Prediction and prevention of psychosis: current progress and future tasks

Prevention of psychoses has been intensively investigated within the past two decades, and particularly, prediction has been much advanced. Depending on the applied risk indicators, current criteria are associated with average, yet significantly heterogeneous transition rates of ≥30 % within 3 years, further increasing with longer follow-up periods. Risk stratification offers a promising approach to advance current prediction as it can help to reduce heterogeneity of transition rates and to identify subgroups with specific needs and response patterns, enabling a targeted intervention. It may also be suitable to improve risk enrichment. Current results suggest the future implementation of multi-step risk algorithms combining sensitive risk detection by cognitive basic symptoms (COGDIS) and ultra-high-risk (UHR) criteria with additional individual risk estimation by a prognostic index that relies on further predictors such as additional clinical indicators, functional impairment, neurocognitive deficits, and EEG and structural MRI abnormalities, but also considers resilience factors. Simply combining COGDIS and UHR criteria in a second step of risk stratification produced already a 4-year hazard rate of 0.66. With regard to prevention, two recent meta-analyses demonstrated that preventive measures enable a reduction in 12-month transition rates by 54-56 % with most favorable numbers needed to treat of 9-10. Unfortunately, psychosocial functioning, another important target of preventive efforts, did not improve. However, these results are based on a relatively small number of trials; and more methodologically sound studies and a stronger consideration of individual profiles of clinical needs by modular intervention programs are required

Evolving biomarkers improve prediction of long-term mortality in patients with stable coronary artery disease: the BIO-VILCAD score.

OBJECTIVE Algorithms to predict the future long-term risk of patients with stable coronary artery disease (CAD) are rare. The VIenna and Ludwigshafen CAD (VILCAD) risk score was one of the first scores specifically tailored for this clinically important patient population. The aim of this study was to refine risk prediction in stable CAD creating a new prediction model encompassing various pathophysiological pathways. Therefore, we assessed the predictive power of 135 novel biomarkers for long-term mortality in patients with stable CAD. DESIGN, SETTING AND SUBJECTS We included 1275 patients with stable CAD from the LUdwigshafen RIsk and Cardiovascular health study with a median follow-up of 9.8 years to investigate whether the predictive power of the VILCAD score could be improved by the addition of novel biomarkers. Additional biomarkers were selected in a bootstrapping procedure based on Cox regression to determine the most informative predictors of mortality. RESULTS The final multivariable model encompassed nine clinical and biochemical markers: age, sex, left ventricular ejection fraction (LVEF), heart rate, N-terminal pro-brain natriuretic peptide, cystatin C, renin, 25OH-vitamin D3 and haemoglobin A1c. The extended VILCAD biomarker score achieved a significantly improved C-statistic (0.78 vs. 0.73; P = 0.035) and net reclassification index (14.9%; P < 0.001) compared to the original VILCAD score. Omitting LVEF, which might not be readily measureable in clinical practice, slightly reduced the accuracy of the new BIO-VILCAD score but still significantly improved risk classification (net reclassification improvement 12.5%; P < 0.001). CONCLUSION The VILCAD biomarker score based on routine parameters complemented by novel biomarkers outperforms previous risk algorithms and allows more accurate classification of patients with stable CAD, enabling physicians to choose more personalized treatment regimens for their patients.

Good reproducibility of heart rate variability after orthostatic challenge in patients with a history of acute coronary syndrome

