Missing Value Imputation Using Stratified Supervised Learning for Cardiovascular Data

Legacy (and current) medical datasets are rich source of information and knowledge. However, the use of most legacy medical datasets is beset with problems. One of the most often faced is the problem of missing data, often due to oversights in data capture or data entry procedures. Algorithms commonly used in the analysis of data often depend on a complete data set. Missing value imputation offers a solution to this problem. This may result in the generation of synthetic data, with artificially induced missing values, but simply removing the incomplete data records often produces the best classifier results. With legacy data, simply removing the records from the original datasets can significantly reduce the data volume and often affect the class balance of the dataset. A suitable method for missing value imputation is very much needed to produce good quality datasets for better analysing data resulting from clinical trials. This paper proposes a framework for missing value imputation using stratified machine learning methods. We explore machine learning technique to predict missing value for incomplete clinical (cardiovascular) data, with experiments comparing this with other standard methods. Two machine learning (classifier) algorithms, fuzzy unordered rule induction algorithm and decision tree, plus other machine learning algorithms (for comparison purposes) are used to train on complete data and subsequently predict missing values for incomplete data. The complete datasets are classified using decision tree, neural network, K-NN and K-Mean clustering. The classification performances are evaluated using sensitivity, specificity, accuracy, positive predictive value and negative predictive value. The results show that final classifier performance can be significantly improved for all class labels when stratification was used with fuzzy unordered rule induction algorithm to predict missing attribute values

Multiprocessor task scheduling in multistage hyrid flowshops: a genetic algorithm approach

This paper considers multiprocessor task scheduling in a multistage hybrid flow-shop environment. The objective is to minimize the make-span, that is, the completion time of all the tasks in the last stage. This problem is of practical interest in the textile and process industries. A genetic algorithm (GA) is developed to solve the problem. The GA is tested against a lower bound from the literature as well as against heuristic rules on a test bed comprising 400 problems with up to 100 jobs, 10 stages, and with up to five processors on each stage. For small problems, solutions found by the GA are compared to optimal solutions, which are obtained by total enumeration. For larger problems, optimum solutions are estimated by a statistical prediction technique. Computational results show that the GA is both effective and efficient for the current problem. Test problems are provided in a web site at www.benchmark.ibu.edu.tr/mpt-h; fsp

Abundance and exploitation rate of the blue crab (Callinectes sapidus) in Chesapeake Bay

We estimated absolute abundance of the blue crab stock in Chesapeake Bay during winter from stratified random surveys conducted baywide from 1990 to 1999, using the swept-area method. We estimated catching efficiency of the survey gear from multiple depletion experiments to correct for temporal and vessel/area differences in catchability. The survey was conducted during the winter, when crabs are dormant and buried in the bottom. Analysis of crab carapace width (CW) frequency distributions revealed two size modes: CW less or equal 60 mm and CW greater than 60 mm, corresponding to age-0 (recruits) and age-1+ (one year and older), respectively. Absolute density of blue crab recruits varied from 10 to 55 crabs per 1,000 m(2) across years (95 million to 540 million baywide), with no significant trends over time. Abundance of age-1 + crabs declined significantly from 35 to 38 crabs per I 000 m(2) in 1990-1991 (342 million to 371 million crabs baywide) to 8.3 in 1999 (92 million crabs baywide). A stronger decline in the number of males indicates that males were exploited more intensively than females. A three-year moving average of spawning stock abundance (age- 1+ females) declined twofold from the early to the late 1990s. The absolute abundance of the blue crab population in Chesapeake Bay varied from 241 million to 867 million. Over-wintering mortality was usually less than 2%, but substantially higher mortality occurred in 1994 (7.3%) and 1996 (11.9%). High correlation between January water temperature and the percentage of dead crabs provides strong evidence of the adverse effect of cold winter on survival of crabs. Large crabs were affected most by cold winter temperatures. We estimated exploitation rates for the commercial fishery by comparing abundance with total landings. The estimated exploitation rates varied from 40% to 52% from 1990 to 1998 and increased to a record high of 70% in 1999. Fishing mortality rates varied from 0.6 to 0.9 year(-1) ill most years and were above the level providing maximum yield per recruit (F-max = 0.64 year(-1)) in nearly all years. The record fishing mortality in 1999 (F-1999, = 1.6 year(-1)) exceeded the overfishing threshold (F-10% = 1.0 year(-1)). Despite evidence of growth overfishing, the blue crab population supported large harvests throughout the 1990s. Increase of fishing mortality above the F-10% in 1999, indicates that the population was overfished and is at risk of recruitment overfishing if fishing mortality remains at this level

Pruritus is a common feature in sheep infected with the BSE agent.

