Using a Logic Programming Framework to Control Database Query Dialogues in Natural Language

We present a natural language question/answering system to interface the University of Évora databases that uses clarification dialogs in order to clarify user questions. It was developed in an integrated logic programming framework, based on constraint logic programming using the GnuProlog(-cx) language [2,11] and the ISCO framework [1]. The use of this LP framework allows the integration of Prolog-like inference mechanisms with classes and inheritance, constraint solving algorithms and provides the connection with relational databases, such as PostgreSQL. This system focus on the questions’ pragmatic analysis, to handle ambiguity, and on an efficient dialogue mechanism, which is able to place relevant questions to clarify the user intentions in a straightforward manner. Proper Nouns resolution and the pp-attachment problem are also handled. This paper briefly presents this innovative system focusing on its ability to correctly determine the user intention through its dialogue capability

Predictive Factors of Piperacillin Exposure and the Impact on Target Attainment after Continuous Infusion Administration to Critically Ill Patients

Critically ill patients undergo significant pathophysiological changes that affect antibiotic pharmacokinetics. Piperacillin/tazobactam administered by continuous infusion (CI) improves pharmacokinetic/pharmacodynamic (PK/PD) target attainment. This study aimed to characterize piperacillin PK after CI administration of piperacillin/tazobactam in critically ill adult patients with preserved renal function and to determine the empirical optimal dosing regimen. A total of 218 piperacillin concentrations from 106 patients were simultaneously analyzed through the population PK approach. A two-compartment linear model best described the data. Creatinine clearance (CLCR) estimated by CKD-EPI was the covariate, the most predictive factor of piperacillin clearance (CL) interindividual variability. The mean (relative standard error) parameter estimates for the final model were: CL: 12.0 L/h (6.03%); central and peripheral compartment distribution volumes: 20.7 L (8.94%) and 62.4 L (50.80%), respectively; intercompartmental clearance: 4.8 L/h (26.4%). For the PK/PD target of 100% fT(>1xMIC), 12 g of piperacillin provide a probability of target attainment > 90% for MIC 100 mL/min. For 100% fT(>4xMIC), the highest dose (24 g/24 h) was not sufficient to ensure adequate exposure, except for MICs of 1 and 4 mg/L. Our model can be used as a support tool for initial dose guidance and during therapeutic drug monitoring

Above-ground carbon stocks, species diversity and fire dynamics in the Bateke Plateau

Savannas are heterogeneous systems characterised by a high spatial and temporal variation in ecosystem structure. Savannas dominate the tropics, with important ecological functions, and play a prominent role in the global carbon cycle, in particular responsible for much of its inter-annual variability. They are shaped by resource availability, soil characteristics and disturbance events, particularly fire. Understanding and predicting the demographic structure and woody cover of savannas remains a challenge, as it is currently poorly understood due to the complex interactions and processes that determine them. A predictive understanding of savanna ecosystems is critical in the context of land use management and global change. Fire is an essential ecological disturbance in savannas, and forest-savanna mosaics are maintained by fire-mediated positive feedbacks. Over half of the world’s savannas are found in Africa, and over a quarter Africa’s surface burns every year, with fires occurring principally in the savanna biome. These have strong environmental and social impacts. Most fires in Africa are anthropogenic and occur during the late dry season, but their dynamics and effects remain understudied. The main objective of this research is to understand the floristic composition, carbon storage, woody cover and fire regime of the mesic savannas of the Bateke Plateau. The Bateke Plateau is savanna-forest mosaic ecosystem, situated mainly in the Republic of Congo, with sandy Kalahari soils and enough precipitation for potential forest establishment (1600 mm/yr). Despite occupying 89,800 km2, its ecology and ecosystem functions are poorly understood. This study combines two approaches: firstly experimental, setting up long term field experiments where the fire regime is manipulated, and then observational, using remote sensing to estimate the carbon storage and study the past history of the fire regime in the region. I established four large (25 ha) plots at two savanna sites, measured their carbon stocks, spatial structure and floristic composition, and applied different annual fire treatments (early and late dry season burns). These treatments were applied annually during 3 years (2015, 2016 and 2017), and the plots were re-measured every year to estimate tree demographic rates and the identification of the key processes that impact them, including fire and competition. Field data were combined with satellite radar data from ALOS PALSAR, and the fire products of the MODIS satellites, to estimate carbon stocks and fire regimes for the entire Bateke Plateau. I also analyse the underlying biophysical and anthropogenic processes that influence the patterns in Above-Ground Woody Biomass (AGWB) and their spatial variability in the Bateke landscape. The total plant carbon stocks (above-ground and below-ground) were low, averaging only 6.5 ± 0.3 MgC/ha, with grass representing over half the biomass. Soil organic matter dominate the ecosystem carbon stocks, with 16.7 ± 0.9 Mg/ha found in the top 20 cm alone. We identified 49 plant species (4 trees, 13 shrubs, 4 sedges, 17 forbs and 11 grass species), with a tree hyperdominance of Hymenocardia acida, and a richer herbaceous species composition. These savannas showed evidence of tree clustering, and also indications of tree-tree competition. Trees had low growth rates (averaging 1.21 mm/yr), and mortality was relatively low (3.24 %/yr) across all plots. The experiment showed that late dry season fires significantly reduced tree growth compared to early dry season fires, but also reduced stem mortality rates. Results show that these mesic savannas had very low tree biomass, with tree cover held far below its climate potential closed-canopy maximum, likely due to nutrient poor sandy soils and frequent fires. Results from the remote sensing analysis indicated that multiple explanatory variables had a significant effect on AGWB in the Bateke Plateau. Overall, the frequency of fire had the largest impact on AGWB (with higher fire frequency resulting in lower AGWB), with sand content the next most important explanatory variable (with more sand reducing AGWB). Fires in the Bateke are very frequent, and show high seasonality. The proportion of fires that occurred in the late dry season, though smaller predictor, was also more important than other factors (including soil carbon proportion, whether or not the savanna area was in a protected area, annual rainfall, or distance to the nearest town, river or road), with a larger proportion of late dry season fires associated with a small increase in AGWB. The results give pointers for management of the savannas of the Bateke Plateau, as well as improving our understanding of vegetation dynamics in this understudied ecosystem and help orient policy and conservation

