FLOSS, COTS, and Safety: A Business Perspective

International audienceThis paper discusses the relationship between COTS software (Commercial-off-the-shelf) and FLOSS (Freely Licensed Open Source Software) from a purely business perspective. The emphasis of this work is on safety-centric industries such as aerospace, automotive, and railways

Score-Driven Modeling of Spatio-Temporal Data

A simultaneous autoregressive score-driven model with autoregressive disturbances is developed for spatio-temporal data that may exhibit heavy tails. The model specification rests on a signal plus noise decomposition of a spatially filtered process, where the signal can be approximated by a nonlinear function of the past variables and a set of explanatory variables, while the noise follows a multivariate Student-t distribution. The key feature of the model is that the dynamics of the space-time varying signal are driven by the score of the conditional likelihood function. When the distribution is heavy-tailed, the score provides a robust update of the space-time varying location. Consistency and asymptotic normality of maximum likelihood estimators are derived along with the stochastic properties of the model. The motivating application of the proposed model comes from brain scans recorded through functional magnetic resonance imaging when subjects are at rest and not expected to react to any controlled stimulus. We identify spontaneous activations in brain regions as extreme values of a possibly heavy-tailed distribution, by accounting for spatial and temporal dependence

Weekly paclitaxel plus capecitabine in advanced breast cancer patients: dose-finding trial of GOIRC and GOL

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Vitamin D effects on bone homeostasis and cardiovascular system in patients with chronic kidney disease and renal transplant recipients

Poor vitamin D status is common in patients with impaired renal function and represents one main component of the complex scenario of chronic kidney disease–mineral and bone disorder (CKD–MBD). Therapeutic and dietary efforts to limit the consequences of uremia-associated vitamin D deficiency are a current hot topic for researchers and clinicians in the nephrology area. Evidence indicates that the low levels of vitamin D in patients with CKD stage above 4 (GFR < 15 mL/min) have a multifactorial origin, mainly related to uremic malnutrition, namely impaired gastrointestinal absorption, dietary restrictions (low-protein and low-phosphate diets), and proteinuria. This condi-tion is further worsened by the compromised response of CKD patients to high-dose cholecalciferol supplementation due to the defective activation of renal hydroxylation of vitamin D. Currently, the literature lacks large and interventional studies on the so-called non-calcemic activities of vitamin D and, above all, the modulation of renal and cardiovascular functions and immune response. Here, we review the current state of the art of the benefits of supplementation with native vitamin D in various clinical settings of nephrological interest: CKD, dialysis, and renal transplant, with a special focus on the effects on bone homeostasis and cardiovascular outcomes

Interleukin-6 and Outcome of Chronic Hemodialysis Patients with SARS-CoV-2 Pneumonia

Background and Objectives: Chronic hemodialysis (CHD) patients are at increased risk of SARS-CoV-2 infection and the related complications and mortality of COVID-19 due to the high rate of comorbidities combined with advanced age. This observational study investigated the clinical manifestations of SARS-CoV-2 infection in CHD and the risk factors for patients ' death. Materials and Methods: The study included 26 CHD patients with SARS-CoV-2 pneumonia detected by positive RT-PCR on nasopharyngeal swabs and high-resolution computed tomography at hospital admission, aged 71 + 5.9 years, 14 of which (53.8%) were male, 20 (77%) under hemodiafiltration, and 6 (23%) on standard hemodialysis, with a median follow-up of 30 days. Results: Simple logistic regression analysis revealed that the factors associated with a higher risk of death were older age (OR: 1.133; 95%CI: 1.028-1.326, p = 0.0057), IL-6 levels at admission (OR: 1.014; 95%CI: 1.004-1.028, p = 0.0053), and C-reactive protein (OR: 1.424; 95%CI: 1.158-2.044, p < 0.0001). In the multiple logistic regression model, circulating IL-6 values at admission remained the only significant prognosticator of death. The ROC curve indicated the discriminatory cut-off value of 38.20 pg/mL of blood IL-6 for predicting death in chronic hemodialysis patients with SARS-CoV-2 pneumonia (sensitivity: 100%; specificity: 78%; AUC: 0.8750; p = 0.0027). Conclusions: This study identified a threshold of IL-6 levels at hospital admission for death risk in CHD patients with SARS-CoV-2 pneumonia. This might represent a valuable outcome predictor, feasibly better than other clinical, radiological, or laboratory parameters and preceding the IL-6 peak, which is unpredictable