BACKGROUND: Several parameters of heart rate variability (HRV) have been shown to predict the risk of sudden cardiac death (SCD) in cardiac patients. There is consensus that risk prediction is increased when measuring HRV during specific provocations such as orthostatic challenge. For the first time, we provide data on reproducibility of such a test in patients with a history of acute coronary syndrome. METHODS: Sixty male patients (65+/-8years) with a history of acute coronary syndrome on stable medication were included. HRV was measured in supine (5min) and standing (5min) position on 2 occasions separated by two weeks. For risk assessment relevant time-domain [standard deviation of all R-R intervals (SDNN) and root mean squared standard differences between adjacent R-R intervals (RMSSD)], frequency domain [low-frequency power (LF), high-frequency power (HF) and LF/HF power ratio] and short-term fractal scaling component (DF1) were computed. Absolute reproducibility was assessed with the standard errors of the mean (SEM) and 95% limits of random variation, and relative reproducibility by the intraclass correlation coefficient (ICC). RESULTS: We found comparable SEMs and ICCs in supine position and after an orthostatic challenge test. All ICCs were good to excellent (ICCs between 0.636 and 0.869). CONCLUSIONS: Reproducibility of HRV parameters during orthostatic challenge is good and comparable with supine position.

Automatic Stabilizer Feature of Fixed Exchange Rate Regimes in Emerging Markets

This paper shows that countries characterized by a financial accelerator mechanism may reverse the usual finding of the literature -- flexible exchange rate regimes do a worse job of insulating open economies from external shocks. I obtain this result with a calibrated small open economy model that endogenizes foreign interest rates by linking them to the banking sector's foreign currency leverage. This relationship renders exchange rate policy more important compared to the usual exogeneity assumption. I find empirical support for this prediction using the Local Projections method. Finally, 2nd order approximation to the model finds larger welfare losses under flexible regimes.

Prediction of sepsis in the burn intensive care unit patient

Sepsis is a significant cause for multiple organ failure and death in the burn patient, yet identification in this population is confounded by chronic hypermetabolism and impaired immune function. The purpose of this study was twofold: 1) determine the ability of the systemic inflammatory response syndrome (SIRS) and American Burn Association (ABA) criteria to predict sepsis in the burn patient; and 2) develop a model representing the best combination of clinical predictors associated with sepsis in the same population. A retrospective, case-controlled, within-patient comparison of burn patients admitted to a single intensive care unit (ICU) was conducted for the period January 2005 to September 2010. Blood culture results were paired with clinical condition: "positive-sick"; "negative-sick", and "screening-not sick". Data were collected for the 72 hours prior to each blood culture. The most significant predictors were evaluated using logistic regression, Generalized Estimating Equations (GEE) and ROC area under the curve (AUC) analyses to assess model predictive ability. Bootstrapping methods were employed to evaluate potential model over-fitting. Fifty-nine subjects were included, representing 177 culture periods. SIRS criteria were not found to be associated with culture type, with an average of 98% of subjects meeting criteria in the 3 days prior. ABA sepsis criteria were significantly different among culture type only on the day prior (p = 0.004). The variables identified for the model included: heart rate>130 beats/min, mean blood pressure<60 mmHg, base deficit<-6 mEq/L, temperature>36°C, use of vasoactive medications, and glucose>150 mg/d1. The model was significant in predicting "positive culture-sick" and sepsis state, with AUC of 0.775 (p < 0.001) and 0.714 (p < .001), respectively; comparatively, the ABA criteria AUC was 0.619 (p = 0.028) and 0.597 (p = .035), respectively. SIRS criteria are not appropriate for identifying sepsis in the burn population. The ABA criteria perform better, but only for the day prior to positive blood culture results. The time period useful to diagnose sepsis using clinical criteria may be limited to 24 hours. A combination of predictors is superior to individual variable trends, yet algorithms or computer support will be necessary for the clinician to find such models useful. ^

HF spectrum activity prediction model based on HMM for cognitive radio applications

