A Service-Based Framework for Flexible Business Processes

This article describes a framework for the design and enactment of flexible and adaptive business processes. It combines design-time and run-time mechanisms to offer a single integrated solution. The design-time environment supports the specification of process-drivenWeb applications with Quality of Service (QoS) constraints and monitoring annotations. The runtime identifies the actual services, from the QoS perspective, oversees the execution through monitoring, and reacts to failures and infringement of QoS constraints. The article also discusses these issues on a proof of concept application developed for an industrial supply chain scenario

An open platform for personal health record apps with platform-level privacy protection

One of the main barriers to the adoption of Personal Health Records (PHR) systems is their closed nature. It has been argued in the literature that this barrier can be overcome by introducing an open market of substitutable PHR apps. The requirements introduced by such an open market on the underlying platform have also been derived. In this paper, we argue that MyPHRMachines, a cloud-based PHR platform recently developed by the authors, satisfies these requirements better than its alternatives. The MyPHRMachines platform leverages Virtual Machines as flexible and secure execution sandboxes for health apps. MyPHRMachines does not prevent pushing hospital- or patient-generated data to one of its instances, nor does it prevent patients from sharing data with their trusted caregivers. External software developers have minimal barriers to contribute innovative apps to the platform, since apps are only required to avoid pushing patient data outside a MyPHRMachines cloud. We demonstrate the potential of MyPHRMachines by presenting two externally contributed apps. Both apps provide functionality going beyond the state-of-the-art in their application domain, while they did not require any specific MyPHRMachines platform extension

Pediatric ultrasound-guided dorsal penile nerve block and sedation in spontaneous breathing: a prospective observational study

Background: Worldwide, one of the most common surgical procedures in the pediatric population is circumcision. There is no consent on the best anesthesiologic approach. This study aimed to investigate ultrasound-guided dorsal penile nerve block (DPNB) plus sedation in spontaneous breathing as a time-saving, safe, effective, and opioid-sparing technique. Aims: The primary outcome was the assessment of the time from the end of surgery and the discharge to the post-anesthesia care unit. Secondary outcomes were to evaluate the cumulative dosages of opioids, differences in pain levels between the two groups, and complications at the awakening, 4 h and 72 h after surgery, respectively. Methods: This was a prospective study with a retrospective control group, approved by the Friuli–Venezia Giulia Ethics Committee. Children in the intervention group received an ultrasound-guided DPNB under sedation and spontaneous breathing. With the probe positioned transversally at the base of the penis using an in-plane approach with a modified technique, local anesthetic was injected under the deep fascia of the penis. Results: We recruited 70 children who underwent circumcision at the University Hospital of Udine, Italy, from 1 January 2016 to 1 October 2021: 35 children in the ultrasound-guided DPNB group and 35 children in the control group. Children who received ultrasound-guided DPNB had a statistically significant lower time to discharge from the operating room, did not require mechanical ventilation, maintained spontaneous breathing at all times, received fewer opioids, had lower mean intraoperative arterial pressures, and lower pain levels immediately after surgery. Conclusion: Ultrasound-guided DPNB associated with sedation and spontaneous breathing is a time-saving, opioid-sparing, safe, and effective strategy for the management of intraoperative and postoperative pain in children undergoing circumcision. Clinical trial registration: ClinicalTrial.gov (NCT04475458, 17 July 2020)

Genetic deletion of osteopontin in TRAMP mice skews prostate carcinogenesis from adenocarcinoma to aggressive human-like neuroendocrine cancers

Osteopontin (OPN) is a secreted glycoprotein, that belongs to the non-structural extracellular matrix (ECM), and its over expression in human prostate cancer has been associated with disease progression, androgen independence and metastatic ability. Nevertheless, the pathophysiology of OPN in prostate tumorigenesis has never been studied. We crossed TRansgenic Adenocarcinoma of the Mouse Prostate (TRAMP) mice with OPN deficient (OPN-/-) mice and followed tumor onset and progression in these double mutants. Ultrasound examination detected the early onset of a rapidly growing, homogeneous and spherical tumor in about 60% of OPN-/- TRAMP mice. Such neoplasms seldom occurred in parental TRAMP mice otherwise prone to adenocarcinomas and were characterized for being androgen receptor negative, highly proliferative and endowed with neuroendocrine (NE) features. Gene expression profiling showed up-regulation of genes involved in tumor progression, cell cycle and neuronal differentiation in OPN-deficient versus wild type TRAMP tumors. Downregulated genes included key genes of TGFa pathway, including SMAD3 and Filamin, which were confirmed at the protein level. Furthermore, NE genes and particularly those characterizing early prostatic lesions of OPN-deficient mice were found to correlate with those of human prostate NE tumours. These data underscore a novel role of OPN in the early stages of prostate cancer growth, protecting against the development of aggressive NE tumors

Regional lung recruitability during pneumoperitoneum depends on chest wall elastance - A mechanical and computed tomography analysis in rats

Laparoscopic surgery has been increasingly used as an alternative to open surgery for its well-known post-operative benefits. However, it is associated to intra-operative respiratory impairment (Valenza et al., 2010). Mechanical ventilation management is a challenge for the anesthetist in this scenario of intra-abdominal hypertension, because it is not clear how the modification of the ventilation parameters affects the different components of the respiratory system. The respiratory system is composed of two elastic elements in series: the lung and the chest wall. The latter, in turn, is made up of two parallel components: the rib cage and the diaphragm, which is also part of the abdominal wall. Disregarding airflow resistances, the positive pressure applied to the respiratory system during mechanical ventilation distends all these elements. How the applied pressure is distributed within the respiratory system depends on the compliance of each single element (Cortes-Puentes et al., 2015) and its distribution within the lungs depends on the compliance of the lung zones, i.e., regional compliance (Mutoh et al., 1991; Lowhagen et al., 2010)

Using Relational Verification for Program Slicing

Program slicing is the process of removing statements from a program such that defined aspects of its behavior are retained. For producing precise slices, i.e., slices that are minimal in size, the program\u27s semantics must be considered. Existing approaches that go beyond a syntactical analysis and do take the semantics into account are not fully automatic and require auxiliary specifications from the user. In this paper, we adapt relational verification to check whether a slice candidate obtained by removing some instructions from a program is indeed a valid slice. Based on this, we propose a framework for precise and automatic program slicing. As part of this framework, we present three strategies for the generation of slice candidates, and we show how dynamic slicing approaches - that interweave generating and checking slice candidates - can be used for this purpose. The framework can easily be extended with other strategies for generating slice candidates. We discuss the strengths and weaknesses of slicing approaches that use our framework

Androgen regulation of the androgen receptor coregulators

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Context Management for Adaptive Information Systems

AbstractModern technologies enable users accessing services using multiple channels. In the service design phase, this poses additional requirements for high software adaptivity along different technical requirements and different user expectations. During execution, services are usually dynamically selected; this service selection phase requires the identification of the most suitable service along the context that characterizes the users in the time instant in which they send the service request. This paper focuses on the selection phase and it aims at providing a framework to define and manage the context in a general environment characterized by adaptivity and multichannel access. An example to demonstrate the suitability and feasibility of the framework is provided referring to the MAIS (Multichannel Adaptive Information Systems) architecture and considering services related to the tourism domain. The MAIS architecture aims at providing automatically and efficiently services with the appropriate features by choosing among many provider offerings