Big Data Analytics for QoS Prediction Through Probabilistic Model Checking

As competitiveness increases, being able to guaranting QoS of delivered services is key for business success. It is thus of paramount importance the ability to continuously monitor the workflow providing a service and to timely recognize breaches in the agreed QoS level. The ideal condition would be the possibility to anticipate, thus predict, a breach and operate to avoid it, or at least to mitigate its effects. In this paper we propose a model checking based approach to predict QoS of a formally described process. The continous model checking is enabled by the usage of a parametrized model of the monitored system, where the actual value of parameters is continuously evaluated and updated by means of big data tools. The paper also describes a prototype implementation of the approach and shows its usage in a case study.Comment: EDCC-2014, BIG4CIP-2014, Big Data Analytics, QoS Prediction, Model Checking, SLA compliance monitorin

Runtime model checking for sla compliance monitoring and qos prediction

Sophisticated workflows, where multiple parties cooperate towards the achievement of a shared goal are today common. In a market-oriented setup, it is key that effective mechanisms be available for providing accountability within the business process. The challenge is to be able to continuously monitor the progress of the business process, ideally,anticipating contract breaches and triggering corrective actions. In this paper we propose a novel QoS prediction approach which combines runtime monitoring of the real system with probabilistic model-checking on a parametric system model. To cope with the huge amount of data generated by the monitored system, while ensuring that parameters are extracted in a timing fashion, we relied on big data analytics solutions. To validate the proposed approach, a prototype of the QoS prediction framework has been developed, and an experimental campaign has been conducted with respect to a case study in the field of Smart Grids

NGAL: a new missing link between inflammation and uremic anemia?

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Renal Concerns in the Treatment of Chronic Hepatitis B with Tenofovir

Tenofovir, a third generation oral nucleos(t)ide analogue, currently represents one of the first-line drugs recommended for treating chronic hepatitis B virus (HBV) infection. After oral administration, tenofovir is mostly excreted in the urine by glomerular filtration and proximal tubular secretion. Hence, an impaired kidney function may lead to an increased renal exposure to the drug in patients with coexistent renal damage. This could further worsen kidney disease through different mechanisms of nephrotoxicity such as mitochondrial DNA depletion and tubular cytotoxicity. Despite several studies performed so far to assess tenofovir-related renal toxicity, data in HBV patients are not yet conclusive. Screening of risk factors for kidney disease before starting therapy and a careful monitoring of serum creatinine, glomerular filtration rate, serum phosphate and urine analysis during treatment are advocated to adjust the dose or stop treatment if needed. New biomarkers of tubular injury, such as neutrophil gelatinase associated lipocalin, could become helpful in the future for the timely identification and risk stratification of renal damage induced by tenofovir

Pharmacological effects of raas blockade in ischemic nephropathy

Background: The management of ischemic nephropathy due to atherosclerotic renal artery stenosis has become increasingly conservative in the modern era, with current guidelines recommending optimized medical therapy as the initial step. The doubts raised by the recently published trials of revascularization strategies have led to a renewed focus on pharmacological strategies promoting blood pressure control and renal protection. It is essential to further elucidate the pathophysiological mechanisms underlying hypoperfusion induced renal microvascular dysfunction with subsequent tissue injury and fibrogenesis. The role of renin angiotensin aldosterone system as a mediator of the main pathophysiological consequences of ischemic nephropathy is well known. However, more recent experimental evidence on the adrenergic system and intrarenal tubular feedback mechanisms has stimulated new interest towards a multi-target therapeutic approach. Methods: This review focuses on the pharmacology of the principle therapeutic drug classes currently used in the treatment of atherosclerotic renal artery stenosis with an analysis of their metabolic aspects and use in clinical practice based on evidence from clinical trials. Results and Conclusions: An optimal pharmacologic approach is crucial for a successful prevention of renal injury and cardiovascular events in this high-risk population. Antihypertensive treatment should include renin angiotensin aldosterone system blockade medication not only for their antihypertensive properties, but especially for those cardio and renoprotectiv

Aquaporin-2 (AQP2) Urinary Excretion and Assumption of Water with Different Mineral Content in Healthy Subjects

The aquaporin-2 (AQP2) plays a key role in AVP-induced absorption of water, and its urinary excretion is related to its function. We aimed to test if the assumption of water with different mineral content can modify the expression of AQP2, leading to a change in AQP2 urinary concentration, in 20 healthy young subjects. Each subject received an oral water load (LM or HM) of 250 mL/hour for four hours, and several variables were measured. Plasmatic osmolality after water assumption was significantly reduced with no differences after the low (LM) or the high mineral (HM) water load. Urinary osmolality and plasmatic vasopressin concentration were significantly reduced after an assumption of both kinds of water. However, serum vasopressin was lower after HM water assumption than after LM. AQP2 urinary excretion was significantly reduced after water assumption with respect to the basal level and it was lower after LM than after HM water assumption. The different mineral content of water was investigated as a factor contributing to the development of hypertension. Considering that AQP2 can play a role in pathogenesis of hypertension, our demonstration that AVP-mediated AQP2 urinary excretion is strictly influenced by the consumption of water with different mineral content suggests a new, interesting field of investigation related to the link between blood pressure alterations and nutritional habits

Arrhythmias and hemodialysis: role of potassium and new diagnostic tools.