BACKGROUND: The variability in the clinical or pathological presentation of transmissible spongiform encephalopathies (TSEs) in sheep, such as scrapie and bovine spongiform encephalopathy (BSE), has been attributed to prion protein genotype, strain, breed, clinical duration, dose, route and type of inoculum and the age at infection. The study aimed to describe the clinical signs in sheep infected with the BSE agent throughout its clinical course to determine whether the clinical signs were as variable as described for classical scrapie in sheep. The clinical signs were compared to BSE-negative sheep to assess if disease-specific clinical markers exist. RESULTS: Forty-seven (34%) of 139 sheep, which comprised 123 challenged sheep and 16 undosed controls, were positive for BSE. Affected sheep belonged to five different breeds and three different genotypes (ARQ/ARQ, VRQ/VRQ and AHQ/AHQ). None of the controls or BSE exposed sheep with ARR alleles were positive. Pruritus was present in 41 (87%) BSE positive sheep; the remaining six were judged to be pre-clinically infected. Testing of the response to scratching along the dorsum of a sheep proved to be a good indicator of clinical disease with a test sensitivity of 85% and specificity of 98% and usually coincided with weight loss. Clinical signs that were displayed significantly earlier in BSE positive cases compared to negative cases were behavioural changes, pruritic behaviour, a positive scratch test, alopecia, skin lesions, teeth grinding, tremor, ataxia, loss of weight and loss of body condition. The frequency and severity of each specific clinical sign usually increased with the progression of disease over a period of 16-20 weeks. CONCLUSION: Our results suggest that BSE in sheep presents with relatively uniform clinical signs, with pruritus of increased severity and abnormalities in behaviour or movement as the disease progressed. Based on the studied sheep, these clinical features appear to be independent of breed, affected genotype, dose, route of inoculation and whether BSE was passed into sheep from cattle or from other sheep, suggesting that the clinical phenotype of BSE is influenced by the TSE strain more than by other factors. The clinical phenotype of BSE in the genotypes and breed studied was indistinguishable from that described for classical scrapie cases

Marine Macroalgal Diversity Assessment of Saba Bank, Netherlands Antilles

Background: Located in the Dutch Windward Islands, Saba Bank is a flat-topped seamount (20–45 m deep in the shallower regions). The primary goals of the survey were to improve knowledge of biodiversity for one of the world’s most significant, but little-known, seamounts and to increase basic data and analyses to promote the development of an improved management plan. Methodology/Principal Findings: Our team of three divers used scuba to collect algal samples to depths of 50 m at 17 dive sites. Over 360 macrophyte specimens (12 putative new species) were collected, more than 1,000 photographs were taken in truly exceptional habitats, and three astonishing new seaweed community types were discovered. These included: (1) ‘‘Field of Greens’ ’ (N 17u30.6209, W63u27.7079) dominated by green seaweeds as well as some filamentous reds, (2) ‘‘Brown Town’ ’ (N 17u28.0279, W63u14.9449) dominated by large brown algae, and (3) ‘‘Seaweed City’ ’ (N 17u26.4859, W63u16.8509) with a diversity of spectacular fleshy red algae. Conclusions/Significance: Dives to 30 m in the more two-dimensional interior habitats revealed particularly robust specimens of algae typical of shallower seagrass beds, but here in the total absence of any seagrasses (seagrasses generally do not grow below 20 m). Our preliminary estimate of the number of total seaweed species on Saba Bank ranges from a minimum of 150 to 200. Few filamentous and thin sheet forms indicative of stressed or physically disturbed environments were observed. A more precise number still awaits further microscopic and molecular examinations in the laboratory. The expedition, while intensive, has only scratched the surface of this unique submerged seamount/atoll

Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame.

