A “watch and wait” strategy, delaying treatment until active disease manifests, is adopted for most CLL cases; however, prognostic models incorporating biomarkers have shown to be useful to predict treatment requirement. In our prospective O-CLL1 study including 224 patients, we investigated the predictive role of 513 microRNAs (miRNAs) on time to first treatment (TTFT). In the context of this study, six well-established variables (i.e., Rai stage, beta-2-microglobulin levels, IGVH mutational status, del11q, del17p, and NOTCH1 mutations) maintained significant associations with TTFT in a basic multivariable model, collectively yielding a Harrell’s C-index of 75% and explaining 45.4% of the variance in the prediction of TTFT. Concerning miRNAs, 73 out of 513 were significantly associated with TTFT in a univariable model; of these, 16 retained an independent relationship with the outcome in a multivariable analysis. For 8 of these (i.e., miR-582-3p, miR-33a-3p, miR-516a-5p, miR-99a-5p, and miR-296-3p, miR-502-5p, miR-625-5p, and miR-29c-3p), a lower expression correlated with a shorter TTFT, whereas in the remaining eight (i.e., miR-150-5p, miR-148a-3p, miR-28-5p, miR-144-5p, miR-671-5p, miR-1-3p, miR-193a-3p, and miR-124-3p), the higher expression was associated with shorter TTFT. Integrating these miRNAs into the basic model significantly enhanced predictive accuracy, raising the Harrell’s C-index to 81.1% and the explained variation in TTFT to 63.3%. Moreover, the inclusion of the miRNA scores enhanced the integrated discrimination improvement (IDI) and the net reclassification index (NRI), underscoring the potential of miRNAs to refine CLL prognostic models and providing insights for clinical decision-making. In silico analyses on the differently expressed miRNAs revealed their potential regulatory functions of several pathways, including those involved in the therapeutic responses. To add a biological context to the clinical evidence, an miRNA–mRNA correlation analysis revealed at least one significant negative correlation between 15 of the identified miRNAs and a set of 50 artificial intelligence (AI)-selected genes, previously identified by us as relevant for TTFT prediction in the same cohort of CLL patients. In conclusion, the identification of specific miRNAs as predictors of TTFT holds promise for enhancing risk stratification in CLL to predict therapeutic needs. However, further validation studies and in-depth functional analyses are required to confirm the robustness of these observations and to facilitate their translation into meaningful clinical utility.

In this paper, we consider the problem of fair division of indivisible goods, where the allocation of goods impacts society. Specifically, we introduce a second valuation function for each agent, which determines the social impact of allocating a good to the agent. Such impact is considered desirable for the society -- the higher, the better. Our goal is to understand how to allocate goods fairly from the agents' perspective while maintaining society as happy as possible. To this end, we measure the impact on society using the utilitarian social welfare, and provide both possibility and impossibility results. Our findings reveal that achieving good approximations, better than linear in the number of agents, is not possible while ensuring fairness to the agents. These impossibility results can be attributed to the fact that agents are completely unconscious of their social impact. Consequently, we explore scenarios where agents are socially aware, by introducing related fairness notions, and demonstrate that an appropriate definition of fairness is compatible with the social objective.

A “watch and wait” strategy, delaying treatment until active disease manifests, is adopted for most CLL cases; however prognostic models incorporating biomarkers have shown to be useful to predict treatment requirement. In our prospective O-CLL1 study including 224 patients, we investigated the predictive role of 513 microRNAs (miRNAs) on time to first treatment (TTFT). In the context of this study six well-established variables (i.e., Rai stage, beta-2-microglobulin levels, IGVH mutational status, del11q, del17p, and NOTCH1 mutations) maintained significant associations with TTFT in a basic multivariable model, collectively yielding a Harrell's C-index of 75% and explaining 45.4% of the variance in the prediction of TTFT. Concerning miRNAs, 73 out of 513 were significantly associated with TTFT in a univariable model; of these, 16 retained an in-dependent relationship with the outcome in a multivariable analysis. For 8 of these (i.e., miR-582-3p, miR-33a-3p, miR-516a-5p, miR-99a-5p, and miR-296-3p, miR-502-5p, miR-625-5p, and miR-29c-3p) a lower expression correlated with a shorter TTFT, whereas in the remaining eight (i.e., miR-150-5p, miR-148a-3p, miR-28-5p, miR-144-5p, miR-671-5p, miR-1-3p, miR-193a-3p, and miR-124-3p) the higher expression was associated with shorter TTFT. Integrating these miRNAs into the basic model significantly enhanced predictive accuracy, raising the Harrell’C index to 81.1% and the explained variation in TTFT to 63.3%. Moreover, the inclusion of the miRNA scores enhanced the Integrated Discrimination Improvement (IDI) and the Net Reclassification Index (NRI), underscoring the potential of miRNAs to refine CLL prognostic models and providing insights for clinical decision-making. In silico analyses on the differently expressed miRNAs revealed their potential regulatory functions of several pathways, including those involved in the therapeutic responses. To add a bio-logical context to the clinical evidence, a miRNA-mRNA correlation analysis revealed at least one significant negative correlation between 15 of the identified miRNAs and a set of 50 Artificial Intelligence (AI) selected genes, previously identified by us as relevant for TTFT prediction in the same cohort of CLL patients. In conclusion, the identification of specific miRNAs as predictors of TTFT holds promise for enhancing risk stratification in CLL to predict therapeutic needs. However, further validation studies and in-depth functional analyses are required to confirm the robustness of these observations and to facilitate their translation into meaningful clinical utility.

Electronic proceedings of IJCAI 2023

Fair allocation of indivisible goods presents intriguing challenges from both a social choice perspective and an algorithmic standpoint. Due to the indivisibility of goods, it is common for one agent to envy the bundle of goods assigned to another agent and, indeed, envy-free solutions do not exist in general. In line with the classical game-theoretic concept of Nucleolus in coalitional games, we propose that a fair allocation should minimize the agents’ dissatisfaction profile in a lexicographic manner, where the dissatisfaction of an agent is defined as her maximum envy towards other agents. Therefore, we seek allocations that minimize the maximum envy. In cases where multiple solutions have an equal maximum value, we minimize the second-worst value, and so on. Additionally, as is customary in fair division problems, we also consider an efficiency requirement: among the allocations with the best agents’ dissatisfaction profile, we prioritize those that maximize the sum of agents’ utilities, known as maximum social welfare. Such allocations, referred to as maxileximin allocations, always exist. In this study, we analyze the computational properties of maxileximin allocations in the context of fair allocation problems with constraints. Specifically, we focus on the Connected Fair Division problem, where goods correspond to the nodes of a graph, and a bundle of goods is allowed if the subgraph formed by those goods is connected. We demonstrate that the problem is F∆P2 -complete, even for instances with simple graphical structures such as path and star graphs. However, we identify islands of tractability for instances with more intricate graphs, such as those having bounded treewidth, provided that the number of agents is bounded by a fixed number and utility functions use small values.