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1.
J Environ Manage ; 344: 118594, 2023 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-37473555

RESUMO

Modern wastewater treatment plants base their biological processes on advanced control systems which ensure compliance with discharge limits and minimize energy consumption responding to information from on-line probes. The correct readings of probes are particularly crucial for intermittent aeration controllers, which rely on real-time measurements of ammonia and oxygen in biological tanks. These data are also an important resource for developing artificial intelligence algorithms that can identify process or sensor anomalies, thus guiding the choices of plant operators and automatic process controllers. However, using anomaly detection and classification algorithms in real-time wastewater treatment is challenging because of the noisy nature of sensor measurements, the difficulty of obtaining labeled real-plant data, and the complex and interdependent mechanisms that govern biological processes. This work aims at thoroughly exploring the performance of machine learning methods in detecting and classifying the main anomalies in plants operating with intermittent aeration. Using oxygen, ammonia and aeration power measurements from a set of plants in Italy, we perform both binary and multiclass classification, and we compare them through a rigorous validation procedure that includes a test on an unknown dataset, proposing a new evaluation protocol. The classification methods explored are support vector machine, multilayer perceptron, random forest, and two gradient boosting methods (LightGBM and XGBoost). The best performance was achieved using the gradient boosting ensemble algorithms, with up to 96% of anomalies detected and up to 84% and 62% of anomalies classified correctly on the first and second datasets respectively.


Assuntos
Inteligência Artificial , Purificação da Água , Amônia , Aprendizado de Máquina , Redes Neurais de Computação , Algoritmos , Máquina de Vetores de Suporte
2.
J Clin Med ; 9(5)2020 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-32466228

RESUMO

Diabetic nephropathy (DN) is the primary cause of end-stage renal disease, worldwide, and oxidative stress has been recognized as a key factor in the pathogenesis and progression of DN. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase has the most important contribution to reactive oxygen species generation during the development of DN. Bioactive compound use has emerged as a potential approach to reduce chronic renal failure. Therefore, a red orange and lemon extract (RLE) rich in anthocyanins was chosen in our study, to reduce the toxic renal effects during the development of DN in Zucker diabetic fatty rat (ZDF). RLE effects were examined daily for 24 weeks, through gavage, in ZDF rats treated with RLE (90 mg/kg). At the end of the experiment, ZDF rats treated with RLE showed a reduction of the diabetes-associated up-regulation of both NOX4 and the p47-phox and p22-phox subunits, and restored the BAX/BCL-2 ratio respect to ZDF rats. Furthermore, RLE was able to reduce the oxidative DNA damage measured in urine samples in ZDF rats. This study showed that RLE could prevent the renal damage induced by DN through its capacity to inhibit NOX4 and apoptosis mechanisms.

3.
J Nephrol ; 33(3): 619-620, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32383078

RESUMO

It occurred to us that a simple but significant calculation error was made in Table 2 in the dose of bicarbonate administered. Indeed, contrary to what reported in Table 2, the dose of sodium bicarbonate administered during study was.

4.
J Nephrol ; 32(6): 989-1001, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31598912

RESUMO

BACKGROUND: Metabolic acidosis is associated with accelerated progression of chronic kidney disease (CKD). Whether treatment of metabolic acidosis with sodium bicarbonate improves kidney and patient survival in CKD is unclear. METHODS: We conducted a randomized (ratio 1:1). open-label, controlled trial (NCT number: NCT01640119. www.clinicaltrials.gov ) to determine the effect in patients with CKD stage 3-5 of treatment of metabolic acidosis with sodium bicarbonate (SB) on creatinine doubling (primary endpoint), all-cause mortality and time to renal replacement therapy compared to standard care (SC) over 36-months. Parametric, non-parametric tests and survival analyses were used to assess the effect of SB on these outcomes. RESULTS: A total of 376 and 364 individuals with mean (SD) age 67.8 (14.9) years, creatinine clearance 30 (12) ml/min, and serum bicarbonate 21.5 (2.4) mmol/l were enrolled in SB and SC, respectively. Mean (SD) follow-up was 29.6 (9.8) vs 30.3 (10.7) months in SC and SB. respectively. The mean (SD) daily doses of SB was 1.13 (0.10). 1.12 (0.11). and 1.09 (0.12) mmol/kg*bw/day in the first, second and third year of follow-up, respectively. A total of 87 participants reached the primary endpoint [62 (17.0%) in SC vs 25 (6.6%) in SB, p < 0.001). Similarly, 71 participants [45 (12.3%) in SC and 26 (6.9%) in SB, p = 0.016] started dialysis while 37 participants [25 (6.8%) in SC and 12 (3.1%) in SB, p = 0.004] died. There were no significant effect of SB on blood pressure, total body weight or hospitalizations. CONCLUSION: In persons with CKD 3-5 without advanced stages of chronic heart failure, treatment of metabolic acidosis with sodium bicarbonate is safe and improves kidney and patient survival.


