Las Comunidades Terapéuticas para el Tratamiento de la Drogodependencia en Europa

Después de una breve introduccción sobre el concepto de drogodependencia que se podría entender como un modo de auto curación y un modo errado de resolver problemas personales y de relación y después de brindar una visión panorámica sobre el consumo de sustancias en Europa, el artículo aborda el tema de los tratamientos de rehabilitación en las comunidades terapéuticas y brinda un panorama general sobre la evolución de los escenarios terapéuticos de los tratamientos residenciales en las comunidades.Por lo tanto, se desarrolla el tema de los tratamientos de rehabilitación para personas con problemas de abuso de sustancias estupefacientes brindados por sistemas socio-sanitarios de ocho países europeos que, en el 2006, tenían la tasa más alta de preponderancia en el consumo de drogas (Reino Unido, España, Italia, Alemania, Francia, Austria, República Checa y Grecia). Según los informes nacionales de estos ocho países, los tratamientos terapéuticos ambulatorios están aumentando en número y capacidad, mientras que los recursos dedicados a los tratamientos residenciales están disminuyendo progresivamente.Según el autor, dentro el preocupante escenario dado el incremento del uso de estupefacientes en Europa, las comunidades terapéuticas pueden aún representar un recurso útil en cuanto a la oferta de servicios de calidad y tratamientos de rehabilitación personalizados

Using multi-locators to increase the robustness of web test cases

The main reason for the fragility of web test cases is the inability of web element locators to work correctly when the web page DOM evolves. Web elements locators are used in web test cases to identify all the GUI objects to operate upon and eventually to retrieve web page content that is compared against some oracle in order to decide whether the test case has passed or not. Hence, web element locators play an extremely important role in web testing and when a web element locator gets broken developers have to spend substantial time and effort to repair it. While algorithms exist to produce robust web element locators to be used in web test scripts, no algorithm is perfect and different algorithms are exposed to different fragilities when the software evolves. Based on such observation, we propose a new type of locator, named multi-locator, which selects the best locator among a candidate set of locators produced by different algorithms. Such selection is based on a voting procedure that assigns different voting weights to different locator generation algorithms. Experimental results obtained on six web applications, for which a subsequent release was available, show that the multi-locator is more robust than the single locators (about -30% of broken locators w.r.t. the most robust kind of single locator) and that the execution overhead required by the multiple queries done with different locators is negligible (2-3% at most)

Why Creating Web Page Objects Manually if It Can Be Done Automatically?

Page Object is a design pattern aimed at making web test scripts more readable, robust and maintainable. The effort to manually create the page objects needed for a web application may be substantial and unfortunately existing tools do not help web developers in such task.In this paper we present APOGEN, a tool for the automatic generation of page objects for web applications. Our tool automatically derives a testing model by reverse engineering the target web application and uses a combination of dynamic and static analysis to generate Java page objects for the popular Selenium WebDriver framework. Our preliminary evaluation shows that it is possible to use around 3/4 of the automatic page object methods as they are, while the remaining 1/4 need only minor modifications

Research and Intervention for Drug-Addicted Mothers and Their Children: New Perspectives

According to research carried out by the EMCDDA, drug-addicted women in Europe account for at least one quarter of the total European population consuming illicit substances (Emcdda, 2006a). A specific research platform entitled \u201cWomen and Drugs\u201d was created within the context of the second European project \u201cDemocracies, Cities and Drugs.\u201d This platform is focused on what characterizes and distinguishes female substance addiction from male substance addiction: its manifestation, its attributes, and the interventions or services which can be put into effect while devoting special attention and offering specialized care to this phenomenon. Our findings confirm that women substance users are exposed to a great number of risks such as medical, social, economic, familial and psychopathological risks requiring intervention through specific tools and aimed responses (see Brentari, Hernandez, Tripodi, 2011). The investigated factors included pregnancy, parenthood and the well-being as well as development of the child, while taking into account institutional and ethical reflections regarding this complex theme. The substance abuse phenomenon indeed affects a high number of fertile women. When drugs are consumed during pregnancy, they can have serious, direct and indirect effects on the postpartum development with subsequent effects on the child (OTIS, 2010). Substance abusing mothers represent an at-risk parenting situation which, in turn, profoundly influences the quality of the mother-child relationship. The awareness of these at-risk situations for children along with the widely accepted notion that ideally, children should always be raised by their mothers led to the introduction of residential treatment in Italy. These services deal with maternal pathologies and provide care and assistance for children; in fact, these therapeutic communities accommodate addicted mothers as well as their children. Up until recently, therapies for children (particularly medical ones) were administered by institutions outside of the community, while no therapeutic treatment was mandated for minors. The first therapeutic communities for drug addicted mothers and their children appeared in Europe in the early nineties. These institutions must provide assistance to children and assure them the greatest possible social, psychological and physical well-being. In addition to the funds available for each mother, funds for each individual minor are made available on a daily basis. Our project: \u201cResearch and intervention on minors in communities for addicted mothers and their children: from at-risk parenting to child wellbeing\u201d was promoted within this specific intervention framework. The project aims to secure child well-being by assessing maternal parenting as well as by carrying out direct and indirect observations of the child, his/her caregivers and the caregiver-child relationship. At the same time, the most suitable intervention for each single subject is put into effect

