Chaos Embed Marine Predator (CMPA) Algorithm for Feature Selection

Data mining applications are growing with the availability of large data; sometimes, handling large data is also a typical task. Segregation of the data for extracting useful information is inevitable for designing modern technologies. Considering this fact, the work proposes a chaos embed marine predator algorithm (CMPA) for feature selection. The optimization routine is designed with the aim of maximizing the classification accuracy with the optimal number of features selected. The well-known benchmark data sets have been chosen for validating the performance of the proposed algorithm. A comparative analysis of the performance with some well-known algorithms advocates the applicability of the proposed algorithm. Further, the analysis has been extended to some of the well-known chaotic algorithms; first, the binary versions of these algorithms are developed and then the comparative analysis of the performance has been conducted on the basis of mean features selected, classification accuracy obtained and fitness function values. Statistical significance tests have also been conducted to establish the significance of the proposed algorithm

National immunization strategies targeting migrants in six European countries

Over the last three years an unprecedented flow of migrants arrived in Europe. There is evidence that vaccine preventable diseases have caused outbreaks in migrant holding centres. These outbreaks can be favored by a combination of factors including low immunization coverage, bad conditions that migrants face during their exhausting journey and overcrowding within holding facilities. In 2017, we conducted an online survey in Croatia, Greece, Italy, Malta, Portugal and Slovenia to explore the national immunization strategies targeting irregular migrants, refugees and asylum seekers. All countries stated that a national regulation supporting vaccination offer to migrants is available. Croatia, Italy, Portugal and Slovenia offer to migrant children and adolescents all vaccinations included in the National Immunization Plan; Greece and Malta offer only certain vaccinations, including those against diphtheria-tetanus-pertussis, poliomyelitis and measles-mumps-rubella. Croatia, Italy, Malta and Portugal also extend the vaccination offer to adults. All countries deliver vaccinations in holding centres and/or community health services, no one delivers vaccinations at entry site. Operating procedures that guarantee the migrants' access to vaccination at the community level are available only in Portugal. Data on administered vaccines is available at the national level in four countries: individual data in Malta and Croatia, aggregated data in Greece and Portugal. Data on vaccination uptake among migrants is available at national level only in Malta. Concluding, although diversified, strategies for migrant vaccination are in place in all the surveyed countries and generally in line with WHO and ECDC indications. Development of procedures to keep track of migrants' immunization data across countries, development of strategies to facilitate and monitor migrants' access to vaccinations at the community level and collection of data on vaccination uptake among migrants should be promoted to meet existing gaps. The study was conducted in the framework of the CARE (''Common Approach for REfugees and other migrants' health") project (717217/CARE) that received funding from the EU health Programme (2014–2020). info:eu-repo/semantics/publishedVersio

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Politiche e strategie di offerta vaccinale ai migranti nei paesi dell’UE e EEA

Introduzione e obiettivi: I migranti sono considerati un gruppo potenzialmente vulnerabile. I motivi che li hanno spinti a partire, la complessità e la precarietà che caratterizzano il loro percorso migratorio, il sovraffollamento nei centri di accoglienza, insieme alle difficoltà di accesso ai servizi sanitari nei paesi ospitanti, possono peggiorare il loro stato di salute. Parte di loro proviene da paesi in cui i programmi vaccinali non sono completamente garantiti o sono stati interrotti. Inoltre, la documentazione relativa al loro stato immunitario non è generalmente disponibile all’arrivo in Europa perché non è stata portata oppure è stata perduta nel percorso migratorio. In considerazione di questi aspetti, il progetto VENICE (Vaccine European New Integrated Collaboration Effort), coordinato dall’Istituto Superiore di Sanità, in collaborazione con l’ECDC (Europeran Centre for Disease Prevention and Control), ha avviato un’indagine finalizzata a descrivere le politiche e le strategie di offerta vaccinale ai richiedenti asilo, rifugiati e migranti irregolari nei paesi dell’UE/EEA. Metodi/azioni: I dati vengono raccolti attraverso un questionario online, sviluppato attraverso SurveyMonkey, che indaga i seguenti aspetti: leggi e regolamenti che supportano l’offerta vaccinale per i migranti; strategie di immunizzazione previste per bambini/adolescenti e per adulti; modalità di raccolta dei dati relativa all’immunizzazione dei migranti; difficoltà emerse e sfide segnalate dai vari paesi. Dopo una fase ‘pilota’, che ha coinvolto referenti in Italia, Grecia, Malta, Croazia, Slovenia, Portogallo, Germania e Svezia, a gennaio 2018 il questionario è stato inviato ai membri del network VENICE dei 28 paesi dell’UE e di 3 paesi EEA e la raccolta dati è in corso. Risultati: In occasione del Convegno verranno presentate e comparate le politiche e le strategie vaccinali offerte dai paesi partecipanti, con particolare attenzione per quelle rivolte ai minori, tenendo in considerazione i loro diversi sistemi sanitari. Si verificherà inoltre se vi sono differenze tra i paesi considerati di primo arrivo, di transito o di destinazione anche in base al numero di migranti entrati negli ultimi anni. Conclusioni: Considerata la potenziale vulnerabilità della popolazione target, è importante che i paesi cooperino per garantire una offerta che permetta una copertura vaccinale adeguata e completa anche per i migranti che si spostano tra i paesi UE/EEA. La conoscenza delle differenti politiche sanitarie, le loro differenze ed eventuali uniformità, rappresenta una risorsa strategica per migliorare la salute dei migranti. Infine, questa indagine può permettere di identificare aree di difficoltà comuni dove lo sviluppo di linee guida di carattere tecnico a livello Europeo potrà sostenere e complementare gli sforzi a livello nazionale