The polio eradication endgame aims to bring transmission of all polioviruses to a halt. To achieve this aim, it is essential to block viral replication in individuals via induction of a robust mucosal immune response. Although it has long been recognized that inactivated poliovirus vaccine (IPV) is incapable of inducing a strong mucosal response on its own, it has recently become clear that IPV may boost immunity in the intestinal mucosa among individuals previously immunized with oral poliovirus vaccine. Indeed, mucosal protection appears to be stronger following a booster dose of IPV than oral poliovirus vaccine, especially in older children. Here, we review the available evidence regarding the impact of IPV on mucosal immunity, and consider the implications of this evidence for the polio eradication endgame. We conclude that the implementation of IPV in both routine and supplementary immunization activities has the potential to play a key role in halting poliovirus transmission, and thereby hasten the eradication of polio

Successful C1 inhibitor short-term prophylaxis during redo mitral valve replacement in a patient with hereditary angioedema

Hereditary angioedema is characterized by sudden episodes of nonpitting edema that cause discomfort and pain. Typically the extremities, genitalia, trunk, gastrointestinal tract, face, and larynx are affected by attacks of swelling. Laryngeal swelling carries significant risk for asphyxiation. The disease results from mutations in the C1 esterase inhibitor gene that cause C1 esterase inhibitor deficiency. Attacks of hereditary angioedema result from contact, complement, and fibrinolytic plasma cascade activation, where C1 esterase inhibitor irreversibly binds substrates. Patients with hereditary angioedema cannot replenish C1 esterase inhibitor levels on pace with its binding. When C1 esterase inhibitor is depleted in these patients, vasoactive plasma cascade products cause swelling attacks. Trauma is a known trigger for hereditary angioedema attacks, and patients have been denied surgical procedures because of this risk. However, uncomplicated surgeries have been reported. Appropriate prophylaxis can reduce peri-operative morbidity in these patients, despite proteolytic cascade and complement activation during surgical trauma. We report a case of successful short-term prophylaxis with C1 esterase inhibitor in a 51-year-old man with hereditary angioedema who underwent redo mitral valve reconstructive surgery

Impact of the introduction of pneumococcal conjugate vaccine on immunization coverage among infants

Background The introduction of pneumococcal conjugate vaccine (PCV) to the U.S. recommended childhood immunization schedule in the year 2000 added three injections to the number of vaccinations a child is expected to receive during the first year of life. Surveys have suggested that the addition of PCV has led some immunization providers to move other routine childhood vaccinations to later ages, which could increase the possibility of missing these vaccines. The purpose of this study was to evaluate whether introduction of PCV affected immunization coverage for recommended childhood vaccinations among 13-month olds in four large provider groups. Methods In this retrospective cohort study, we analyzed computerized data on vaccinations for 33,319 children in four large provider groups before and after the introduction of PCV. The primary outcome was whether the child was up to date for all non-PCV recommended vaccinations at 13 months of age. Logistic regression was used to evaluate the association between PCV introduction and the primary outcome. The secondary outcome was the number of days spent underimmunized by 13 months. The association between PCV introduction and the secondary outcome was evaluated using a two-part modelling approach using logistic and negative binomial regression. Results Overall, 93% of children were up-to-date at 13 months, and 70% received all non-PCV vaccinations without any delay. Among the entire study population, immunization coverage was maintained or slightly increased from the pre-PCV to post-PCV periods. After multivariate adjustment, children born after PCV entered routine use were less likely to be up-to-date at 13 months in one provider group (Group C: OR = 0.5; 95% CI: 0.3 – 0.8) and were less likely to have received all vaccine doses without any delay in two Groups (Group B: OR = 0.4, 95% CI: 0.3 – 0.6; Group C: OR = 0.5, 95% CI: 0.4 – 0.7). This represented 3% fewer children in Group C who were up-to-date and 14% (Group C) to 16% (Group B) fewer children who spent no time underimmunized at 13 months after PCV entered routine use compared to the pre-PCV baseline. Some disruptions in immunization delivery were also observed concurrent with temporary recommendations to suspend the birth dose of hepatitis B vaccine, preceding the introduction of PCV. Conclusion These findings suggest that the introduction of PCV did not harm overall immunization coverage rates in populations with good access to primary care. However, we did observe some disruptions in the timely delivery of other vaccines coincident with the introduction of PCV and the suspension of the birth dose of hepatitis B vaccine. This study highlights the need for continued vigilance in coming years as the U.S. introduces new childhood vaccines and policies that may change the timing of existing vaccines