Severe Class Research Articles

Analyzing the impacts of watershed management interventions and scenarios on soil erosion reduction using InVEST model in Yezat watershed, North West Ethiopia

ABSTRACT Land degradation is a serious problem for Ethiopia's productive capacity for land resources. To reverse these environmental dynamics, slow down soil degradation, and raise smallholder farmers’ agricultural yields, watershed management interventions have been implemented in Ethiopia since the 1980s. Thus, this study was aimed at assessing the effects of watershed management interventions on soil erosion reduction by using the InVEST model in the Yezat watershed, north-west Ethiopia. The modified ecosystem services valuation model (InVEST) was employed to evaluate soil loss reduction in response to watershed management interventions. Different watershed management intervention scenarios (baseline scenarios, afforestation scenarios, soil/stone bund scenarios, and integrated scenarios) were also applied to evaluate the effectiveness of watershed management interventions on soil loss reduction. The result of the study indicated that a high amount of mean annual soil loss (111 tons ha− 1 year−1) was observed in 2000 in the study area due to the expansion of cultivated land and built-up area at the expense of forest, shrubland, and grassland. However, the mean annual soil loss decreased from 111 tons per year in 2000 to 79 tons per year in 2021 in the study area due to different watershed management interventions. Additionally, at the baseline scenario, the estimated mean annual soil loss of the watershed was 111 tons ha-1 yr-1. Conversely, it was reduced to 49.3 ton ha-1 yr-1 in the reforestation scenario, 16.49 ton ha-1 yr-1 in the soil bund scenario, and 8.26 ton ha-1 yr-1 in the integrated scenario. The watershed covered by the very severe soil erosion severity class was reduced in all watershed management intervention scenarios. Among others, the highest soil erosion reduction was observed in the integrated (bio-physical) scenarios of watershed management interventions. Therefore, watershed management interventions and scenarios were the best mechanisms for soil loss reduction.

Enhanced pendulum appliance utilizing temporary anchorage device-based Nance arch and modified springs for optimized molar distalization control: a case report.

A 20-year-old female patient with severe maxillary crowding and skeletal Class III malocclusion was successfully treated using an enhanced pendulum appliance. Camouflage treatment was chosen because the patient refused surgical intervention. Detailed examination and analysis revealed that labial inclination of the maxillary anterior teeth could provide the alignment space necessary after tooth extraction in the maxillary arch but it would not be beneficial esthetically and would increase the moment perpendicular to the tooth long axis as well as increase the risk of bone dehiscence. Therefore, lingual inclination of the mandibular anterior teeth was performed. To create space for aligning the maxillary arch, an enhanced pendulum appliance was utilized, in addition to premolar extraction. The enhanced pendulum appliance had one mesial and one distal helix on each spring, exerting opposing forces in the buccolingual direction and reducing the buccolingual inclination of the molars. In addition, miniscrews were integrated into the Nance arch of the enhanced pendulum appliance to provide skeletal anchorage, minimizing the reciprocal movement of anchorage teeth. This modification not only enhanced control over tooth movement but also improved treatment efficiency. During the entire treatment duration of 17 months, substantial improvement in facial and occlusal aspects were noted. Additionally, the patient retained these positive changes until the subsequent 2-year follow-up period.

Class 3 Obesity and Oral Health in Adults: A Scoping Review of the Challenges for Oral Healthcare Services.

Background: Obesity is one of the most neglected public health problems affecting both developed and developing countries. The most clinically severe obesity (Class 3 obesity) has both clinical and service delivery implications on dental services. However, associations between Class 3 obesity and oral health are minimally explored in the literature and thus poorly understood. Aims: This scoping review aimed to explore the existing evidence on Class 3 obesity and oral health. Methods: A literature search was performed via Medline, Scopus, Google scholar and Embase research databases. Results: A total of 375 papers were sourced from the database search. Twenty seven full-text papers were included in the final literature review. Results revealed findings from both quantitative and qualitative studies. Papers included results pertaining to associations with dental disease, oral health and associated behaviours, oral health-related quality of life and the barriers experienced by adults with Class 3 obesity in accessing dental services. Conclusions: While mixed findings were identified, this scoping review reports associations between Class 3 obesity and poor oral health across various domains including clinical parameters and oral health related quality of life. The literature has also highlighted important barriers to dental care in those with the most severe Class 3 obesity. Based upon our findings, we have summarised current oral health management implications and directions for future research.

