Scheduling of routing table calculation schemes in open shortest path first using artificial neural network

Internet topology changes due to events such as router or link goes up and down. Topology changes trigger routing protocol to undergo convergence process which eventually prepares new shortest routes needed for packet delivery. Real-time applications (e.g. VoIP) are increasingly being deployed in internet nowadays and require the routing protocols to have quick convergence times in the range of milliseconds. To speed-up its convergence time and better serve real-time applications, a new routing table calculation scheduling schemes for Interior Gateway Routing Protocol called Open Shortest Path First (OSPF) is proposed in this research. The proposed scheme optimizes the scheduling of OSPF routing table calculations using Artificial Neural Network technique called Generalized Regression Neural Network. The scheme determines the suitable hold time based on three parameters: LSA-inter arrival time, the number of important control message in queue, and the computing utilization of the routers. The GRNN scheme is tested using Scalable Simulation Framework (SSFNet version 2.0) network simulator. Two kind of network topology with several link down scenarios used to test GRNN scheme and existing scheme (fixed hold time scheme). Results shows that GRNN provide faster convergence time compared to the existing scheme

Artificial Neural Network Parameter Tuning Framework For Heart Disease Classification

Heart Disease are among the leading cause of death worldwide. The application of artificial neural network as decision support tool for heart disease detection. However, artificial neural network required multitude of parameter setting in order to find the optimum parameter setting that produce the best performance. This paper proposed the parameter tuning framework for artificial neural network. Statlog heart disease dataset and Cleveland heart disease dataset is used to evaluate the performance of the proposed framework. The results show that the proposed framework able to produce high classification accuracy where the overall classification accuracy for Cleveland dataset is 90.9% and 90% for Statlog dataset

Clinical pathway variance prediction using artificial neural network for acute decompensated heart failure clinical pathway

Patients in modern healthcare demand superior healthcare quality. Clinical pathways are introduced as the main tools to manage this quality. A clinical pathway is a task-oriented care plan that specifies steps to be taken for patient care. It follows the clinical course according to the specific clinical problem. During clinical pathway execution, variance or deviation from the specified care plan could occur, and may endanger the patient’s life. In this paper, a proposed framework for artificial neural networks (ANNs) in clinical pathway variance predictions is presented. This proposed research method predicts the variance that may occur during Acute Decompensated Heart Failure Clinical Pathway. By using the Artificial Neural Network, 3 variances (Dialysis, PCI, and Cardiac Catherization) are predicted from 55 input. The results show that artificial neural networks with the Levenberg-Marquadt training algorithm with a 55-27-27-1 architecture achieve the best prediction rate, with an average prediction accuracy of 87.4425% for the training dataset and 85.255% for the test dataset

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Mortality prediction for acute decompensated heart failure patient using fuzzy neural network

It has been reported that patients admitted with acute decompensated heart failure (ADHF) face high risk of mortality where 30-day mortality rates are reaching 10%. Identifying patient with high and low risk of mortality could improve clinical outcomes and hospital resources allocation. This paper proposed the use of fuzzy neural network to predict mortality for the patient admitted with ADHF. Results show that fuzzy neural network can predict mortality for ADHF patient with good prediction accuracy with overall accuracy of 88.8% for partition 50 and 90.40% for partition 80

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality