Prediction of response to antiretroviral therapy by human experts and by the EuResist data-driven expert system (the EVE study).

OBJECTIVES: The EuResist expert system is a novel data-driven online system for computing the probability of 8-week success for any given pair of HIV-1 genotype and combination antiretroviral therapy regimen plus optional patient information. The objective of this study was to compare the EuResist system vs. human experts (EVE) for the ability to predict response to treatment. METHODS: The EuResist system was compared with 10 HIV-1 drug resistance experts for the ability to predict 8-week response to 25 treatment cases derived from the EuResist database validation data set. All current and past patient data were made available to simulate clinical practice. The experts were asked to provide a qualitative and quantitative estimate of the probability of treatment success. RESULTS: There were 15 treatment successes and 10 treatment failures. In the classification task, the number of mislabelled cases was six for EuResist and 6-13 for the human experts [mean±standard deviation (SD) 9.1±1.9]. The accuracy of EuResist was higher than the average for the experts (0.76 vs. 0.64, respectively). The quantitative estimates computed by EuResist were significantly correlated (Pearson r=0.695, P<0.0001) with the mean quantitative estimates provided by the experts. However, the agreement among experts was only moderate (for the classification task, inter-rater κ=0.355; for the quantitative estimation, mean±SD coefficient of variation=55.9±22.4%). CONCLUSIONS: With this limited data set, the EuResist engine performed comparably to or better than human experts. The system warrants further investigation as a treatment-decision support tool in clinical practice.

Hypertrophic osteodystrophy in six weimaraner puppies associated with systemic signs.

Six weimaraner puppies, five of which were genetically related, showed systemic signs associated with hypertrophic osteodystrophy, including fever and involvement of the gastrointestinal, respiratory or nervous systems, in addition to the metaphyseal lesions. In five of the dogs the clinical signs developed less than 10 days after they had been vaccinated with a modified live virus vaccine. Radiographic findings suggested that both the hindlimbs and forelimbs were equally involved in the disease process. Abnormal haematological findings included leucocytosis with neutrophilia and monocytosis, and there was a consistent increase in the activity of alkaline phosphatase. Serum protein electrophoretic studies of three of the dogs revealed hypogammaglobulinaemia and abetaglobulinaemia in two of them. Conservative treatment with rest and non-steroidal anti-inflammatory drugs had little effect, and treatment with corticosteroids appeared to give the best results.

Psychological androgyny and sexual adequacy.

This study investigated the hypothesis that individuals with androgynous personalities would be more competent sexually than individuals with sex-typed personalities. Scores on the Bem Sex-Role Inventory were compared for a patient group and a control group. The data revealed a higher percentage of androgynous subjects in the control group than in the patient group. Even when only one spouse was androgynous, the chances of sexual competence within the couple increased. In addition, there was more sex typing among the longer married patient couples and more stereotyped femininity in both men and women in the patient group. The results were taken to support the view that the androgynous person's flexibility and adaptability is conducive to a satisfactory sexual relationship. Some cultural differences between Israeli and American samples were noted. Findings contradicted the cultural stereotypes of the macho Israeli male and the nonfeminine Israeli woman.

An evaluation of sexual performance--comparison between sexually dysfunctional and functional couples.

A multidisciplinary team approach was used to identify different correlates of sexual inadequacy, by comparing sexually dysfunctional and adequately functioning couples. Early familial disruption, traditional/religious upbringing and current religiosity of the male patient, prejudices concerning normal sex behavior, sexual ignorance, communication problems, and myths resulted in rigid stereotyped sexual behavior for both partners in our dysfunctional, patient group. These behaviors are characterized by "gender asymmetry" in all aspects of sexual activity. Contrary to previous reports, it was found that men are very concerned with partner satisfaction and are the primary initiators for therapy.