Designing a goal-oriented smart-home environment

The final publication is available at Springer via http://dx.doi.org/10.1007/s10796-016-9670-x[EN] Nowadays, systems are growing in power and in access to more resources and services. This situation makes it necessary to provide user-centered systems that act as intelligent assistants. These systems should be able to interact in a natural way with human users and the environment and also be able to take into account user goals and environment information and changes. In this paper, we present an architecture for the design and development of a goal-oriented, self-adaptive, smart-home environment. With this architecture, users are able to interact with the system by expressing their goals which are translated into a set of agent actions in a way that is transparent to the user. This is especially appropriate for environments where ambient intelligence and automatic control are integrated for the user’s welfare. In order to validate this proposal, we designed a prototype based on the proposed architecture for smart-home scenarios. We also performed a set of experiments that shows how the proposed architecture for human-agent interaction increases the number and quality of user goals achieved.This work is partially supported by the Spanish Government through the MINECO/FEDER project TIN2015-65515-C4-1-R.Palanca Cámara, J.; Del Val Noguera, E.; García-Fornes, A.; Billhard, H.; Corchado, JM.; Julian Inglada, VJ. (2016). Designing a goal-oriented smart-home environment. Information Systems Frontiers. 1-18. https://doi.org/10.1007/s10796-016-9670-xS118Alam, M. R., Reaz, M. B. I., & Ali, M. A. M. (2012). A review of smart homes: Past, present, and future. IEEE Transactions on Systems, Man, and Cybernetics, Part C: Applications and Reviews, 42(6), 1190–1203.Andrushevich, A., Staub, M., Kistler, R., & Klapproth, A. (2010). Towards semantic buildings: Goal-driven approach for building automation service allocation and control. In 2010 IEEE conference on emerging technologies and factory automation (ETFA) (pp. 1–6) IEEE.Ayala, I., Amor, M., & Fuentes, L. (2013). Self-configuring agents for ambient assisted living applications. Personal and Ubiquitous Computing, 17(6), 1159–1169.Cetina, C., Giner, P., Fons, J., & Pelechano, V. (2009). Autonomic computing through reuse of variability models at runtime: The case of smart homes. Computer, 42(10), 37–43.Cook, D. J. (2009). Multi-agent smart environments. Journal of Ambient Intelligence and Smart Environments, 1(1), 51–55.Dalpiaz, F., Giorgini, P., & Mylopoulos, J. (2009). An architecture for requirements-driven self-reconfiguration. In Advanced information systems engineering (pp. pp 246–260). Springer.De Silva, L. C., Morikawa, C., & Petra, I. M. (2012). State of the art of smart homes. Engineering Applications of Artificial Intelligence, 25(7), 1313–1321.Huhns, M., & et al. (2005). Research directions for service-oriented multiagent systems. IEEE Internet Computing, 9, 69–70.Iftikhar, M. U., & Weyns, D. (2014). Activforms: active formal models for self-adaptation. In SEAMS, (pp 125–134).Kucher, K., & Weyns, D. (2013). A self-adaptive software system to support elderly care. Modern Information Technology, MIT.Lieberman, H., & Espinosa, J. (2006). A goal-oriented interface to consumer electronics using planning and commonsense reasoning. In Proceedings of the 11th international conference on Intelligent user interfaces (pp. 226–233).Liu, H., & Singh, P. (2004). ConceptNet—a practical commonsense reasoning tool-kit. BT Technology Journal, 22(4), 211–226.Loseto, G., Scioscia, F., Ruta, M., & Di Sciascio, E. (2012). Semantic-based smart homes: a multi-agent approach. In 13th Workshop on objects and Agents (WOA 2012) (Vol. 892, pp. 49–55).Martin, D., Burstein, M., Hobbs, J., Lassila, O., McDermott, D., McIlraith, S., Narayanan, S., Paolucci, M., Parsia, B., Payne, T., & et al (2004). OWL-S: Semantic markup for web services. W3C Member Submission, 22, 2007–2004.Matthews, R. B., Gilbert, N. G., Roach, A., Polhill, J. G, & Gotts, N. M. (2007). Agent-based land-use models: a review of applications. Landscape Ecology, 22(10), 1447–1459.Molina, J. M., Corchado, J. M., & Bajo, J. (2008). Ubiquitous computing for mobile environments. In Issues in multi-agent systems (pp 33–57). Birkhäuser, Basel.Palanca, J., Navarro, M., Julian, V., & García-Fornes, A. (2012). Distributed goal-oriented computing. Journal of Systems and Software, 85(7), 1540–1557. doi: 10.1016/j.jss.2012.01.045 .Rao, A., & Georgeff, M. (1995). BDI agents: From theory to practice. In Proceedings of the first international conference on multi-agent systems (ICMAS95) (pp. 312–319).Reddy, Y. (2006). Pervasive computing: implications, opportunities and challenges for the society. In 1st International symposium on pervasive computing and applications (p. 5).de Silva, L., & Padgham, L. (2005). Planning as needed in BDI systems. International Conference on Automated Planning and Scheduling.Singh, P. (2002). The public acquisition of commonsense knowledge. In Proceedings of AAAI Spring symposium acquiring (and using) linguistic (and world) knowledge for information access

