The Seville Expert Workshop for Progress in Posttransplant Lymphoproliferative Disorders

Posttransplant lymphoproliferative disorders (PTLDs) are associated with significant morbidity and mortality among solid-organ transplant patients, but approaches to diagnosis and management vary considerably. An international multidisciplinary panel evaluated current understanding of risk factors and classification systems and developed recommendations to aid in PTLD prevention. We considered evidence on PTLD risk factors including Epstein- Barr virus serostatus and immunosuppression and identified knowledge gaps for future research. Recommendations address prophylactic and preemptive strategies to minimize PTLD development, including modulation of immunosuppression and antiviral drug regimens. Finally, new classification criteria were outlined that may help facilitate standardized reporting and improve our understanding of PTLD.

A New Subgeneric Classification of Rhipsalis (Cactoideae, Cactaceae)

Most Cactaceae have succulent stems and inhabit dry or arid areas, but some are epiphytes of humid regions. Rhipsalis is the largest genus of epiphytic cacti. Species of Rhipsalis are notoriously difficult to identify, and the subgeneric classification of the genus has remained controversial. Between 1837 and 1995, eight different subgeneric classifications have been proposed for Rhipsalis. The most comprehensive taxonomic treatment of the genus recognized five subgenera, Phyllarthrorhipsalis, Rhipsalis, Epallagogonium, Calamorhipsalis, and Erythrorhipsalis, characterized mainly by stem morphology. Here, molecular phylogenetic information combined with morphological data is used to re-evaluate the former subgeneric classifications proposed for the genus. Three monophyletic subgenera are recognized, Rhipsalis, Calamorhipsalis and Erythrorhipsalis, which are mainly characterized by floral traits. The changes proposed include expanding the circumscription of Rhipsalis by the inclusion of species previously included in Phyllarthrorhipsalis and Epallagogoniwn and recognizing a broader Calamorhipsalis, also including species from subgenus Epallagogonium. The circumscription of Erythrorhipsalis remains unchanged. For each subgenus a list of synonyms, a brief description and a list of species included are presented. A key for the identification of subgenera is also provided.

Classification of the severity of diabetic neuropathy: a new approach taking uncertainties into account using fuzzy logic

OBJECTIVE: This study proposes a new approach that considers uncertainty in predicting and quantifying the presence and severity of diabetic peripheral neuropathy. METHODS: A rule-based fuzzy expert system was designed by four experts in diabetic neuropathy. The model variables were used to classify neuropathy in diabetic patients, defining it as mild, moderate, or severe. System performance was evaluated by means of the Kappa agreement measure, comparing the results of the model with those generated by the experts in an assessment of 50 patients. Accuracy was evaluated by an ROC curve analysis obtained based on 50 other cases; the results of those clinical assessments were considered to be the gold standard. RESULTS: According to the Kappa analysis, the model was in moderate agreement with expert opinions. The ROC analysis (evaluation of accuracy) determined an area under the curve equal to 0.91, demonstrating very good consistency in classifying patients with diabetic neuropathy. CONCLUSION: The model efficiently classified diabetic patients with different degrees of neuropathy severity. In addition, the model provides a way to quantify diabetic neuropathy severity and allows a more accurate patient condition assessment.

A NEW GENUS AND SPECIES OF CAMAENID FROM THE AMAZON RAINFOREST, BRAZIL (PULMONATA, HELICOIDEA)

Olympus nimbus, new genus and species, is described for the Amazon Rainforest, collected at Neblina Peak, Amazonas, Brazil. The taxon is clearly related to the camaenid genus Solaropsis because of conchological and anatomical attributes. However, the new taxon differs from its allies mainly in its smaller size (about 15 mm), its tall spire (almost as tall as wide), its narrow umbilicus, in lacking a bursa copulatrix diverticulum and a clear penial epiphallus, and by its complex internal penial organization. This paper also discusses the state of current knowledge of the South American Camaenidae.

