Match It or Die: Proving Integrity by Equality

Cryptographic hash functions are commonly used as modification detection codes. The goal is to provide message integrity assurance by comparing the digest of the original message with the hash of what is thought to be the intended message. This paper generalizes this idea by applying it to general expressions instead of just digests: success of an equality test between a tainted data and a trusted one can be seen as a proof of high-integrity for the first item. Secure usage of hash functions is also studied with respect to the confidentiality of digests by extending secret-sensitive noninterference of Demange and Sands

Estratégias de coping utilizadas por familiares de indivíduos em tratamento hemodialítico

This descriptive, qualitative study aims to identify the coping strategies used most by the family members of patients with chronic kidney disease receiving hemodialysis. The data were collected through interviews, with the Coping Strategies Inventory questionnaire administered to ten family members, and were submitted to descriptive statistics and to thematic content analysis. The strategy used most was escape-avoidance, demonstrating that the family members prefer not to face the situation. The second most-used strategy was social support, ratified by the fact that they stated that they talk with other persons and professionals, seeking information about the problem, and because they accept the support received positively. The third was problem resolution, represented by the attitude of accepting responsibility for the care, either through strong affective bonds or through a feeling of responsibility established prior to the disease. The families use coping strategies of different intensities, while, nevertheless, indicating involvement and major participation in the care for the patient.Estudio cualitativo, que trató de identificar las estrategias de afrontamiento empleadas por las familias de los pacientes con insuficiencia renal crónica en hemodiálisis. Se aplicó el Inventario de Estrategias de Afrontamiento y una questión abierta con diez familiares. Los datos cuantitativos fueron sometidos a procedimientos estatísticos y análisis de contenido cualitativo. La estrategia de mayor utilización fue el escape y evitación (oito), lo que demuestra que los miembros de las familisa preferían no tener que enfrentar esta situación. La siguiente estrategia fue utilizada más apoyo social, ya hablé con otras personas y profesionales que buscan información sobre el problema, y aceptar el apoyo positivo recibido. A terceira foi resolução de problemas, representada pela atitude em assumir o cuidado, seja pelo forte vínculo afetivo ou pelo sentimento de responsabilidade já estabelecido antes da doença. Familias de las estrategias de afrontamiento empleadas con diferentes intensidades, pero mostrando una gran implicación y la participación en el cuidado del paciente crónico.Estudo descritivo, de natureza quali-quantitativa, que objetivou identificar as estratégias de enfrentamento mais utilizadas por familiares de pacientes com doença renal crônica em hemodiálise. Os dados foram coletados por meio de entrevista, com aplicação do Inventário de Estratégias de Coping a dez familiares, e submetidos à estatística descritiva e à análise de conteúdo temática. A estratégia mais utilizada foi fuga e esquiva, demonstrando que os familiares preferiam não enfrentar a situação. A segunda estratégia mais usada foi suporte social, ratificada ao afirmarem que conversaram com outras pessoas e profissionais buscando informações sobre o problema, e por aceitarem positivamente o apoio recebido. A terceira foi resolução de problemas, representada pela atitude em assumir o cuidado, seja pelo forte vínculo afetivo ou pelo sentimento de responsabilidade já estabelecido antes da doença. As famílias empregaram estratégias de enfrentamento com intensidades diferentes, porém indicando envolvimento e grande participação no cuidado ao doente.Universidade Federal de São Paulo (UNIFESP)aff2Universidade Estadual de MaringáUEMUNIFESPSciEL

Can School Children Support Ecological Research? Lessons from the Oak Bodyguard Citizen Science Project

Peer reviewe

Herbivory on the pedunculate oak along an urbanization gradient in Europe : Effects of impervious surface, local tree cover, and insect feeding guild

