Is it time for midwives to do intrapartum ultrasound in the delivery ward?

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Data security issues in cloud scenarios

The amount of data created, stored, and processed has enormously increased in the last years. Today, millions of devices are connected to the Internet and generate a huge amount of (personal) data that need to be stored and processed using scalable, efficient, and reliable computing infrastructures. Cloud computing technology can be used to respond to these needs. Although cloud computing brings many benefits to users and companies, security concerns about the cloud still represent the major impediment for its wide adoption. We briefly survey the main challenges related to the storage and processing of data in the cloud. In particular, we focus on the problem of protecting data in storage, supporting fine-grained access, selectively sharing data, protecting query privacy, and verifying the integrity of computations

Ultrasonic assessment of cesarean section scar to vesicovaginal fold distance: an instrument to estimate pre-labor uterine rupture risk

Background: The number of Cesarean sections (CS) is growing worldwide, intensifying the risk of complications in subsequent pregnancies and leading to increased maternal and fetal morbidity and mortality. In particular, the literature shows a higher risk of uterine rupture (UR) in subsequent pregnancy with trial of labor after cesarean section (TOLAC) Furthermore, there are few data about pre-labor UR in scarred uteri. Objective: Since the key factor for management is timing, the aim of this study was to evaluate the accuracy of prenatal ultrasound (US) of scars in the early determining of pre-labor UR risk in women with a previous CS during their subsequent pregnancy Methods: From April 2014 to November 2018 a retrospective analysis was performed in order to evaluate the scar to vesicovaginal fold (VVF) distance in three patients with pre-labor UR and in 60 cases of the control group. Results: The periconceptional CS scar-VVF distance in the three UR cases resulted significantly increased compared to the controls (23.7 ± 3.5 mm vs 2.3 ± 2.7 mm, p < 005); moreover, a time interval of less than 18 months and a previous pre-labor preterm CS were found as known risk factors. Conclusion: In this study, a higher uterine incision due to placenta previa or isthmic myoma seems to be correlated with a major risk of UR. Therefore, periconceptional US examination of CS-VVF distance, (which represents the level of the previous CS), seems to be a useful predictive factor of pre-labor UR in subsequent pregnancies

Laminar Necrosis and Hypoxic Damage of the Placenta: A Case-Control Study

The aim of this study is to verify the role of laminar necrosis (LN) in the diagnosis of hypoxic damage of the placenta. This is a retrospective case-control study in which 50 cases with laminar necrosis were compared with 100 gestational age-matched controls without laminar necrosis in a 1:2 ratio. The parameters analyzed were: the presence of other placental lesions, obstetric characteristics and neonatal outcome. For each of the 50 cases, the area affected by the lesion was detected, and the lesions were classified into three groups based on the morphology and time of onset of the lesion in order to understand whether these characteristics of the lesion had a clinical-pathology. The results showed that including the search for LN among placental lesions generally examined is useful to guide the pathologist in the diagnosis of placental dysfunction of hypoxic origin

BNT162b2 mRNA COVID-19 vaccine effectiveness in the prevention of SARS-CoV-2 infection and symptomatic disease in five-month follow-up: A retrospective cohort study

To combat the COVID-19 pandemic, a mass vaccination campaign was initiated in Italy on December 27, 2020. The vaccine available to immunize Italian healthcare workers (HCWs) was the BNT162b2 mRNA COVID-19 vaccine (Comirnaty). This study evaluated the effectiveness of the vaccine against documented SARS-CoV-2 infection and symptomatic diseases in the medium- to long-term. HCWs at Bari Policlinico University-Hospital (Italy) who completed the vaccination schedule were matched with HCWs who had refused vaccination; the two groups were followed-up for 5 months (January–May 2021). Vaccine effectiveness (VE) against infection was 97.7% (95.4– 99.0%) at 14–34 days after the first dose, and 94.8% (87.0–97.8%), 83.0% (65.0–92.0%), and 81.0% (42.0–94.0%) at 14–41, 42–69, and >69 days, respectively, after the second dose. The estimated VE for documented symptomatic disease was 99.2% (96.4–99.8%) at 14–34 days after the first dose and 97.2% (90.3–99.2%), 85.0% (63.0–94.2%), and 88.0% (42.0–97.6%) at 14–41, 42–69, and >69 days, respectively, after the second dose. Efforts to increase vaccination rates should be strengthened, including mandatory vaccination for HCWs and greater incentives to increase vaccine acceptance by the general population