Exhaled Acetone as a New Biomarker of Heart Failure Severity

Background: Heart failure (HF) is associated with poor prognosis, and the identification of biomarkers of its severity could help in its treatment. In a pilot study, we observed high levels of acetone in the exhaled breath of patients with HF. The present study was designed to evaluate exhaled acetone as a biomarker of HF diagnosis and HF severity. Methods: Of 235 patients with systolic dysfunction evaluated between May 2009 and September 2010, 89 patients (HF group) fulfilled inclusion criteria and were compared with sex- and age-matched healthy subjects (control group, n = 20). Patients with HF were grouped according to clinical stability (acute decompensated HF [ADHF], n = 59; chronic HF, n = 30) and submitted to exhaled breath collection. Identification of chemical species was done by gas chromatography-mass spectrometry and quantification by spectrophotometry. Patients with diabetes were excluded. Results: The concentration of exhaled breath acetone (EBA) was higher in the HF group (median, 3.7 mu g/L; interquartile range [IQR], 1.69-10.45 mu g/L) than in the control group (median, 0.39 mu g/L; IQR, 0.30-0.79 mu g/L; P < .001) and higher in the ADHF group (median, 7.8 mu g/L; IQR, 3.6-15.2 mu g/L) than in the chronic HF group (median, 1.22 mu g/L; IQR, 0.68-2.19 P < .001). The accuracy and sensitivity of this method in the diagnosis of HF and ADHF were about 85%, a value similar to that obtained with B-type natriuretic peptide (BNP). EBA levels differed significantly as a function of severity of HF (New York Heart Association classification, P < .001). There was a positive correlation between EBA and BNP (r = 0.772, P < .001). Conclusions: EBA not only is a promising noninvasive diagnostic method of HF with an accuracy equivalent to BNP but also a new biomarker of HF severity. CHEST 2012; 142(2):457-466

Mannheimsia Beyer (Diptera: Phoridae): description of a new species, redescription of Mannheimsia stricta and studies on hypopygial morphology

Mannheimsia conica, sp. nov., is described, M. stricta redescribed and the hypopygial morphology including the phallus of all four Mannheimsia species is illustrated and discussed. A table with the different phallus terminology used in the main studies of this structure in Phoridae is presented. Uniformization of phallus terminology is suggested.

Complex network classification using partially self-avoiding deterministic walks

Complex networks have attracted increasing interest from various fields of science. It has been demonstrated that each complex network model presents specific topological structures which characterize its connectivity and dynamics. Complex network classification relies on the use of representative measurements that describe topological structures. Although there are a large number of measurements, most of them are correlated. To overcome this limitation, this paper presents a new measurement for complex network classification based on partially self-avoiding walks. We validate the measurement on a data set composed by 40000 complex networks of four well-known models. Our results indicate that the proposed measurement improves correct classification of networks compared to the traditional ones. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4737515]

Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas

Mutations in the critical chromatin modifier ATRX and mutations in CIC and FUBP1, which are potent regulators of cell growth, have been discovered in specific subtypes of gliomas, the most common type of primary malignant brain tumors. However, the frequency of these mutations in many subtypes of gliomas, and their association with clinical features of the patients, is poorly understood. Here we analyzed these loci in 363 brain tumors. ATRX is frequently mutated in grade II-III astrocytomas (71%), oligoastrocytomas (68%), and secondary glioblastomas (57%), and ATRX mutations are associated with IDH1 mutations and with an alternative lengthening of telomeres phenotype. CIC and FUBP1 mutations occurred frequently in oligodendrogliomas (46% and 24%, respectively) but rarely in astrocytomas or oligoastrocytomas (<10%). This analysis allowed us to define two highly recurrent genetic signatures in gliomas: IDH1/ATRX (I-A) and IDH1/CIC/FUBP1 (I-CF). Patients with I-CF gliomas had a significantly longer median overall survival (96 months) than patients with I-A gliomas (51 months) and patients with gliomas that did not harbor either signature (13 months). The genetic signatures distinguished clinically distinct groups of oligoastrocytoma patients, which usually present a diagnostic challenge, and were associated with differences in clinical outcome even among individual tumor types. In addition to providing new clues about the genetic alterations underlying gliomas, the results have immediate clinical implications, providing a tripartite genetic signature that can serve as a useful adjunct to conventional glioma classification that may aid in prognosis, treatment selection, and therapeutic trial design.

Remarks on the classification of a pair of commuting semilinear operators

Gelfand and Ponomarev [I.M. Gelfand, V.A. Ponomarev, Remarks on the classification of a pair of commuting linear transformations in a finite dimensional vector space, Funct. Anal. Appl. 3 (1969) 325-326] proved that the problem of classifying pairs of commuting linear operators contains the problem of classifying k-tuples of linear operators for any k. We prove an analogous statement for semilinear operators. (C) 2011 Elsevier Inc. All rights reserved.

