An Accurate Data Preparation Approach for the Prediction of Mortality in ACLF Patients using the CANONIC Dataset

The incidence of chronic liver disease has increased in Europe and can lead to Acute on Chronic Liver Failure (ACLF) which is associated with high levels of mortality due to multisystem organ failure. The characteristics of the ACLF patients can change very rapidly within a short period of time. Continuous assessment of their recovery status is critical for clinicians to adjust and deliver effective treatment. The aim of this paper is to validate the usefulness of a data preparation approach by combining different criteria to replace missing values, balance target-class variables, select useful patient characteristics and optimise hyperparameters of machine learning models for the prediction of ACLF associated mortality rates. A key step in the data preparation is a feature selection Mutual Information (MI) based multivariate approach to build smaller, and yet equally and in some cases more informative, subsets of patient characteristics than those frequently proposed for the prediction of mortality, from patients with ACLF in the CANONIC dataset. The usefulness of the data preparation approach proposed to predict mortality was evaluated by training the XGBoost and Logistic Regression models with the prepared data. Evaluations of the models trained using a test set provided evidence of an overall high accuracy in the prediction of the mortality rates of patients for days after their diagnosis, and in some cases even higher when reduced and more informative subsets of patient characteristics were found

Investigation of VvMybA1 and VvMybA2 berry color genes in ‘Aglianico’ biotypes

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Characterization of Vitis vinifera L. subspecies sylvestris (Gmelin) Hegi in the Ebro river Basin (Spain)

A wild grapevine population of 76 vines of Vitis vinifera L. subspecies sylvestris (Gmelin) Hegi was found along the Iregua river valley (Northeastern Spain), located in the Ibérica mountain-range. The characterization of this phytogenetic resource was based on an ampelographic description of the male and female individuals and an evaluation of their sanitary state. This shows that the imported North American downy and powdery mildews are the main pathogens, but no symptoms caused by phylloxera on roots were found. Different degrees of infestation caused by Eryophid mites, Colomerus vitis and Calipitrimerus vitis, were also registered on leaves. On the other hand, the red wines obtained show an alcoholic degree situated between 8.5 and 10.8, pH around 3.5 and a high intensity of colour, between 10.2 and, 11.3. The vinegar had only 3.5° of acetic acid. Its phenolic composition is similar to those reported from red and Sherry vinegars produced from cultivars. The genetic analysis based on 18 samples, using 16 nuclear microsatellites, shows a low genetic diversity (He = 0.45). This might be due to inbreeding caused by mating among siblings in this isolated population. The genetic comparison with the allowed cultivars of this Guarantee of Origin showed two distinct gene pools. So it indicated that there is no genetic contribution of these native vines to current instead of actual local varieties. It is necessary to preserve this phytogenetic resource to be used in breeding programs and to restore its destructed habitats by human different impacts.

Acute-on-chronic liver failure in cirrhosis

The definition of acute-on-chronic liver failure (ACLF) remains contested. In Europe and North America, the term is generally applied according to the European Association for the Study of the Liver-Chronic Liver Failure (EASL-CLIF) Consortium guidelines, which defines this condition as a syndrome that develops in patients with cirrhosis and is characterized by acute decompensation, organ failure and high short-term mortality. One-third of patients who are hospitalized for acute decompensation present with ACLF at admission or develop the syndrome during hospitalization. ACLF frequently occurs in a closed temporal relationship to a precipitating event, such as bacterial infection or acute alcoholic, drug-induced or viral hepatitis. However, no precipitating event can be identified in approximately 40% of patients. The mechanisms of ACLF involve systemic inflammation due to infections, acute liver damage and, in cases without precipitating events, probably intestinal translocation of bacteria or bacterial products. ACLF is graded into three stages (ACLF grades 1–3) on the basis of the number of organ failures, with higher grades associated with increased mortality. Liver and renal failures are the most common organ failures, followed by coagulation, brain, circulatory and respiratory failure. The 28-day mortality rate associated with ACLF is 30%. Depending on the grade, ACLF can be reversed using standard therapy in only 16–51% of patients, leaving a considerable proportion of patients with ACLF that remains steady or progresses. Liver transplantation in selected patients with ACLF grade 2 and ACLF grade 3 increases the 6-month survival from 10% to 80%

