The burden of kidney disease: Improving global outcomes. Chronic kidney disease (CKD) is a worldwide public health problem with an increasing incidence and prevalence of patients requiring replacement therapy. There is an even higher prevalence of patients in earlier stages of CKD, with adverse outcomes such as kidney failure, cardiovascular disease, and premature death. Patients at earlier stages of CKD can be detected through laboratory testing and their treatment is effective in slowing the progression to kidney failure and reducing cardiovascular events. The evidence-based care of these patients are universal and independent of their geographic location. This paper describes the need to develop a uniform and global public health approach to the worldwide epidemic of CKD. It is to this end that a new initiative Kidney Disease: Improving Global Outcomes' has been established. Some current and future activities of this initiative are described. They include among others modification of the classification of CKD, the development of guidelines on hepatitis C, the organisation of consensus conferences like on Renal Osteodystrophy, and the creation of a website allowing the comparison of the five main English language clinical practice guidelines in kidney disease worldwide.

In this paper, we propose a fragile watermarking hybrid approach using rough set kmeans and exponential particle swarm optimization (EPSO) systems. It is based on a block-wise dependency mechanism which can detect any alterations made to the protected image. Initially, the input image is divided into blocks with equal size in order to improve image tamper localization precision. Then feature sequence is generated by applying rough k-means and EPSO clustering to create the relationship between all image blocks and cluster
all of them since EPSO is used to optimize the parameters of rough k-means. Both feature sequence and generated secret key are used to construct the authentication data. Each resultant 8-bit authentication data is embedded into the eight least significant bits (LSBs) of the corresponding image block. We gives experimental results which show the feasibility of using these optimization algorithms for the fragile watermarking and demonstrate the
accuracy of the proposed approach. The performance comparison of the approach was also realized. The performance of a fragile watermarking approach has been improved in this paper by using exponential particle swarm optimization (EPSO) to optimize the rough kmean parameters. The proposed approach can embed watermark without causing noticeable visual artifacts, and does not only achieve superior tamper detection in images accurately,
it also recovers tampered regions effectively. In addition, the results show that the proposed approach can effectively thwart different attacks, such as the cut-and paste attack and collage attack, while sustaining superior tamper detection and localization accuracy.

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