The importance of meal assessment in ALS patients

Background: the importance of instrumental evaluation of swallowing in ALS patients is highly recognized in order to assess swallowing safety and prevent pulmonary complications. However, swallowing performance during instrumental assessment may not be representative of what happens when consuming meals in everyday life. Indeed, as fatigue is a common feature in ALS patients, swallowing efficacy may progressively decline during mealtime consumption and food and liquid oral intake may not be sufficient. Objectives: to investigate the relationship between the performance during mealtime consumption and the efficacy of oral and pharyngeal phase of swallowing in ALS patients. Methods: thirteen ALS patients, 7 males and 6 females with a median age of 68.5 years (range 51-78) were enrolled in the study. Fiberoptic endoscopic evaluation of swallowing (FEES) was conducted testing liquids, semisolids and, whether possible, solids. The Penetration-Aspiration Scale (PAS) and the Dysphagia Outcome and Severity Scale (DOSS) were used to assess the FEES. The Test of Mastication and Swallowing Solids (TOMASS) was performed. Tongue strength and resistance were assessed through the Iowa Oral Performance Instrument (IOPI). Patients completed the Eating Assessment Tool-10, a self-reported questionnaire. Typical oral intake was recorded using the Functional Oral Intake Scale (FOIS). Meal consumption was observed and scored through the Mealtime Assessment Scale (MAS); the time the patients needed to consume a meal was recorded. Correlations between MAS total score or time and PAS, DOSS, EAT-10, FOIS, TOMASS and IOPI measures were studied using Spearman\u2019s correlation coefficient. Results: a statistically significant correlation was found between MAS total scores and FOIS (r=0.755, p=0.007), EAT-10 (r=-0.724, p=0.012), tongue strength (r=0.718, p=0.019) and TOMASS total time (r=-0.709, p=0.046). Time needed to consume a meal significantly correlated with tongue resistance (r=0.675, p=0.032) and number of discrete bites during TOMASS (r=-0.793, p=0.033). No statistically significant correlations were found between MAS and PAS or DOSS. Discussion and conclusion: these preliminary results suggest that instrumental assessment of swallowing, especially FEES, may not be exhaustive in ALS patients as it does not predict patient\u2019s performance during meals. Efficacy of swallowing oral phase seems to be related to meal consumption more than pharyngeal phase. Therefore, our data stress the need of a comprehensive swallowing evaluation in ALS patients, including instrumental, oral phase and mealtime assessment, in order to estimate the risk of both pulmonary and nutritional complications related to dysphagia