Neural Embeddings for Web Testing

Web test automation techniques employ web crawlers to automatically produce a web app model that is used for test generation. Existing crawlers rely on app-specific, threshold-based, algorithms to assess state equivalence. Such algorithms are hard to tune in the general case and cannot accurately identify and remove near-duplicate web pages from crawl models. Failing to retrieve an accurate web app model results in automated test generation solutions that produce redundant test cases and inadequate test suites that do not cover the web app functionalities adequately. In this paper, we propose WEBEMBED, a novel abstraction function based on neural network embeddings and threshold-free classifiers that can be used to produce accurate web app models during model-based test generation. Our evaluation on nine web apps shows that WEBEMBED outperforms state-of-the-art techniques by detecting near-duplicates more accurately, inferring better web app models that exhibit 22% more precision, and 24% more recall on average. Consequently, the test suites generated from these models achieve higher code coverage, with improvements ranging from 2% to 59% on an app-wise basis and averaging at 23%.Comment: 12 pages; in revisio

Thiopurine metabolites variations during co-treatment with aminosalicylates for inflammatory bowel disease: effect of N-acetyl transferase polymorphisms

AIM: To evaluate variation of the concentration of thiopurine metabolites after 5-aminosalicylate (5-ASA) interruption and the role of genetic polymorphisms of N-acetyl transferase (NAT) 1 and 2. METHODS: Concentrations of thioguanine nucleotides (TGN) and methymercaptopurine nucleotides (MMPN), metabolites of thiopurines, were measured by high performance liquid chromatography in 12 young patients (3 females and 9 males, median age 16 years) with inflammatory bowel disease (6 Crohn's disease and 6 ulcerative colitis) treated with thiopurines (7 mercaptopurine and 5 azathioprine) and 5-ASA. Blood samples were collected one month before and one month after the interruption of 5-ASA. DNA was extracted and genotyping of NAT1, NAT2, inosine triphosphate pyrophosphatase (ITPA) and thiopurine methyl transferase (TPMT) genes was performed using PCR assays. RESULTS: Median TGN concentration before 5-ASA interruption was 270 pmol/8 x 108 erythrocytes (range: 145-750); after the interruption of the aminosalicylate, a 35% reduction in TGN mean concentrations (absolute mean reduction 109 pmol/8 7 108 erythrocytes) was observed (median 221 pmol/8 7 108 erythrocytes, range: 96-427, P value linear mixed effects model 0.0011). Demographic and clinical covariates were not related to thiopurine metabolites concentrations. All patients were wild-type for the most relevant ITPA and TPMT variants. For NAT1 genotyping, 7 subjects presented an allele combination corresponding to fast enzymatic activity and 5 to slow activity. NAT1 genotypes corresponding to fast enzymatic activity were associated with reduced TGN concentration (P value linear mixed effects model 0.033), putatively because of increased 5-ASA inactivation and consequent reduced inhibition of thiopurine metabolism. The effect of NAT1 status on TGN seems to be persistent even after one month since the interruption of the aminosalicylate. No effect of NAT1 genotypes was shown on MMPN concentrations. NAT2 genotyping revealed that 6 patients presented a genotype corresponding to fast enzymatic activity and 6 to slow activity; NAT2 genotypes were not related to thiopurine metabolites concentration in this study. CONCLUSION: NAT1 genotype affects TGN levels in patients treated with thiopurines and aminosalicylates and could therefore influence the toxicity and efficacy of these drugs; however the number of patients evaluated is limited and this has to be considered a pilot study

Assessment of the INLA approach on gerarchic bayesian models for the spatial disease distribution: a real data application

The use of approximate methods as the INLA (Integrated Nested Laplace Approximation) approach is being widely used in Bayesian inference, especially in spatial risk model estimation where the Besag-York-Mollie (BYM) model ` has found a proper use. INLA appears time saving compared to Monte Carlo simulations based on Markov Chains (MCMC), but it produces some differences in estimates [1, 2]. Data from the Veneto Cancer Registry has been considered with the scope to compare cancer incidence estimates with INLA method and with two other procedures based on MCMC simulation, WinBUGS and CARBayes, under R environment. It is noteworthy that INLA returns estimates comparable to both MCMC procedures, but it appears sensitive to the a-priori distribution. INLA is fast and efficient in particular with samples of moderate-high size. However, care must to be paid to the choice of the parameter relating to the a-priori distribution

In vitro assessment of a novel composite scaffold for articular cartilage restoration

