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Fairness-Aware Ranking in Search & Recommendation Systems with Application to LinkedIn Talent Search

We present a framework for quantifying and mitigating algorithmic bias in mechanisms designed for ranking individuals, typically used as part of web-scale search and recommendation systems. We first propose complementary measures to quantify bias with respect to protected attributes such as gender and age. We then present algorithms for computing fairness-aware re-ranking of results. For a given search or recommendation task, our algorithms seek to achieve a desired distribution of top ranked results with respect to one or more protected attributes. We show that such a framework can be tailored to achieve fairness criteria such as equality of opportunity and demographic parity depending on the choice of the desired distribution. We evaluate the proposed algorithms via extensive simulations over different parameter choices, and study the effect of fairness-aware ranking on both bias and utility measures. We finally present the online A/B testing results from applying our framework towards representative ranking in LinkedIn Talent Search, and discuss the lessons learned in practice. Our approach resulted in tremendous improvement in the fairness metrics (nearly three fold increase in the number of search queries with representative results) without affecting the business metrics, which paved the way for deployment to 100% of LinkedIn Recruiter users worldwide. Ours is the first large-scale deployed framework for ensuring fairness in the hiring domain, with the potential positive impact for more than 630M LinkedIn members.Comment: This paper has been accepted for publication at ACM KDD 201

Subclinical Magnetic Resonance Imaging Markers of Cerebral Small Vessel Disease in Relation to Office and Ambulatory Blood Pressure Measurements

Background: Twenty-four-hour and nighttime blood pressure (BP) levels are more strongly associated with cardiovascular risk than office or daytime BP measurements. However, it remains undocumented which of the office and ambulatory BP measurements have the strongest association and predictive information in relation to the presence of type I, or arteriolosclerosis type, cerebral small vessel diseases (CSVD). Methods: A subset of 429 participants from the Maracaibo Aging Study [aged ≥40 years (women, 73.7%; mean age, 59.3 years)] underwent baseline brain magnetic resonance imaging (MRI) to visualize CSVD, which included log-transformed white matter hyperintensities (log-WMH) volume and the presence (yes/no) of lacunes, cerebral microbleeds (CMB), or enlarged perivascular spaces (EPVS). Linear and logistic regression models were applied to examine the association between CSVD and each +10-mmHg increment in the office and ambulatory systolic BP measurements. Improvement in the fit of nested logistic models was assessed by the log-likelihood ratio and the generalized R 2 statistic. Results: Office and ambulatory systolic BP measurements were related to log-WMH (β-correlation coefficients ≥0.08; P \u3c 0.001). Lacunes and CMB were only associated with ambulatory systolic BP measurements (odds ratios [OR] ranged from 1.31 [95% confidence interval, 1.10-1.55] to 1.46 [1.17-1.84], P ≤ 0.003). Accounted for daytime systolic BP, both the 24-h (β-correlation, 0.170) and nighttime (β-correlation, 0.038) systolic BP measurements remained related to log-WMH. When accounted for 24-h or daytime systolic BP levels, the nighttime systolic BP retained the significant association with lacunes (ORs, 1.05-1.06; 95% CIs, ≥1.01 to ≤ 1.13), whereas the 24-h and daytime systolic BP levels were not associated with lacunes after adjustments for nighttime systolic BP (ORs, ≤ 0.88; 95% CI, ≥0.77 to ≤ 1.14). On top of covariables and office systolic BP, ambulatory systolic BP measurements significantly improved model performance (1.05% ≥ R 2 ≤ 3.82%). Compared to 24-h and daytime systolic BP, nighttime systolic BP had the strongest improvement in the model performance; for WMH (1.46 vs. 1.05%) and lacunes (3.06 vs. ≤ 2.05%). Conclusions: Twenty-four-hour and nighttime systolic BP were the more robust BP measurements associated with CSVD, but the nighttime systolic BP level had the strongest association. Controlling ambulatory BP levels might provide additional improvement in the prevention of CSVD

Normal-tension glaucomatous optic neuropathy is related to blood pressure variability in the Maracaibo Aging Study

