This study presents the K-means clustering-based grey wolf optimizer, a new algorithm intended to improve the optimization capabilities of the conventional grey wolf optimizer in order to address the problem of data clustering. The process that groups similar items within a dataset into non-overlapping groups. Grey wolf hunting behaviour served as the model for grey wolf optimizer, however, it frequently lacks the exploration and exploitation capabilities that are essential for efficient data clustering. This work mainly focuses on enhancing the grey wolf optimizer using a new weight factor and the K-means algorithm concepts in order to increase variety and avoid premature convergence. Using a partitional clustering-inspired fitness function, the K-means clustering-based grey wolf optimizer was extensively evaluated on ten numerical functions and multiple real-world datasets with varying levels of complexity and dimensionality. The methodology is based on incorporating the K-means algorithm concept for the purpose of refining initial solutions and adding a weight factor to increase the diversity of solutions during the optimization phase. The results show that the K-means clustering-based grey wolf optimizer performs much better than the standard grey wolf optimizer in discovering optimal clustering solutions, indicating a higher capacity for effective exploration and exploitation of the solution space. The study found that the K-means clustering-based grey wolf optimizer was able to produce high-quality cluster centres in fewer iterations, demonstrating its efficacy and efficiency on various datasets. Finally, the study demonstrates the robustness and dependability of the K-means clustering-based grey wolf optimizer in resolving data clustering issues, which represents a significant advancement over conventional techniques. In addition to addressing the shortcomings of the initial algorithm, the incorporation of K-means and the innovative weight factor into the grey wolf optimizer establishes a new standard for further study in metaheuristic clustering algorithms. The performance of the K-means clustering-based grey wolf optimizer is around 34% better than the original grey wolf optimizer algorithm for both numerical test problems and data clustering problems.
The article Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update, written by [Shiv Sarin], was originally published electronically on the publisher's internet portal (currently SpringerLink) on June 06, 2019 without open access.
The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the "APASL ACLF Research Consortium (AARC)" was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the 'Golden Therapeutic Window', extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information and areas requiring future studies are presented here.