Urbanization is an important driver of the diversity and abundance of tree-associated insect herbivores, but its consequences for insect herbivory are poorly understood. A likely source of variability among studies is the insufficient consideration of intraurban variability in forest cover. With the help of citizen scientists, we investigated the independent and interactive effects of local canopy cover and percentage of impervious surface on insect herbivory in the pedunculate oak (Quercus robur L.) throughout most of its geographic range in Europe. We found that the damage caused by chewing insect herbivores as well as the incidence of leaf-mining and gall-inducing herbivores consistently decreased with increasing impervious surface around focal oaks. Herbivory by chewing herbivores increased with increasing forest cover, regardless of impervious surface. In contrast, an increase in local canopy cover buffered the negative effect of impervious surface on leaf miners and strengthened its effect on gall inducers. These results show that – just like in non-urban areas – plant-herbivore interactions in cities are structured by a complex set of interacting factors. This highlights that local habitat characteristics within cities have the potential to attenuate or modify the effect of impervious surfaces on biotic interactions.Agence Nationale de la Recherche, Grant/Award Number: ANR-10--LABX-45; Fondation BNP Paribas.info:eu-repo/semantics/publishedVersio

Factors affecting adherence to guidelines for antithrombotic therapy in elderly patients with atrial fibrillation admitted to internal medicine wards

Current guidelines for ischemic stroke prevention in atrial fibrillation or flutter (AFF) recommend Vitamin K antagonists (VKAs) for patients at high-intermediate risk and aspirin for those at intermediate-low risk. The cost-effectiveness of these treatments was demonstrated also in elderly patients. However, there are several reports that emphasize the underuse of pharmacological prophylaxis of cardio-embolism in patients with AFF in different health care settings. AIMS: To evaluate the adherence to current guidelines on cardio-embolic prophylaxis in elderly (> 65 years old) patients admitted with an established diagnosis of AFF to the Italian internal medicine wards participating in REPOSI registry, a project on polypathologies/polytherapies stemming from the collaboration between the Italian Society of Internal Medicine and the Mario Negri Institute of Pharmacological Research; to investigate whether or not hospitalization had an impact on guidelines adherence; to test the role of possible modifiers of VKAs prescription. METHODS: We retrospectively analyzed registry data collected from January to December 2008 and assessed the prevalence of patients with AFF at admission and the prevalence of risk factors for cardio-embolism. After stratifying the patients according to their CHADS(2) score the percentage of appropriateness of antithrombotic therapy prescription was evaluated both at admission and at discharge. Univariable and multivariable logistic regression models were employed to verify whether or not socio-demographic (age >80years, living alone) and clinical features (previous or recent bleeding, cranio-facial trauma, cancer, dementia) modified the frequency and modalities of antithrombotic drugs prescription at admission and discharge. RESULTS: Among the 1332 REPOSI patients, 247 were admitted with AFF. At admission, CHADS(2) score was ≥ 2 in 68.4% of patients, at discharge in 75.9%. Among patients with AFF 26.5% at admission and 32.8% at discharge were not on any antithrombotic therapy, and 43.7% at admission and 40.9% at discharge were not taking an appropriate therapy according to the CHADS(2) score. The higher the level of cardio-embolic risk the higher was the percentage of antiplatelet- but not of VKAs-treated patients. At admission or at discharge, both at univariable and at multivariable logistic regression, only an age >80 years and a diagnosis of cancer, previous or active, had a statistically significant negative effect on VKAs prescription. Moreover, only a positive history of bleeding events (past or present) was independently associated to no VKA prescription at discharge in patients who were on VKA therapy at admission. If heparin was considered as an appropriate therapy for patients with indication for VKAs, the percentage of patients admitted or discharged on appropriate therapy became respectively 43.7% and 53.4%. CONCLUSION: Among elderly patients admitted with a diagnosis of AFF to internal medicine wards, an appropriate antithrombotic prophylaxis was taken by less than 50%, with an underuse of VKAs prescription independently of the level of cardio-embolic risk. Hospitalization did not improve the adherence to guideline

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening