GridCertLib: a Single Sign-on Solution for Grid Web Applications and Portals

This paper describes the design and implementation of GridCertLib, a Java library leveraging a Shibboleth-based authentication infrastructure and the SLCS online certificate signing service, to provide short-lived X.509 certificates and Grid proxies. The main use case envisioned for GridCertLib, is to provide seamless and secure access to Grid/X.509 certificates and proxies in web applications and portals: when a user logs in to the portal using Shibboleth authentication, GridCertLib can automatically obtain a Grid/X.509 certificate from the SLCS service and generate a VOMS proxy from it. We give an overview of the architecture of GridCertLib and briefly describe its programming model. Its application to some deployment scenarios is outlined, as well as a report on practical experience integrating GridCertLib into portals for Bioinformatics and Computational Chemistry applications, based on the popular P-GRADE and Django softwares.Comment: 18 pages, 1 figure; final manuscript accepted for publication by the "Journal of Grid Computing

Among once-daily regimens, single tablet regimens (STRs) are associated with better adherence

Previous published evidences showed that taking HAART once-daily (OD) is associated to better adherence when compared to BID or TID regimens. However, no further studies investigated whether, among OD regimens, adherence levels can be differently influenced. Aim of the study was to evaluate levels of self-reported adherence in HIV+ people according to type of HAART dosing (STR, OD with more than one pill or BID). To limit reporting biases, the study was performed in five different non-clinic settings covering North and Central Italy. A total of 230 patients on stable HAART were asked to complete a semi-structured, anonymous questionnaire reporting their attitude toward HAART, their adherence and the acceptability of their regimen. Self-perception of adherence was also investigated with a single item for comparison with real adherence behavior. Most of the subjects were males (66%) with a mean age of 46 years, with higher education level (72%) and a long history of HIV infection (mean 13.6 years). 17% of patients were on a first-line regimen. 21% reported to miss at least one dose during the past week (STR: 6%; OD >1 pill 23% and BID 21%; p<0.05). People taking STR and BID tend to report less discontinuations (all the drug of the day for at least 3 times in a month) compared to OD>1 pill (6 and 4% vs 11%). People taking therapies other than HAART reported similar adherence levels of people taking only HAART, even when stratified for dosing groups. Even people judging their adherence as ‘optimal’ or ‘very good’, 10 and 17% respectively, reported having missed a dose during the last week. At stepwise regression model, optimal adherence was correlated to being male (OR: 2.38; 95% CI: 1.19–4.74), younger (OR: 3.04; 95% CI: 1.01–9.13) and with a shorter HIV infection (OR: 3.58; 95% CI: 1.04–12.38). People taking simpler once-daily STR tend to report better adherence than people taking OD>1 pill or BID. Perception of optimal adherence is largely variable among HIV-infected people taking HAART, although only a minority of subjects showing less than perfect adherence do judge their behavior as ‘optimal’

Risk factors for recurrence in patients with Clostridium difficile infection due to 027 and non-027 ribotypes

Objectives: Our objective was to evaluate factors associated with recurrence in patients with 027+ and 027– Clostridium difficile infection (CDI). Methods: Patients with CDI observed between January and December 2014 in six hospitals were consecutively included in the study. The 027 ribotype was deduced by the presence of tcdB, tcdB, cdt genes and the deletion Δ117 in tcdC (Xpert® C. difficile/Epi). Recurrence was defined as a positive laboratory test result for C. difficile more than 14 days but within 8 weeks after the initial diagnosis date with reappearance of symptoms. To identify factors associated with recurrence in 027+ and 027– CDI, a multivariate analysis was performed in each patient group. Subdistributional hazard ratios (sHRs) and 95% confidence intervals (95%CIs) were calculated. Results: Overall, 238 patients with 027+ CDI and 267 with 027– CDI were analysed. On multivariate analysis metronidazole monotherapy (sHR 2.380, 95%CI 1.549–3.60, p <0.001) and immunosuppressive treatment (sHR 3.116, 95%CI 1.906–5.090, p <0.001) were factors associated with recurrence in patients with 027+ CDI. In this patient group, metronidazole monotherapy was independently associated with recurrence in both mild/moderate (sHR 1.894, 95%CI 1.051–3.410, p 0.033) and severe CDI (sHR 2.476, 95%CI 1.281–4.790, p 0.007). Conversely, non-severe disease (sHR 3.704, 95%CI 1.437–9.524, p 0.007) and absence of chronic renal failure (sHR 16.129, 95%CI 2.155–125.000, p 0.007) were associated with recurrence in 027– CDI. Conclusions: Compared to vancomycin, metronidazole monotherapy appears less effective in curing CDI without relapse in the 027+ patient group, independently of disease severity

Good adherence to HAART and improved survival in a community HIV/AIDS treatment and care programme: the experience of The AIDS Support Organization (TASO), Kampala, Uganda.

