Brain death and postmortem organ donation: Report of a questionnaire from the CENTER-TBI study

Background: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. Methods: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). Results: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time. Conclusions: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation

Variation in neurosurgical management of traumatic brain injury

Background: Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods: A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results: The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion: Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care

Genome-wide scan demonstrates significant linkage for male sexual orientation

BackgroundFindings from family and twin studies support a genetic contribution to the development of sexual orientation in men. However, previous studies have yielded conflicting evidence for linkage to chromosome Xq28.MethodWe conducted a genome-wide linkage scan on 409 independent pairs of homosexual brothers (908 analyzed individuals in 384 families), by far the largest study of its kind to date.ResultsWe identified two regions of linkage: the pericentromeric region on chromosome 8 (maximum two-point LOD = 4.08, maximum multipoint LOD = 2.59), which overlaps with the second strongest region from a previous separate linkage scan of 155 brother pairs; and Xq28 (maximum two-point LOD = 2.99, maximum multipoint LOD = 2.76), which was also implicated in prior research.ConclusionsResults, especially in the context of past studies, support the existence of genes on pericentromeric chromosome 8 and chromosome Xq28 influencing development of male sexual orientation.</jats:sec

Static Detection of Logic Flaws in Service-Oriented Applications ⋆

Abstract. Application or business logic, used in the development of services, has to do with the operations that define the application functionalities and not with the platform ones. Often security problems can be found at this level, because circumventing or misusing the required operations can lead to unexpected behaviour or to attacks, called application logic attacks. We investigate this issue, by using the CaSPiS calculus to model services, and by providing a Control Flow Analysis able to detect and prevent some possible misuses.

Calculi for Service Oriented Computing

It is widely recognised that process calculi stay to concurrent computing as lambda-calculus stays to sequential computing; in fact, they lay abstract, rigorous foundations for the analysis of interactive, communicating systems. Nowadays, the increasing popularity of Service-Oriented Computing (SOC) challenges the quest for novel abstractions tailored to the well-disciplined handling of specific issues, like long running interactions, orchestration, and unexpected events. In fact, these features emerge neatly in most SOC applications and need to be studied as first-class aspects, whereas they would be obfuscated if dealt with by sophisticated encoding in traditional process calculi. This paper overviews some of the most recent proposals emerged in the literature, pointing out their main characteristics and presents in more detail one such proposal, called caspis, by providing several examples to give evidence of its flexibility. No prior acquaintance with process calculi is assumed, indeed a gentle introduction to their basics is provided before the more advanced material be presented

Dielectric Lens Antennas

Dielectric lens antennas are attracting a renewed interest for millimeter- and submillimeter-wave applications where they become compact, especially for configurations with integrated feeds usually referred as integrated lens antennas. Lenses are very flexible and simple to design and fabricate, being a reliable alternative at these frequencies to reflector antennas. Lens target output can range from a simple collimated beam (increasing the feed directivity) to more complex multi-objective specifications. This chapter presents a review of different types of dielectric lens antennas and lens design methods. Representative lens antenna design examples are described in detail, with emphasis on homogeneous integrated lenses. A review of the different lens analysis methods is performed, followed by the discussion of relevant lens antenna implementation issues like feeding options, dielectric material characteristics, fabrication methods, and a few dedicated measurement techniques. The chapter ends with a detailed presentation of some recent application examples involving dielectric lens antennas