A Mitocentric View of the Main Bacterial and Parasitic Infectious Diseases in the Pediatric Population

Infectious diseases occur worldwide with great frequency in both adults and children. Both infections and their treatments trigger mitochondrial interactions at multiple levels: (i) incorporation of damaged or mutated proteins to the complexes of the electron transport chain, (ii) mitochondrial genome (depletion, deletions, and point mutations) and mitochondrial dynamics (fusion and fission), (iii) membrane potential, (iv) apoptotic regulation, (v) generation of reactive oxygen species, among others. Such alterations may result in serious adverse clinical events with great impact on children’s quality of life, even resulting in death. As such, bacterial agents are frequently associated with loss of mitochondrial membrane potential and cytochrome c release, ultimately leading to mitochondrial apoptosis by activation of caspases-3 and -9. Using Rayyan QCRI software for systematic reviews, we explore the association between mitochondrial alterations and pediatric infections including (i) bacterial: M. tuberculosis, E. cloacae, P. mirabilis, E. coli, S. enterica, S. aureus, S. pneumoniae, N. meningitidis and (ii) parasitic: P. falciparum. We analyze how these pediatric infections and their treatments may lead to mitochondrial deterioration in this especially vulnerable population, with the intention of improving both the understanding of these diseases and their management in clinical practice

Performance of QuantiFERON-TB Gold Plus assays in children and adolescents at risk of tuberculosis: a cross-sectional multicentre study

Introduction: The QuantiFERON-TB Gold Plus (QFT-Plus) assay, which features two antigen-stimulated tubes (TB1 and TB2) instead of a single tube used in previous-generation interferon-gamma release assays (IGRAs), was launched in 2016. Despite this, data regarding the assay’s performance in the paediatric setting remain scarce. This study aimed to determine the performance of QFT-Plus in a large cohort of children and adolescents at risk of tuberculosis (TB) in a low-burden setting. Methods: Cross-sectional, multicentre study at healthcare institutions participating in the Spanish Paediatric TB Research Network, including patients <18 years who had a QFT-Plus performed between September 2016 and June 2020. Results: Of 1726 patients (52.8% male, median age: 8.4 years), 260 (15.1%) underwent testing during contact tracing, 288 (16.7%) on clinical/radiological suspicion of tuberculosis disease (TBD), 649 (37.6%) during new-entrant migrant screening and 529 (30.6%) prior to initiation of immunosuppressive treatment. Overall, the sensitivity of QFT-Plus for TBD (n=189) and for latent tuberculosis infection (LTBI, n=195) was 83.6% and 68.2%, respectively. The agreement between QFT-Plus TB1 and TB2 antigen tubes was excellent (98.9%, κ=0.961). Only five (2.5%) patients with TBD had discordance between TB1 and TB2 results (TB1+/TB2−, n=2; TB1−/TB2+, n=3). Indeterminate assay results (n=54, 3.1%) were associated with young age, lymphopenia and elevated C reactive protein concentrations. Conclusions: Our non-comparative study indicates that QFT-Plus does not have greater sensitivity than previous-generation IGRAs in children in both TBD and LTBI. In TBD, the addition of the second antigen tube, TB2, does not enhance the assay’s performance substantially

