Monroe College

Chronic Kidney Disease (CKD) is a significant global health concern that requires an early and accurate diagnosis to prevent long-term complications. This study presents a machine learning-based framework for automated CKD detection using a synthetic dataset of 1,659 patient records and 54 clinical features. Six classifiers, Logistic Regression, Support Vector Machine (SVM), Decision Tree, Random Forest, Naive Bayes, and Gradient Boosting, were evaluated with and without hyperparameter tuning. Results showed that Gradient Boosting achieved the highest performance with tuning, yielding 93.07\% accuracy and a 95.22 \% AUC. Comparatively, its untuned version also outperformed other models, with 92.77% accuracy and 95.14% AUC. These findings suggest that Gradient Boosting, especially when fine-tuned, is highly effective for predicting CKD. This methodology emphasizes robust cross-validation and comprehensive metric reporting, offering a reproducible approach for early kidney disease detection.

The fashion industry is characterized by its fast-paced nature and constant evolution of consumer preferences, making accurate fashion forecasting essential for brands to remain competitive. Traditional forecasting methods, which rely heavily on historical sales data and expert intuition, are increasingly being complemented or replaced by advanced consumer data analytics. This article explores the integration of consumer data analytics into fashion forecasting, drawing insights from recent literature. By examining methodologies such as machine learning, big data analytics, and AI, as well as utilizing diverse data sources including social media, online shopping behaviors, and mobile data, this study highlights the significant improvements in trend prediction accuracy and operational efficiency. Key findings indicate that data-driven approaches provide more precise and real-time insights into consumer preferences, enabling brands to better anticipate market demands and optimize inventory management. The discussion underscores the transformative potential of consumer data analytics in enhancing the overall effectiveness of fashion forecasting.

Choledocholithiasis presents variably, with some patients remaining asymptomatic, complicating decisions regarding the timing and necessity of endoscopic retrograde cholangiopancreatography (ERCP). This study represents the first meta-analysis assessing the impact of symptomatic status on post-ERCP complications and provides critical data to optimize treatment strategies. A systematic review and meta-analysis were conducted by searching PubMed, Embase, and Google Scholar through February 2024, focusing on comparing ERCP outcomes between symptomatic and asymptomatic patients with choledocholithiasis. Seven studies were included from an initial pool of 1,200 articles screened. The analysis revealed that asymptomatic patients exhibited a significantly higher overall complication rate (17.4% vs. 6.6%), including a threefold increase in the risk of developing complications overall (OR: 3.02; 95% CI: 2.26-4.03) and specifically post-ERCP pancreatitis (OR: 3.62; 95% CI: 2.63-4.99). Perforation and procedural durations were also notably higher among asymptomatic individuals. Subgroup analyses highlighted prolonged cannulation times and the use of precut sphincterotomy as potential influential factors. These findings challenge the current practice that does not differentiate based on symptomatic status and suggest a need for more tailored approaches in managing asymptomatic individuals to minimize risks associated with ERCP.

The airline industry places significant emphasis on improving customer experience, and Twitter has emerged as a key platform for passengers to share their opinions. This research introduces a machine learning approach to analyze tweets and enhance customer experience. Features are extracted from tweets using both the Glove dictionary and n-gram methods for word embedding. The study explores various artificial neural network (ANN) architectures and Support Vector Machines (SVM) to create a classification model for categorizing tweets into positive and negative sentiments. Additionally, a Convolutional Neural Network (CNN) is developed for tweet classification, and its performance is compared with the most accurate model identified among SVM and multiple ANN architectures. The results indicate that the CNN model surpasses the SVM and ANN models. To provide further insights, association rule mining is applied to different tweet categories, revealing connections with sentiment categories. These findings offer valuable information to help airline industries refine and enhance their customer experience strategies.

ABSTRACT LGBT individuals experience discrimination in health care settings and report difficulty accessing clinically competent healthcare. This study examined the self-assessed knowledge, clinical preparedness, LGBT health focused education received and attitudinal awareness of health care workers (HCW) (n = 215) toward LGBT patients at an urban hospital in New York City. HCW completed a one-time survey, that included the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale. Forty percent of HCW treated LGB patients and 30% treated transgender patients, 11% and 18% reported they were unaware if their patients were LGB or transgender. Seventy-four percent of HCW received less than two hours of formal education in LGBT health. A slight majority of HCW (51%) reported not receiving adequate clinical training to work with transgender clients. Forty-six percent of HCW reported not receiving adequate clinical training to work with LGB clients. A significant difference in LGBT health knowledge, clinical preparedness, and attitudinal awareness was found by LGBT health education received. HCW that reported more LGBT focused health education reported higher basic LGBT health knowledge, felt more clinically prepared, and reported affirming attitudes regarding LGBT patients. This research suggests that more LGBT health focused education of HCW is needed.