Using Machine Learning Classifiers to Assist Healthcare-Related Decisions: Classification of Electronic Patient Records

Surveillance Levels (SLs) are categories for medical patients (used in Brazil) that represent different types of medical recommendations. SLs are defined according to risk factors and the medical and developmental history of patients. Each SL is associated with specific educational and clinical measures. The objective of the present paper was to verify computer-aided, automatic assignment of SLs. The present paper proposes a computer-aided approach for automatic recommendation of SLs. The approach is based on the classification of information from patient electronic records. For this purpose, a software architecture composed of three layers was developed. The architecture is formed by a classification layer that includes a linguistic module and machine learning classification modules. The classification layer allows for the use of different classification methods, including the use of preprocessed, normalized language data drawn from the linguistic module. We report the verification and validation of the software architecture in a Brazilian pediatric healthcare institution. The results indicate that selection of attributes can have a great effect on the performance of the system. Nonetheless, our automatic recommendation of surveillance level can still benefit from improvements in processing procedures when the linguistic module is applied prior to classification. Results from our efforts can be applied to different types of medical systems. The results of systems supported by the framework presented in this paper may be used by healthcare and governmental institutions to improve healthcare services in terms of establishing preventive measures and alerting authorities about the possibility of an epidemic.

A NEW AND THREATENED INSULAR SPECIES OF LANCEHEAD FROM SOUTHEASTERN BRAZIL

We describe a new species of Bothrops from Vitoria Island, off the coast of Sao Paulo, southeastern Brazil. The new species differs from the mainland coastal populations of B. jararaca mostly in its smaller and stouter body, number and form of scales, and hemipenial morphology. From B. insularis and B. alcatraz, both related species endemic to islands in southeastern Brazil, B. otavioi sp. nov. differs mainly in its body form and number of scales. The new species has the twist common mitochondrial haplotype for mainland populations of B. jararaca, which is also found in B. alcatraz. A mitochondrial genealogy (gene tree) shows the new species nested within the northern clade of B. jararaca. This genealogical pattern can be explained by a recent speciation event for B. otavioi sp. nov. The isolation of insular species of Bothrops from continental ancestor populations are probably related to the same vicariant process, the oscillations of sea level during the Pleistocene. The new species feeds on small hylid frogs, and attains sexual maturity at 388 mm snout-vent length (SVL; males) and 692 mm SVL (females). Bothrops facial sp. nov. is endemic to Vitoria Island, and should be listed as critically endangered because it is known from only a single area (an island), its geographic range covers less than 100 km(2), and there is a projected continuing decline in the quality of its habitat because of increasing human settlement.

A New Species of Evandromyia (Diptera: Psychodidae: Phlebotominae) From Minas Gerais State, Brazil

A new species of phlebotomine sand fly found in Minas Gerais state, Brazil, is described and illustrated based on male and female morphological characteristics. The new species belongs to the rupicola series within the subgenus Evandromyia Mangabeira. Both sexes are morphologically close to Evandromyia rupicola (Martins, Godoy & Silva) and Evandromyia grimaldii Andrade Filho, Pinto, Santos & Carvalho and the characteristics for their classification are here presented.

New Insights on Nontechnical Losses Characterization Through Evolutionary-Based Feature Selection

Although nontechnical losses automatic identification has been massively studied, the problem of selecting the most representative features in order to boost the identification accuracy and to characterize possible illegal consumers has not attracted much attention in this context. In this paper, we focus on this problem by reviewing three evolutionary-based techniques for feature selection, and we also introduce one of them in this context. The results demonstrated that selecting the most representative features can improve a lot of the classification accuracy of possible frauds in datasets composed by industrial and commercial profiles.

Hierarchical multi-label classification using local neural networks

Hierarchical multi-label classification is a complex classification task where the classes involved in the problem are hierarchically structured and each example may simultaneously belong to more than one class in each hierarchical level. In this paper, we extend our previous works, where we investigated a new local-based classification method that incrementally trains a multi-layer perceptron for each level of the classification hierarchy. Predictions made by a neural network in a given level are used as inputs to the neural network responsible for the prediction in the next level. We compare the proposed method with one state-of-the-art decision-tree induction method and two decision-tree induction methods, using several hierarchical multi-label classification datasets. We perform a thorough experimental analysis, showing that our method obtains competitive results to a robust global method regarding both precision and recall evaluation measures.