The flare likelihood and region eruption forecasting (FLARECAST) project: flare forecasting in the big data & machine learning era

The European Union funded the FLARECAST project, that ran from January 2015 until February 2018. FLARECAST had a research-to-operations (R2O) focus, and accordingly introduced several innovations into the discipline of solar flare forecasting. FLARECAST innovations were: first, the treatment of hundreds of physical properties viewed as promising flare predictors on equal footing, extending multiple previous works; second, the use of fourteen (14) different machine learning techniques, also on equal footing, to optimize the immense Big Data parameter space created by these many predictors; third, the establishment of a robust, three-pronged communication effort oriented toward policy makers, space-weather stakeholders and the wider public. FLARECAST pledged to make all its data, codes and infrastructure openly available worldwide. The combined use of 170+ properties (a total of 209 predictors are now available) in multiple machine-learning algorithms, some of which were designed exclusively for the project, gave rise to changing sets of best-performing predictors for the forecasting of different flaring levels, at least for major flares. At the same time, FLARECAST reaffirmed the importance of rigorous training and testing practices to avoid overly optimistic pre-operational prediction performance. In addition, the project has (a) tested new and revisited physically intuitive flare predictors and (b) provided meaningful clues toward the transition from flares to eruptive flares, namely, events associated with coronal mass ejections (CMEs). These leads, along with the FLARECAST data, algorithms and infrastructure, could help facilitate integrated space-weather forecasting efforts that take steps to avoid effort duplication. In spite of being one of the most intensive and systematic flare forecasting efforts to-date, FLARECAST has not managed to convincingly lift the barrier of stochasticity in solar flare occurrence and forecasting: solar flare prediction thus remains inherently probabilistic

Pain and Frailty in Hospitalized Older Adults

Introduction: Pain and frailty are prevalent conditions in the older population. Many chronic diseases are likely involved in their origin, and both have a negative impact on quality of life. However, few studies have analysed their association. Methods: In light of this knowledge gap, 3577 acutely hospitalized patients 65 years or older enrolled in the REPOSI register, an Italian network of internal medicine and geriatric hospital wards, were assessed to calculate the frailty index (FI). The impact of pain and some of its characteristics on the degree of frailty was evaluated using an ordinal logistic regression model after adjusting for age and gender. Results: The prevalence of pain was 24.7%, and among patients with pain, 42.9% was regarded as chronic pain. Chronic pain was associated with severe frailty (OR = 1.69, 95% CI 1.38–2.07). Somatic pain (OR = 1.59, 95% CI 1.23–2.07) and widespread pain (OR = 1.60, 95% CI 0.93–2.78) were associated with frailty. Osteoarthritis was the most common cause of chronic pain, diagnosed in 157 patients (33.5%). Polymyalgia, rheumatoid arthritis and other musculoskeletal diseases causing chronic pain were associated with a lower degree of frailty than osteoarthritis (OR = 0.49, 95%CI 0.28–0.85). Conclusions: Chronic and somatic pain negatively affect the degree of frailty. The duration and type of pain, as well as the underlying diseases associated with chronic pain, should be evaluated to improve the hospital management of frail older people

The multifaceted spectrum of liver cirrhosis in older hospitalised patients: Analysis of the REPOSI registry

Background: Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives: To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. Methods: A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. Results: LC was diagnosed in 315 patients (5%). LC was associated with rehospitalisation (age-sex adjusted hazard ratio, [aHR] 1.44; 95% CI, 1.10-1.88) and with mortality after discharge, independently of all confounders (multiple aHR, 2.1; 95% CI, 1.37-3.22), but not with in-hospital mortality and incident disability. Three main clinical phenotypes of LC patients were recognised: relatively fit subjects (FIT, N = 150), subjects characterised by poor social support (PSS, N = 89) and, finally, subjects with disability and multimorbidity (D&M, N = 76). PSS subjects had an increased incident disability (35% vs 13%, P < 0.05) compared to FIT. D&M patients had a higher mortality (in-hospital: 12% vs 3%/1%, P < 0.01; post-discharge: 41% vs 12%/15%, P < 0.01) and less rehospitalisation (10% vs 32%/34%, P < 0.01) compared to PSS and FIT. Conclusions: LC has a relatively low prevalence in older hospitalised subjects but, when present, accounts for worse post-discharge outcomes. Phenotypic analysis unravelled the heterogeneity of LC older population and the association of selected phenotypes with different clinical and prognostic features

Tubulointerstitial Nephritis and Uveitis Syndrome

Tubulointerstitial nephritis and uveitis syndrome is likely underdiagnosed. A 13-year-old girl with no significant medical history had photophobia, ocular pain, and decreased visual acuity. Bilateral papilledema was present. Renal biopsy revealed interstitial nephritis. Immunosuppressive therapy was added (3 mg/kg/d of cyclosporine). One year later, visual acuity was 20/20 and findings were normal on ocular examination and laboratory tests

Global Compact on Education. La pace come cammino di speranza, dialogo, riconciliazione e conversione ecologica

Un patto educativo per l\u2019ecologia integrale \ue8 una sfida e un impegno nei diversi contesti in cui si svolge la vita quotidiana, a fondamento della libert\ue0, della giustizia e del futuro. Aprire e perseguire un cammino di pace \ue8 un compito certamente difficile in quanto gli interessi in gioco, nei rapporti con le persone, le comunit\ue0 e le nazioni sono molteplici e contraddittori. I saggi presenti nel volume Global Compact on Education, secondo un originale punto di vista, propongono una lettura pedagogica delle questioni che attraversano la cultura per la sostenibilit\ue0. Di fronte alle nuove povert\ue0, dai cambiamenti climatici alle ingiustizie sociali, un patto educativo per l\u2019ecologia integrale \ue8 cammino di speranza, dialogo, riconciliazione e conversione ecologica. \uc8 la possibilit\ue0 di un autentico cambiamento, personale e comunitario, per coltivare il sogno di un umanesimo solidale