Hypoperfusion of the optic nerve might be involved in the pathogenesis of normal-tension glaucomatous optic neuropathy (GON). Mean arterial pressure (MAP) drives ocular perfusion, but no previous studies have addressed the risk of GON in relation to blood pressure (BP) variability, independent of BP level. In a cross-sectional study, 93 residents of Maracaibo, Venezuela, underwent optical coherence tomography, visual field assessments and 24-h ambulatory BP monitoring between 2011 and 2016. We investigated the association of normal-tension GON with or without visual field defects with reading-to reading variability of 24-h MAP, as captured by variability independent of the MAP level (VIMmap). Odds ratios (ORs) were adjusted for 24-h MAP level and for a propensity score of up to five risk factors. Among the 93 participants (87.1% women; mean age, 61.9 years), 26 had open-angle normal-tension GON at both eyes; 14 had visual field defects; and 19 did not have visual field defects. The OR ratios for normal-tension GON, expressed per 1-SD increment in VIMmap (2 mm Hg), were 2.17 (95% confidence interval, 1.33–3.53) unadjusted; 2.20 (1.35–3.61) adjusted for 24-h MAP level only; 1.93 (1.10–3.41) with additional adjustment for age, educational attainment, high-density lipoprotein (HDL) cholesterol and office hypertension; and 1.95 (1.10–3.45) in models including intraocular pressure. We confirmed our a priori hypothesis that BP variability, most likely operating via hypoperfusion of the optic nerve, is associated with normal-tension GON. 24-H ambulatory BP monitoring might therefore help stratify the risk of normal-tension GON

Cognitive Decline Associated with Longitudinal Changes in 24-h Ambulatory Blood Pressure Variability

Background: Cognitive decline has been associated with variability in blood pressure (BP). However, whether the increment of the BP variability during follow-up precedes cognitive decline remains undocumented. We aimed this study to investigate cognitive decline in relation to longitudinal changes in 24-h reading-to-reading BP variability. Methods: We conducted an observational longitudinal study that included 717 dementia-free participants from the Maracaibo Aging Study who underwent follow-up assessment in both 24-h ambulatory BP monitoring and cognitive tests between 1998 and 2015. Cognitive domains consisted of selective reminding tests (total, long-term, short-term, and recognition memory) and the Mini-Mental State Examination (MMSE). Cognitive decline was a longitudinal decrease in cognitive scores. Participants underwent 24-h ambulatory BP monitoring between 2-4 times – with at least one-year interval. Systolic and diastolic BP variability was studied during 24-h and divided into daytime (from 06h00 to 23h00), and nighttime (23h00 to 06h00) periods. To account for BP level, we used variability independent of the mean (VIM) to compute systolic and diastolic BP variability. Other measures of BP variability included the nocturnal BP drop in comparison to the daytime BP level, which was estimated as the night-to-day ratio. Statistics included multivariate linear regression mixed models. Results: Overall, the mean age was 65.6±7.36 years old and 66.5% (n=447) of the participants were women. In mixed models, a decline in all memory domains was associated with greater variability in the 24-h, daytime, and nighttime systolic BP during follow-up, with an estimated decline in cognitive scores ranging from -0.2 to -0.04 points per unit increase in VIM systolic BP during follow-up (P values ranged from 0.022 to 0.003). Decline in total, short-term, and MMSE memory domains was associated with greater 24-h and daytime diastolic BP variability (P≤0.015). A lower night-to-day dipping ratio during follow-up increased the risk of cognitive decline, with a -5.8 to -1.6 decline in long-term memory and MMSE scores; respectively (P≤0.037). Conclusions: Cognitive decline associates with greater reading-to-reading 24-h BP variability and lower falls in nocturnal BP over time. These findings might be indicative of deteriorated regulatory mechanisms to maintain steady BP levels as individuals age

Expression of CXCL10 is associated with response to radiotherapy and overall survival in squamous cell carcinoma of the tongue

Five-year survival for patients with oral cancer has been disappointingly stable during the last decades, creating a demand for new biomarkers and treatment targets. Lately, much focus has been set on immunomodulation as a possible treatment or an adjuvant increasing sensitivity to conventional treatments. The objective of this study was to evaluate the prognostic importance of response to radiotherapy in tongue carcinoma patients as well as the expression of the CXC-chemokines in correlation to radiation response in the same group of tumours. Thirty-eight patients with tongue carcinoma that had received radiotherapy followed by surgery were included. The prognostic impact of pathological response to radiotherapy, N-status, T-stage, age and gender was evaluated using Cox's regression models, Kaplan-Meier survival curves and chi-square test. The expression of 23 CXC-chemokine ligands and their receptors were evaluated in all patients using microarray and qPCR and correlated with response to treatment using logistic regression. Pathological response to radiotherapy was independently associated to overall survival with a 2-year survival probability of 81 % for patients showing a complete pathological response, while patients with a non-complete response only had a probability of 42 % to survive for 2 years (p = 0.016). The expression of one CXC-chemokine, CXCL10, was significantly associated with response to radiotherapy and the group of patients with the highest CXCL10 expression responded, especially poorly (p = 0.01). CXCL10 is a potential marker for response to radiotherapy and overall survival in patients with squamous cell carcinoma of the tongue

Association of Variability and Hypertensive Peaks in 24-h Blood Pressure with Cardiovascular Risk and Mortality

