Expert cancer model using supervised algorithms with a LASSO selection approach

One of the most critical issues of the mortality rate in the medical field in current times is breast cancer. Nowadays, a large number of men and women is facing cancer-related deaths due to the lack of early diagnosis systems and proper treatment per year. To tackle the issue, various data mining approaches have been analyzed to build an effective model that helps to identify the different stages of deadly cancers. The study successfully proposes an early cancer disease model based on five different supervised algorithms such as logistic regression (henceforth LR), decision tree (henceforth DT), random forest (henceforth RF), Support vector machine (henceforth SVM), and K-nearest neighbor (henceforth KNN). After an appropriate preprocessing of the dataset, least absolute shrinkage and selection operator (LASSO) was used for feature selection (FS) using a 10-fold cross-validation (CV) approach. Employing LASSO with 10-fold cross-validation has been a novel steps introduced in this research. Afterwards, different performance evaluation metrics were measured to show accurate predictions based on the proposed algorithms. The result indicated top accuracy was received from RF classifier, approximately 99.41% with the integration of LASSO. Finally, a comprehensive comparison was carried out on Wisconsin breast cancer (diagnostic) dataset (WBCD) together with some current works containing all features

Second trimester amniocentesis for prenatal diagnosis of genetic disorders in Bangladesh

Background: Amniocentesis is characteristically carried out under ultra-sonographic control, between 15 and 17 weeks of pregnancy. The term prenatal diagnosis firmly comprises all diagnostic modalities aimed at gaining information about the embryo. Its history includes the development of cytogenetic, molecular genetics and molecular cytogenetic methods. Prenatal diagnosis is now possible for a considerable number of genetic diseases and/or birth defects using a variety of techniques. Objective was to evaluate the safety, feasibility and outcome of second trimester amniocentesis for prenatal diagnosis of genetic disorders.Methods: This was a descriptive study, conducted at fetal medicine center, Family Care Foundation, Dhaka, Bangladesh from June 2014 to December 2019. A total of 350 pregnant women had undergone 15-20 week’s transabdominal amniocentesis under real-time ultrasound guidance. A 23 gm/ 88 mm spinal needle was used. The needle was passed though the maternal abdomen into the amniotic cavity in its longitudinal direction. Once the needle was adequately placed, the amniotic fluid is aspirated with a suction force through a 20 cc syringe. All amniocentesis was performed with “two operators” technique.Results: A total of 350 Amniocentesis were done. Beta thalassemia was most common (79.7%). Followed by aneuploidy (10.2%), hemophilia (6.2%), SMA (2.0%), DMD (1.7%), hematoma (7%), intra amniotic bleeding (2%) and per vaginal bleeding (2.8%). 3.7% aspiration was difficult due to fibroid and retroverted uterus. The overall aspiration success rate was 100%.Conclusions: Second trimester transabdominal amniocentesis in an outdoor setting with the help of real-time sonography is a safe procedure with no significant risk to the mother and the fetus

Grain yield performance, correlation, and cluster analysis in elite bread wheat (Triticum aestivum L.) lines

Wheat is a leading cereal, playing a crucial role in feeding the hungry world and improving global food security. The present study was undertaken to comparatively analyze the extent of genetic diversity for various quantitative traits among the wheat material exotic to Pakistan, received from CIMMYT (The International Maize and Wheat Improvement Center), Mexico. Nineteen advanced lines from the Semi-Arid Wheat Yield Trial (SAWYT) were studied along with a local cultivar, considered a control (NIA-Amber). Data were recorded on nine important agro-morphic traits. The compared genotypes differed significantly (p ≤ 0.05) in the studied traits, where line V6 produced the highest mean grain yield (6,049 kg ha−1) and maximum 1,000-grain weight (45.0 g). Other lines, V19, V17, and V2, also showed superiority in yield (5,723, 5,150, and 5,067 kg ha−1, respectively). Days to heading established a significant positive association with days to maturity (r = 0.7995), plant height (r = 0.3168), spike length (r = 0.2696), and spikelets per spike (r = 0.4391). The important yield associated trait, 1,000-grain weight, had a highly significant positive correlation (r = 0.6833) with grain yield. Cluster analysis for various quantitative traits showed important information about genetic diversity for the studied traits among wheat genotypes. Hence, selection of genotypes for higher grain yield based on these traits could be useful for future breeding

'I once wore an angry bird t-shirt and went to read Qur’an': asymmetrical institutional complexity and emerging consumption practices in Pakistan

This article brings together theories of institutional logics and the exploration of the lives of tweens in Pakistan to understand how emerging consumption practices fit within Pakistani children’s daily lives, and how institutional complexity that includes the dominance of religion under Pakistani Islamization is negotiated to separate and maintain the differences between them. We identify resolutions to asymmetrical institutional complexity in the consumption of character T-shirts: spatial–temporal practices, visual practices, symbolic substitution practices and single logic practices. We contribute to an understanding of how consumption happens in an Eastern Muslim culture, and how multiple institutional logics shape the consumption practices of children, by articulating how halal consumption practices, far from being essentialist, or presented as market segmentation, form from negotiations and reflections at the boundaries where Islam and Market logics meet

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Antithrombotic therapy in patients with atrial fibrillation and coronary artery disease

Atrial fibrillation and coronary artery disease are commonly coexisting conditions that necessitate the use of an oral anticoagulant as well as dual antiplatelet therapy. Commonly referred to as triple oral antithrombotic therapy (TT), this helps prevent ischemic stroke and myocardial infarction but comes at the expense of an increased risk of bleeding. There is a growing body of evidence that the omission of aspirin from TT has the same preventive efficacy in terms of major adverse cardiacvascular and cerebrovascular events (MACCE) with significantly lower bleeding events. The combination of antiplatelet agents and direct oral anticoagulants (DOAC) is a matter of ongoing research. However, initial studies showed favorable safety profile of DOAC over vitamin K antagonist in combination with antiplatelet agents

The Influence of The Principle's Leadership Style and Achievement Motivation on Teachers' Work Effectiveness

Principal leadership has an important role in running educational institutions. The principal is not only a manager but also a role model for members of the organization through a good leadership model or style. This research looks for gaps in previous research that have not been researched. Apart from that, this research aims to find out and analyze the influence of leadership style on teacher work effectiveness, secondly, analyze the influence of achievement motivation on teacher work effectiveness and analyze the principal's leadership style and achievement motivation on effectiveness. teacher work simultaneously. This type of research is quantitative research with a survey method with a population and sample of 33 people, in selecting the sample using non-probability sampling with the census method. The data used is primary data obtained through questionnaires which were distributed and filled in directly by the respondents and it was obtained that partial and simultaneous research results showed that leadership style and achievement motivation had a positive and significant influence on teacher work effectiveness