Indeterminate QunatiFERON-TB Gold In-Tube assay results in association with procedural specimen collection in children

BACKGROUND. The development of interferon-gamma release assays (IGRA) has introduced powerful tools in diagnosing latent tuberculosis infection (LTBI) and may play a critical role in the future of tuberculosis diagnosis. However, there have been reports of high indeterminate results in young patient populations (0-18 years). This study investigated results of the QunatiFERON-TB Gold In-Tube (QFT-GIT) IGRA in a population of children (0-18 years) at Texas Children's Hospital in association with specimen collection procedures using surrogate variables. ^ METHODS. A retrospective case-control study design was used for this investigation. Cases were defined as having QFT-GIT indeterminate results. Controls were defined as having either positive or negative results (determinates). Patients' admission status, staff performing specimen collection, and specific nurse performing specimen collection were used as surrogates to measure specimen collection procedures. ^ To minimize potential confounding, abstraction of patients' electronic medical records was performed. Abstracted data included patients' medications and evaluation at the time of QFT-GIT specimen collection in addition to their medical history. QFT-GIT related data was also abstracted. Cases and controls were characterized using chi-squared tests or Fisher's exact tests across categorical variables. Continuous variables were analyzed using one-way ANOVA and t-tests for continuous variables. A multivariate model was constructed by backward stepwise removal of statistically significant variables from univariate analysis. ^ RESULTS. Patient data was abstracted from 182 individuals aged 0-18 years from July 2010 to August 2011 at Texas Children's Hospital. 56 cases (indeterminates) and 126 controls (determinates) were enrolled. Cancer was found to be an effect modifier with subsequent stratification resulting in a cancer patient population too small to analyze (n=13). Subsequent analyses excluded these patients. ^ The exclusion of cancer patients resulted in a population of 169 patients with 49 indeterminates (28.99%) and 120 determinates (71.01%), with mean ages of 9.73 (95% CI: 8.03, 11.43) years and 11.66 (95% CI: 10.75, 12.56) years (p = 0.033), respectively. Median age of patients who were indeterminates and determinates were 12.37 and 12.87 years, respectively. Lack of data for our specific nurse surrogate (QFTNurse) resulted in its exclusion from analysis. The final model included only our remaining surrogate variables (QFTStaff and QFTInpatientOutpatient). The staff collecting surrogate (QFTStaff) was found to be modestly associated with indeterminates when nurses collected the specimen (OR = 1.54, 95% CI: 0.51, 4.64, p = 0.439) in the final model. Inpatients were found to have a strong and statistically significant association with indeterminates (OR = 11.65, 95% CI: 3.89, 34.9, p < 0.001) in the final model. ^ CONCLUSION. Inpatient status was used as a surrogate for indication of nurse drawn blood specimens. Nurses have had little to no training regarding shaking of tubes versus phlebotomists regarding QFT-GIT testing procedures. This was also measured by two other surrogates; specifically a medical note stating whether a nurse or phlebotomist collected the specimen (QFTStaff) and the name and title of the specific nurse if collection was performed by a nurse (QFTNurse). Results indicated that inpatient status was a strong and statistically significant factor for indeterminates, however, nurse collected specimens and indeterminate results had no statistically significant association in non-cancer patients. The lack of data denoting the specific nurse performing specimen collection excluded the QFTNurse surrogate in our analysis. ^ Findings suggests training of staff personnel in specimen procedures may have little effect on the number of indeterminates while inpatient status and thus possibly illness severity may be the most important factor for indeterminate results in this population. The lack of congruence between our surrogate measures may imply that our inpatient surrogate gauged illness severity rather than collection procedures as intended. ^ Despite the lack of clear findings, our analysis indicated that more than half of indeterminates were found in specimens drawn by nurses and as such staff training may be explored. Future studies may explore methods in measuring modifiable variables during pre-analytical QFT-GIT procedures that can be discerned and controlled. Identification of such measures may provide insight into ways to lowering indeterminate QFT-GIT rates in children.^