Although most of the research on Cognitive Radio is focused on communication bands above the HF upper limit (30 MHz), Cognitive Radio principles can also be applied to HF communications to make use of the extremely scarce spectrum more efficiently. In this work we consider legacy users as primary users since these users transmit without resorting to any smart procedure, and our stations using the HFDVL (HF Data+Voice Link) architecture as secondary users. Our goal is to enhance an efficient use of the HF band by detecting the presence of uncoordinated primary users and avoiding collisions with them while transmitting in different HF channels using our broad-band HF transceiver. A model of the primary user activity dynamics in the HF band is developed in this work to make short-term predictions of the sojourn time of a primary user in the band and avoid collisions. It is based on Hidden Markov Models (HMM) which are a powerful tool for modelling stochastic random processes and are trained with real measurements of the 14 MHz band. By using the proposed HMM based model, the prediction model achieves an average 10.3% prediction error rate with one minute-long channel knowledge but it can be reduced when this knowledge is extended: with the previous 8 min knowledge, an average 5.8% prediction error rate is achieved. These results suggest that the resulting activity model for the HF band could actually be used to predict primary users activity and included in a future HF cognitive radio based station.

Latest developments in data analysis tools for disruption prediction and for the exploration of multimachine operational spaces.

In the last years significant efforts have been devoted to the development of advanced data analysis tools to both predict the occurrence of disruptions and to investigate the operational spaces of devices, with the long term goal of advancing the understanding of the physics of these events and to prepare for ITER. On JET the latest generation of the disruption predictor called APODIS has been deployed in the real time network during the last campaigns with the new metallic wall. Even if it was trained only with discharges with the carbon wall, it has reached very good performance, with both missed alarms and false alarms in the order of a few percent (and strategies to improve the performance have already been identified). Since for the optimisation of the mitigation measures, predicting also the type of disruption is considered to be also very important, a new clustering method, based on the geodesic distance on a probabilistic manifold, has been developed. This technique allows automatic classification of an incoming disruption with a success rate of better than 85%. Various other manifold learning tools, particularly Principal Component Analysis and Self Organised Maps, are also producing very interesting results in the comparative analysis of JET and ASDEX Upgrade (AUG) operational spaces, on the route to developing predictors capable of extrapolating from one device to another.