Non-surgery Treatment with MEAW Technique in Skeletal Class III Malocclusion and Facial Asymmetry in Adults: A Case Report

Background Treating skeletal Class III malocclusions characterized by mandibular deviation, facial asymmetry, and other complex orthodontic issues is among the most demanding orthodontic procedures. Orthognathic surgery is not recommended to everyone due to the dangers involved. Hence, it is considered to be very difficult to correct face asymmetry with orthodontics alone, much less without surgery. Objective The goals of this case study were to decrease crowding in the upper teeth, manage the vertical dimension, and treat the patient's primary complaints of crossbite in the anterior teeth and facial asymmetry. Case Presentation A female patient, aged 21, came in with many concerns, including an incisor crossbite, facial asymmetry, and an insecurity that manifested only when she smiled. An adult patient with a mandibular deviation to the right and an incisor crossbite received orthodontic treatment for these issues. The patient had asymmetric molar extraction in both the lower and upper jaws to retract the lower incisors and correct the midline of the teeth using intermaxillary elastic. Fixed appliances were utilized in conjunction with overbearing lower anterior braces to manage the torque on the lower anterior teeth. As a result, she had a pleasant smile, a harmonious face, and stable dental and skeletal connections. The whole therapeutic period lasted 30 months. As a result, asymmetric molar extraction may be an acceptable option for retracting mandibular incisors in Class III malocclusion with facial asymmetry. Conclusion The most important step in treating the severe skeletal Class III malocclusion in this patient without surgery was to retract the lower arch. After using the MEAW approach, Class III elastics, posterior bite turbos, and orthopedic splint treatment, the patient reported a satisfactory achievement.

Balancing the Scales: Caution in Reduction Mammaplasty Recommendations for Obesity Class III Patients.

The prevalence of obesity has risen worldwide, posing a problem to surgeons as obesity is a well-known risk factor for surgical outcomes. While prior studies have suggested performing reduction mammaplasty (RM) in patients with obesity, the variance in outcomes and quality of life (QoL) for obesity classes are ill-defined. We investigated whether obesity classes should be considered for RM by examining the surgical outcomes and QoL across different weight classes, aiming to pinpoint when outcomes become less favorable. Patients undergoing RM by nine surgeons from 2016 to 2022 were included. Body mass index (BMI) cohorts were formed according to the Center for Disease Control and Prevention (CDC) guidelines: Healthy (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obesity class I (30-34.9 kg/m2), II (35-39.9 kg/m2), and III (>40 kg/m2). QoL was assessed by comparing preoperative and postoperative BREAST-Q scores within cohorts. A comparison analysis was performed between weight classes. A total of 461 RM patients were identified (healthy: 83, overweight: 178, I: 142, II: 39, III: 19). Percentage of Black patients, procedure length, weight of tissue removed, and inferior pedicle technique all significantly increased as BMI increased (P < 0.001). Higher BMI cohorts, especially class III, had significantly higher rates of surgical site infections (healthy: 0%, overweight: 1.1%, I: 1.4%, II: 0%, III: 15.8%, P < 0.01), fat necrosis (healthy: 1.2%, overweight: 5.1%, I: 7%, II: 0%, III: 22.2%, P = 0.01), dehiscence (healthy: 3.6%, overweight: 2.8%, I: 2.1%, II: 5.1%, III: 31.6%, P < 0.01), delayed healing (health: 4.8%, overweight: 11.2%, I: 16.9%, II: 28.2%, III: 42.1%, P < 0.01), minor T-point breakdown (healthy: 10.8%, overweight: 15.7%, I: 23.9%, II: 23.1%, III: 52.6%, P = 0.01), and surgical site occurrence requiring procedural intervention (healthy: 6.0%, overweight: 5.6%, I: 6.3%, II: 15.4%, III: 21.1%, P < 0.05). When compared to the other weight classes independently, class III was associated with unfavorable outcomes (P < 0.05). Significant improvement in average postoperative QoL scores in satisfaction with breast, psychosocial well-being, sexual well-being, and physical well-being were seen in all cohorts except class III (P < 0.05). Severe obesity class III patients undergoing RM have a higher yet still acceptable risk profile and should be counseled on the risks despite its improved quality of life.

