ETL for data science?: A case study

Big data has driven data science development and research over the last years. However, there is a problem - most of the data science projects don't make it to production. This can happen because many data scientists don’t use a reference data science methodology. Another aggravating element is data itself, its quality and processing. The problem can be mitigated through research, progress and case studies documentation about the topic, fostering knowledge dissemination and reuse. Namely, data mining can benefit from other mature fields’ knowledge that explores similar matters, like data warehousing. To address the problem, this dissertation performs a case study about the project “IA-SI - Artificial Intelligence in Incentives Management”, which aims to improve the management of European grant funds through data mining. The key contributions of this study, to the academia and to the project’s development and success are: (1) A combined process model of the most used data mining process models and their tasks, extended with the ETL’s subsystems and other selected data warehousing best practices. (2) Application of this combined process model to the project and all its documentation. (3) Contribution to the project’s prototype implementation, regarding the data understanding and data preparation tasks. This study concludes that CRISP-DM is still a reference, as it includes all the other data mining process models’ tasks and detailed descriptions, and that its combination with the data warehousing best practices is useful to the project IA-SI and potentially to other data mining projects.A big data tem impulsionado o desenvolvimento e a pesquisa da ciência de dados nos últimos anos. No entanto, há um problema - a maioria dos projetos de ciência de dados não chega à produção. Isto pode acontecer porque muitos deles não usam uma metodologia de ciência de dados de referência. Outro elemento agravador são os próprios dados, a sua qualidade e o seu processamento. O problema pode ser mitigado através da documentação de estudos de caso, pesquisas e desenvolvimento da área, nomeadamente o reaproveitamento de conhecimento de outros campos maduros que exploram questões semelhantes, como data warehousing. Para resolver o problema, esta dissertação realiza um estudo de caso sobre o projeto “IA-SI - Inteligência Artificial na Gestão de Incentivos”, que visa melhorar a gestão dos fundos europeus de investimento através de data mining. As principais contribuições deste estudo, para a academia e para o desenvolvimento e sucesso do projeto são: (1) Um modelo de processo combinado dos modelos de processo de data mining mais usados e as suas tarefas, ampliado com os subsistemas de ETL e outras recomendadas práticas de data warehousing selecionadas. (2) Aplicação deste modelo de processo combinado ao projeto e toda a sua documentação. (3) Contribuição para a implementação do protótipo do projeto, relativamente a tarefas de compreensão e preparação de dados. Este estudo conclui que CRISP-DM ainda é uma referência, pois inclui todas as tarefas dos outros modelos de processos de data mining e descrições detalhadas e que a sua combinação com as melhores práticas de data warehousing é útil para o projeto IA-SI e potencialmente para outros projetos de data mining

LIBERDADE DE EXPRESSÃO E DISCURSO DO ÓDIO: O CONFLITO DISCURSIVO NAS REDES SOCIAIS

O presente artigo pretende discutir os limites que precisam ser traçados para enfrentar o discurso do ódio intensificado pela utilização da internet e das redes sociais que reduzem, por um lado, a interação social direta entre os atores que passam a ser produtores de mensagens e não apenas receptores, e por outro, potencializam o anonimato e permitem a publicação instantânea de conteúdos com uma velocidade gigantesca. De forma a cumprir esse objetivo, emprega-se uma pesquisa biblio­gráfica complementada com dados jurisprudenciais brasileiros. Conclui-se que, diante da ausência de textos normativos que fixem a responsabilização diante de mensagens de intolerância e discriminatórias, as restrições, que devem ser preservadas para casos extremos, ocorrerão pela ponderação dos interesses em jogo em conformidade com uma metódica de proporcionalidade, de modo a evitar decisões desproporcionais que interditem o debate público. Por fim, apresenta alguns parâmetros objetivos que devem ser seguidos pelo julgador que estiver diante de litígios envolvendo o conflito mencionado

Perspectivas Futuras em Terapias Imunomoduladoras para Psoríase uma análise abrangente

