Exploring Features Contributing to the Early Prediction of Sepsis Using Machine Learning.

The increasing availability of electronic health records and administrative data and the adoption of computer-based technologies in healthcare have significantly focused on medical informatics. Sepsis is a time-critical condition with high mortality, yet it is often not identified in a timely fashion. The early detection and diagnosis of sepsis can increase the likelihood of survival and improve long-term outcomes for patients. In this paper, we use SHapley Additive exPlanations (SHAP) analysis to explore the variables most highly associated with developing sepsis in patients and evaluating different supervised learning models for classification. To develop our predictive models, we used the data collected after the first and the fifth hour of admission and evaluated the contribution of different features to the prediction results for both time intervals. The results of our study show that, while there is a high level of missing data during the early stages of admission, this data can be effectively utilized for the early prediction of sepsis. We also found a high level of inconsistency between the contributing features at different stages of admission, which should be considered when developing machine learning models.

ASSOCIATION OF IRS1 GLY971ARG GENE POLYMORPHISM WITH INSULIN RESISTANCE IN IRANIAN NEWLY DIAGNOSED DIABETIC ADULTS.

CONTEXT: Insulin receptor substrate-1 (IRS-1) has an important role in insulin signaling and the common Gly971Arg polymorphism is related to type 2 diabetes (T2D). IRS-1 Gly971Arg polymorphism can modify tyrosine phosphorylation at a specific site of IRS-1 and may have a critical role in the development of insulin resistance (IR). OBJECTIVE: The purpose of this study was to investigate the association between this polymorphism and IR in Iranian patients with newly-diagnosed type 2 diabetes. DESIGN: The study was conducted on 114 individuals with newly-diagnosed T2D and 118 healthy matched controls, aged 20-80 years. Fasting blood glucose and insulin were measured by the enzymatic method and enzyme-linked immunosorbent assay, respectively. Insulin-resistance was calculated by homeostasis model assessment estimated-insulin resistance (HOMA-IR). The gene polymorphism was examined by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: There are significant differences between IRS1 Gly971Arg polymorphism and studied individuals (P<0.0001). The findings showed that the risk of developing T2D in individuals who had R-alleles was 3.74 folds higher than those without R-alleles. However, IRS1 Gly971Arg polymorphism was not associated with high HOMA-IR, high BMI and familial history of diabetes. CONCLUSIONS: Even though there was not a significant relationship between IRS-1 G971R polymorphism with insulin resistance and high BMI, this polymorphism was correlated to newly-diagnosed diabetic patients. Thus, the evaluation of IRS-1 G971R polymorphism may be helpful for predicting T2D new cases.

Removal of BTEX by using a surfactant--Bio originated composite.

The application of ostrich bone waste-loaded a cationic surfactant (OBW-OH-CTABr) bioadsorbent for benzene, toluene, ethylbenzene and p-xylene (BTEX) removal from the synthetic and real waters have been studied, and the prepared biomaterials were studied by Fourier transform infrared (FTIR), X-ray diffraction (XRD), surface area measurements (BET), scanning electron microscopy (SEM), Energy-dispersive X-ray spectroscopy (EDX) and point of zero (pH(PZC)). The immobilization of CTABr molecules on the framework of modified OBW showed good tendency to adsorb BTEX from aqueous solution. The exposure time to obtain equilibrium for maximum removal of BTEX was observed to be 60 min. The removal kinetics of BTEX has been evaluated in terms of pseudo-first- and -second-order kinetics, and the Freundlich and Langmuir isotherm models have also been utilized to the equilibrium removal data. The removal process was spontaneous and endothermic in nature and followed pseudo-second-order kinetic model. The immobilized CTABr showed high reusability because of its high adsorption efficiency after 12th cycles. The proposed low-cost bioadsorbent could also be utilized to adsorb BTEX from the real water (Anzali lagoon water). The OBW-OH-CTABr composite is indeed an attractive biomaterial for drinking water-based pollutants and act as an adsorbent for BTEX and oil spills especially in third world due to its low-cost preparation and regeneration and clean processing of the biomaterial with no byproducts after utilize.

The relationship between isokinetic muscle strength and spasticity in the lower limbs of stroke patients.

OBJECTIVE: In this study the relationship between degree of spasticity and strength of knee extensor and ankle plantar flexor muscles of post stroke hemiparetic patients has been investigated. MATERIALS & METHODS: The participants of this study were 40 stroke patients whose elapsed time of stroke onset was at least 3 months. Their age averaged 59 years. Spasticity was measured with the Modified Ashworth Scale. Isokinetic muscle strength was measured with an isokinetic dynamometer. Two methods of torque normalization - subtractive and weight based normalization - were used for comparing torques among participants. RESULTS: Kendall's tau-b coefficient was calculated for investigating this relationship. This coefficient was not significant for the relationship between weight based normalized data and modified Ashworth scale (MAS) in any of each muscle groups (α = 0.05). This coefficient was significant for the relationship between the subtractive normalization method and MAS in knee extensors (P = 0.005, α = 0.01) and ankle plantar flexors (P = 0.002, α = 0.01). CONCLUSION: This study suggests a negative relationship between spasticity and muscle strength and provided evidence that spastic muscles are weaker.

Detection of West Nile virus genome and specific antibodies in Iranian encephalitis patients.

West Nile virus (WNV) is a mosquito-borne flavivirus which circulates in birds, horses and humans. An estimated 80% of WNV infections are asymptomatic. Fewer than 1% of infected persons develop neuroinvasive disease, which typically presents as encephalitis, meningitis, or acute flaccid paralysis. This study was conducted from January 2008 to June 2009 in Isfahan, Iran. Patients attending the emergency department with fever and loss of consciousness were consecutively included. Cerebrospinal fluids (CSF) were initially analysed through bacteriology and biochemistry examinations, resulting in those with evidence of meningitis being excluded. Patients' CSF and serum were diagnosed by serological and molecular assays. A total of 632 patients with fever and loss of consciousness were tested by CSF analyses. Samples of the remaining patients (39·4%) were referred for WNV investigation. Three (1·2%) of the patients were positive for both serum and CSF by RT-PCR, and six (2·4%) were positive only for IgG antibodies. History of insect bite, and blood transfusion and transplantation were risk factors for being positive by RT-PCR (P=0·048) and being IgG positive (P=0·024), respectively. The results of this study showed that the prevalence of West Nile fever is low in patients with encephalitis.