Consistent Second-Order Conic Integer Programming for Learning Bayesian Networks

Bayesian Networks (BNs) represent conditional probability relations among a set of random variables (nodes) in the form of a directed acyclic graph (DAG), and have found diverse applications in knowledge discovery. We study the problem of learning the sparse DAG structure of a BN from continuous observational data. The central problem can be modeled as a mixed-integer program with an objective function composed of a convex quadratic loss function and a regularization penalty subject to linear constraints. The optimal solution to this mathematical program is known to have desirable statistical properties under certain conditions. However, the state-of-the-art optimization solvers are not able to obtain provably optimal solutions to the existing mathematical formulations for medium-size problems within reasonable computational times. To address this difficulty, we tackle the problem from both computational and statistical perspectives. On the one hand, we propose a concrete early stopping criterion to terminate the branch-and-bound process in order to obtain a near-optimal solution to the mixed-integer program, and establish the consistency of this approximate solution. On the other hand, we improve the existing formulations by replacing the linear "big-$M$" constraints that represent the relationship between the continuous and binary indicator variables with second-order conic constraints. Our numerical results demonstrate the effectiveness of the proposed approaches

Avances recientes en métodos moleculares para el diagnóstico precoz y tuberculosis resistente al tratamiento

Tuberculosis (TB) remains the main infectious cause of deaths in the world. Due to the slow metabolism of the causative agent, Mycobacterium tuberculosis, the isolation, identification and drug susceptibility testing requires several weeks. New techniques have improved specificity, turnaround time and cost effectiveness. Although these methods yield results within hours from sample collection, the clinical significance of each positive result requires rigorous evaluation in most cases. Herein the advantages and disadvantages of the most promising molecular techniques for detection of TB and drug resistance are discussed.La tuberculosis sigue siendo la principal causa de mortalidad por un agente infeccioso a escala mundial. Debido al metabolismo lento de su agente etiológico, Mycobacterium tuberculosis, el aislamiento, la identificación y las pruebas de susceptibilidad tardan varias semanas. Nuevas técnicas moleculares desarrolladas ofrecen mejorías en la especificidad, el tiempo para la obtención de resultados y su costo-efectividad. Estas pruebas producen resultados en pocas horas a partir de la toma de muestra, pero su relevancia clínica requiere aún ser evaluada rigurosamente en la mayoría de los casos. En esta revisión se discuten las ventajas y las desventajas de las pruebas moleculares más promisorias desarrolladas para el diagnóstico de la tuberculosis y la tuberculosis resistente a medicamentos

The Relationship between Coronavirus Anxiety, Resilience, and Islamic Beliefs in Hemodialysis Patients during the Pandemic: A Survey in Iran

The coronavirus disease has been converted into one of the greatest present public health crises. Patients with chronic diseases, including people with kidney failure undergoing hemodialysis treatment, are one of the main groups at risk of coronavirus. The present study aimed at investigating the relationship between coronavirus anxiety, resilience, and religious beliefs in hemodialysis patients during the Covid-19 pandemic in Iran. A total of 160 patients undergoing hemodialysis participated in this cross-sectional study. The data was collected by convenient sampling from three hemodialysis centers from April 15 to May 15, 2022, in Northern Khorasan province. Patients completed four questionnaires: demographic information questionnaires, Corona Disease Anxiety Scale (CDAS), Connor-Davidson Resilience Scale (CD-RISC), and Golriz and Baraheni's Religious Attitude (2013). Data were analyzed using Stata14. The findings showed that 98.8% of the participants had mild anxiety and 1.2% had moderate anxiety. Anxiety (the physical component) had an inverse relationship with resilience (the control component) (P < .05); also, resilience and its components had a direct correlation with religion (P < .05). Resilience and religious beliefs are related to corona anxiety in hemodialysis patients, and targeting these two components through psychological treatments can be effective in reducing corona anxiety

Isolated anterior cruciate ligament deficiency : comparison of results following acute and chronic arthroscopic reconstruction with patellar tendon autograft

