Assessing the Adequacy of Hemodialysis Patients via the Graph-Based Takagi-Sugeno-Kang Fuzzy System.

Maintenance hemodialysis is the main method for the treatment of end-stage renal disease in China. The Kt/V value is the gold standard of hemodialysis adequacy. However, Kt/V requires repeated blood drawing and evaluation; it is hard to monitor dialysis adequacy frequently. In order to meet the need for repeated clinical assessments of dialysis adequacy, we want to find a noninvasive way to assess dialysis adequacy. Therefore, we collect some clinically relevant data and develop a machine learning- (ML-) based model to predict dialysis adequacy for clinical hemodialysis patients. We collect 250 patients, including gender, age, ultrafiltration (UF), predialysis body weight (preBW), postdialysis body weights (postBW), blood pressure (BP), heart rate (HR), and blood flow (BF). An efficient graph-based Takagi-Sugeno-Kang Fuzzy System (G-TSK-FS) model is proposed to predict the dialysis adequacy of hemodialysis patients. The root mean square error (RMSE) of our model is 0.1578. The proposed model can be used as a feasible method to predict dialysis adequacy, providing a new way for clinical practice. Our G-TSK-FS model could be used as a feasible method to predict dialysis adequacy, providing a new way for clinical practice.

Evidence summary of human milk fortifier in preterm infants.

BACKGROUND: To search for and collect evidence on human milk fortifier in preterm infants, and to summarize the latest and best evidence, so as to provide reference for clinical work. METHODS: We searched the databases of UpToDate, American Guide Network, Cochrane Library, Joanna Briggs Institute (JBI), PubMed, ResearchGate, China National Knowledge Infrastructure (CNKI), Wan Fang, Chinese Biology Medicine disc (CBM), and Yi Maitong, and collected relevant guidelines, systematic reviews, evidence summaries, expert consensuses, and randomized controlled trials (RCTs). The retrieval time limit was from the database establishment to July 2021. The quality of the literature was independently evaluated by 2 researchers, who then extracted and summarized the evidence from qualifying articles. RESULTS: A total of 16 articles were selected, including 3 guidelines, 3 systematic reviews, 5 expert consensuses, 3 RCTs, and 1 best practice guideline, including indications, time for usage, methods, monitoring and management, time of cessation, health education, and post-discharge feeding. CONCLUSIONS: This study summarized the best evidence for human milk fortifier in preterm infants. Medical staff should assess the specific clinical conditions and parental wishes when applying the best evidence to ensure the effectiveness and safety of human milk fortifier, thus improving the quality of clinical nursing.