The importance of meal assessment in ALS patients

Background: the importance of instrumental evaluation of swallowing in ALS patients is highly recognized in order to assess swallowing safety and prevent pulmonary complications. However, swallowing performance during instrumental assessment may not be representative of what happens when consuming meals in everyday life. Indeed, as fatigue is a common feature in ALS patients, swallowing efficacy may progressively decline during mealtime consumption and food and liquid oral intake may not be sufficient. Objectives: to investigate the relationship between the performance during mealtime consumption and the efficacy of oral and pharyngeal phase of swallowing in ALS patients. Methods: thirteen ALS patients, 7 males and 6 females with a median age of 68.5 years (range 51-78) were enrolled in the study. Fiberoptic endoscopic evaluation of swallowing (FEES) was conducted testing liquids, semisolids and, whether possible, solids. The Penetration-Aspiration Scale (PAS) and the Dysphagia Outcome and Severity Scale (DOSS) were used to assess the FEES. The Test of Mastication and Swallowing Solids (TOMASS) was performed. Tongue strength and resistance were assessed through the Iowa Oral Performance Instrument (IOPI). Patients completed the Eating Assessment Tool-10, a self-reported questionnaire. Typical oral intake was recorded using the Functional Oral Intake Scale (FOIS). Meal consumption was observed and scored through the Mealtime Assessment Scale (MAS); the time the patients needed to consume a meal was recorded. Correlations between MAS total score or time and PAS, DOSS, EAT-10, FOIS, TOMASS and IOPI measures were studied using Spearman\u2019s correlation coefficient. Results: a statistically significant correlation was found between MAS total scores and FOIS (r=0.755, p=0.007), EAT-10 (r=-0.724, p=0.012), tongue strength (r=0.718, p=0.019) and TOMASS total time (r=-0.709, p=0.046). Time needed to consume a meal significantly correlated with tongue resistance (r=0.675, p=0.032) and number of discrete bites during TOMASS (r=-0.793, p=0.033). No statistically significant correlations were found between MAS and PAS or DOSS. Discussion and conclusion: these preliminary results suggest that instrumental assessment of swallowing, especially FEES, may not be exhaustive in ALS patients as it does not predict patient\u2019s performance during meals. Efficacy of swallowing oral phase seems to be related to meal consumption more than pharyngeal phase. Therefore, our data stress the need of a comprehensive swallowing evaluation in ALS patients, including instrumental, oral phase and mealtime assessment, in order to estimate the risk of both pulmonary and nutritional complications related to dysphagia

Integrità elettorale e voto regionale

La sezione monografica ha un duplice intento. Da un lato, dar conto di alcuni degli sviluppi e delle problematiche di integrità elettorale associati alla dimensione propriamente procedurale delle consultazioni elettorali in Italia. In particolare sono stati considerati argomenti problematici che impattano sia sulla formazione dell’offerta politica (la trasparenza nella selezione e proposta delle coalizioni e delle candidature); la possibilità di un terzo mandato per i Presidenti di regione; l’uso della propaganda online nelle campagne elettorali regionali; l’espressione della partecipazione (l’opportunità di dotarsi di modalità di voto elettronico; l’incidenza del voto non valido nelle elezioni parlamentari in prospettiva comparata europea. Dall’altro lato si è inteso soffermare l’attenzione sul voto regionale, con riferimento ad alcuni degli aspetti procedurali appena richiamati, ma anche (secondo una prassi consolidata della Rivista) all’analisi delle elezioni regionali del febbraio 2023 – segnate da un forte tasso di astensionismo nonché da una netta affermazione della coalizione conservatrice che ha vinto le elezioni politiche del settembre 2022 – nelle due Regioni più popolose d’Italia: Lazio e Lombardia. L’insieme dei contributi si contraddistingue, oltre che per l’approfondimento dei temi con una particolare attenzione alla dimensione empirica, per la sua interdisciplinarietà che offre spazio a contributi di taglio non solo giuridico ma anche politologico

Point-of-care testing allows successful simultaneous screening of sickle cell disease, HIV, and tuberculosis for households in rural Guinea-Bissau, West Africa

Diagnosis of noncommunicable genetic diseases like sickle cell disease (SCD) and com municable diseases such as human immunodeficiency virus (HIV) or tuberculosis (TB) is often difficult in rural areas of Africa due to the lack of infrastructures, trained staff, or capacity to involve families living in remote areas. The availability of point-of-care (POC) tests for the above diseases offers the opportunity to build joint programs to tackle all conditions. We report successful simultaneous screening of SCD, HIV, and TB utilizing POC tests in 898 subjects in Fanhe, in rural Guinea-Bissau. Adherence was 100% and all diagnosed subjects were enrolled in care program