Aim
To predict the risk of hypoglycaemia using machine‐learning techniques in hospitalized patients.
Methods
We conducted a retrospective cohort study of patients hospitalized under general internal ...medicine (GIM) and cardiovascular surgery (CV) at a tertiary care teaching hospital in Toronto, Ontario. Three models were generated using supervised machine learning: least absolute shrinkage and selection operator (LASSO) logistic regression; gradient‐boosted trees; and a recurrent neural network. Each model included baseline patient data and time‐varying data. Natural‐language processing was used to incorporate text data from physician and nursing notes.
Results
We included 8492 GIM admissions and 8044 CV admissions. Hypoglycaemia occurred in 16% of GIM admissions and 13% of CV admissions. The area under the curve for the models in the held‐out validation set was approximately 0.80 on the GIM ward and 0.82 on the CV ward. When the threshold for hypoglycaemia was lowered to 2.9 mmol/L (52 mg/dL), similar results were observed. Among the patients at the highest decile of risk, the positive predictive value was approximately 50% and the sensitivity was 99%.
Conclusion
Machine‐learning approaches can accurately identify patients at high risk of hypoglycaemia in hospital. Future work will involve evaluating whether implementing this model with targeted clinical interventions can improve clinical outcomes.
Elaborating upon the role of surfactant and sonication, this work addresses the combinatorial plating characteristics for the fabrication of nickel ceramic composite membranes. Specific novelty ...corresponds to controlled addition of hydrazine hydrate as a reducing agent to nickel electroless plating bath. The experimental investigations evaluated the optimality of solution concentrations of cetyltrimethylammonium bromide (CTAB) and sodium dodecyl sulphate surfactants during coupled sonication and surfactant based electroless plating. Among both surfactants, CTAB surfactant with a solution concentration of 4 CMC provided maximum combinations of pore densification (73·4%), metal film thickness (8·4 μm) and plating efficiency (89·9%). In all, it was observed that with CTAB surfactant the pore densification and plating efficiencies increased with increasing surfactant solution concentration from 1-4 CMC and were maximum at 4 CMC which drastically decreased at 6 CMC respectively probably due to surfactant adsorption on the substrate surface.
This work addresses the effect of palladium solution concentration on combinatorial plating characteristics of surfactant and sonication coupled electroless plating baths for the fabrication of dense ...palladium films on porous stainless steel substrates. All plating experiments were carried out using palladium solution concentration of 0·005 and 0·01M plating baths with cetyltrimethylammonium bromide surfactant at four critical micelle concentrations and loading ratio of 203 cm
2
L
−1
. The evaluated combinatorial plating characteristics include selective conversion, plating efficiency, plating rate, Pd film thickness and per cent pore densification. The enhancement in palladium solution concentration was found to be insignificant to provide better combinatorial plating characteristics, and the plating bath consisting of 0·005M Pd solution concentration has provided 99·98% per cent pore densification with a Pd film thickness of 8·81 μm and plating efficiency of 80·69%.
Background: Type 2 diabetes mellitus (T2DM) has risen to become the world's most serious public health problem in recent years, and the role of long noncoding RNAs (lncRNAs) in the onset and ...progression of T2DM, as well as special attention to vitamins, has gotten a lot of attention recently. Methods: The aim of the study was to analyze lncRNA LINC01 173 expression along with assessment of vitamin-D and B12 among the T2DM cases. Quantitative RT-PCR was used to analyze the expression of lncRNA LINC01 173. Vitamin-D and B12 were analyzed by chemiluminescence-based assay. Results: The present study observed that the T2DM cases had 6.67-fold increased lncRNA LINC01 173 expression compared to healthy controls. Expression of lncRNA LINC01173 was found to be associated with hypertension (p=0.03), wound healing (p=0.04), and blurred vision (p <0.0001). It was observed that the T2DM cases with vitamin-D deficiency had a significant association with fasting glucose level (p=0.01) and HbA1C level (p=0.01) among the T2DM cases. The association of lncRNA LINC01173 with vitamin-D was analyzed and it was observed that the vitamin-D deficient cases had higher lncRNA LINC01 173 expression compared to insufficient T2DM cases (p=0.01) and sufficient T2DM cases (p=0.0006). It was also observed that the T2DM cases with smoking had a 8.33-fold lncRNA LINC01173 expression while non-smokers had a 5.43-fold lncRNA LINC01173 expression (p<0.0001). Conclusion: The study concluded that the increased lncRNA LINC01 173 expression was observed to be linked with alteration in vitamin-D level and smoking habit. Altered expression of lncRNA LINC01173 expression was linked with fasting glucose and HbA1C alteration. Collectively, lncRNA LINC01 173 expression, vitamin-D alteration, as well as smoking habit may cause the disease severity and increase the pathogenesis of disease. Keywords: long noncoding RNA, vitamin-D, vitamin-B12, diabetes
Contributory evidence on a direct association between asymptomatic atrial fibrillation (AF) burden and thromboembolic events is conflicting and contradictory. The aim of the article is to gather ...evidence available for a direct correlation between burden and stroke.
