Improved feature selection using a hybrid side-blotched lizard algorithm and genetic algorithm approach

Feature selection entails choosing the significant features among a wide collection of original features that are essential for predicting test data using a classifier. Feature selection is commonly used in various applications, such as bioinformatics, data mining, and the analysis of written texts, where the dataset contains tens or hundreds of thousands of features, making it difficult to analyze such a large feature set. Removing irrelevant features improves the predictor performance, making it more accurate and cost-effective. In this research, a novel hybrid technique is presented for feature selection that aims to enhance classification accuracy. A hybrid binary version of side-blotched lizard algorithm (SBLA) with genetic algorithm (GA), namely SBLAGA, which combines the strengths of both algorithms is proposed. We use a sigmoid function to adapt the continuous variables values into a binary one, and evaluate our proposed algorithm on twenty-three standard benchmark datasets. Average classification accuracy, average number of selected features and average fitness value were the evaluation criteria. According to the experimental results, SBLAGA demonstrated superior performance compared to SBLA and GA with regards to these criteria. We further compare SBLAGA with four wrapper feature selection methods that are widely used in the literature, and find it to be more efficient

Persistence of pulmonary arteriovenous malformations after successful embolotherapy with Amplatzer vascular plug: long-term results

PURPOSE:We aimed to evaluate the frequency of persistence and complication rates of pulmonary arteriovenous malformations (PAVMs) treated with Amplatzer vascular plug (AVP) or Amplatzer vascular plug type 2 (AVP2).METHODS:We retrospectively reviewed a total of 22 patients with 54 PAVMs between June 2004 and June 2014. We included 12 patients with 35 PAVMs who received percutaneous embolization using AVP or AVP2 only without the use of any other embolic devices. The mean follow-up was 54±24.3 months (range, 31–97 months). The primary end-points of the study were the efficacy of embolotherapy, the increase in oxygen saturation, and the persistence of PAVM on follow-up. Secondary end point was the incidence of complications.RESULTS:The study included 10 female and two male patients with a mean age of 50.2±13.7 years (range, 21–66 years). All PAVMs had a simple angioarchitecture. The technical success of the procedure for PAVM occlusion was 100%. There was a significant increase in the oxygen saturation following embolotherapy (P < 0.0001). Follow-up computed tomography angiography revealed successful treatment in 34 PAVMs (97%) and failed treatment in one PAVM (3%). Twenty-three aneurysmal sacs (67%) showed complete disappearance. The failed treatment was due to persistence of PAVM caused by subsequent development of systemic reperfusion, which did not require further intervention. There were two minor complications but no major complications were encountered.CONCLUSION:Embolotherapy of PAVMs using AVP or AVP2 devices is safe and effective, with high technical success rate, low persistence and complication rates, and with excellent long-term results

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Masked uncontrolled hypertension: Prevalence and predictors

Background: There are limited data on ‘masked uncontrolled hypertension’ (MUCH) in patients with treated and apparently well-controlled BP is unknown. Objectives: To define the prevalence and predictors of MUCH among hypertensive patients with controlled office blood pressure. Methods: One hundred ninety-nine hypertensive patients presented to the specialized hypertension clinics at two University Hospitals. All patients had controlled office blood pressure (less than 140/90 mmHg). Patients were assessed regarding history, clinical examination, and laboratory data. All patients underwent ambulatory blood pressure monitoring (ABPM) for 24 h, within a week after the index office visit. MUCH was diagnosed if average 24-h ABPM was elevated (systolic BP ≥ 130 mmHg and/or diastolic BP ≥ 80 mmHg) despite controlled clinic BP. Results: Sixty-six patients (33.2%) had MUCH according to 24-h ABPM criteria (mean age 53.5 ± 9.3 years, 60.6% men). MUCH was mostly caused by the poor control of nocturnal BP; with the percentage of patients in whom MUCH was solely attributable to an elevated nocturnal BP almost double that due to daytime BP elevation (57.3% vs. 27.1%, P < 0.001). The most common predictors of MUCH were smoking, DM and positive family history of DM. Conclusion: The prevalence of masked suboptimal BP control is high. Office BP monitoring alone is thus inadequate to ascertain optimal BP control because many patients have an elevated nocturnal BP. ABPM is needed to confirm proper BP control, especially in patients with high cardiovascular risk profile. Smoking, DM and positive family history of DM were the most common predictors of MUCH. Keywords: Ambulatory BP monitoring, Masked hypertension, Uncontrolled hypertensio

Registry of the Egyptian specialized hypertension clinics: Sex‐related differences in clinical characteristics and hypertension management among low socioeconomic hypertensive patients

Hypertension is a major modifiable risk factor for cardiovascular disease (CVD) which is a leading cause of death in developing countries affecting both genders. Gender dissimilarity in clinical characteristics and hypertension (HTN) management among hypertensive patients has been reported in several reports before. The aim was to detect sex differences in clinical characteristics and HTN management among Egyptian hypertensive patients. Data from 4701 hypertensive patients attending 9 university located Specialized Hypertension clinic (SHC) were collected from October 2014 to September 2017. The collected data included demographics, cardiovascular risk profile, hypertension‐related history, anthropometric and blood pressure (BP) measurements, antihypertensive medications used, number of patients attending the follow‐up visits, and HTN control rate. Females represented 58.5% of the recruited patients, they were younger, with higher BMI, lower education level, and employment rate compared with males. Females had lower mean office systolic and diastolic BP than males (144.2 ± 22.6 vs. 146.5 ± 22.0 mmHg and 88.1 ± 13.0 vs. 89.9 ± 12.6 mmHg, respectively) and lower rate of uncontrolled BP (54.8% vs. 61.1% in males P < .001). Antihypertensive drugs were comparable among both sexes except for angiotensin converting enzyme inhibitors which were more prescribed in males. Compliance to antihypertensive medications was better in females (63.6% vs. 60.1% in males, P = .015). To conclude, Egyptian hypertensive females have different clinical characteristics as compared to their counterpart males with better BP control, adherence to antihypertensive medications, lower systolic and diastolic BP, and no major differences in the prescribed antihypertensive distribution