Detection and Classification of Lanes Using Reannotated Lane Dataset to Aid Autonomous Driving

The core functionality of advanced driver assistance systems and self-driving cars depends on the ability to recognize drivable road areas. As there are many different categories of useful markings incorporated within the road area, lane detection and classification form a major step for taking appropriate actions leading to truly autonomous driving. Existing datasets do not provide ample classification of lane types and adequate granularity for precise localization of lane markings. A new dedicated dataset for semantic segmentation of 11 varied lane types obtained by reannotating the BDD100K dataset is presented. The reannotation process involves pixel-level lane markings of 76,000 image instances of the BDD100K dataset, which were originally represented as a sequence of coordinate points. This opens up the possibility of high resolution both spatially and semantically in the context of lane understanding for autonomous driving. Baseline results on the proposed dataset based on the Bilateral Segmentation Network (BiSeNetV2), which considers the spatial data and the categorical semantics distinctly, are presented. The performance is pinned at 85% accuracy during testing using BiSeNetV2 architecture. The dataset is expected to open up new directions of research to address problems such as severe class imbalance, segmentation of multiple classes of texture-less and eccentric features (lanes), and so forth. As a result, applications such as lane-centric activity interpretation, future event prediction, and continuous learning are expected.

High-resolution soil erosion mapping in croplands via Sentinel-2 bare soil imaging and a two-step classification approach

Erosion-induced lateral soil redistribution leads to spatially heterogenous soil composition, which can be captured through the distinctive spectral reflectance of soils under varying levels of erosion influence. This points to the potential of using remotely sensed soil spectra to detect severe erosion and deposition hotspots in exposed croplands and, importantly, further differentiate the intra-class spectral variability of moderate erosion that often occupies the largest proportion. Here, we aim to develop a two-step erosion classification and mapping approach based on multitemporal compositing of Sentinel-2 bare soil images of a typical agricultural region (11,500 km2) of northeast China. A random forest classifier was firstly trained against the ground-truth data derived from very high resolution (VHR) imagery in Google Earth, with an overall accuracy of 91 % that allowed for clear delineation of severe erosion and deposition areas based on their distinct topographic and spectral features particularly in the red and red-edge bands. In the second step, the remaining area of moderate erosion (60.30 %) was further differentiated using Iterative Self-Organizing cluster unsupervised classification to yield a five-class soil erosion map at 10 m spatial resolution. The accuracy of the predicted map was successfully validated by independent Caesium-137 (137Cs) and soil organic carbon observations at catchment and regional scales, as revealed by significant inter-class differences in soil redistribution rates estimated from 137Cs inventory. The severe erosion class had a soil loss rate of 5.5 mm yr−1, suggesting that previous assessments have underestimated erosion severity. The spatial accordance of crop growth with soil erosion intensity, particularly in localized settings, further highlighted the potential of bare soil imaging for mapping the spatiotemporal development of soil erosion and its response to targeted sustainable cropland management efforts.