1RM prediction: a data mining case study

In the last few years there has been a heightened interest in data treatment and analysis with the aim of discovering hidden knowledge and eliciting relationships and patterns within this data. Data mining techniques (also known as Knowledge Discovery in Databases) have been applied over a wide range of fields such as marketing, investment, fraud detection, manufacturing, telecommunications and health. In this study, well-known data mining techniques such as artificial neural networks (ANN), genetic programming (GP), forward selection linear regression (LR) and k-means clustering techniques, are proposed to the health and sports community in order to aid with resistance training prescription. Appropriate resistance training prescription is effective for developing fitness, health and for enhancing general quality of life. Resistance exercise intensity is commonly prescribed as a percent of the one repetition maximum. 1RM, dynamic muscular strength, one repetition maximum or one execution maximum, is operationally defined as the heaviest load that can be moved over a specific range of motion, one time and with correct performance. The safety of the 1RM assessment has been questioned as such an enormous effort may lead to muscular injury. Prediction equations could help to tackle the problem of predicting the 1RM from submaximal loads, in order to avoid or at least, reduce the associated risks. We built different models from data on 30 men who performed up to 5 sets to exhaustion at different percentages of the 1RM in the bench press action, until reaching their actual 1RM. Also, a comparison of different existing prediction equations is carried out. The LR model seems to outperform the ANN and GP models for the 1RM prediction in the range between 1 and 10 repetitions. At 75% of the 1RM some subjects (n = 5) could perform 13 repetitions with proper technique in the bench press action, whilst other subjects (n = 20) performed statistically significant (p < 0:05) more repetitions at 70% than at 75% of their actual 1RM in the bench press action. Rate of perceived exertion (RPE) seems not to be a good predictor for 1RM when all the sets are performed until exhaustion, as no significant differences (p < 0:05) were found in the RPE at 75%, 80% and 90% of the 1RM. Also, years of experience and weekly hours of strength training are better correlated to 1RM (p < 0:05) than body weight. O'Connor et al. 1RM prediction equation seems to arise from the data gathered and seems to be the most accurate 1RM prediction equation from those proposed in literature and used in this study. Epley's 1RM prediction equation is reproduced by means of data simulation from 1RM literature equations. Finally, future lines of research are proposed related to the problem of the 1RM prediction by means of genetic algorithms, neural networks and clustering techniques. RESUMEN En los últimos años ha habido un creciente interés en el tratamiento y análisis de datos con el propósito de descubrir relaciones, patrones y conocimiento oculto en los mismos. Las técnicas de data mining (también llamadas de \Descubrimiento de conocimiento en bases de datos\) se han aplicado consistentemente a lo gran de un gran espectro de áreas como el marketing, inversiones, detección de fraude, producción industrial, telecomunicaciones y salud. En este estudio, técnicas bien conocidas de data mining como las redes neuronales artificiales (ANN), programación genética (GP), regresión lineal con selección hacia adelante (LR) y la técnica de clustering k-means, se proponen a la comunidad del deporte y la salud con el objetivo de ayudar con la prescripción del entrenamiento de fuerza. Una apropiada prescripción de entrenamiento de fuerza es efectiva no solo para mejorar el estado de forma general, sino para mejorar la salud e incrementar la calidad de vida. La intensidad en un ejercicio de fuerza se prescribe generalmente como un porcentaje de la repetición máxima. 1RM, fuerza muscular dinámica, una repetición máxima o una ejecución máxima, se define operacionalmente como la carga máxima que puede ser movida en un rango de movimiento específico, una vez y con una técnica correcta. La seguridad de las pruebas de 1RM ha sido cuestionada debido a que el gran esfuerzo requerido para llevarlas a cabo puede derivar en serias lesiones musculares. Las ecuaciones predictivas pueden ayudar a atajar el problema de la predicción de la 1RM con cargas sub-máximas y son empleadas con el propósito de eliminar o al menos, reducir los riesgos asociados. En este estudio, se construyeron distintos modelos a partir de los datos recogidos de 30 hombres que realizaron hasta 5 series al fallo en el ejercicio press de banca a distintos porcentajes de la 1RM, hasta llegar a su 1RM real. También se muestra una comparación de algunas de las distintas ecuaciones de predicción propuestas con anterioridad. El modelo LR parece superar a los modelos ANN y GP para la predicción de la 1RM entre 1 y 10 repeticiones. Al 75% de la 1RM algunos sujetos (n = 5) pudieron realizar 13 repeticiones con una técnica apropiada en el ejercicio press de banca, mientras que otros (n = 20) realizaron significativamente (p < 0:05) más repeticiones al 70% que al 75% de su 1RM en el press de banca. El ínndice de esfuerzo percibido (RPE) parece no ser un buen predictor del 1RM cuando todas las series se realizan al fallo, puesto que no existen diferencias signifiativas (p < 0:05) en el RPE al 75%, 80% y el 90% de la 1RM. Además, los años de experiencia y las horas semanales dedicadas al entrenamiento de fuerza están más correlacionadas con la 1RM (p < 0:05) que el peso corporal. La ecuación de O'Connor et al. parece surgir de los datos recogidos y parece ser la ecuación de predicción de 1RM más precisa de aquellas propuestas en la literatura y empleadas en este estudio. La ecuación de predicción de la 1RM de Epley es reproducida mediante simulación de datos a partir de algunas ecuaciones de predicción de la 1RM propuestas con anterioridad. Finalmente, se proponen futuras líneas de investigación relacionadas con el problema de la predicción de la 1RM mediante algoritmos genéticos, redes neuronales y técnicas de clustering.

Analysis of pixel-mapping rounding on geometric distortion as a prediction for view synthesis distortion

We analyze the performance of the geometric distortion, incurred when coding depth maps in 3D Video, as an estimator of the distortion of synthesized views. Our analysis is motivated by the need of reducing the computational complexity required for the computation of synthesis distortion in 3D video encoders. We propose several geometric distortion models that capture (i) the geometric distortion caused by the depth coding error, and (ii) the pixel-mapping precision in view synthesis. Our analysis starts with the evaluation of the correlation of geometric distortion values obtained with these models and the actual distortion on synthesized views. Then, the different geometric distortion models are employed in the rate-distortion optimization cycle of depth map coding, in order to assess the results obtained by the correlation analysis. Results show that one of the geometric distortion models is performing consistently better than the other models in all tests. Therefore, it can be used as a reasonable estimator of the synthesis distortion in low complexity depth encoders.