Assuntos
Acidose/tratamento farmacológico , Taxa de Filtração Glomerular/fisiologia , Rim/fisiopatologia , Insuficiência Renal Crônica/complicações , Bicarbonato de Sódio/uso terapêutico , Acidose/etiologia , Acidose/metabolismo , Idoso , Progressão da Doença , Feminino , Humanos , Itália/epidemiologia , Masculino , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/fisiopatologia , Taxa de Sobrevida/tendências
5.
J Clin Med ; 8(9)2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31510015

RESUMO

In chronic kidney disease (CKD), the gut-microbiota metabolites indoxyl sulfate (IS) and p-cresyl sulfate (PCS) progressively accumulate due to their high albumin-binding capacity, leading to clinical complications. In a prospective crossover controlled trial, 60 patients with CKD grades 3B-4 (GFR = 21.6 ± 13.2 mL/min) were randomly assigned to two dietary regimens: (i) 3 months of free diet (FD) (FD is the diet usually used by the patient before being enrolled in the Medika study), 6 months of very low protein diet (VLPD), 3 months of FD and 6 months of Mediterranean diet (MD); (ii) 3 months of FD, 6 months of MD, 3 months of FD, and 6 months of VLPD. VLPD reduced inflammatory Proteobacteria and increased Actinobacteria phyla. MD and VLPD increased some butyrate-forming species of Lachnospiraceae, Ruminococcaceae, Prevotellaceae, Bifidobacteriaceae, and decrease the pathobionts Enterobacteriaceae. The increased level of potential anti-inflammatory Blautia and Faecalibacterium, as well as butyrate-forming Coprococcus and Roseburia species in VLPD was positively associated with dietary intakes and it was negatively correlated with IS and PCS. Compared to FD and MD, VLPD showed a lower amount of some Lactobacillus, Akkermansia, Streptococcus, and Escherichia species. MD and VLPD reduced both the total and free serum IS (MD -36%, -40% and VLPD -69%, -73%, respectively) and PCS (MD -38%, -44% and VLPD -58%, -71%, respectively) compared to FD. VLPD reduced serum D-lactate compared to MD and FD. MD and, to a greater extent, VLPD are effective in the beneficial modulation of gut microbiota, reducing IS and PCS serum levels, and restoring intestinal permeability in CKD patients.

6.
J Clin Med ; 8(7)2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31336909

RESUMO

Background: The perturbation of phosphate homeostasis portends unfavorable outcomes in chronic kidney disease (CKD). However, the absence of randomized clinical trials (RCT) fuels the discussion of whether phosphate or some other phosphorous-related factor(s) such as fibroblast growth factor 23 (FGF-23) mediates the cardiovascular and systemic toxicity. We herein test whether the fractional excretion of phosphate (FeP) as a marker of renal stress to excrete phosphorous predicts unfavorable outcomes in CKD patients. Methods: Retrospective, cross-sectional observational study. For current analysis, an historical cohort of 407 records of CKD stage 3b-5 patients attending between January 2010 and October 2015 at the Nephrology Unit of Solofra (AV), Italy were utilized. Demographic, clinical, laboratory, and outcome data were identified through the subjects' medical records. We tested whether quartiles of FeP are associated with the risk of CKD progression or all causes of death. Parametric as well as non-parametric tests, linear and logistic regression, as well as survival analysis were utilized. Results: Overall, we investigated middle-age (mean 66.0, standard deviation 12.3 years) men and women (male 43%) with CKD stage 3b to 5 (creatinine clearance 32.0 (13.3) mL/min). Older age, lower diastolic blood pressure, poor renal function, as well as higher serum phosphate were associated with FeP. Patients with higher FeP were at an increased risk of starting dialysis or dying (hazard ratio 2.40; 95% confidence interval (1.44, 3.99)). Notably, when the two endpoints were analyzed separately, FeP was associated with renal but not all-cause survival. Conclusion: FeP is associated with ESRD, but not all-cause mortality risk in a large cohort of moderate to advanced CKD patients. Future efforts are required to validate FeP as a marker of nephron stress and risk factor for CKD progression in this high-risk population.

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