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

Impact of wastewater treatment plant discharges on macroalgae and macrofauna assemblages of the intertidal rocky shore in the southeastern Bay of Biscay

International audienceRocky intertidal habitats are particularly vulnerable to anthropogenic pressures especially in areas with high urban concentrations such as southeastern Bay of Biscay. This research aims to establish an assessment of the potential impact of sewage discharges on intertidal rocky benthic assemblages on macroalgae and on macrofauna as required by the European Directives (Water Framework Directive -WFD and Marine Strategy Framework Directive -MSFD). The assemblages were sampled at five locations according to a control-impact design. A moderate detectable effect of discharges was highlighted on the assemblage structure by means of multivariate analyses but this was less evident using other biological and ecological metrics. Results would also suggest that benthic macroalgae constitute for the study area the best relevant biotic component to assess the effect of this pressure on the intertidal rocky platform habitats. Changes in the relative abundance of Ceramium spp., Corallina spp. and Halopteris scoparia were mainly responsible of the dissimilarities found. Finally, a pseudo-ecological quality ratio, based on the current WFD metrics, was also calculated for each site within locations (i.e. each distance from the outfall) to assess its sensitivity to this type of pressure. Results were conformed with those of the WFD monitoring because the un- or less-impacted sites were ranked as “Good” contrary to the others ranked as “Moderate”. Thus, this work provides additional information for the MSFD and bridges deficiencies emphasized by Directives on the response of biological indicators to various pressures and the biocenosis of southeastern Bay of Biscay

Continuous capillary-flow sensing of glucose and lactate in sweat with an electrochemical sensor based on functionalized graphene oxide

We describe an electrochemical device for the simultaneous monitoring of glucose and lactate in sweat, based on enzymatic sensors exploiting capillary flow to induce continuous, stable sensing. The enzymes, namely glucose oxidase and lactate oxidase, were anchored to a graphene oxide and chitosan composite (GO-Ch) of original synthesis, to achieve stable deposition of the bioreceptors on the electrochemical platform. We tested both biosensors on a realistic device architecture: they were embedded in a nitrocellulose strip, to exploit capillary force to induce a continuous flux of sweat on the sensor platform, ensuring the constant renewal of sample. We could achieve good sensitivity at potentials close to zero by using Prussian Blue as redox mediator, thus avoiding interference from other chemical species present in the complex matrix. The sensing signal was stable and linear over two hours in a concentration range of glucose and lactate between the limit of quantification (32 and 68 nM, respectively) and the upper limit of linearity (3.8 and 50.0 mM, respectively). The device is simple, robust, stable, and can be easily worn without the direct contact of the active part with the skin, making it suitable for simultaneous monitoring of glucose and lactate in human sweat

Financial and consumption habits and behaviors during the COVID-19 pandemic : a short-term study of Argentina, Chile and Colombia

This study aimed at describing the impact that the COVID 19 pandemic had on the financial and consumption habits of Chilean, Argentinean and Colombian families. This was a cross-sectional on-line study. The final sample consisted of 1,184 adults who managed independent financial resources and from urban areas of Argentina, Chile, and Colombia. Results show an increased use of credit to pay for basic services and on the late payments of expenses. The current main fears are linked to contracting the disease, losing employment and not being able to pay basic expenses. Finally, groups of participants emerge based on based on ways of dealing with the crisis and differentiated by sociodemographic variables.https://orcid.org/0000-0001-7954-3697https://orcid.org/0000-0002-5328-0304https://orcid.org/0000-0003-1938-0675https://orcid.org/0000-0003-1682-9481https://orcid.org/0000-0002-4955-1976https://www.scopus.com/authid/detail.uri?authorId=6603020270https://www.scopus.com/authid/detail.uri?authorId=36094902600https://www.scopus.com/authid/detail.uri?authorId=57499249800https://www.scopus.com/authid/detail.uri?authorId=35621650400https://www.scopus.com/authid/detail.uri?authorId=57224192013https://www.scopus.com/authid/detail.uri?authorId=57204114134https://www.scopus.com/authid/detail.uri?authorId=57328548600https://www.scopus.com/authid/detail.uri?authorId=5746718580

Towards process mining of EMR data: case study for sepsis management

Imagine you have cold shivers and a racing heartbeat and high fever. Clear thinking is impossible! Ceiling lights flash by as you are rushed to the emergency department (ED). You feel your body is getting even sicker. Doctors are doing their utmost to treat this acute and threatening condition, while they work piece together all small parts of evidence to set the diagnosis and start targeted treatment. In this situation, the clinical staff depends on a clinical pathway protocol to streamline communication and deliver care according to the latest medical evidence. Today, such clinical pathways are mainly executed and tracked using paper. Hence, there is ample opportunity for technology in a supportive role. Automated process analysis can help improve these processes of delivering standardized care beyond their current level. In this paper, we provide insight into the steps required to perform process mining to EMR data in the challenging domain of sepsis treatment and provide learnings from our preliminary analysis of these data using process mining techniques