INCIDENCE AND MORTALITY RISK OF AKD AND AKI IN THE PRIMARY CARE

Objective: Objective: The aim of the present study was to assess the impact of hypertension in the incidence of Acute Kidney Damage and Acute Kidney Injury episodes in the community, defined by changes in serum creatinine and temporal window. Design and method: The study analyzed the EHR of a community of 1,863,731 adult subjects &gt;23 years of age with serum creatinine before, during and after the AKD episode for a variable period of time. eGFR was calculated using the CKD-EPI formula. AKD and AKI were defined according to the harmonized KDIGO criteria (Lameire 2021). The acute event was defined as having occurred when the blood creatinine was at least 150% of the mean of the previous creatinine measurement. AKD is considered to have ended when the creatinine falls to at least the threshold created by the pre-event mean plus half the increment produced during the episode within three months. AKI was defined as a sudden drop in creatinine within seven days. The RIFLE scale was used to classify episodes. HTN was considered when it was recorded in the EHR (CIE9 and 10). Results: During a mean follow-up of 4.8 years, 56,850 episodes of AKD were identified in 47,670 patients. The incidence was 4.49 and 19.0/1000 patients/year in non-CKD and CKD subjects, respectively. Overall, HTN was present in 62.8% of patients, 49,9% among those without CKD before the event and in 92.6% in CKD patients. In patients without CKD, HTN increases the risk of more severe RIFLE class of AKD (Risk 47.4%, Injury 64.1% and Failure 66.0%). The prevalence of HTN in patients with AKI was 76.6% without differences in the RIFLE class (Risk 76.3%, Injury 77.2% and Failure 76.9%). A higher mortality was recorded among the AKI patients. Conclusions: The data from this study reinforce the concept that acute elevations in serum creatinine occurring and managed in the community may pose a health risk and HTN is an important risk factor. Future work should consider how best eAlerts can be utilized, targeted and implemented.

EFFECTIVENESS OF CONSERVATIVE TREATMENTS ON CHRONIC VENOUS DISEASE SYMPTOMS AND QUALITY OF LIFE IN HYPERTENSIVE PATIENTS: A SUBGROUP ANALYSIS FROM THE VEINSTEP OBSERVATIONAL STUDY

Objective: Chronic venous disease (CVeD) and arterial hypertension (HTA) are common circulatory system disorders associated with significant patient and healthcare burdens. Despite their high prevalence, patients presenting with both conditions are poorly studied resulting in a lack of evidence regarding optimal CVeD management in this specific group. This VeinStep sub-analysis evaluates the effectiveness of conservative treatments on CVeD symptoms and QoL in hypertensive patients. Design and method: VeinStep was an international, observational, prospective study, involving outpatients with symptomatic CVeD. Patients underwent a clinical examination to identify CVeD signs using CEAP classification. Main outcomes after 4 weeks were intensity of symptoms (VAS) and QoL using CIVIQ14. Changes over time were analyzed using a Wilcoxon test. Between-group comparisons for most prescribed venoactive drugs (VADs) used ranked ANCOVA with baseline value as covariate, adjusted on main baseline characteristics. Results: Among the 6084 patients analyzed in VeinStep, 1230 had HTA. They were more frequently men (28.9% vs 20.3%), older (Mean age±SD: 61.5±11.5 vs 47.9±13.0 yrs), obese (BMI&gt;30 kg/m2: 43.9% vs 27.0%) and had more severe CEAP class (&gt;=C4:26.6% vs 9.5%) than non-HTA patients. Most prescribed treatments involved VADs (97.2% of patients) mainly combined with compression and/or topicals: Micronized Purified Flavonoid Fraction (MPFF):77.5%, diosmin:17.7%, compression:59.1%, topicals:43.7%. VADs treatment resulted in significant decreases vs baseline in global symptoms intensity:- 2.39±1.78 (p&lt;0.001) and in each symptom intensity (p&lt;0.001) along with significant improvement in QoL: CIVIQ-14 score decreased by -10.49±8.21 (p&lt;0.001). For MPFF- or diosmin-based therapy, global symptoms intensity decreased by -2.50±1.73 and -1.87±1.85, respectively (p&lt;0.001 in favor of MPFF). MPFF-based therapy showed a higher beneficial effect on pain:-2.42±1.83 vs -1.77±1.69 (P=0.002); heaviness:-2.53±1.86 vs -1.79±1.75 (P&lt;0.001); swelling:-2.46±1.92 vs - 1.76±2.03 (P&lt;0.001); cramps:-2.15±1.96 vs -1.53±1.76 (P=0.002) and QoL:-10.94±8.02 vs - 9.07±8.87 (P=0.012) compared with diosmin-based therapy. Conclusions: This VeinStep sub-analysis offers valuable insights into the patient characteristics with both CVeD and HTA in real-life settings, guiding clinicians in selecting optimal treatments for improved outcomes. The findings suggest that VADs, particularly MPPF, significantly reduce CVeD symptoms and improve QoL in this population.