Essentials in Ontology Engineering: Methodologies, Languages, and Tools

In the beginning of the 90s, ontology development was similar to an art: ontology developers did not have clear guidelines on how to build ontologies but only some design criteria to be followed. Work on principles, methods and methodologies, together with supporting technologies and languages, made ontology development become an engineering discipline, the so-called Ontology Engineering. Ontology Engineering refers to the set of activities that concern the ontology development process and the ontology life cycle, the methods and methodologies for building ontologies, and the tool suites and languages that support them. Thanks to the work done in the Ontology Engineering field, the development of ontologies within and between teams has increased and improved, as well as the possibility of reusing ontologies in other developments and in final applications. Currently, ontologies are widely used in (a) Knowledge Engineering, Artificial Intelligence and Computer Science, (b) applications related to knowledge management, natural language processing, e-commerce, intelligent information integration, information retrieval, database design and integration, bio-informatics, education, and (c) the Semantic Web, the Semantic Grid, and the Linked Data initiative. In this paper, we provide an overview of Ontology Engineering, mentioning the most outstanding and used methodologies, languages, and tools for building ontologies. In addition, we include some words on how all these elements can be used in the Linked Data initiative.

Parallelizing irregular and pointer-based computations automatically: perspectives from logic and constraint programming

Irregular computations pose sorne of the most interesting and challenging problems in automatic parallelization. Irregularity appears in certain kinds of numerical problems and is pervasive in symbolic applications. Such computations often use dynamic data structures, which make heavy use of pointers. This complicates all the steps of a parallelizing compiler, from independence detection to task partitioning and placement. Starting in the mid 80s there has been significant progress in the development of parallelizing compilers for logic pro­gramming (and more recently, constraint programming) resulting in quite capable paralle­lizers. The typical applications of these paradigms frequently involve irregular computations, and make heavy use of dynamic data structures with pointers, since logical variables represent in practice a well-behaved form of pointers. This arguably makes the techniques used in these compilers potentially interesting. In this paper, we introduce in a tutoríal way, sorne of the problems faced by parallelizing compilers for logic and constraint programs and provide pointers to sorne of the significant progress made in the area. In particular, this work has resulted in a series of achievements in the areas of inter-procedural pointer aliasing analysis for independence detection, cost models and cost analysis, cactus-stack memory management, techniques for managing speculative and irregular computations through task granularity control and dynamic task allocation such as work-stealing schedulers), etc.

Designing a high performance parallel logic programming system

Compilation techniques such as those portrayed by the Warren Abstract Machine(WAM) have greatly improved the speed of execution of logic programs. The research presented herein is geared towards providing additional performance to logic programs through the use of parallelism, while preserving the conventional semantics of logic languages. Two áreas to which special attention is given are the preservation of sequential performance and storage efficiency, and the use of low overhead mechanisms for controlling parallel execution. Accordingly, the techniques used for supporting parallelism are efficient extensions of those which have brought high inferencing speeds to sequential implementations. At a lower level, special attention is also given to design and simulation detail and to the architectural implications of the execution model behavior. This paper offers an overview of the basic concepts and techniques used in the parallel design, simulation tools used, and some of the results obtained to date.

A framework for assertion-based debugging in constraint logic programming

We propose a general framework for assertion-based debugging of constraint logic programs. Assertions are linguistic constructions which allow expressing properties of programs. We define assertion schemas which allow writing (partial) specifications for constraint logic programs using quite general properties, including user-defined programs. The framework is aimed at detecting deviations of the program behavior (symptoms) with respect to the given assertions, either at compile-time or run-time. We provide techniques for using information from global analysis both to detect at compile-time assertions which do not hold in at least one of the possible executions (i.e., static symptoms) and assertions which hold for all possible executions (i.e., statically proved assertions). We also provide program transformations which introduce tests in the program for checking at run-time those assertions whose status cannot be determined at compile-time. Both the static and the dynamic checking are provably safe in the sense that all errors flagged are definite violations of the specifications. Finally, we report on an implemented instance of the assertion language and framework.