A Declarative Framework for Specifying and Enforcing Purpose-aware Policies

Purpose is crucial for privacy protection as it makes users confident that their personal data are processed as intended. Available proposals for the specification and enforcement of purpose-aware policies are unsatisfactory for their ambiguous semantics of purposes and/or lack of support to the run-time enforcement of policies. In this paper, we propose a declarative framework based on a first-order temporal logic that allows us to give a precise semantics to purpose-aware policies and to reuse algorithms for the design of a run-time monitor enforcing purpose-aware policies. We also show the complexity of the generation and use of the monitor which, to the best of our knowledge, is the first such a result in literature on purpose-aware policies.Comment: Extended version of the paper accepted at the 11th International Workshop on Security and Trust Management (STM 2015

Consensus and controversy in the discipline of invasion science

Approaches, values and perceptions in invasion science are highly dynamic, and like in other disciplines, views among different people can be somewhat divergent. This has led to debate in the field specifically surrounding the core themes relating to values, management, impacts, and terminology. Considering these debates, we surveyed the views of 698 scientists and practitioners to assess levels of polarization (opposing views) on core and contentious invasion science topics. Our results indicate that although there are generally high levels of consensus in the field, there are still some areas of polarization. Relating to values, there was high polarization regarding claims of invasive species denialism, if invasive species contribute to biodiversity, and, how biodiversity reporting should be conducted. Linking to management there were polarized views on banning the commercial use of beneficial invasive species, the extent to which stakeholders’ perceptions should influence management, if invasive species utilization alone is an appropriate control strategy, and, whether the eradication of invasive plants is possible. For impacts, there was high polarization concerning whether invasive species drive, or are a side effect of degradation, and, if invasive species benefits are understated. For terminology, polarized views related to defining invasive species based only on spread, if labelling species as invasive in their native ranges, and, if language used is too xenophobic. Factor and regression analysis revealed that views were particularly divergent between people working on different invasive taxa (plants and mammals) and in different disciplines (especially between biologists and social scientists), between academics and practitioners, and between world regions (especially between Africa and the Global North). Unlike in other studies, age and gender had a limited influence on response patterns. We highlight that better integration globally and between disciplines, taxa and sectors (e.g., academic vs. practitioners), could help build broader understanding and consensus in the field

Is the first of the two born saved? A rare and dramatic case of double placental damage from SARS-CoV-2

The current coronavirus pandemic has affected, in a short time, various and different areas of medicine. Among these, the obstetric field has certainly been touched in full, and the knowledge of the mechanisms potentially responsible for placental damage from SARS-CoV-2 occupy a certain importance. Here we present here a rare case of dichorionic twins born at 30 weeks and 4 days of amenorrhea, one of whom died in the first few hours of life after placental damages potentially related to SARS-CoV-2. We also propose a brief review of the current literature giving ample emphasis to similar cases described

Genomic changes of chromosomes 8p23.1 and 1q21: Novel mutations in malignant mesothelioma

Introduction: Malignant mesothelioma is an aggressive malignancy of the thoracic cavity caused by prior asbestos exposure. In the peritoneum the mesothelioma is an extremely rare condition. In the present preliminary study, high-resolution array-comparative genomic hybridization (a-CGH) was performed to identify genetic imbalances in a series of malignant peritoneal mesothelioma cases. Materials and methods: Between 1990 and 2008, among the cases recorded in the Apulia Mesothelioma Register, we found 22 peritoneal mesothelioma cases. CGH-array was performed on samples from all patients. Results: The CGH-array analysis revealed multiple chromosomal imbalances. Interestingly, deletion at 8p23.1 was observed in 12 cases. Furthermore, another novel deletion at 1q21 was present in 11. Often, 1q21 and 8p23.1 losses were present in the same patient (7 cases). Losses of BAP1 and CDKN2A loci were not detected. Discussion: The region at 8p23.1 contains the beta-defensin gene cluster (DEF) and 1q21 contains ubiquitin conjugating enzyme E2 (UBE2Q1). We hypotesized that the loss of function of ubiquitination, as well as of the defensins, could play an important role in the initial development and subsequent progression of mesothelioma