Isolated injury of the anterior cruciate ligament (ACL) is less frequent and typically perceived as less severe than ACL injuries with concurrent damage to other knee stabilizing structures. The timing of the ACL reconstructive surgery is thought to be a critical factor that affects the patient's postoperative outcome. No previous study has compared the results of acute reconstruction (interval between injury and surgery less than or equal to 3 months) and chronic reconstruction (interval between injury and surgery greater than 3 months) of isolated ruptures of the ACL. The primary aim of this study was to assess the differences in functional outcomes between two distinct patient populations treated using the same surgical intervention. The secondary aim of this study was to determine which functional outcome variables differed between the acute isolated and chronic isolated patient populations in order to identify the etiology of any long-term functional impairment. Two separate investigations were conducted to address these questions. The first study evaluated the efficacy of an arthroscopic-assisted surgical technique using an autogenous substitute for the ACL in a group of patients who had surgery more than 3 months after isolated injury to their ACL. Fifty-five patients from Cairo, Egypt (mean age, 27.1 ± 4.5 years) underwent ACL reconstruction an average of 7.0 ± 2.6 months (range, 3.3 to 16.6 months) after injury. Patients were evaluated at an average of 2.2 ± .3 years postoperatively (range, 2.0 to 3.4 years) using a battery of objective and subjective tests. No significant differences were observed between the patients' surgical and contralateral normal knees (p>.05). International Knee Documentation Committee (IKDC) scores questionnaire rated 48 of 55 patients (87.3%) as "normal", 5 patients (9.1%) as "nearly normal" and 2 patients (3.6%) as "abnormal"; no patients were categorized as "severely abnormal". The second investigation evaluated the effect of timing of surgery on functional outcomes. From a group of 773 arthroscopic-assisted ACL reconstruction patients in Cairo, Egypt, 200 of 234 patients (mean age, 32.2 ± 6.9 yrs.) with isolated ACL injuries participated in this study. Subjects were assigned to groups based on the interval between ACL injury and surgery. Patients in the acute reconstruction group (n=100) had surgery an average of 62 days postinjury, while the chronic reconstruction group (n=100) had surgery an average of 211 days postinjury. The mean follow-up period was 2.2 ± 0.3 years (range, 2.0 to 3.8 years) for all subjects. There were statistically significant differences between the acute and chronic group in the final score (x² 2=6.43 with p=0.04). IKDC scores rated 62% of the acute and 58% of chronic group patients as "normal", 37% of acute and 38% of chronic group patients as "near normal", and 1% of acute and 4% of chronic group knees as "abnormal". Delaying the ACL reconstruction to allow for reduction of the acute inflammatory process and participation in pre-operative rehabilitation resulted in fewer cases of postoperative arthrofibrosis in the chronic group compared to the acute group. However, delays of surgery more than 3 months between isolated injury of the ACL and surgical reconstruction resulted in greater frequency of arthritic changes

Phylogenomic analysis of the species of the Mycobacterium tuberculosis complex demonstrates that Mycobacterium africanum, Mycobacterium bovis, Mycobacterium caprae, Mycobacterium microti and Mycobacterium pinnipedii are later heterotypic synonyms of Mycobacterium tuberculosis

International audienc

Investigating the Correlation Among Personality Traits, Familial Functioning, and Suicidal Thoughts Among University Students: A Descriptive Correlational Study

Objectives: Suicide is a serious public health problem, especially among students as active members of the community. The present study aimed to determine the correlation among personality characteristics, family functioning, and suicidal ideation in students of Shahid Beheshti University of Medical Sciences in Tehran, Iran in 2018. Materials and Methods: The population of this descriptive correlational study included all 675 students of Shahid Beheshti University of Medical Sciences, from whom 244 students were selected using stratified random sampling. The required data was collected using four questionnaires, including demographic characteristics, personality traits, family functioning, and Beck Scale for Suicidal Ideation (BSSI). To analyze data, we used multiple linear regression and the Statistical Package for the Social Sciences (SPSS, version 22). Results: Examination of personality traits suggested that the correlation between psychosis and suicidal thoughts was positive and significant (P<0.05). The correlation coefficients between the components of extraversion-introversion, agreeability, and responsibility and suicidal ideation were negative and significant (P<0.05). There was also a positive and significant relationship between all components of family functioning and suicidal ideation (P<0.05). Conclusions: Effective steps can be taken to prevent suicide among students through providing optimal psychological healthcare and periodic screening of students in terms of suicidal thoughts and mental disorders