IDRA (IDeal Resource Allocation): Computing ideal speedups in parallel logic programming

We present a technique to estimate accurate speedups for parallel logic programs with relative independence from characteristics of a given implementation or underlying parallel hardware. The proposed technique is based on gathering accurate data describing one execution at run-time, which is fed to a simulator. Alternative schedulings are then simulated and estimates computed for the corresponding speedups. A tool implementing the aforementioned techniques is presented, and its predictions are compared to the performance of real systems, showing good correlation.

Some methodological issues in the design of CIAO - A generic, parallel concurrent constraint system

We informally discuss several issues related to the parallel execution of logic programming systems and concurrent logic programming systems, and their generalization to constraint programming. We propose a new view of these systems, based on a particular definition of parallelism. We argüe that, under this view, a large number of the actual systems and models can be explained through the application, at different levéis of granularity, of only a few basic principies: determinism, non-failure, independence (also referred to as stability), granularity, etc. Also, and based on the convergence of concepts that this view brings, we sketch a model for the implementation of several parallel constraint logic programming source languages and models based on a common, generic abstract machine and an intermedíate kernel language.

Some techniques for automated, resource-aware distributed and mobile computing in a multi-paradigm programming system

Distributed parallel execution systems speed up applications by splitting tasks into processes whose execution is assigned to different receiving nodes in a high-bandwidth network. On the distributing side, a fundamental problem is grouping and scheduling such tasks such that each one involves sufñcient computational cost when compared to the task creation and communication costs and other such practical overheads. On the receiving side, an important issue is to have some assurance of the correctness and characteristics of the code received and also of the kind of load the particular task is going to pose, which can be specified by means of certificates. In this paper we present in a tutorial way a number of general solutions to these problems, and illustrate them through their implementation in the Ciao multi-paradigm language and program development environment. This system includes facilities for parallel and distributed execution, an assertion language for specifying complex programs properties (including safety and resource-related properties), and compile-time and run-time tools for performing automated parallelization and resource control, as well as certification of programs with resource consumption assurances and efñcient checking of such certificates.

Agent Programming in Ciao Prolog

The agent programming landscape has been revealed as a natural framework for developing “intelligence” in AI. This can be seen from the extensive use of the agent concept in presenting (and developing) AI systems, the proliferation of agent theories, and the evolution of concepts such as agent societies (social intelligence) and coordination.

Programming with global analysis

Global data-flow analysis of (constraint) logic programs, which is generally based on abstract interpretation [7], is reaching a comparatively high level of maturity. A natural question is whether it is time for its routine incorporation in standard compilers, something which, beyond a few experimental systems, has not happened to date. Such incorporation arguably makes good sense only if: • the range of applications of global analysis is large enough to justify the additional complication in the compiler, and • global analysis technology can deal with all the features of "practical" languages (e.g., the ISO-Prolog built-ins) and "scales up" for large programs. We present a tutorial overview of a number of concepts and techniques directly related to the issues above, with special emphasis on the first one. In particular, we concéntrate on novel uses of global analysis during program development and debugging, rather than on the more traditional application área of program optimization. The idea of using abstract interpretation for validation and diagnosis has been studied in the context of imperative programming [2] and also of logic programming. The latter work includes issues such as using approximations to reduce the burden posed on programmers by declarative debuggers [6, 3] and automatically generating and checking assertions [4, 5] (which includes the more traditional type checking of strongly typed languages, such as Gódel or Mercury [1, 8, 9]) We also review some solutions for scalability including modular analysis, incremental analysis, and widening. Finally, we discuss solutions for dealing with meta-predicates, side-effects, delay declarations, constraints, dynamic predicates, and other such features which may appear in practical languages. In the discussion we will draw both from the literature and from our experience and that of others in the development and use of the CIAO system analyzer. In order to emphasize the practical aspects of the solutions discussed, the presentation of several concepts will be illustrated by examples run on the CIAO system, which makes extensive use of global analysis and assertions.