Cardiovascular diseases represent the main causes of death in patients affected by renal failure, and arrhythmias are frequently observed in patients undergoing hemodialysis. Dialytic treatment per se can be considered as an arrhythmogenic stimulus; moreover, uraemic patients are characterized by a "pro-arrhythmic substrate" because of the high prevalence of ischaemic heart disease, left ventricular hypertrophy and autonomic neuropathy. One of the most important pathogenetic element involved in the onset of intra-dialytic arrhythmias is the alteration in electrolytes concentration, particularly calcium and potassium. It may be very useful to monitor the patient's cardiac activity during the whole hemodilaytic session. Nevertheless, the application of an extended intradialytic electrocardiographic monitoring is not simple because of several technical and structural impairments. We tried to overcome these difficulties using Whealthy, a wearable system consisting in a t-shirt composed of conductors and piezoresistive materials, integrated to form fibers and threads connected to tissutal sensors, electrodes, and connectors. ECG and pneumographic impedance signals are acquired by the electrodes in the tissue, and the data are registered by a small computer and transmitted via GPRS or Bluetooth

Pulmonary Hypertension and Erythropoietin

Numerous uremic patients on hemodialysis have pulmonary hypertension attributable to the presence of arteriovenous fistulas, vascular calcification, and endothelial dysfunction due to alterations in the balance between vasoconstrictive and vasodilatory substances. For these reasons, the effects of recombinant human erythropoietin, a drug widely used in patients on dialysis, on the pulmonary circulation were studied. Some authors maintain that recombinant human erythropoietin has an antihypertensive effect, while others have observed that this hormone induces a reduction in pulmonary arterial pressure due to its vasoactive and stimulatory effects on endothelial and smooth muscle cell precursors

Delirium accompanies kidney dysfunction in hospitalized elderly patients

Introduction. Delirium, defined as an acute mental status with altered level of consciousness, is a common geriatric syndrome and a typical complication in hospitalized elderly patients. We aimed to assess the occurrence of delirium and the possible relationship with renal impairment. Methods. Patients aged over 65 years admitted consecutively to a Geriatric Unit, were screened for a first diagnosis of delirium. Delirium was evaluated using the validated Assessment Test for Delirium and Cognitive Impairment (4AT). Results. Final analysis included 311 patients (182 women,129 men). Mean eGFR was 62.44 ± 28.84 mL/min/1.73 m2. Prevalence of Cognitive impairment or delirium was 5.4, 84.8 e 9.8% for 0, 1-3 and ≥ 4 4AT scores. At univariate analysis, prevalence of clear delirium was increased with the worsening of CKD, being 3.7% in stage IIIb up to 68% in stage IV-V (p < 0.001). At multivariable logistic analysis, adjusted for gender and smoking habit, higher eGFR levels were associated with a reduced risk for the presence of delirium (OR = 0.86 95% CI 0.82-0.91, p < 0.001) and for developing possible cognitive impairment (OR = 0.87 95% CI 0.83- 0.90, p < 0.001). Discussion. Mild to moderate delirium is a pervasive condition among geriatric patients with manifested renal function impairment

Toxic epidermic necrolysis by allopurinol: a case report

Toxic epidermal necrolysis (TEN) or Lyell’s syndrome is a rare but serious potentially fatal autoimmune dermatologic disease. It is characterized by cutaneous damage due to apoptosis of the keratinocytes with consequent dermo-epidermal separation for a >30% extension of the body surface, associated with mucosal lesions. It is due to the activation of the immune system, often following the intake of potentially toxic drugs [antibiotics, antiepileptics, non-steroidal antinflammatory drugs (NSAIDs), allopurinol] or after infection with herpetic viruses or mycoplasma. We describe the case of an 82- year-old man starting therapy of Allopurinol for hyperuricemia. After four days the patient shows an extensive erythematous rash localized to the trunk and upper limbs. The following day the rash also involves the face, tending to the confluence and after another two days, the macules turn into de-epithelized areas because of dermo-epidermal separation and the lesions involve the oral and ocular mucosa, causing dysphagia and difficulty in speaking. He was treated with steroid and antihistamine therapy, suspending the previously undertaken therapy with antibiotic and Allopurinol