EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Mechanisms Involved in Childhood Obesity-Related Bone Fragility

Childhood obesity is one of the major health problems in western countries. The excessive accumulation of adipose tissue causes inflammation, oxidative stress, apoptosis, and mitochondrial dysfunctions. Thus, obesity leads to the development of severe co-morbidities including type 2 diabetes mellitus, liver steatosis, cardiovascular, and neurodegenerative diseases which can develop early in life. Furthermore, obese children have low bone mineral density and a greater risk of osteoporosis and fractures. The knowledge about the interplay bone tissue and between adipose is still growing, although recent findings suggest that adipose tissue activity on bone can be fat-depot specific. Obesity is associated to a low-grade inflammation that alters the expression of adiponectin, leptin, IL-6, Monocyte Chemotactic Protein 1 (MCP1), TRAIL, LIGHT/TNFSF14, OPG, and TNFα. These molecules can affect bone metabolism, thus resulting in osteoporosis. The purpose of this review was to deepen the cellular mechanisms by which obesity may facilitate osteoporosis and bone fractures

An Efficient Approach for Automatic Fault Classification Based on Data Balance and One-Dimensional Deep Learning

Predictive maintenance (PdM) is implemented to efficiently manage maintenance schedules of machinery and equipment in manufacturing by predicting potential faults with advanced technologies such as sensors, data analysis, and machine learning algorithms. This paper introduces a study of different methodologies for automatically classifying the failures in PdM data. We first present the performance evaluation of fault classification performed by shallow machine learning (SML) methods such as Decision Trees, Support Vector Machines, k-Nearest Neighbors, and one-dimensional deep learning (DL) techniques like 1D-LeNet, 1D-AlexNet, and 1D-VGG16. Then, we apply normalization, which is a scaling technique in which features are shifted and rescaled in the dataset. We reapply classification algorithms to the normalized dataset and present the performance tables in comparison with the first results we obtained. Moreover, in contrast to existing studies in the literature, we generate balanced dataset groups by randomly selecting normal data and all faulty data for all fault types from the original dataset. The dataset groups are generated with 100 different repetitions, recording performance scores for each one and presenting the maximum scores. All methods utilized in the study are similarly employed on these groups. From these scores, the use of 1D-LeNet deep learning classifiers and feature normalization resulted in achieving the highest overall accuracy and F1-score performance of 98.50% and 98.32%, respectively. As a result, the goal of this study was to develop an efficient approach for automatic fault classification, leveraging data balance, and additionally, to provide an analysis of one-dimensional deep learning and shallow machine learning-based classification methods. In light of the experimentation and comparative analysis, this study successfully achieves its stated goal by demonstrating that one-dimensional deep learning and data balance collectively emerge as the optimal approach, offering good prediction accuracy