The Pediatric Rheumatology International Trials Organization American-College-of-Rheumatology provisional criteria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: Prospective validation of the definition of improvement

Objective. To use the Pediatric Rheumatology International Trials Organization (PRINTO) core set of outcome measures to develop a validated definition of improvement for the evaluation of response to therapy in juvenile systemic lupus erythematosus (SLE).Methods. Thirty-seven experienced pediatric rheumatologists from 27 countries, each of whom had specific experience in the assessment of juvenile SLE patients, achieved consensus on 128 patient profiles as being clinically improved or not improved. Using the physicians' consensus ratings as the gold standard measure, the chi-square, sensitivity, specificity, false-positive and false-negative rates, area under the receiver operating characteristic curve, and kappa level of agreement for 597 candidate definitions of improvement were calculated. Only definitions with a kappa value greater than 0.7 were retained. The top definitions were selected based on the product of the content validity score multiplied by its kappa statistic.Results. The definition of improvement with the highest final score was at least 50% improvement from baseline in any 2 of the 5 core set measures, with no more than 1 of the remaining worsening by more than 30%.Conclusion. PRINTO proposes a valid and reproducible definition of improvement that reflects well the consensus rating of experienced clinicians and that incorporates clinically meaningful change in core set measures in a composite end point for the evaluation of global response to therapy in patients with juvenile SLE. The definition is now proposed for use in juvenile SLE clinical trials and may help physicians to decide whether a child with SLE responded adequately to therapy.

Accumulation of semivolatile organic compounds in Antarctic vegetation: A case study of polybrominated diphenyl ethers

Antarctic plant communities are dominated by lichens and mosses which accumulate semivolatile organic compounds (SOCs) such as polybrominated diphenyl ethers (PBDEs) directly from the atmosphere. Differences in the levels of PBDEs observed in lichens and mosses collected at King George Island in the austral summers 2004-05 and 2005-06 are probably explained by environmental and/or plant parameters. Contamination of lichens showed a positive correlation with local precipitation, suggesting that wet deposition processes are a major mechanism controlling the uptake of most PBDE congeners. These findings are in agreement with physical-chemical data supporting that tetra- through hepta-BDEs in the Antarctic atmosphere are basically bound to aerosols. Conversely, accumulation of PBDEs in mosses appears to be controlled by other environmental factors and/or plant-specific characteristics. Model simulations demonstrated that an ocean-atmosphere coupling may have played a role in the long-range transport of less volatile SOCs such as PBDEs to Antarctica. According to simulations, the atmosphere is the most important transport medium for PBDEs while the surface ocean serves as a temporary storage compartment, boosting the deposition/volatilization ""hopping"" effect similarly to vegetation on continents. (C) 2011 Elsevier B.V. All rights reserved.

Mapping the biosphere: exploring species to understand the origin, organization and sustainability of biodiversity

The time is ripe for a comprehensive mission to explore and document Earth's species. This calls for a campaign to educate and inspire the next generation of professional and citizen species explorers, investments in cyber-infrastructure and collections to meet the unique needs of the producers and consumers of taxonomic information, and the formation and coordination of a multi-institutional, international, transdisciplinary community of researchers, scholars and engineers with the shared objective of creating a comprehensive inventory of species and detailed map of the biosphere. We conclude that an ambitious goal to describe 10 million species in less than 50 years is attainable based on the strength of 250 years of progress, worldwide collections, existing experts, technological innovation and collaborative teamwork. Existing digitization projects are overcoming obstacles of the past, facilitating collaboration and mobilizing literature, data, images and specimens through cyber technologies. Charting the biosphere is enormously complex, yet necessary expertise can be found through partnerships with engineers, information scientists, sociologists, ecologists, climate scientists, conservation biologists, industrial project managers and taxon specialists, from agrostologists to zoophytologists. Benefits to society of the proposed mission would be profound, immediate and enduring, from detection of early responses of flora and fauna to climate change to opening access to evolutionary designs for solutions to countless practical problems. The impacts on the biodiversity, environmental and evolutionary sciences would be transformative, from ecosystem models calibrated in detail to comprehensive understanding of the origin and evolution of life over its 3.8 billion year history. The resultant cyber-enabled taxonomy, or cybertaxonomy, would open access to biodiversity data to developing nations, assure access to reliable data about species, and change how scientists and citizens alike access, use and think about biological diversity information.