BACKGROUND: Poor adherence to highly active antiretroviral therapy (HAART) may result in treatment failure and death. Most reports of the effect of adherence to HAART on mortality come from studies where special efforts are made to provide HAART under ideal conditions. However, there are few reports of the impact of non-adherence to HAART on mortality from community HIV/AIDS treatment and care programmes in developing countries. We therefore conducted a study to assess the effect of adherence to HAART on survival in The AIDS Support Organization (TASO) community HAART programme in Kampala, Uganda. METHODS: The study was a retrospective cohort of 897 patients who initiated HAART at TASO clinic, Kampala, between May 2004 and December 2006. A total of 7,856 adherence assessments were performed on the data. Adherence was assessed using a combination of self-report and pill count methods. Patients who took 95%. The crude death rate was 12.2 deaths per 100 patient-years, with a rate of 42.5 deaths per 100 patient-years for non-adherent patients and 6.1 deaths per 100 patient-years for adherent patients. Non-adherence to ART was significantly associated with mortality. Patients with a CD4 count of less than 50 cells/mm3 had a higher mortality (HR = 4.3; 95% CI: 2.22-5.56) compared to patients with a CD4 count equal to or greater than 50 cells/mm3 (HR = 2.4; 95% CI: 1.79-2.38). CONCLUSION: Our study showed that good adherence and improved survival are feasible in community HIV/AIDS programmes such as that of TASO, Uganda. However, there is need to support community HAART programmes to overcome the challenges of funding to provide sustainable supplies particularly of antiretroviral drugs; provision of high quality clinical and laboratory support; and achieving a balance between expansion and quality of services. Measures for the early identification and treatment of HIV infected people including home-based VCT and HAART should be strengthened

Facial lipohypertrophy in HIV-infected subjects who underwent autologous fat tissue transplantation.

Of 41 HIV-infected patients with facial lipoatrophy who underwent autologous fat transplantation, disfiguring facial lipohypertrophy at the graft site occurred at the same time as recurrent fat accumulation at the tissue harvest site in 4 patients who had had fat transferred from the dorsocervical fat pad or from subcutaneous abdominal tissue

Dental avulsion: therapeutic protocols and oral health-related quality of life.

AIM: The aim of this study is to describe oral health-related quality of life (OHRQoL) among patients who have had a complete dislocation of the tooth out of its socket (tooth avulsion). The study also sought to identify clinical evidence, associated with OHRQoL, of the ideal therapeutic choice after tooth avulsion among these patients under 18 years old. STUDY DESIGN: 73 patients under 18 year old were selected between 101 studied; they received different treatments, after one year adverse impacts on OHRQoL were measured using the 14-item OHIP. RESULTS: Our findings show that if patients got into tooth avulsion their quality of life is adversely affected. In this study, 21.2\% of subjects reported 1 or more of the 14 OHIP items during the preceding 12 months, which is significantly high. In group A just 4\% of subjects reported 1 or more of the 14 OHIP items, while in the other groups the percentage rose, reaching 50\% in group F. Group C D G reported a value of 20\%, while in group E this is 12\%. CONCLUSION This study shows how different treatment options have different effects on quality of life; the ideal one is the immediate replantation, when this is not possible, RPD or functional appliance seem to be the best choice

Guidelines for VCCT-Based Interlaminar Fatigue and Progressive Failure Finite Element Analysis

This document is intended to detail the theoretical basis, equations, references and data that are necessary to enhance the functionality of commercially available Finite Element codes, with the objective of having functionality better suited for the aerospace industry in the area of composite structural analysis. The specific area of focus will be improvements to composite interlaminar fatigue and progressive interlaminar failure. Suggestions are biased towards codes that perform interlaminar Linear Elastic Fracture Mechanics (LEFM) using Virtual Crack Closure Technique (VCCT)-based algorithms [1,2]. All aspects of the science associated with composite interlaminar crack growth are not fully developed and the codes developed to predict this mode of failure must be programmed with sufficient flexibility to accommodate new functional relationships as the science matures

Rehabilitation of a patient with mini-implants after avulsion of the upper incisors: A 13-year follow up

Treatment following avulsion of a tooth in the growing patient requires a complex multidisciplinary therapeutic approach for the clinical team. The literature offers different therapeutic solutions following the avulsion of one or more teeth, but unfortunately all of them have negative repercussions on the patients' life quality, they involve long treatment plans, they are not always feasible, and they have limits. Alternatively, a new treatment concept that uses mini-implants can be considered and is presented with its rationale, clinical steps and 13&nbsp;years of follow up of one case