Post-licensing safety of fosamprenavir in HIV-infected children in Europe

Purpose: Fosamprenavir, combined with low-dose ritonavir (FPV/r), is indicated for treatment of HIV-infected children aged ≥6 years in Europe. Our purpose was to assess the safety of licensed use of FPV/r in HIV-infected children reported to six cohorts in the European Pregnancy and Paediatric HIV Cohort Collaboration. Methods: Retrospective analysis of individual patient data for all children aged 6–18 years taking the licensed dose of FPV up to 31/12/10. Adverse events (clinical events and absolute neutrophil counts, total cholesterol and triglycerides, and alanine transaminase) were summarised and DAIDS gradings characterised severity. Results: Ninety-two HIV-infected children aged 6–18 years took the licensed dose, comprising 3% of the total number of children in follow-up in participating cohorts. Median age at antiretroviral therapy initiation was 6 years (interquartile range 1–11 years), and median age at start of FPV/r was 15 years (12–17 years). Estimated median time on an FPV-containing regimen was 52 months, with a total of 266.9 patient years of exposure overall. Half (54%) were on an FPV-containing regimen at last follow-up. Rates of grade 3/4 events were generally low for all biochemical toxicity markers, and no serious adverse events considered to be causally related to FPV/r were reported. Conclusions: Results suggest that long-term licensed dose FPV-containing regimens appear to be generally well tolerated with few reported toxicities in HIV-infected children in Europe, although relatively infrequently prescribed. No serious events were reported

Interferon-Gamma Release Assays Differentiate Between Mycobacterium avium Complex and Tuberculous Lymphadenitis in Children

OBJECTIVES: To assess the performance of interferon-gamma release assays (IGRAs) in the differential diagnosis between Mycobacterium avium complex (MAC) and tuberculosis (TB) in children affected with subacute/chronic submandibular/cervical lymphadenitis. STUDY DESIGN: Multicenter observational study comparing children with microbiologically-confirmed MAC lymphadenitis from the European NontuberculouS MycoBacterial Lymphadenitis in childrEn (ENSeMBLE) study with children with TB lymphadenitis from the Spanish Network for the Study of Pediatric TB (pTBred) database. RESULTS: Overall, 78 patients with MAC and 34 with TB lymphadenitis were included. Among MAC cases, 44/74 (59.5%) had positive tuberculin skin test (TST) results at the 5 mm cutoff, compared with 32/33 (97%) TB cases (p<0.001); at the 10 mm cutoff TST results were positive in 23/74 (31.1%) vs. 26/31 (83.9%), respectively (P < .001). IGRA results were positive in only 1/32 (3.1%) MAC cases who had undergone IGRA testing, compared with 21/23 (91.3%) TB cases (p<0.001). Agreement between TST and IGRA results was poor in MAC (23.3%;κ=0.017), but good in TB cases (95.6%;κ=0.646). IGRAs had a specificity of 96.9% (95%CI:84.3-99.8%), positive predictive value (PPV) of 95.4% (95%CI:78.2-99.8%), and negative predictive value (NPV) of 93.9% (95%CI:80.4-98.9%) for TB lymphadenitis. CONCLUSIONS: In contrast to TST, IGRAs have high specificity, NPV and PPV for TB lymphadenitis in children with subacute/chronic lymphadenopathy, and consequently can help to discriminate between TB and MAC disease. Therefore, IGRAs are useful tools in the diagnostic work-up of children with lymphadenopathy, particularly when culture- and PCR-results are negative

Tuberculosis infection in children visiting friends and relatives in countries with high incidence of tuberculosis : A study protocol

Tuberculosis (TB) is a global infectious disease. In low-incidence countries, paediatric TB affects mostly immigrant children and children of immigrants. We hypothesize that these children are at risk of exposure to Mycobacterium tuberculosis when they travel to the country of origin of their parents to visit friends and relatives (VFR). In this study, we aim to estimate the incidence rate and risk factors associated to latent tuberculosis infection (LTBI) and TB in VFR children. A prospective study will be carried out in collaboration with 21 primary health care centres (PCC) and 5 hospitals in Catalonia, Spain. The study participants are children under 15 years of age, either immigrant themselves or born to immigrant parents, who travel to countries with high incidence of TB (≥ 40 cases/100,000 inhabitants). A sample size of 492 children was calculated. Participants will be recruited before traveling, either during a visit to a travel clinic or to their PCC, where a questionnaire including sociodemographic, epidemiological and clinical data will be completed, and a tuberculin skin test (TST) will be performed and read after 48 to 72 hours; patients with a positive TST at baseline will be excluded. A visit will be scheduled eight to twelve-weeks after their return to perform a TST and a QuantiFERON-TB Gold Plus test. The incidence rate of LTBI will be estimated per individual/month and person/year per country visited, and also by age-group. The study protocol was approved by the Clinical Research Ethics Committee of the Hospital Universitari Mútua Terrassa (code 02/16) and the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (code P16/094). Articles will be published in indexed scientific journals