Acute-on-Chronic Liver Failure: Definition, Diagnosis, and Clinical Characteristics

Acute-on-chronic liver failure (ACLF) is a recently recognized syndrome in cirrhosis characterized by acute decompensation (AD), organ failure(s), and high short-term mortality. Organ failure(s) is defined by the Chronic Liver Failure-Sequential Organ Failure (CLIF-SOFA) score or by its simplified version Chronic Liver Failure-Organ Failure Assessment (CLIF-OF) score. They include six types of organ failure: liver, renal, coagulation, cerebral, respiratory, and circulatory. One third of patients hospitalized with AD present with ACLF at admission or develop ACLF during hospitalization. Acute-on-chronic liver failure frequently occurs in a closed relationship to a precipitating event. According to the number of organ failures, ACLF is graded into three stages: ACLF-1 = single renal failure or single nonrenal organ failure if associated with renal dysfunction and/or cerebral dysfunction; ACLF-2 = two organ failures; and ACLF-3 = three to six organ failures, with increasing 28-day mortality rate (from 23%–74%). Acute-on-chronic liver failure may develop at any phase during the clinical course of the disease. Patients without prior AD develop a severe form of ACLF

Promoting global clinical care and research for children with orthopaedic disabilities through motion analysis technology

Human motion analysis is a tool used to understand orthopaedic disabilities in children and to plan and monitor treatment strategies. It enables clinicians to quantitatively describe rehabilitative progress, plan surgeries, and conduct research. While this technology is prevalent in major academic medical centers, access is lacking in many regions throughout the world. This paper presents a novel approach to offer more accessible technology at greatly reduced cost. Current applications are underway in the Philippines, Mexico, and Colombia. Through international partnerships, improvements in clinical care, medical education, and research have been observed

A spectroscopy approach to the study of virus infection in the endophytic fungus Epichloë festucae

<p>Abstract</p> <p>Background</p> <p>In this work we propose a rapid method based on visible and near-infrared (Vis-NIR) spectroscopy to determine the occurrence of double-stranded RNA (dsRNA) viruses in <it>Epichloë festucae </it>strains isolated from <it>Festuca rubra </it>plants. In addition, we examined the incidence of infections by <it>E. festucae </it>in populations of <it>F. rubra </it>collected in natural grasslands of Western Spain.</p> <p>Methods</p> <p>Vis-NIR spectra (400-2498 nm) from 124 virus-infected and virus-free <it>E. festucae </it>isolates were recorded directly from ground and freeze-dried mycelium. To estimate how well the spectra for uninfected and infected fungal samples could be differentiated, we used partial least-squares discriminant analysis (PLS1-DA) and several data pre-treatments to develop calibration models.</p> <p>Results</p> <p>Applying the best regression model, obtained with two sampling years and using standard normal variate (SNV) combined with first derivative transformation to a new validating data set (42 samples), we obtained a correct classification for 75% of the uninfected isolates and up to 86% of the infected isolates.</p> <p>Conclusions</p> <p>The results obtained suggest that Vis-NIR spectroscopy is a promising technology for detection of viral infections in fungal samples when an alternative faster approach is desirable. It provides a tool adequately exact and more time- and cost-saving than the conventional reference analysis.</p

The reproductive capacity of Monk Parakeets Myiopsitta monachus is higher in their invasive range

Breeding parameters for Monk Parakeets Myiopsitta monachus nesting in Barcelona, Spain, were collected for 651 nests over five breeding seasons. This invasive population has a high reproductive capacity compared with the species in the native range: fledging success was double, the percentage of pairs attempting second broods three times higher and 55% of first-year birds bred compared with almost zero in South America