A literature search was performed to capture studies reporting data on the impact of asymptomatic AF burden on the risk of stroke. Data was then extracted from each included study including burden of AF, hazard ratio (HR) for stroke, and CHADS2 score. A random effects meta-analysis was carried out on the log-transformed HRs for different subgroups of AF burden. A meta-regression was performed on the two variables: burden of asymptomatic AF and CHADS2 score.
The random-effect pooled analysis performed on a single subgroup of the six studies reporting data on HR, showed a HR of 2.150 (95% CI 1.523-3.003) for stroke during asymptomatic AF compared to sinus rhythm. At univariate meta-regression, no correlation was detected between burden of asymptomatic AF and HR for stroke (p-value 0,874). When CHADS2 score was included in the regression model as a covariate, no significant association was detected (p-value 0,939).
A direct correlation between burden of asymptomatic AF and HR for stroke cannot be detected in our pooled analysis. However, due to the limitations acknowledged in the analysis, our findings need to be confirmed in large cohort studies.
Insufficient knowledge of medical chemicals and their improper use have destructive effects. Accidental exposure to chemicals on facial tissue may result in large facial defect. For ages the ...tradition of piercing nose is common but improper use of unknown chemical for piercing has deleterious effect. Mostly rhinectomy defects are acquired caused by trauma or malignant diseases. Prosthetic rehabilitation is the preferred treatment of choice for any large rhinectomy defects as medical and surgical interventions are ineffective in developing esthetics. Main concern with the prosthesis for such defects is retention. This article describes rehabilitation of a patient with large size nasal defect created by chemical burn in childhood during piercing. Implant retained customized silicone nasal prosthesis was fabricated using simple O-ring attachments and innovative modified polyamide acrylic resin substructure acting as skeleton.
Magnetic properties such as Curie temperature, saturation magnetisation, hysteresis loop and permeability loss factor of various compositions of NiZn ferrites prepared by the non-conventional citrate ...precursor method are reported. The optimum properties are obtained for samples sintered at 1200°C. The significant advantages of this method of preparation are: (i)
the low relative loss factor, tan
δ/
μ
i, of the order of 10
−4–10
−5 in the frequency range 100
kHz to 8
MHz, depending upon the composition, (ii)
reduction in the sintering temperature by atleast 100°C and (iii)
reduction in the sintering time from more than 3
h for the conventional method to 1
h in the present method.
Artificial neural networks have a wide application in many areas of science and engineering and, particularly, in geotechnical problems with some degree of success due to the fact that the mechanical ...behavior of rocks are not salient. They are highly nonlinear, quite complex and complicated. While applying neural network in such complicated problems, epoch determination is based on hit-and-trail basis mainly. In this paper, the effect of different number of epochs is shown on the network and a method is proposed to determine the optimum number of epoch with the help of self-organized map (SOM) to avoid overtraining of the network. Data distribution is also done with the help of SOM and a statistical analysis is made to show consistency between training and testing dataset for ensuring the optimal model performance.
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