Pre-trained contextual embeddings like BERT have shown substantial improvement across a wide range of natural language processing tasks.We proposed Sliding-BERT, which incorporates BERT with state-of-the-art conversational machine comprehension (MC) model, 1325

BackgroundElevated levels of procalcitonin (PCT) reflect systemic inflammation associated with bacterial infection (BI). Compared with other acute-phase reactants, PCT levels more rapidly rise with BI and decline quickly as BI improves. A PCT protocol was implemented at University Medical Center New Orleans (UMCNO) in November 2017 that guided discontinuation of antimicrobial therapy in septic and septic shock patients if clinically improving with declining levels of PCT.MethodsWe performed a retrospective chart review of UMCNO patients 18+ years with a diagnosis of sepsis and a PCT level between January 1st, 2018 to July 31st, 2018 compared with those with sepsis and no PCT level. ICD-9/10 codes were used for diagnoses of sepsis and septic shock. The baseline characteristics including age, gender, body mass index, race and Charlston Comorbidity Index (CCI) data were collected. The primary objective was to compare the total days of antibiotic therapy (DOT) between the two groups. Secondary outcomes were broad-spectrum antibiotic DOT, patient length of stay (LOS), and all-cause 28-day mortality. SPSS was used for data analysis. P < 0.05 indicated statistical significance.ResultsThere were 44 patients in the PCT group (PCTg) and 35 in the non-PCT group (nPCTg). The demographics are outlined in Table. The mean DOT was 6.25 days in PCTg and 10.74 days in nPCTg (P = 0.006). LOS was 7.5 days in PCTg and 14 in nPCTg (P = 0.006). The mean CCI was 2.4 in PCTg and 4 in nPCTg (P = 0.007). The all-cause 28-day mortality was 11% in PCTg and 23% in nPCTg (OR 0.4; 95% CI 0.128–1.466). On bivariate analysis, LOS was significantly associated with CCI (P < 0.05) and total DOT (P = 0.000). On multivariate analysis, LOS was only significantly associated with age (P = 0.015) and total DOT (P = 0.000) but not CCI (P = 0.811) nor PCTg (P = 0.250).ConclusionDOT was significantly shorter in the PCTg than in nPCTg. The LOS was 50% less in PCTg than in nPCTg; however, PCT monitoring did not contribute to LOS in multivariate analysis. Although the nPCTg were sicker, CCI did not correlate with LOS either. However, age and total DOT therapy remained positive predictors of LOS. Monitoring PCT levels decreased antibiotic use in septic patients. LOS, however, was not significantly affected by PCT monitoring.DisclosuresAll authors: No reported disclosures.

The topic of this research article examines the unique leadership challenges confronted by staff and faculty of higher education institutions that serve a predominantly diverse and multi-cultural student population in urban areas of the United States. Urban colleges and universities are found in the large metropolitan cities of the United States where students are from the area, as well as domestic and international. The study isolates five areas of concern that raise leadership challenges for these institutions of higher learning. Specific areas of challenge are the rising cost of tuition, retention, student preparedness for higher education, technology, and gainful employment. The exploratory research within this study was conducted primarily in the New York tri-state area. It is qualitative in nature and conclusions are based on research and observations of subjects directly affiliated with these institutions.

Abstract IntroductionCerefolinNAC (CFLN-NAC) is a prescription medical food reported to help with mild to moderate cognitive impairment [Pamlab 2017]. It contains L-methylfolate calcium (6mg), methylcobalamin (2mg), Schizochytrium (90.3mg), and N-acetylcysteine (NAC) (600mg) [Pamlab 2017]. However, dysgeusia secondary to CFLN-NAC therapy has not heretofore been described.MethodsA 64 year-old female presented with an eight year history of progressively decreased ability to smell and taste of unknown origin. CFLN-NAC was prescribed off-label to treat her hypogeusia and hyposmia. Three days after treatment initiation, her taste sensations gradually returned and she was able to describe food as bitter, salty, sour and sweet. Also, she was able to decipher the taste of different nuts, such as almonds, macadamia, pecans, and peanuts at baseline. However, her taste sensations became distorted and she was unable to distinguish specific foods. She reported that most food tasted bland, but she was still able to sense textures of various foods describing them as, “crunchy, but without taste.” She denied any oral pain, xerostomia, hot flashes, and psychological distress. CFLN-NAC was continued for three months and her hypogeusia improved from 20% to 80%. Her dysgeusia persisted, but remitted once CFLN-NAC was discontinued.ResultsAbnormalities in physical examination: General: scalloped tongue, decreased blink frequency, and hypokinesia. Cranial Nerve (CN) Examination: Olfaction (CN I) Testing: Alcohol Sniff Test: 8 (hyposmia). Pocket Smell Test: 2 (hyposmia). Olfactometer Identification Test: Left: 5 (anosmia); Right: 12 (hyposmia). CN III, IV, VI: saccadization on horizontal eye movement. Motor Examination: hypokinetic movements and 1+ cogwheel rigidity in bilateral upper extremities. Drift Test: bilateral abductor digiti minimi signs with cerebellar spooning. Reflexes: absent patellar and Achilles bilaterally. Hoffman’s Reflex: present bilaterally. Other: Magnetic resonance imaging (MRI) of the brain with contrast was unremarkable.ConclusionWhen treating taste impairments, vitamins and minerals have been found to enhance the effect of non-injured nerves, but they do not repair damaged nerves. The presence of a scalloped tongue may suggest nerve injury of unknown proportion, and can either diminish or alter taste. CFLN-NAC may have enhanced the gustatory stimulus of the non-injured nerves. This transient increase could have either caused her dysgeusia or possibly unmasked the dysgeusia secondary to a scalloped tongue. Notable impairments found in her exam evince Parkinson’s disease as a possible etiology, but structural abnormalities were not seen on brain MRI, making this unlikely. Conversely, the relatively rapid resolution after terminating CFLN-NAC strongly suggests that this is not merely a coincidence, but rather an origin. Those initiated on CFLN-NAC should be queried for new onset of dysgeusia and warrant other treatment options.Funding Acknowledgements: Smell &amp; Taste Treatment and Research Foundation