Automatic parallelization of irregular and pointer-based computations: perspectives from logic and constraint programming

Irregular computations pose some of the most interesting and challenging problems in automatic parallelization. Irregularity appears in certain kinds of numerical problems and is pervasive in symbolic applications. Such computations often use dynamic data structures which make heavy use of pointers. This complicates all the steps of a parallelizing compiler, from independence detection to task partitioning and placement. In the past decade there has been significant progress in the development of parallelizing compilers for logic programming and, more recently, constraint programming. The typical applications of these paradigms frequently involve irregular computations, which arguably makes the techniques used in these compilers potentially interesting. In this paper we introduce in a tutorial way some of the problems faced by parallelizing compilers for logic and constraint programs. These include the need for inter-procedural pointer aliasing analysis for independence detection and having to manage speculative and irregular computations through task granularity control and dynamic task allocation. We also provide pointers to some of the progress made in these áreas. In the associated talk we demónstrate representatives of several generations of these parallelizing compilers.

On the role of semantic approximations in validation and diagnosis of constraint logic programs

Abstract is not available.

The role of computational logic as a hinge paradigm among deduction, problem solving, programming, and parallelism

This paper presents some brief considerations on the role of Computational Logic in the construction of Artificial Intelligence systems and in programming in general. It does not address how the many problems in AI can be solved but, rather more modestly, tries to point out some advantages of Computational Logic as a tool for the AI scientist in his quest. It addresses the interaction between declarative and procedural views of programs (deduction and action), the impact of the intrinsic limitations of logic, the relationship with other apparently competing computational paradigms, and finally discusses implementation-related issues, such as the efficiency of current implementations and their capability for efficiently exploiting existing and future sequential and parallel hardware. The purpose of the discussion is in no way to present Computational Logic as the unique overall vehicle for the development of intelligent systems (in the firm belief that such a panacea is yet to be found) but rather to stress its strengths in providing reasonable solutions to several aspects of the task.

A documentation generator for logic programming systems

We describe lpdoc, a tool which generates documentation manuals automatically from one or more logic program source files, written in ISO-Prolog, Ciao, and other (C)LP languages. It is particularly useful for documenting library modules, for which it automatically generates a rich description of the module interface. However, it can also be used quite successfully to document full applications. The documentation can be generated in many formats including t e x i n f o, dvi, ps, pdf, inf o, html/css, Unix nrof f/man, Windows help, etc., and can include bibliographic citations and images, lpdoc can also genérate "man" pages (Unix man page format), nicely formatted plain ascii "readme" files, installation scripts useful when the manuals are included in software distributions, brief descriptions in html/css or inf o formats suitable for inclusión in on-line Índices of manuals, and even complete WWW and inf o sites containing on-line catalogs of documents and software distributions. A fundamental advantage of using lpdoc is that it helps maintaining a true correspondence between the program and its documentation, and also identifying precisely to what versión of the program a given printed manual corresponds. The quality of the documentation generated can be greatly enhanced by including within the program text assertions (declarations with types, modes, etc. ...) for the predicates in the program, and machine-readable comments. These assertions and comments are written using the Ciao system assertion language. A simple compatibility library allows conventional (C)LP systems to ignore these assertions and comments and treat normally programs documented in this way. The lpdoc manual, all other Ciao system manuals, and most of this paper, are generated by lpdoc.

Some methodological issues in the design of CIAO, a generic, parallel concurrent constraint system

We informally discuss several issues related to the parallel execution of logic programming systems and concurrent logic programming systems, and their generalization to constraint programming. We propose a new view of these systems, based on a particular definition of parallelism. We argüe that, under this view, a large number of the actual systems and models can be explained through the application, at different levéis of granularity, of only a few basic principies: determinism, non-failure, independence (also referred to as stability), granularity, etc. Also, and based on the convergence of concepts that this view brings, we sketch a model for the implementation of several parallel constraint logic programming source languages and models based on a common, generic abstract machine and an intermedíate kernel language.