Ovarian Adnexal Reporting Data System (O-RADS) for Classifying Adnexal Masses: A Systematic Review and Meta-Analysis

In this systematic review and meta-analysis, we aimed to assess the pooled diagnostic performance of the so-called Ovarian Adnexal Report Data System (O-RADS) for classifying adnexal masses using transvaginal ultrasound, a classification system that was introduced in 2020. We performed a search for studies reporting the use of the O-RADS system for classifying adnexal masses from January 2020 to April 2022 in several databases (Medline (PubMed), Google Scholar, Scopus, Cochrane, and Web of Science). We selected prospective and retrospective cohort studies using the O-RADS system for classifying adnexal masses with histologic diagnosis or conservative management demonstrating spontaneous resolution or persistence in cases of benign appearing masses after follow-up scan as the reference standard. We excluded studies not related to the topic under review, studies not addressing O-RADS classification, studies addressing MRI O-RADS classification, letters to the editor, commentaries, narrative reviews, consensus documents, and studies where data were not available for constructing a 2 × 2 table. The pooled sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio (DOR) were calculated. The quality of the studies was evaluated using QUADAS-2. A total of 502 citations were identified. Ultimately, 11 studies comprising 4634 masses were included. The mean prevalence of ovarian malignancy was 32%. The risk of bias was high in eight studies for the "patient selection" domain. The risk of bias was low for the "index test" and "reference test" domains for all studies. Overall, the pooled estimated sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR of the O-RADS system for classifying adnexal masses were 97% (95% confidence interval (CI) = 94%-98%), 77% (95% CI = 68%-84%), 4.2 (95% CI = 2.9-6.0), 0.04 (95% CI = 0.03-0.07), and 96 (95% CI = 50-185), respectively. Heterogeneity was moderate for sensitivity and high for specificity. In conclusion, the O-RADS system has good sensitivity and moderate specificity for classifying adnexal masses

SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Background: The SUCCOR cohort was developed to analyse the overall and disease-free survival at 5 years in women with FIGO 2009 stage IB1 cervical cancer. The aim of this study was to compare the use of adjuvant therapy in these women, depending on the method used to diagnose lymphatic node metastasis. // Patients and Methods: We used data from the SUCCOR cohort, which collected information from 1049 women with FIGO 2009 stage IB1 cervical cancer who were operated on between January 2013 and December 2014 in Europe. We calculated the adjusted proportion of women who received adjuvant therapy depending on the lymph node diagnosis method and compared disease free and overall survival using Cox proportional-hazards regression models. Inverse probability weighting was used to adjust for baseline potential confounders. // Results: The adjusted proportion of women who received adjuvant therapy was 33.8% in the sentinel node biopsy + lymphadenectomy (SNB+LA) group and 44.7% in the LA group (p = 0.02), although the proportion of positive nodal status was similar (p = 0.30). That difference was greater in women with negative nodal status and positive Sedlis criteria (difference 31.2%, p = 0.01). Here, those who underwent a SNB+LA had an increased risk of relapse [hazard ratio (HR) 2.49, 95% confidence interval (CI) 0.98–6.33, p = 0.056] and risk of death (HR 3.49, 95% CI 1.04–11.7, p = 0.042) compared with those who underwent LA. // Conclusions: Women in this study were less likely to receive adjuvant therapy if their nodal invasion was determined using SNB+LA compared with LA. These results suggest a lack of therapeutic measures available when a negative result is obtained by SNB+LA, which may have an impact on the risk of recurrence and survival