Quality of occlusal outcome in adult class II patients after maxillary total arch distalization with interradicular mini-screws

BackgroundThe aim of the investigation was to evaluate if a Class II malocclusion in adult patients can be successfully corrected by maxillary total arch distalization with interradicular mini-screws in combination with completely customized lingual appliances (CCLA).MethodsTwo patient groups were matched for age and gender to determine differences in the quality of final treatment outcome. The treatment results of 40 adult patients with a Class I malocclusion (Group 1) were compared with those of 40 adult patients with a moderate to severe Class II malocclusion (Group 2). All patients had completed treatment with a CCLA (WIN, DW Lingual Systems, Bad Essen, Germany) without overcorrection in the individual treatment plan defined by a target set-up. To compare the treatment results of the two groups, 7 measurements using the American Board of Orthodontics Model Grading System (ABO MGS) and linear measurements for anterior-posterior (AP) and vertical dimensions were assessed at the start of lingual treatment (T1), after debonding (T2B), and compared to the individual target set-up (T2A).ResultsA statistically significant AP correction (mean 4.5 mm, min/max 2.1/8.6, SD 1.09) was achieved in Group 2, representing 99% of the planned amount. The planned overbite correction was fully achieved in both the Class I and Class II groups. There was a statistically significant improvement in the ABO scores in both groups (Group 1: 39.4 to 17.7, Group 2: 55.8 to 17.1), with no significant difference between the two groups at T2B. 95% of the adult patients in Group 1 and 95% in Group 2 would meet the ABO standards after maxillary total arch distalization with a CCLA and interradicular mini-screws.ConclusionsCCLAs in combination with interradicular mini-screws for maxillary total arch distalization can successfully correct moderate to severe Class II malocclusions in adult patients. The quality of the final occlusal outcome is high and the amount of the sagittal correction can be predicted by the individual target set-up.

Cross-project concurrency bug prediction using domain-adversarial neural network

In recent years, software bug prediction has shown to be effective in narrowing down the potential bug modules and boosting the efficiency and precision of existing testing and analysis tools. However, due to its non-deterministic nature and low presence, concurrency bug labeling is a challenging task, which limits the implementation of within-project concurrency bug prediction. This paper proposes DACon, a Domain-Adversarial neural network-based cross-project Concurrency bug prediction approach to tackle this problem by leveraging information from another related project. By combining a set of designed concurrency code metrics with widely used sequential code metrics, DACon uses SMOTE (Synthetic Minority Over-sampling TEchnique) and domain-adversarial neural network to mitigate two challenges including the severe class imbalance between concurrency bug-prone samples and concurrency bug-free samples, and shift between source and target distribution during bug prediction implementation. Our evaluation on 20 pair-wise groups of experiments constructed from 5 real-world projects indicates that cross-project concurrency bug prediction is feasible, and DACon can effectively predict concurrency bugs across different projects.

MAF-Net: A multi-attention fusion network for power transmission line extraction from aerial images

Automatic extraction of power transmission lines from remote sensing images is important for intelligent power inspection. However, this task faces many challenges, such as complex backgrounds and varying illumination, which make accurate segmentation difficult. Additionally, the severe class imbalance issue arising from the smaller pixel proportion of transmission lines compared to background makes segmentation even more challenging. To address these challenges, a multi-attention fusion network, named MAF-Net, is put forward to achieve accurate end-to-end segmentation of remote sensing images of transmission lines. Firstly, aimed at the inadequate process of local features, a multi-scale context fusion (MCF) block is put forward for effective feature aggregation of multi-scale features. Meanwhile, a dense block is also introduced for feature enhancement to acquire multi-scale contexts. Secondly, considering the pooling operation will bring the problem of information loss, a three-branch pooling (TP) block is proposed to take the best of the advantages of different pooling operations. In addition, the multi-scale input unit is also proposed to support deep layers for extracting the discriminative context information. Furthermore, to tackle the class imbalance issue, a multi-attention block (MA) is used to optimize the simple skip connections to fully aggregate spatial attention, pixel attention, and channel attention features, allowing this segmentation model to focus on the key areas containing power transmission lines. Comparison experiments and ablation experiments are carried out on the remote aerial sensing images for performance analysis. Experiments indicate that proposed MAF-Net could achieve a superior segmentation ability.

Long-Term Mortality after Transcatheter Edge-to-Edge Mitral Valve Repair Significantly Decreased over the Last Decade: Comparison between Initial and Current Experience from the MiTra Ulm Registry.

(1) Objective: We aimed to assess whether the candidate profile, the long-term outcomes and the predictors for long-term mortality after transcatheter edge-to-edge mitral valve repair (M-TEER) have changed over the last decade; (2) Methods: Long-term follow-up data (median time of 1202 days) including mortality, MACCE and functional status were available for 677 consecutive patients enrolled in the prospective MiTra Ulm registry from January 2010 to April 2019. The initial 340 patients treated in our institution before January 2016 were compared with the following 337 patients; (3) Results: Patients treated after 2016 showed significantly less ventricular dilatation (left ventricular end-systolic diameter of 43 ± 13 mm vs. 49 ± 16 mm, p < 0.007), lower systolic pulmonary pressures (50 ± 15 mmHg vs. 57 ± 21 mmHg, p = 0.01) and a lower prevalence of severe tricuspid regurgitation (27.2% vs. 47.3%, p < 0.001) at baseline than patients treated before 2016. Compared to the cohort treated before 2016, patients treated afterwards showed a significantly lower all-cause 3-year mortality (29.4% vs. 43.8%, p < 0.001) and lower MACCE (38.6% vs. 54.1%, p < 0.001), without differences for MR etiology. While severe tricuspid regurgitation and NYHA class IV remained independently associated with an increased long-term mortality over the last decade, severe left ventricular dilatation (hazard ratio, HR 2.12, p = 0.047) and severe pulmonary hypertension (HR 2.18, p = 0.047) were predictors of long-term mortality only in patients treated before 2016. (4) Conclusions: The M-TEER candidates are currently treated earlier in the course of disease and benefit significantly in terms of a better long-term survival than patients treated at the beginning of the M-TEER era.

Mandibular Body Osteotomy Combined with Sagittal Split Ramus Osteotomy for the Treatment of Severe Skeletal Class Ⅲ Malocclusion with Ankylosed Teeth.

This study presents a combination of 2 different surgery procedures performed on the mandible as part of the treatment aiming to improve the facial profile and occlusal function of patients with severe skeletal class Ⅲ malocclusion and bilateral edentulous gaps. The teeth next to the edentulous gaps were found to be ankylosed. Mandibular setback by bilateral sagittal split ramus osteotomies and mandibular body osteotomies, combined with Le Fort Ⅰ level maxillary advancement were performed, since the chief complaint of the patient was a concave profile. As a result, the skeletal class Ⅲ malocclusion had been corrected, a satisfying facial profile had been achieved, and no apparent adverse effect was found. Thus, it has been proved that the combination of sagittal split ramus osteotomy and mandibular body osteotomy is available for correcting skeletal class Ⅲ malocclusion.

Assessment of rainfall erosivity for Bundelkhand region of central India using long-term rainfall data

Prevention of soil erosion requires long term assessment of rainfall erosivity and other related variables of the region. In the present study, four variables related to rainfall erosivity i.e. modified Fournier index (MFI), rainfall erosivity (R) factor, erosivity density (ED) and precipitation concentration index (PCI) were calculated. Long-term (1901-2021) daily rainfall data of Bundelkhand region (Central India) were used in the analysis. The above variables were assessed for spatial and temporal variability on annual and seasonal scale. The R-factor values range from 3010.61 MJ.mm ha-1 h-1 to 5346.53 MJ.mm ha-1 h-1, showing the region belongs to moderate to severe erosivity class. The mean annual R-factor, MFI, ED and PCI values for the Bundelkhand region were calculated as 4072.86 MJ.mm ha-1 h-1, 270.55 mm, 19.13 MJ ha-1 h-1 and 28.88, respectively. This study provides the insights of soil erosion problems of Bundelkhand region and would help in adopting the preventive measures and watershed development activities.