Learning for scheduling a portfolio of constraint solvers

Nel lavoro di tesi qui presentato si indaga l'applicazione di tecniche di apprendimento mirate ad una più efficiente esecuzione di un portfolio di risolutore di vincoli (constraint solver). Un constraint solver è un programma che dato in input un problema di vincoli, elabora una soluzione mediante l'utilizzo di svariate tecniche. I problemi di vincoli sono altamente presenti nella vita reale. Esempi come l'organizzazione dei viaggi dei treni oppure la programmazione degli equipaggi di una compagnia aerea, sono tutti problemi di vincoli. Un problema di vincoli è formalizzato da un problema di soddisfacimento di vincoli(CSP). Un CSP è descritto da un insieme di variabili che possono assumere valori appartenenti ad uno specico dominio ed un insieme di vincoli che mettono in relazione variabili e valori assumibili da esse. Una tecnica per ottimizzare la risoluzione di tali problemi è quella suggerita da un approccio a portfolio. Tale tecnica, usata anche in am- biti come quelli economici, prevede la combinazione di più solver i quali assieme possono generare risultati migliori di un approccio a singolo solver. In questo lavoro ci preoccupiamo di creare una nuova tecnica che combina un portfolio di constraint solver con tecniche di machine learning. Il machine learning è un campo di intelligenza articiale che si pone l'obiettivo di immettere nelle macchine una sorta di `intelligenza'. Un esempio applicativo potrebbe essere quello di valutare i casi passati di un problema ed usarli in futuro per fare scelte. Tale processo è riscontrato anche a livello cognitivo umano. Nello specico, vogliamo ragionare in termini di classicazione. Una classicazione corrisponde ad assegnare ad un insieme di caratteristiche in input, un valore discreto in output, come vero o falso se una mail è classicata come spam o meno. La fase di apprendimento sarà svolta utilizzando una parte di CPHydra, un portfolio di constraint solver sviluppato presso la University College of Cork (UCC). Di tale algoritmo a portfolio verranno utilizzate solamente le caratteristiche usate per descrivere determinati aspetti di un CSP rispetto ad un altro; queste caratteristiche vengono altresì dette features. Creeremo quindi una serie di classicatori basati sullo specifico comportamento dei solver. La combinazione di tali classicatori con l'approccio a portfolio sara nalizzata allo scopo di valutare che le feature di CPHydra siano buone e che i classicatori basati su tali feature siano affidabili. Per giusticare il primo risultato, eettueremo un confronto con uno dei migliori portfolio allo stato dell'arte, SATzilla. Una volta stabilita la bontà delle features utilizzate per le classicazioni, andremo a risolvere i problemi simulando uno scheduler. Tali simulazioni testeranno diverse regole costruite con classicatori precedentemente introdotti. Prima agiremo su uno scenario ad un processore e successivamente ci espanderemo ad uno scenario multi processore. In questi esperimenti andremo a vericare che, le prestazioni ottenute tramite l'applicazione delle regole create appositamente sui classicatori, abbiano risultati migliori rispetto ad un'esecuzione limitata all'utilizzo del migliore solver del portfolio. I lavoro di tesi è stato svolto in collaborazione con il centro di ricerca 4C presso University College Cork. Su questo lavoro è stato elaborato e sottomesso un articolo scientico alla International Joint Conference of Articial Intelligence (IJCAI) 2011. Al momento della consegna della tesi non siamo ancora stati informati dell'accettazione di tale articolo. Comunque, le risposte dei revisori hanno indicato che tale metodo presentato risulta interessante.

Prognostic value of the modified American College of Cardiology/American Heart Association lesion morphology classification for clinical outcome after sirolimus-eluting stent placement (results of the prospective multicenter German Cypher Registry)

The modified American College of Cardiology/American Heart Association (ACC/AHA) lesion morphology classification scheme has prognostic impact for early and late outcomes when bare-metal stents are used. Its value after drug-eluting stent placement is unknown. The predictive value of this lesion morphology classification system in patients treated using sirolimus-eluting stents included in the German Cypher Registry was prospectively examined. The study population included 6,755 patients treated for 7,960 lesions using sirolimus-eluting stents. Lesions were classified as type A, B1, B2, or C. Lesion type A or B1 was considered simple (35.1%), and type B2 or C, complex (64.9%). The combined end point of all deaths, myocardial infarction, or target vessel revascularization was seen in 2.6% versus 2.4% in the complex and simple groups, respectively (p = 0.62) at initial hospital discharge, with a trend for higher rates of myocardial infarction in the complex group. At the 6-month clinical follow-up and after adjusting for other independent factors, the composite of cumulative death, myocardial infarction, and target vessel revascularization was nonsignificantly different between groups (11.4% vs 11.2% in the complex and simple groups, respectively; odds ratio 1.08, 95% confidence interval 0.8 to 1.46). This was also true for target vessel revascularization alone (8.3% of the complex group, 9.0% of the simple group; odds ratio 0.87, 95% confidence interval 0.72 to 1.05). In conclusion, the modified ACC/AHA lesion morphology classification system has some value in determining early complications after sirolimus-eluting stent implantation. Clinical follow-up results at 6 months were generally favorable and cannot be adequately differentiated on the basis of this lesion morphology classification scheme.