. CASE REPORT: The first symptoms in a nineteen-year-old female patient were caused by anemia. Two months later she reported symptoms of pulmonary hemorrhage. At that point of time she already had renal insufficiency and was immediately hospitalized. The same day we started therapy with corticosteroids, endoxan and plasmapheresis was initiated Recovery of pulmonary function was obtained, but kidney function was lost. DISCUSSION AND CONCLUSIONS: The most important thing in regard to Goodpasture's syndrome is quick diagnosis. Because of that, if patients report any kind of pulmonary hemorrhage, this syndrome must be considered At that point of time, kidney function is usually not irreversibly damaged. The second important thing in Goodpasture's syndrome is that treatment must be very aggressive using a combination of immunosuppressives and plasmapheresis. This is the only chance for these patients to avoid hemodialysis or death.