Dynamic and fault tolerant three-dimensional cellular genetic algorithms

In the area of artificial intelligence, the development of Evolutionary Algorithms (EAs) has been very active, especially in the last decade. These algorithms started to evolve when scientists from various regions of the world applied the principles of evolution to algorithmic search and problem solving. EAs have been utilised successfully in diverse complex application areas. Their success in tackling hard problems has been the engine of the field of Evolutionary Computation (EC). Nowadays, EAs are considered to be the best solution to use when facing a hard search or optimisation problem. Various improvements are continually being made with the design of new operators, hybrid models, among others. A very important example of such improvements is the use of parallel models of GAs (PGAs). PGAs have received widespread attention from various researchers as they have proved to be more effective than panmictic GAs, especially in terms of efficacy and speedup. This thesis focuses on, and investigates, cellular Genetic Algorithms (cGAs)-a competitive variant of parallel GAs. In a cGA, the tentative solutions evolve in overlapped neighbourhoods, allowing smooth diffusion of the solutions. The benefits derived from using cGAs come not only from flexibility gains and their fitness to the objective target in combination with a robust behaviour but also from their high performance and amenability to implementation using advanced custom silicon chip technologies. Nowadays, cGAs are considered as adaptable concepts for solving problems, especially complex optimisation problems. Due to their structural characteristics, cGAs are able to promote an adequate exploration/exploitation trade-off and thus maintain genetic diversity. Moreover, cGAs are characterised as being massively parallel and easy to implement. The structural characteristics inherited in a cGA provide an active area for investigation. Because of the vital role grid structure plays in determining the effectiveness of the algorithm, cellular dimensionality is the main issue to be investigated here. The implementation of cGAs is commonly carried out on a one- or two-dimensional structure. Studies that investigate higher cellular dimensions are lacking. Accordingly, this research focuses on cGAs that are implemented on a three-dimensional structure. Having a structure with three dimensions, specifically a cubic structure, facilitates faster spreading of solutions due to the shorter radius and denser neighbourhood that result from the vertical expansion of cells. In this thesis, a comparative study of cellular dimensionality is conducted. Simulation results demonstrate higher performance achieved by 3D-cGAs over their 2D-cGAs counterparts. The direct implementation of 3D-cGAs on the new advanced 3D-IC technology will provide added benefits such as higher performance combined with a reduction in interconnection delays, routing length, and power consumption. The maintenance of system reliability and availability is a major concern that must be addressed. A system is likely to fail due to either hard or soft errors. Therefore, detecting a fault before it deteriorates system performance is a crucial issue. Single Event Upsets (SEUs), or soft errors, do not cause permanent damage to system functionality, and can be handled using fault-tolerant techniques. Existing fault-tolerant techniques include hardware or software fault tolerance, or a combination of both. In this thesis, fault-tolerant techniques that mitigate SEUs at the algorithmic level are explored and the inherent abilities of cGAs to deal with these errors are investigated. A fault-tolerant technique and several mitigation techniques are also proposed, and faulty critical data are evaluated critical fault scenarios (stuck at ‘1’ and stuck at ‘0’ faults) are taken into consideration. Chief among several test and real world problems is the problem of determining the attitude of a vehicle using a Global Positioning System (GPS), which is an example of hard real-time application. Results illustrate the ability of cGAs to maintain their functionality and give an adequate performance even with the existence of up to 40% errors in fitness score cells. The final aspect investigated in this thesis is the dynamic characteristic of cGAs. cGAs, and EAs in general, are known to be stochastic search techniques. Hence, adaptive systems are required to continue to perform effectively in a changing environment, particularly when tackling real-world problems. The adaptation in cellular engines is mainly achieved through dynamic balancing between exploration and exploitation. This area has received considerable attention from researchers who focus on improving the algorithmic performance without incurring additional computational effort. The structural properties and the genetic operations provide ways to control selection pressure and, as a result, the exploration/exploitation trade-off. In this thesis, the genetic operations of cGAs, particularly the selection aspect and their influence on the search process, are investigated in order to dynamically control the exploration/exploitation trade-off. Two adaptive-dynamic techniques that use genetic diversity and convergence speeds to guide the search are proposed. Results obtained by evaluating the proposed approaches on a test bench of diverse-characteristic real-world and test problems showed improvement in dynamic cGAs performance over their static counterparts and other dynamic cGAs. For example, the proposed Diversity-Guided 3D-cGA outperformed all the other dynamic cGAs evaluated by obtaining a higher search success rate that reached to 55%

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research