Kidney Histopathology of Patients with Hepatitis C Infection and Diabetes Mellitus before and after Availability of Direct-Acting Antiviral Therapy

Introduction: Type 2 diabetes mellitus (DM) and diabetic kidney disease are increasing. Hepatitis C infection (HCV) occurs in 1% of the world population and can induce several kidney diseases. DM prevalence is increased in individuals with HCV; however, kidney diseases in those with both DM and HCV have not been assessed. Direct-acting antiviral agents (DAAs) became available for HCV treatment in 2014; it is unknown if DAAs altered the spectrum of kidney disease in patients with DM and HCV. Methods: Case review identifying patients with kidney biopsy and clinical history of DM and HCV between 2009–2013 (pre-DAA) and 2016–2020 (post-DAA), excluding kidney transplant, hepatitis B, HIV, and inadequate biopsy, identified 245 biopsies. Biopsies were evaluated for diabetic glomerulosclerosis (DGS) class, global and focal segmental glomerulosclerosis (FSGS), other glomerular diseases, interstitial fibrosis/tubular atrophy (IFTA), interstitial nephritis, acute tubular injury and degree of arterial and arteriolar sclerosis. Kidney disease differences in pre-DAA versus post-DAA eras and in mild versus severe DGS were assessed by χ2 and Fisher’s exact tests. Results: The most common non-DGS lesions were non-collapsing FSGS (41%), HCV-related IgM dominant immune complex glomerulonephritis (IgM-ICGN, 18%), IgA nephropathy (9%), and membranoproliferative glomerulonephritis (MPGN, 7%). Collapsing FSGS was more common pre-DAA versus post-DAA (8% vs. 1%, p = 0.03). Biopsies from patients with HCV and DM were reduced in post-DAA (0.7%) versus pre-DAA (1.3%) (p < 0.0001). Post-DAA there were less MPGN (2% vs. 10%, p = 0.02) and more advanced DGS (85% vs. 61%, p = 0.0002), non-collapsing FSGS (57% vs. 31%, p < 0.0001), IFTA (2.0 vs. 1.6, p = 0.0002), and vascular sclerosis (2.1 vs. 1.6, p < 0.0001). Conclusion: Post-DAA there were reduced biopsies and MPGN, with more severe DGS class, non-collapsing FSGS, IFTA, and chronic vascular changes. This suggests a modulating effect of DAAs on HCV-related kidney pathology with DM and chronic changes driving indications for kidney biopsy.

Effective Natural Language Processing Algorithms for Early Alerts of Gout Flares from Chief Complaints

Early identification of acute gout is crucial, enabling healthcare professionals to implement targeted interventions for rapid pain relief and preventing disease progression, ensuring improved long-term joint function. In this study, we comprehensively explored the potential early detection of gout flares (GFs) based on nurses’ chief complaint notes in the Emergency Department (ED). Addressing the challenge of identifying GFs prospectively during an ED visit, where documentation is typically minimal, our research focused on employing alternative Natural Language Processing (NLP) techniques to enhance detection accuracy. We investigated GF detection algorithms using both sparse representations by traditional NLP methods and dense encodings by medical domain-specific Large Language Models (LLMs), distinguishing between generative and discriminative models. Three methods were used to alleviate the issue of severe data imbalances, including oversampling, class weights, and focal loss. Extensive empirical studies were performed on the Gout Emergency Department Chief Complaint Corpora. Sparse text representations like tf-idf proved to produce strong performances, achieving F1 scores higher than 0.75. The best deep learning models were RoBERTa-large-PM-M3-Voc and BioGPT, which had the best F1 scores for each dataset, with a 0.8 on the 2019 dataset and a 0.85 F1 score on the 2020 dataset, respectively. We concluded that although discriminative LLMs performed better for this classification task when compared to generative LLMs, a combination of using generative models as feature extractors and employing a support vector machine for classification yielded promising results comparable to those obtained with discriminative models.