Growth rate and TRI5 gene expression profiles of Fusarium equiseti strains isolated from Spanish cereals cultivated on wheat and barley media at different environmental conditions

Fusarium equiseti is a toxigenic species that often contaminates ce real crops from diverse climatic regions such as Northern and Southern Europe. Previous results suggested the existence of two distinct populations within this species with differences in toxin pro file which largely corresponded to North and South Europe (Spain). In this work, growth rate profiles of 4 F. equiseti strains isolated from different cereals and distinct Spanish regions were determined on wheat and barley based media at a range of temperatures (15, 20, 25, 30, 35 and 40 °C) and water potentialregimens(−0.7,−2.8,−7.0,and −9.8MPa,correspondingto 0.99,0.98,0.95 and 0.93aw values).Growth was observed at all temperatures except at 40 °C, and at all the solute potential values except at−9.8 MPa when combined with 15 °C. Optimal growth was observed at 20– 30 °C and −0.7/−2.8 MPa. The effect of these factors on trichothecene biosynthesis was examined on a F. equiseti strain using a newly developed real time RT-PCR protocol to quantify TRI5 gene expression at 15, 25 and 35 °C and −0.7, −2.8, − 7.0 and −9.8 MPa on wheat and barley based media. Induction of TRI5 expression was detected between 25 and 35 °C and −0.7 and − 2.8 MPa, with maximum values at 35 °C and −2.8 MPa being higher in barley than in wheat medium. These results appeared to be consistent with a population well adapted to the present climatic conditions and predicted scenarios for Southern Europe and suggested some differences depending on the cereal considered. These are also discussed in relation to other Fusarium species co-occurring in cereals grown in this region and to their significance for prediction and control strategies of toxigenic risk in future scenarios of climate change for this region.

An optimal yet fast pruning algorithm to reduce latency in multiview prediction structures

We propose a new algorithm for the design of prediction structures with low delay and limited penalty in the rate-distortion performance for multiview video coding schemes. This algorithm constitutes one of the elements of a framework for the analysis and optimization of delay in multiview coding schemes that is based in graph theory. The objective of the algorithm is to find the best combination of prediction dependencies to prune from a multiview prediction structure, given a number of cuts. Taking into account the properties of the graph-based analysis of the encoding delay, the algorithm is able to find the best prediction dependencies to eliminate from an original prediction structure, while limiting the number of cut combinations to evaluate. We show that this algorithm obtains optimum results in the reduction of the encoding latency with a lower computational complexity than exhaustive search alternatives.

Computation, prediction, and experimental tests of fitness for bacteriophage T7 mutants with permuted genomes

We created a simulation based on experimental data from bacteriophage T7 that computes the developmental cycle of the wild-type phage and also of mutants that have an altered genome order. We used the simulation to compute the fitness of more than 105 mutants. We tested these computations by constructing and experimentally characterizing T7 mutants in which we repositioned gene 1, coding for T7 RNA polymerase. Computed protein synthesis rates for ectopic gene 1 strains were in moderate agreement with observed rates. Computed phage-doubling rates were close to observations for two of four strains, but significantly overestimated those of the other two. Computations indicate that the genome organization of wild-type T7 is nearly optimal for growth: only 2.8% of random genome permutations were computed to grow faster, the highest 31% faster, than wild type. Specific discrepancies between computations and observations suggest that a better understanding of the translation efficiency of individual mRNAs and the functions of qualitatively “nonessential” genes will be needed to improve the T7 simulation. In silico representations of biological systems can serve to assess and advance our understanding of the underlying biology. Iteration between computation, prediction, and observation should increase the rate at which biological hypotheses are formulated and tested.

