Are CAPTCHAs preventing robotic intrusion or accessibility for impaired users?

Is the World Wide Web for everyone? Long story short: no and unfortunately it is not only a matter of infrastructures, level of instruction or economic conditions. People affected by visual impairments have often difficulties in navigating web pages for a wide range of reasons. One of the biggest obstacles nowadays is the use of CAPTCHAs, powerful tools against bot attacks but also potential virtual barriers for the aforementioned category of users. In this paper we tested various categories of CAPTCHAs with people affected by visual impairment and not, to understand how discriminatory can be these cybersecurity measures

A Chrome extension to help people with dyslexia

Even if the World Wide Web is one of the main content and service providers, unfortunately, these contents and services are not really available for everyone. People affected by impairments often have difficulties in navigating Web pages for a wide range of reasons. In this paper, we focus on people affected by dyslexia. These users experience difficulties in reading acquisition, despite normal intelligence and adequate access to conventional instruction. For this reason, we have created Help me read!, a Chrome extension that allows to change many features of a Web page. Furthermore, it allows to isolate and enlarge one word at a time. This feature is crucial as it allows people with dyslexia to focus on each single word, thus overcoming one of their main difficulties

Renal function performance in CKD stage 5: a sealed fate?

Introduzione e scopo: Gli stadi 4 e 5 della Malattia Renale Cronica sono sempre stati considerati difficili da modificare nella loro progressione ed evoluzione. Noi abbiamo valutato retrospettivamente i nostri pazienti in CKD5 (dall\u20191/1/2016 al 31/12/2018), per analizzarne l\u2019evoluzione funzionale nel tempo. Materiale e Metodi: Sono stati inclusi pazienti con follow-up >6 mesi e almeno 4 controlli che includessero la clearance della creatinina misurata (ClCr) e stimata mediante la formula CKD-EPI (eGFR). Abbiamo analizzato: la concordanza fra ClCr ed eGFR mediante analisi di Bland-Altman, la modalit\ue0 di progressione classificata come rapida (perdita di eGFR >5 ml/min/anno), lenta (perdita di eGFR 1-5 ml/min/anno) e non evolutiva (perdita di eGFR <1 ml/min/anno oppure guadagno di eGFR). Abbiamo individuato quali parametri clinico-laboratoristici (diabete, controllo pressorio, uso di ACEi/ARBs, cardiopatia ischemica cronica, arteriopatia obliterante cronica periferica, proteinuria, emoglobina, acido urico, PTH, fosforo) sono associati alle diverse modalit\ue0 di progressione, mediante analisi bivariata e un modello di regressione multinomiale multipla. Risultati: ClCr ed eGFR hanno mostrato una elevata concordanza, specialmente per valori di GFR <12 ml/min. Lo slope medio dell\u2019eGFR \ue8 stato pari a -3.05 \ub13.68 ml/min/1.73 m2/anno. La progressione \ue8 stata rapida nel 17.0% dei pazienti, lenta nel 57.6% dei pazienti; un quarto dei pazienti (25.4%) ha avuto un andamento non evolutivo. Alla analisi bivariata, la maggior progressione del danno renale cronico \ue8 risultata associata con lo scarso controllo pressorio (p=0.038) e con l\u2019assunzione di farmaci ACEi/ARBs (p=0.043), mentre nel modello multivariabile solamente la arteriopatia obliterante cronica periferica \ue8 risultata associata a un accresciuto rischio di progressione veloce dell\u2019eGFR (relative risk ratio=5.97). Discussione: Meno di un quinto dei pazienti ha avuto una perdita di filtrato >5 ml/min/anno, mentre nella grande maggioranza dei pazienti si \ue8 assistitito ad una progressione lenta ma anche alla possibilit\ue0 di una stabilizzazione o di un recupero funzionale. Nonostante i limiti legati alla numerosit\ue0 del campione, questi dati ci incoraggiano a non considerare il CKD5 un inesorabile e breve viaggio verso il trattamento sostitutivo.Introduction and aims: Stages 4 and 5 of chronic kidney disease (CKD) have always been considered hard to modify in their speed and evolution. We retrospectively evaluated our CKD stage 5 patients (from 01/1/2016 to 12/31/2018), with a view to analyzing their kidney function evolution. Material and Methods: We included only patients with longer than 6 months follow-up and at least 4 clinical-laboratory controls that included measured Creatinine Clearance (ClCr) and estimated GFR with CKD-EPI (eGFR). We evaluated: the agreement between ClCr and eGFR through Bland-Altman analysis; progression rate, classified as fast (eGFR loss >5ml/min/year), slow (eGFR loss 1-5 ml/min/year) and non-progressive (eGFR loss <1 ml/min/year or eGFR increase). We also evaluated which clinical-laboratory parameters (diabetes, blood pressure control, use of ACEi/ARBs, ischemic myocardiopathy, peripheral obliterant arteriopathy (POA), proteinuria, hemoglobin, uric acid, PTH, phosphorus) were associated to the different eGFR progression classes by means of bivariate regression and multinomial multiple regression model. Results: Measured CrCl and eGFR where often in agreement, especially for GFR values <12ml/min. The average slope of eGFR was -3.05 \ub13.68 ml/min/1.73 m2/year. The progression of kidney function was fast in 17% of the patients, slow in 57.6%, non-progressive in 25.4%. At the bivariate analysis, a fast progression was associated with poor blood pressure control (p=0.038) and ACEi/ARBs use (p=0.043). In the multivariable model, only peripheral obliterative arteriopathy proved associated to an increased risk of fast progression of eGFR (relative risk ratio=5.97). Discussion: Less than one fifth of our patients presented a fast GFR loss (>5 ml/min/year). The vast majority showed a slow progression, stabilisation or even an improvement. Despite the limits due to the small sample size, the data has encouraged us not to consider CKD stage 5 as an inexorable and short journey towards artificial replacement therapy