An Ontology Formalization of Relation Type Hierarchy in Conceptual Structure Theory

This paper presents an enhancement to ontology formalization, combining previous work in Conceptual Structure Theory and Order-Sorted Logic. In particular, the relation type hierarchy of the former theory is a subset of the predicate hierarchy of the latter. Most existing ontology formalisms place greater importance on concept types, but this paper focuses more on relation types, which are in essence predicates on concept types. New notions are introduced and new properties identified with the aim of completing missing arguments in relation types. The end result is a new ontology, that we call the closure of the original ontology, on which automated inference could be more easily produced (e.g., a query-answering system for legal knowledge)

Antibiotic treatment failure in children aged 1 to 59 months with World Health Organization-defined severe pneumonia in Malawi: A CPAP IMPACT trial secondary analysis

Background Pneumonia is a leading cause of mortality in children <5 years globally. Early identification of hospitalized children with pneumonia who may fail antibiotics could improve outcomes. We conducted a secondary analysis from the Malawi CPAP IMPACT trial evaluating risk factors for antibiotic failure among children hospitalized with pneumonia. Methods Participants were 1–59 months old with World Health Organization-defined severe pneumonia and hypoxemia, severe malnutrition, and/or HIV exposure/infection. All participants received intravenous antibiotics per standard care. First-line antibiotics were benzylpenicillin and gentamicin for five days. Study staff assessed patients for first-line antibiotic failure daily between days 3–6. When identified, patients failing antibiotics were switched to second-line ceftriaxone. Analyses excluded children receiving ceftriaxone and/or deceased by hospital day two. We compared characteristics between patients with and without treatment failure and fit multivariable logistic regression models to evaluate associations between treatment failure and admission characteristics. Results From June 2015–March 2018, 644 children were enrolled and 538 analyzed. Antibiotic failure was identified in 251 (46.7%) participants, and 19/251 (7.6%) died. Treatment failure occurred more frequently with severe malnutrition (50.2% (126/251) vs 28.2% (81/287), p<0.001) and amongst those dwelling 10km from a health facility (22.3% (56/251) vs 15.3% (44/287), p = 0.026). Severe malnutrition occurred more frequently among children living 10km from a health facility than those living <10km (49.0% (49/100) vs 35.7% (275/ 428), p = 0.014). Children with severe malnutrition (adjusted odds ratio (aOR) 2.2 (95% CI 1.52, 3.24), p<0.001) and pre-hospital antibiotics ((aOR 1.47, 95% CI 1.01, 2.14), p = 0.043) had an elevated aOR for antibiotic treatment failure. Conclusion Severe malnutrition and pre-hospital antibiotic use predicted antibiotic treatment failure in this high-risk severe pneumonia pediatric population in Malawi. Our findings suggest addressing complex sociomedical conditions like severe malnutrition and improving pneumonia etiology diagnostics will be key for better targeting interventions to improve childhood pneumonia outcomes

Cosmological Applications of Gravitational Lensing

The last decade has seen an enormous increase of activity in the field of gravitational lensing, mainly driven by improvements of observational capabilities. I will review the basics of gravitational lens theory, just enough to understand the rest of this contribution, and will then concentrate on several of the main applications in cosmology. Cluster lensing, and weak lensing, will constitute the main part of this review.Comment: 26 pages, including 2 figures (a third figure can be obtained from the author by request) gziped and uuencoded postscript file; to be published in Proceedings of the Laredo Advanced Summer School, Sept. 9

Warts and all: Fingolimod and unusual HPV-associated lesions

Background: Fingolimod is used to reduce relapse rates in relapsing-remitting multiple sclerosis (MS). It is a sphingosine 1-phosphate (S1P) analogue having antagonistic effects on S1P receptors. Its immunosuppressive effect is due to reduced circulating lymphocyte numbers, and it may also be associated with impaired intrinsic cancer surveillance. Fingolimod side effects include increased rates and severity of viral infections particularly varicella zoster. Methods: We present five cases of chronic and treatment refractory warts associated with fingolimod therapy. Results: Each of the five cases presenting with chronic warts while receiving fingolimod therapy had prolonged periods of lymphopenia and improvements were seen following dose reduction or cessation of fingolimod. Conclusion: Cutaneous warts are associated with human papilloma virus (HPV) infection, suggesting an increased risk of other HPV-driven conditions such as cervical cancer following fingolimod administration. HPV viruses are responsible for approximately 90% of cervical cancers as well as a significant portion of anogenital cancers and have a high prevalence in sexually active adults. Given the reduced immune response to viral infections and potential impaired cancer surveillance in those receiving fingolimod, HPV vaccination and frequent assessment for the development of HPV-associated malignancies are recommended