Recent improvements in prediction of protein structure by global optimization of a potential energy function

Recent improvements of a hierarchical ab initio or de novo approach for predicting both α and β structures of proteins are described. The united-residue energy function used in this procedure includes multibody interactions from a cumulant expansion of the free energy of polypeptide chains, with their relative weights determined by Z-score optimization. The critical initial stage of the hierarchical procedure involves a search of conformational space by the conformational space annealing (CSA) method, followed by optimization of an all-atom model. The procedure was assessed in a recent blind test of protein structure prediction (CASP4). The resulting lowest-energy structures of the target proteins (ranging in size from 70 to 244 residues) agreed with the experimental structures in many respects. The entire experimental structure of a cyclic α-helical protein of 70 residues was predicted to within 4.3 Å α-carbon (Cα) rms deviation (rmsd) whereas, for other α-helical proteins, fragments of roughly 60 residues were predicted to within 6.0 Å Cα rmsd. Whereas β structures can now be predicted with the new procedure, the success rate for α/β- and β-proteins is lower than that for α-proteins at present. For the β portions of α/β structures, the Cα rmsd's are less than 6.0 Å for contiguous fragments of 30–40 residues; for one target, three fragments (of length 10, 23, and 28 residues, respectively) formed a compact part of the tertiary structure with a Cα rmsd less than 6.0 Å. Overall, these results constitute an important step toward the ab initio prediction of protein structure solely from the amino acid sequence.

Scale dependence in earthquake phenomena and its relevance to earthquake prediction.

The recent discovery of a low-velocity, low-Q zone with a width of 50-200 m reaching to the top of the ductile part of the crust, by observations on seismic guided waves trapped in the fault zone of the Landers earthquake of 1992, and its identification with the shear zone inferred from the distribution of tension cracks observed on the surface support the existence of a characteristic scale length of the order of 100 m affecting various earthquake phenomena in southern California, as evidenced earlier by the kink in the magnitude-frequency relation at about M3, the constant corner frequency for earthquakes with M below about 3, and the sourcecontrolled fmax of 5-10 Hz for major earthquakes. The temporal correlation between coda Q-1 and the fractional rate of occurrence of earthquakes in the magnitude range 3-3.5, the geographical similarity of coda Q-1 and seismic velocity at a depth of 20 km, and the simultaneous change of coda Q-1 and conductivity at the lower crust support the hypotheses that coda Q-1 may represent the activity of creep fracture in the ductile part of the lithosphere occurring over cracks with a characteristic size of the order of 100 m. The existence of such a characteristic scale length cannot be consistent with the overall self-similarity of earthquakes unless we postulate a discrete hierarchy of such characteristic scale lengths. The discrete hierarchy of characteristic scale lengths is consistent with recently observed logarithmic periodicity in precursory seismicity.

Hypothesis testing and earthquake prediction.

Requirements for testing include advance specification of the conditional rate density (probability per unit time, area, and magnitude) or, alternatively, probabilities for specified intervals of time, space, and magnitude. Here I consider testing fully specified hypotheses, with no parameter adjustments or arbitrary decisions allowed during the test period. Because it may take decades to validate prediction methods, it is worthwhile to formulate testable hypotheses carefully in advance. Earthquake prediction generally implies that the probability will be temporarily higher than normal. Such a statement requires knowledge of "normal behavior"--that is, it requires a null hypothesis. Hypotheses can be tested in three ways: (i) by comparing the number of actual earth-quakes to the number predicted, (ii) by comparing the likelihood score of actual earthquakes to the predicted distribution, and (iii) by comparing the likelihood ratio to that of a null hypothesis. The first two tests are purely self-consistency tests, while the third is a direct comparison of two hypotheses. Predictions made without a statement of probability are very difficult to test, and any test must be based on the ratio of earthquakes in and out of the forecast regions.