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In today's digital landscape, the threat of digital image forgery is on the rise, necessitating the development of advanced detection and authentication techniques. Copy-move image forgery, a prevalent form of manipulation, involves duplicating a portion of an image and inserting it elsewhere with malicious intent. Detecting such forgeries is of utmost importance. This research introduces an innovative approach that combines convolutional neural network (CNN)-based deep features and gray-level co-occurrence matrix (GLCM) features. These hybrid features are carefully selected using neighborhood component analysis (NCA) to optimize their discriminative power. Subsequently, a support vector machine (SVM) classifier is employed to classify these refined hybrid features, resulting in exceptional detection performance. The proposed method achieves remarkable accuracy in forgery detection. In the CASIA 1 dataset, the hybrid features-NCA-SVM method outperforms other techniques with an accuracy of 97.62%. Similarly, on the MICC-F220 dataset, the hybrid features-NCA-SVM approach attains the highest accuracy of 98.00%. These results underscore the robustness and versatility of the proposed method in detecting copy-move forgeries across different datasets. [ABSTRACT FROM AUTHOR]

Introduction: Creatinine has limitations in identifying and predicting acute kidney injury (AKI). Our study examined the utility of neutrophil gelatinase-associated lipocalin (NGAL) in predicting AKI in patients presenting to the emergency department (ED), and in predicting the need for renal replacement therapy (RRT), occurrence of major adverse cardiac events (MACE) and all-cause mortality at three months post visit. Methods: This is a single-centre prospective cohort study conducted at Singapore General Hospital (SGH). Patients presenting to SGH ED from July 2011 to August 2012 were recruited. They were aged =21 years, with an estimated glomerular filtration rate <60 mL/min/1.73 m2, and had congestive cardiac failure, systemic inflammatory response syndrome or required hospital admission. AKI was diagnosed by researchers blinded to experimental measurements. Serum NGAL was measured as a point-of-care test. Results: A total of 784 patients were enrolled, of whom 107 (13.6%) had AKI. Mean serum NGAL levels were raised (P < 0.001) in patients with AKI (670.0 ± 431.9 ng/dL) compared with patients without AKI (490.3 ± 391.6 ng/dL). The sensitivity and specificity of NGAL levels >490 ng/dL for AKI were 59% (95% confidence interval [CI] 49%-68%) and 65% (95% CI 61%-68%), respectively. Need for RRT increased 21% per 100 ng/dL increase in NGAL (P < 0.001), whereas odds of death in three months increased 10% per 100 ng/dL increase in NGAL (P = 0.028). No clear relationship was observed between NGAL levels and MACE. Conclusion: Serum NGAL identifies AKI and predicts three-month mortality. [ABSTRACT FROM AUTHOR]

Introduction: Double‐filtration plasmapheresis (DFPP) has been utilized for immunomodulation in kidney transplantation. Anticoagulation is important to maintain circuit patency during DFPP. We aimed to compare the efficacy and safety of regional citrate anticoagulation (RCA) with systemic heparin anticoagulation during DFPP in kidney transplant recipients. Methods: A retrospective cohort study was conducted to compare the efficacy and safety of RCA (RCA‐DFPP) to systemic heparin anticoagulation (Hep‐DFPP) for DFPP among kidney transplant recipients in a single tertiary center. Results: A total of 112 sessions of DFPP were performed for 23 subjects, of which 62 sessions were RCA‐DFPP and 50 sessions were Hep‐DFPP. There were 13 sessions (11.6%) of premature circuit clotting, 10 sessions (16.1%) for RCA‐DFPP and 3 sessions (6.0%) for Hep‐DFPP (P =.10). All premature circuit clotting episodes occurred in subjects who underwent DFPP through a vascular catheter. Premature circuit clotting was associated with the use of a vascular catheter (odds ratio [OR] 14.2, 95% confidence interval [CI] 2.7‐73.7; P <.01) and high postfilter ionized calcium (OR 12.7, 95% CI 1.4‐112.5; P <.01). There was no major bleeding event. Hep‐DFPP was associated with higher occurrence of hypocalcemia (OR 1.1, 95% CI 1.0‐1.2; P <.01) and metabolic acidosis (OR 1.4, 95% CI 1.2‐2.0; P =.04), while hypomagnesemia was more common for RCA‐DFPP (OR 2.9, 95% CI 1.1‐7.4; P =.03). Conclusion: Amongst kidney transplant patients who receive DFPP therapy, RCA‐DFPP may be comparable to Hep‐DFPP for the maintenance of circuit patency. Functioning vascular access is vital in avoiding premature clotting of the circuit. Close monitoring of electrolyte imbalances and coagulopathy related to DFPP is recommended. [ABSTRACT FROM AUTHOR]

Background: Patients with multiple myeloma and high serum levels of circulating free light chains (FLC) have increased risk of acute kidney injury (AKI) secondary to cast nephropathy and is associated with poor survival. Despite removal of FLC by medium cutoff (MCO) dialyzer, the role of MCO hemodialysis (HD) in the treatment of cast nephropathy and its clinical benefits remain unknown. Methods: A systematic review was conducted to establish the effectiveness of MCO dialyzer and clinical outcomes, compared to other forms of dialyzers in the removal of FLC, in myeloma patients with AKI. The primary outcome was effectiveness of MCO‐HD in reducing serum FLC. The secondary outcomes were HD independence, estimated glomerular filtrate rate, mortality rates, length of hospitalization, rebound of serum FLC before the next dialysis, removal of other molecules during dialysis, and adverse events. Results: We identified three case series, with a total of 17 patients. There were no randomized controlled trials (RCTs) or cohort studies. These case series showed that MCO dialyzer was effective in the removal of FLC and led to a reduction in FLC concentration post‐dialysis. The majority of the case series did not have comparator arm and renal and/or other clinical outcomes. Conclusion: MCO dialyzer appeared to be effective in the removal of FLC based on the existing limited data. However, more data, particularly large‐scale RCTs, are needed to assess the use of MCO dialyzer in reducing serum FLC and its effect on clinical outcomes in patients with multiple myeloma and AKI. [ABSTRACT FROM AUTHOR]