Background: Blood pressure (BP) variability relates to cardiovascular (CV) diseases and one unexplored mechanism may involve hypertensive peaks caused by high BP variability. OBJECTIVES: To test this hypothesis, we studied the association of cumulative hypertensive peaks (CHP) in 24-h systolic BP with CV risk. Methods: A total of 1212 participants from the Maracaibo Aging Study (mean age, 66; women, 67.2%) underwent 24-h ambulatory BP monitoring and were followed between 1998 and 2010. BP variability was the 24-h average real variability (ARV). CHP in systolic BP (expressed as %) was the number of systolic BP measures ≥125 mmHg (based on the ACC/AHA threshold) each participant experienced over 24-h divided by the number of recordings. The primary endpoint was a composite of fatal and nonfatal coronary, heart failure, and stroke events, while secondary endpoints were total and CV mortality, and fatal and nonfatal coronary and stroke endpoints. Statistics included adjusted Cox proportional models adjusted. Results: During a median follow-up of 8 years, 242 participants developed a composite of any CV endpoint, and 353 died (210 cardiovascular deaths), 129 had coronary and 57 stroke endpoints. An increment of +2 mmHg in 24-h ARV (HR [hazard ratio], 1.18; 95% confidence interval [CI], 1.05-1.33) or +5% in CHP (HR, 1.05; 95% CI, 1.02-1.07) increased CV risk. The inclusion of both indexes in the same Cox proportional models resulted in CHP, but not ARV (P=0.075), associated with the primary endpoints (P=0.004). For secondary endpoints, the association of ARV attenuated while CHP was similar. Conclusions: In this population-based cohort study, CHP in 24-h systolic BP explains the association of high 24-h BP variability and CV risk. Clinical management of high 24-h BP variability is challenging but recognizing that an increased variability results in CHP seems a feasible alternative to address in CV prevention

Contribution of 24-h Blood Pressure Variability to Dementia-Related Disorders in Hispanics

Introduction: As the number of people living with dementia is increasing at alarming rates worldwide, there is an urgent need to understand the physiopathology of dementia syndromes. Among the most important preventable risk factors, treatment of vascular risk factors such as high blood pressure (BP) decreases the risk of Alzheimer’s disease and related dementias (ADRD). Recent evidence suggests that examining BP variability provides additional physiopathological and predictive information above the mean BP level. However, studies examining the relationship between 24-h BP variability and ADRD are limited, and evidence of the association with dementia has not been documented yet. Therefore, we aimed in this study to assess the association of 24-h ambulatory BP variability with brain imaging and cognitive markers of ADRD. Methods: A cross-sectional observational study was conducted using a subset of 420 individuals from the Maracaibo Aging Study aged ≥40 years. Study participants underwent brain MRI scanning and 24-h ambulatory BP monitoring assessments. Markers of ADRD included 1) cerebral small vessel disease (CSVD, defined as white matter hyperintensities, presence of lacunes, cerebral microbleeds, and enlarged perivascular spaces, and hippocampal volume), 2) cognitive functioning addressed with the mini-mental state exam (EMEMS), and 3) diagnose of dementia at baseline. 24-h ambulatory BP variability was studied as the average real variability index. Adjusted linear and logistic regression models were used to analyze the association between 24-h BP and ADRD and accounted for age, sex, education level, body mass index (BMI), current smoking, alcohol intake, hypertension treatment, diabetes mellitus, serum total cholesterol, previous cardiovascular diseases, and cephalic circumference and 24-h mean BP level. Results: The mean age was 57.1±11.8 years old and 73.2% were women (n=303). In adjusted analysis, each unit increase in the 24-h systolic BP variability was significantly associated with lower hippocampus volume (β, -0.036; 95% confidence interval [CI], -0.064, -0.008, P=0.011), greater white matter hyper intensities volume (β, 0.026; 95% CI, 0.008, 0.044; P=0.006), lower cognitive scores (β, -0.370; 95% CI, -0.729, -0.011; P=0.044), greater presence of lacunes (Odds ratios [OR], 1.38; 95% CI, 1.10, 1.71; P=0.004), enlarged perivascular spaces (OR,1.34; 95% CI, 1.08, 1.67; P=0.007), and dementia prevalence (OR, 1.41; 95% CI, 1.07, 1.85; P=0.014). 24-hour diastolic blood pressure variability was only significantly associated with lacunes (OR, 1.42; 95% CI, 1.06, 1.90; P=0.017). In exploratory analysis, we found that neither daytime nor nighttime variability in BP significantly relate with ADRD. Conclusions: Excessive 24-h BP variability associates with ADRD independently of the mean BP level. Understanding the physiological mechanisms explaining the relationship between excessive 24-h BP variability and ADRD may be clinically relevant in the prevention of ADRDs