National immunization strategies targeting migrants in six European countries

Over the last three years an unprecedented flow of migrants arrived in Europe. There is evidence that vaccine preventable diseases have caused outbreaks in migrant holding centres. These outbreaks can be favored by a combination of factors including low immunization coverage, bad conditions that migrants face during their exhausting journey and overcrowding within holding facilities. In 2017, we conducted an online survey in Croatia, Greece, Italy, Malta, Portugal and Slovenia to explore the national immunization strategies targeting irregular migrants, refugees and asylum seekers. All countries stated that a national regulation supporting vaccination offer to migrants is available. Croatia, Italy, Portugal and Slovenia offer to migrant children and adolescents all vaccinations included in the National Immunization Plan; Greece and Malta offer only certain vaccinations, including those against diphtheria-tetanus-pertussis, poliomyelitis and measles-mumps-rubella. Croatia, Italy, Malta and Portugal also extend the vaccination offer to adults. All countries deliver vaccinations in holding centres and/or community health services, no one delivers vaccinations at entry site. Operating procedures that guarantee the migrants' access to vaccination at the community level are available only in Portugal. Data on administered vaccines is available at the national level in four countries: individual data in Malta and Croatia, aggregated data in Greece and Portugal. Data on vaccination uptake among migrants is available at national level only in Malta. Concluding, although diversified, strategies for migrant vaccination are in place in all the surveyed countries and generally in line with WHO and ECDC indications. Development of procedures to keep track of migrants' immunization data across countries, development of strategies to facilitate and monitor migrants' access to vaccinations at the community level and collection of data on vaccination uptake among migrants should be promoted to meet existing gaps. (C) 2018 The Authors. Published by Elsevier Ltd

Does the timing of oral feeding affect the fistulization risk among head and neck cancer patients undergoing free flap reconstruction?

No abstract available

Immunisation of migrants in EWEEA countries: Policies and practices

In recent years various EU/EEA countries have experienced an influx of migrants from low and middle income countries. In 2018, the “Vaccine European New Integrated Collaboration Effort (VENICE)” survey group conducted a survey among 30 EU/EEA countries to investigate immunisation policies and practices targeting irregular migrants, refugees and asylum seekers (later called “migrants” in this report). Twenty-nine countries participated in the survey. Twenty-eight countries reported having national policies targeting children/adolescent and adult migrants, however vaccinations offered to adult migrants are limited to specific conditions in seven countries. All the vaccinations included in the National Immunisation Programme (NIP) are offered to children/adolescents in 27/28 countries and to adults in 13/28 countries. In the 15 countries offering only certain vaccinations to adults, priority is given to diphtheria-tetanus, measles-mumps-rubella and polio vaccinations. Information about the vaccines given to child/adolescent migrants is recorded in 22 countries and to adult migrants in 19 countries with a large variation in recording methods found across countries. Individual and aggregated data are reportedly not shared with other centres/institutions in 13 and 15 countries, respectively. Twenty countries reported not collecting data on vaccination uptake among migrants; only three countries have these data at the national level. Procedures to guarantee migrants’ access to vaccinations at the community level are available in 13 countries. In conclusion, although diversified, strategies for migrant vaccination are in place in all countries except for one, and the strategies are generally in line with international recommendations. Efforts are needed to strengthen partnerships and implement initiatives across countries of origin, transit and destination to develop and better share documentation in order to guarantee a completion of vaccination series and to avoid unnecessary re-vaccination. Development of migrant-friendly strategies to facilitate migrants’ access to vaccination and collection of vaccination uptake data among migrants is needed to meet existing gaps. (C) 2019 The Authors. Published by Elsevier Ltd