Higher rates of triple-class virological failure in perinatally HIV-infected teenagers compared with heterosexually infected young adults in Europe

Objectives The aim of the study was to determine the time to, and risk factors for, triple-class virological failure (TCVF) across age groups for children and adolescents with perinatally acquired HIV infection and older adolescents and adults with heterosexually acquired HIV infection. Methods We analysed individual patient data from cohorts in the Collaboration of Observational HIV Epidemiological Research Europe (COHERE). A total of 5972 participants starting antiretroviral therapy (ART) from 1998, aged 500 HIV-1 RNA copies/mL despite >= 4 months of use. TCVF was defined as cumulative failure of two NRTIs, an NNRTI and a bPI. Results The median number of weeks between diagnosis and the start of ART was higher in participants with perinatal HIV infection compared with participants with heterosexually acquired HIV infection overall [17 (interquartile range (IQR) 4-111) vs. 8 (IQR 2-38) weeks, respectively], and highest in perinatally infected participants aged 10-14 years [49 (IQR 9-267) weeks]. The cumulative proportion with TCVF 5 years after starting ART was 9.6% [95% confidence interval (CI) 7.0-12.3%] in participants with perinatally acquired infection and 4.7% (95% CI 3.9-5.5%) in participants with heterosexually acquired infection, and highest in perinatally infected participants aged 10-14 years when starting ART (27.7%; 95% CI 13.2-42.1%). Across all participants, significant predictors of TCVF were those with perinatal HIV aged 10-14 years, African origin, pre-ART AIDS, NNRTI-based initial regimens, higher pre-ART viral load and lower pre-ART CD4. Conclusions The results suggest a beneficial effect of starting ART before adolescence, and starting young people on boosted PIs, to maximize treatment response during this transitional stage of development

CD4 cell count and the risk of AIDS or death in HIV-Infected adults on combination antiretroviral therapy with a suppressed viral load: a longitudinal cohort study from COHERE.

BACKGROUND: Most adults infected with HIV achieve viral suppression within a year of starting combination antiretroviral therapy (cART). It is important to understand the risk of AIDS events or death for patients with a suppressed viral load. METHODS AND FINDINGS: Using data from the Collaboration of Observational HIV Epidemiological Research Europe (2010 merger), we assessed the risk of a new AIDS-defining event or death in successfully treated patients. We accumulated episodes of viral suppression for each patient while on cART, each episode beginning with the second of two consecutive plasma viral load measurements 500 copies/µl, the first of two consecutive measurements between 50-500 copies/µl, cART interruption or administrative censoring. We used stratified multivariate Cox models to estimate the association between time updated CD4 cell count and a new AIDS event or death or death alone. 75,336 patients contributed 104,265 suppression episodes and were suppressed while on cART for a median 2.7 years. The mortality rate was 4.8 per 1,000 years of viral suppression. A higher CD4 cell count was always associated with a reduced risk of a new AIDS event or death; with a hazard ratio per 100 cells/µl (95% CI) of: 0.35 (0.30-0.40) for counts <200 cells/µl, 0.81 (0.71-0.92) for counts 200 to <350 cells/µl, 0.74 (0.66-0.83) for counts 350 to <500 cells/µl, and 0.96 (0.92-0.99) for counts ≥500 cells/µl. A higher CD4 cell count became even more beneficial over time for patients with CD4 cell counts <200 cells/µl. CONCLUSIONS: Despite the low mortality rate, the risk of a new AIDS event or death follows a CD4 cell count gradient in patients with viral suppression. A higher CD4 cell count was associated with the greatest benefit for patients with a CD4 cell count <200 cells/µl but still some slight benefit for those with a CD4 cell count ≥500 cells/µl