Modeling and reasoning with qualitative comparative clinical knowledge

The number of clinical trials reports is increasing rapidly due to a large number of clinical trials being conducted; it, therefore, raises an urgent need to utilize the clinical knowledge contained in the clinical trials reports. In this paper, we focus on the qualitative knowledge instead of quantitative knowledge. More precisely, we aim to model and reason with the qualitative comparison (QC for short) relations which consider qualitatively how strongly one drug/therapy is preferred to another in a clinical point of view. To this end, first, we formalize the QC relations, introduce the notions of QC language, QC base, and QC profile; second, we propose a set of induction rules for the QC relations and provide grading interpretations for the QC bases and show how to determine whether a QC base is consistent. Furthermore, when a QC base is inconsistent, we analyze how to measure inconsistencies among QC bases, and we propose different approaches to merging multiple QC bases. Finally, a case study on lowering intraocular pressure is conducted to illustrate our approaches.

The Rights of Religious Associations to External Relations: A Comparative Study of the OSCE and the Council of Europe

This paper argues that religious associations have a number of substantive rights when it comes to their external relations. It does so though comparing the position of the OSCE and the Council of Europe. This paper considers whether the emerging framework includes: (1) a right to legal entity status, (2) a right to establish and run charitable or educational institutions, (3) a right to privileges and substantive benefits and (4) a right to anything else. It concludes that the current developments are welcome because religious freedom has a collective aspect that is essential to the lives of many believers.

Comparative genomic analysis reveals species-dependent complexities that explain difficulties with microsatellite marker development in molluscs

Reliable population DNA molecular markers are difficult to develop for molluscs, the reasons for which are largely unknown. Identical protocols for microsatellite marker development were implemented in three gastropods. Success rates were lower for Gibbula cineraria compared to Littorina littorea and L. saxatilis. Comparative genomic analysis of 47.2?kb of microsatellite containing sequences (MCS) revealed a high incidence of cryptic repetitive DNA in their flanking regions. The majority of these were novel, and could be grouped into DNA families based upon sequence similarities. Significant inter-specific variation in abundance of cryptic repetitive DNA and DNA families was observed. Repbase scans show that a large proportion of cryptic repetitive DNA was identified as transposable elements (TEs). We argue that a large number of TEs and their transpositional activity may be linked to differential rates of DNA multiplication and recombination. This is likely to be an important factor explaining inter-specific variation in genome stability and hence microsatellite marker development success rates. Gastropods also differed significantly in the type of TEs classes (autonomous vs non-autonomous) observed. We propose that dissimilar transpositional mechanisms differentiate the TE classes in terms of their propensity for transposition, fixation and/or silencing. Consequently, the phylogenetic conservation of non-autonomous TEs, such as CvA, suggests that dispersal of these elements may have behaved as microsatellite-inducing elements. Results seem to indicate that, compared to autonomous, non-autonomous TEs maybe have a more active role in genome rearrangement processes. The implications of the findings for genomic rearrangement, stability and marker development are discussed.

Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland

Objectives: To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI).

Methods: Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993–2005 and prostate cancer deaths 1979–2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression.

Results: Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p < 0.01) and decreased significantly over time in both countries. Mortality rates declined from 1995 in both countries (APC = -1.5% in RoI, -1.3% in NI) at a time when PSA testing was not widespread.

Conclusions: Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.

Identification of gene networks associated with acute myeloid leukemia by comparative molecular methylation and expression profiling

Around 80% of acute myeloid leukemia (AML) patients achieve a complete remission, however many will relapse and ultimately die of their disease. The association between karyotype and prognosis has been studied extensively and identified patient cohorts as having favourable [e.g. t(8; 21), inv (16)/t(16; 16), t(15; 17)], intermediate [e.g. cytogenetically normal (NK-AML)] or adverse risk [e.g. complex karyotypes]. Previous studies have shown that gene expression profiling signatures can classify the sub-types of AML, although few reports have shown a similar feature by using methylation markers. The global methylation patterns in 19 diagnostic AML samples were investigated using the Methylated CpG Island Amplification Microarray (MCAM) method and CpG island microarrays containing 12,000 CpG sites. The first analysis, comparing favourable and intermediate cytogenetic risk groups, revealed significantly differentially methylated CpG sites (594 CpG islands) between the two subgroups. Mutations in the NPM1 gene occur at a high frequency (40%) within the NK-AML subgroup and are associated with a more favourable prognosis in these patients. A second analysis comparing the NPM1 mutant and wild-type research study subjects again identified distinct methylation profiles between these two subgroups. Network and pathway analysis revealed possible molecular mechanisms associated with the different risk and/or mutation sub-groups. This may result in a better classification of the risk groups, improved monitoring targets, or the identification of novel molecular therapies.

The integrated school in a conflict society: a comparative analysis of two integrated primary schools in Northern Ireland

The purpose of this paper is to compare the approach to promoting positive relationships between Catholics and Protestants in two types of integrated primary school in Northern Ireland. Drawing on qualitative interviews with teachers, governors and parents in one transforming school and one grant maintained integrated school, i.e. one representative of each of the two types, the paper shows that whilst there are distinctions in the ways that the schools promote their image and ethos, the ‘lived reality’ of the schools, as reported by the research participants, is almost indistinguishable. The paper suggests that both schools tend not to refer to or explore cultural difference and that this tendency to ‘minimise difference’ seems to have the potential to silence school members who do wish to explore their own and other cultures. It is argued that such practices are likely to impede rather than facilitate the progress of good inter-community relations.