Articular cartilage (AC) lesions are a particular challenge for regenerative medicine due to cartilage low self-ability repair in case of damage. Hence, a significant goal of musculoskeletal tissue engineering is the development of suitable structures in virtue of their matrix composition and biomechanical properties [1]. The objective of our study was to design in vitro a supporting structure for cartilage chondrocytes to treat focal articular joint defects. We realized a bio-hybrid composite scaffold combining decellularized Wharton’s jelly (W’s J) with the biomechanical properties of the synthetic hydrogel polyvinyl alcohol (PVA). The hydrogel itself and the more specific decellularized cartilage matrix were used as controls. Immunohistochemical analysis highlighted a similar histomorphology for W’s J and AC matrices. Human chondrocytes were isolated from articular cartilage by collagenase II digestion and then characterized by flow-cytometry and RT-PCR to assess the expression of specific markers. CD44+/CD73+/CD151+ chondrocytes were seeded on PVA, PVA/AC and PVA/W’s J scaffolds to test their ability to support cell colonization. According to SEM micrographs and MTT proliferation assay, PVA/W’s J revealed a singular attitude to sustain cell proliferation despite its aspecific origin. Our preliminary evidences highlighted the chance of using Wharton’s jelly in combination with PVA hydrogels as an innovative and easily available scaffold for cartilage restoration

In vitro and in vivo study of a novel biodegradable synthetic conduit for injured peripheral nerves

In case of peripheral nerve injury (PNI) with wide substance-loss, surgical reconstruction is still a challenge. Bridging the gap by autologous sensory nerves as grafts is the current standard; nevertheless, the related issues have prompted the research towards the development of effective artificial synthetic/biological nerve conduits (NCs). Here, we manufactured a novel NC using oxidized polyvinyl alcohol (OxPVA) that is a biodegradable cryogel recently patented by our group [1]. Thus, its characteristics were compared with neat polyvinyl alcohol (PVA) and silk-fibroin (SF) NCs through in vitro/in vivo analysis. Considering in vitro studies, a morphological characterization was performed by Scanning Electron Microscopy (SEM). Thereafter, cell adhesion and proliferation of a Schwann-cell line (SH-SY5Y) were evaluated by SEM and MTT assay. Regarding in vivo tests, the NCs were implanted into the surgical injured sciatic nerve (gap: 5 mm) of Sprague-Dawley rats, and the functional recovery was assessed after 12-weeks. The NCs were then processed for histological, immunohistochemical (anti-CD3; -β-tubulin; -S100) and Transmission Electron Microscopy (TEM) analyses. In particular, morphometric analyses (section area, total number and density of nerve fibers) were performed at the level of proximal, central and distal portions with respect to NC. In vitro results by SEM showed that PVA and SF supports have a smoother surface than OxPVA scaffolds. Moreover, unlike SF scaffolds, PVA-based ones do not support SH-SY5Y adhesion and proliferation. Regarding the in vivo study, all animals showed a functional recovery with normal walk, even though only animals implanted with PVA and SF NCs sometimes showed spasms while walking. On the contrary, animals implanted with OxPVA NCs exhibited a normal movement. Anti-CD3 immunohistochemistry assessed the absence of severe inflammatory reactions in all the grafts. A strong positive immunoreaction for β-tubulin and S100 demonstrated the good regeneration of nervous fibers. TEM highlighted regeneration of myelinated/un-myelinated axons and Schwann cells in all the grafts. However, morphometric analysis demonstrated that OxPVA assure a better outcome in nerve regeneration in terms of total number of nerve fibers. Our results sustain the potential of OxPVA for the development of NCs useful for PNI with substance loss with the advantage of biodegradation

Characterization of novel autologous leukocyte fibrin platelet membranes for tissue engineering applications

Autologous hemocomponents have recently emerged as potential biologic tools for regenerative purpose, consisting mainly of platelet concentrates which locally release growth factors (GFs) to enhance the tissue healing process. Despite two decades of clinical studies, the therapeutic efficacy of platelet concentrates is still controversial. This work represents a first characterization of a novel autologous leukocyte fibrin platelet membrane (LFPm), which is prepared by the Department of Immunohematology of Belluno Hospital according to a well standardized protocol. The quantification of their specific content showed that LFPms are enriched not only with platelets, but also with monocytes/macrophages, fibrinogen and CD34+ cells. Mechanical properties of LFPms were investigated by tensile tests, revealing that the specific elasticity of membranes was maintained over time. Furthermore, the release kinetics of Platelet Derived Growth Factor, Vascular Endothelial Growth Factor, Tumor Necrosis Factor alpha and Interleukin-10 was assessed by ELISA, demonstrating that LFPms act as GF delivery systems which sustain the local release of bioactive molecules. For in vitro biodegradation analysis, LFPm samples were incubated into PBS solution for 4, 7, 14, 21 days. SEM micrographs showed a progressive loss in cellular elements associated to a simultaneous exposure of the fibrin scaffold, also confirmed by histological and immunohistochemical investigations. In parallel, LFPm disks were implanted into a subcutaneous dorsal pouch of healthy nude rats and explanted after 4, 7, 14, 21 days for in vivo biodegradation study. SEM, histological and immunohistochemical analysis revealed that the typical LFPm fibrin structure was maintained until day 7, with a contemporary loss of cellular elements. From day 14, the morphology and texture of samples became less and less recognizable, confirming that a progressive biodegradation occurred. Overall, collected evidences could support the rationale for the clinical use of LFPms, shading some light on the regenerative effect they may exert after the autologous implant on a defect site