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McNelly A, Langan A, Bear DE, Page A, Martin T, Seidu F, Santos F, Rooney K, Liang K, Heales SJ, Baldwin T, Alldritt I, Crossland H, Atherton PJ, Wilkinson D, Montgomery H, Prowle J, Pearse R, Eaton S, Puthucheary ZA. A pilot study of alternative substrates in the critically Ill subject using a ketogenic feed. Nat Commun 2023; 14:8345. [PMID: 38102152 PMCID: PMC10724188 DOI: 10.1038/s41467-023-42659-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/18/2023] [Indexed: 12/17/2023] Open
Abstract
Bioenergetic failure caused by impaired utilisation of glucose and fatty acids contributes to organ dysfunction across multiple tissues in critical illness. Ketone bodies may form an alternative substrate source, but the feasibility and safety of inducing a ketogenic state in physiologically unstable patients is not known. Twenty-nine mechanically ventilated adults with multi-organ failure managed on intensive care units were randomised (Ketogenic n = 14, Control n = 15) into a two-centre pilot open-label trial of ketogenic versus standard enteral feeding. The primary endpoints were assessment of feasibility and safety, recruitment and retention rates and achievement of ketosis and glucose control. Ketogenic feeding was feasible, safe, well tolerated and resulted in ketosis in all patients in the intervention group, with a refusal rate of 4.1% and 82.8% retention. Patients who received ketogenic feeding had fewer hypoglycaemic events (0.0% vs. 1.6%), required less exogenous international units of insulin (0 (Interquartile range 0-16) vs.78 (Interquartile range 0-412) but had slightly more daily episodes of diarrhoea (53.5% vs. 42.9%) over the trial period. Ketogenic feeding was feasible and may be an intervention for addressing bioenergetic failure in critically ill patients. Clinical Trials.gov registration: NCT04101071.
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Affiliation(s)
- Angela McNelly
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Anne Langan
- Department of Dietetics, Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Danielle E Bear
- Department of Nutrition and Dietetics, St Thomas' NHS Foundation Trust, London, UK
- Department of Critical Care, Guy's and St. Thomas' NHS, London, UK
| | | | - Tim Martin
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Fatima Seidu
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Filipa Santos
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Kieron Rooney
- Department of Critical Care, Bristol Royal Infirmary, Bristol, UK
| | - Kaifeng Liang
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Simon J Heales
- Genetic & Genomic Medicine Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Tomas Baldwin
- Developmental Biology & Cancer, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Isabelle Alldritt
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Hannah Crossland
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Philip J Atherton
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Daniel Wilkinson
- Centre of Metabolism, Aging & Physiology (COMAP), MRC-Versus Arthritis Centre for Musculoskeletal Aging Research & NIHR Nottingham BRC, University of Nottingham, Nottingham, UK
| | - Hugh Montgomery
- University College London (UCL), London, UK
- UCL Hospitals NHS Foundation Trust (UCLH), National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK
| | - John Prowle
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Rupert Pearse
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital, London, UK
| | - Simon Eaton
- Developmental Biology & Cancer, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Zudin A Puthucheary
- William Harvey Research Institute, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK.
- Adult Critical Care Unit, Royal London Hospital, London, UK.
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Pokhrel DR, Sirisomboon P, Khurnpoon L, Posom J, Saechua W. Comparing Machine Learning and PLSDA Algorithms for Durian Pulp Classification Using Inline NIR Spectra. SENSORS (BASEL, SWITZERLAND) 2023; 23:5327. [PMID: 37300054 PMCID: PMC10256041 DOI: 10.3390/s23115327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
The aim of this study was to evaluate and compare the performance of multivariate classification algorithms, specifically Partial Least Squares Discriminant Analysis (PLS-DA) and machine learning algorithms, in the classification of Monthong durian pulp based on its dry matter content (DMC) and soluble solid content (SSC), using the inline acquisition of near-infrared (NIR) spectra. A total of 415 durian pulp samples were collected and analyzed. Raw spectra were preprocessed using five different combinations of spectral preprocessing techniques: Moving Average with Standard Normal Variate (MA+SNV), Savitzky-Golay Smoothing with Standard Normal Variate (SG+SNV), Mean Normalization (SG+MN), Baseline Correction (SG+BC), and Multiplicative Scatter Correction (SG+MSC). The results revealed that the SG+SNV preprocessing technique produced the best performance with both the PLS-DA and machine learning algorithms. The optimized wide neural network algorithm of machine learning achieved the highest overall classification accuracy of 85.3%, outperforming the PLS-DA model, with overall classification accuracy of 81.4%. Additionally, evaluation metrics such as recall, precision, specificity, F1-score, AUC ROC, and kappa were calculated and compared between the two models. The findings of this study demonstrate the potential of machine learning algorithms to provide similar or better performance compared to PLS-DA in classifying Monthong durian pulp based on DMC and SSC using NIR spectroscopy, and they can be applied in the quality control and management of durian pulp production and storage.
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Affiliation(s)
- Dharma Raj Pokhrel
- Department of Agricultural Engineering, School of Engineering, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand; (D.R.P.); (P.S.)
| | - Panmanas Sirisomboon
- Department of Agricultural Engineering, School of Engineering, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand; (D.R.P.); (P.S.)
| | - Lampan Khurnpoon
- School of Agricultural Technology, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
| | - Jetsada Posom
- Department of Agricultural Engineering, Faculty of Engineering, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Wanphut Saechua
- Department of Agricultural Engineering, School of Engineering, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand; (D.R.P.); (P.S.)
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Automated Fitting Process Using Robust Reliable Weighted Average on Near Infrared Spectral Data Analysis. Symmetry (Basel) 2020. [DOI: 10.3390/sym12122099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
With the complexity of Near Infrared (NIR) spectral data, the selection of the optimal number of Partial Least Squares (PLS) components in the fitted Partial Least Squares Regression (PLSR) model is very important. Selecting a small number of PLS components leads to under fitting, whereas selecting a large number of PLS components results in over fitting. Several methods exist in the selection procedure, and each yields a different result. However, so far no one has been able to determine the more superior method. In addition, the current methods are susceptible to the presence of outliers and High Leverage Points (HLP) in a dataset. In this study, a new automated fitting process method on PLSR model is introduced. The method is called the Robust Reliable Weighted Average—PLS (RRWA-PLS), and it is less sensitive to the optimum number of PLS components. The RRWA-PLS uses the weighted average strategy from multiple PLSR models generated by the different complexities of the PLS components. The method assigns robust procedures in the weighing schemes as an improvement to the existing Weighted Average—PLS (WA-PLS) method. The weighing schemes in the proposed method are resistant to outliers and HLP and thus, preserve the contribution of the most relevant variables in the fitted model. The evaluation was done by utilizing artificial data with the Monte Carlo simulation and NIR spectral data of oil palm (Elaeis guineensis Jacq.) fruit mesocarp. Based on the results, the method claims to have shown its superiority in the improvement of the weight and variable selection procedures in the WA-PLS. It is also resistant to the influence of outliers and HLP in the dataset. The RRWA-PLS method provides a promising robust solution for the automated fitting process in the PLSR model as unlike the classical PLS, it does not require the selection of an optimal number of PLS components.
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