Analysis of the environmental damage and agricultural utilization in Forest Area of Dieang Plateau, Central Java, Indonesia

Dieng Plateau is a renowned tourist attraction due to its captivating panoramas, protected forest, agricultural viability, and geothermal resources. However, encouraging social life forces the local community to depend on the surrounding forest by utilizing the forest area as agricultural land. These activities harm the environment. This study aimed to determine the level of environmental damage and agricultural utilization in forest area of Dieng Plateau. Data collection methods were observation and interviews, with a purposive determination of the sample. Data analysis was carried out spatially to determine the level of environmental damage. The results showed that the erosion rate in the Dieng Plateau was in the moderate (33-35 cm), heavy (86-100 cm) and very heavy class (92-235 cm). The level of canopy cover is in the moderately dense class (60%), sparse class (20-40%) and very sparse class (<20%). The level of land productivity is in the low class (40%), moderate class (45-53%), high class (70%) and very high (93%). The level of environmental management ranged from poor to excellent. The level of environmental damage in total is in the rather severe and damaged class. For this reason, it is necessary to implementing environmental damage control strategies by land rehabilitation and closely monitoring agricultural activities by the forest area management and local government authorities are essential measures.

Modelling Soil Erosion Using RUSLE and GIS for Kadalundi River Basin in Kerala, India

The main objective of the study was to estimate the potential average annual soil loss from Kadalundi river basin using RUSLE model and to prepare the spatial distribution map of soil erosion hazard using GIS to suggest suitable soil conservation and management measures for the basin. The individual factor maps for each factor in the RUSLE equation were prepared and multiplied in raster calculator to obtain the spatial distribution map of soil erosion with the help of ArcGIS. The daily rainfall data, basic soil data, Digital Elevation Model (DEM) and satellite imageries were used as the input data for the calculation of rainfall erosivity factor, soil erodibility factor, topographic factor, cover management factor and conservation practice factor. The results indicated an average annual erosion of 5.48 t·ha-1·yr-1 in the basin during the period of 2001 to 2021. The total quantity of soil washed away from the basin was 694836.60 t·yr-1. The estimated values of R-factor ranged from 938.97 MJ·mm·ha-1·h-1·yr-1 to 1102.65 MJ·mm·ha-1·h-1·yr-1, and the computed erodibility factor values varied between 0.0075 to 0.025 t·h·MJ⁻1·mm⁻1. The topographic factor value of the basin was found between 0 to 9.07. The basin had C-factor values of 0.08 to 1.10 and the P-factor values varied from 0.1 to 1. The spatial distribution map of erosion suggest that major part of the basin is under slight erosion class and only a minor part is under very severe erosion class. Areas in the very severe erosion class is characterised by moderate to steep slopes, or in other words areas with less slope is having slight erosion. As most of the area of the basin is having slight erosion, simple agronomical measures can be adopted for the mitigation purposes.

Use of geomatics, Simulating the Impact of Future Land Use and Climate Change on Soil Erosion in the Tigrigra watershed (Azrou region, Middle Atlas, Morocco)

Soil losses need to be quantified in watersheds to implement erosion protection measures. The main objective of this work is to quantify soil loss in the Tigrigra watershed over the reference period 1985-2020 and two future periods 2050-2070, A Revised Universal Soil Loss Equation (RUSLE) model supported by geographic information systems (GIS) and remote sensing was used. GIS’s model generator can automate various operations of creating thematic layers of model parameters. For future climatic periods (2050-2070), precipitation was produced using a classical statistical downscaling model (SDSM). On the other hand, Automata/Markov models (CA Markov) are used to characterize future land use through modeling in Idrisi software. Over the two periods, the results showed that annual erosivity varies decreases, or increases. The annual soil loss maps showed that 50% of our study area was in the very low class (&lt;5 t/ha/year), while 20% was in the severe class (&gt;80 t/ha/year). These fluctuations are primarily due to the effects of climate change and deforestation/reforestation in the region. This leads to changes in soil erosion due to the important role played by these two factors.