This scientific review provides a comprehensive and up-to-date analysis on Future Perspectives in Immunomodulatory Therapies for Psoriasis. Given the complexity and variability of this dermatological condition, it becomes crucial to thoroughly examine the available therapeutic approaches for a more effective understanding of this clinical challenge. Psoriasis, with its diverse clinical presentations, demands a holistic evaluation of available therapies, ranging from IL-23 inhibitors to lifestyle interventions, offering a complete overview of the current landscape. Not only does it highlight the diversity of available therapeutic approaches, but the review also emphasizes the crucial importance of personalization and early intervention. Recognizing the different manifestations of psoriasis and individual patient responses, the study underscores how therapeutic strategies tailored to the specific characteristics of each individual are essential to optimize outcomes. This personalization not only takes into account the uniqueness of each patient but also underscores the need for an integrative and multifaceted approach to psoriasis treatment. By exploring the latest findings and developments in this field, this study goes beyond consolidating existing information, aiming to foster a critical reflection on current therapeutic practices in psoriasis. In doing so, it provides valuable insights for healthcare professionals, researchers, and patients, fostering a deeper understanding of therapeutic strategies and contributing to the ongoing improvement of the quality of life for individuals with psoriasis.Esta revisão científica proporciona uma análise abrangente e atualizada sobre as Perspectivas Futuras em Terapias Imunomoduladoras para Psoríase. Diante da complexidade e variabilidade dessa condição dermatológica, torna-se crucial examinar detalhadamente as abordagens terapêuticas disponíveis para uma compreensão mais eficaz desse desafio clínico. A psoríase, com sua diversidade de apresentações clínicas, demanda uma avaliação holística das terapias disponíveis, desde os inibidores de IL-23 até intervenções no estilo de vida, oferecendo um panorama completo do cenário atual. Não apenas se destaca a diversidade de abordagens terapêuticas disponíveis, mas a revisão enfatiza a importância crucial da personalização e da intervenção precoce. Reconhecendo as diferentes manifestações da psoríase e as respostas individuais dos pacientes, o estudo ressalta como estratégias terapêuticas adaptadas às características específicas de cada indivíduo são essenciais para otimizar os resultados. Essa personalização não apenas leva em conta a singularidade de cada paciente, mas também sublinha a necessidade de uma abordagem integrativa e multifacetada para o tratamento da psoríase. Ao explorar as últimas descobertas e desenvolvimentos nessa área, este estudo vai além da consolidação de informações existentes, buscando promover uma reflexão crítica sobre as práticas terapêuticas atuais em psoríase. Ao fazê-lo, oferece insights valiosos para profissionais de saúde, pesquisadores e pacientes, fomentando uma compreensão mais profunda das estratégias terapêuticas e contribuindo para a contínua melhoria da qualidade de vida dos indivíduos com psoríase

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Genes Controlled by DNA Methylation Are Involved in Wilms Tumor Progression

To identify underlying mechanisms involved with metastasis formation in Wilms tumors (WTs), we performed comprehensive DNA methylation and gene expression analyses of matched normal kidney (NK), WT blastemal component, and metastatic tissues (MT) from patients treated under SIOP 2001 protocol. A linear Bayesian framework model identified 497 differentially methylated positions (DMPs) between groups that discriminated NK from WT, but MT samples were divided in two groups. Accordingly, methylation variance grouped NK and three MT samples tightly together and all WT with four MT samples that showed high variability. WT were hypomethylated compared to NK, and MT had a hypermethylated pattern compared to both groups. The methylation patterns were in agreement with methylases and demethylases expression. Methylation data pointed to the existence of two groups of metastases. While hierarchical clustering analysis based on the expression of all 2569 differentially expressed genes (DEGs) discriminated WT and MT from all NK samples, the hierarchical clustering based on the expression of 44 genes with a differentially methylated region (DMR) located in their promoter region revealed two groups: one containing all NKs and three MTs and one containing all WT and four MTs. Methylation changes might be controlling expression of genes associated with WT progression. The 44 genes are candidates to be further explored as a signature for metastasis formation in WT

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

PubMe

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally