Personalizable edge services for Web accessibility

Web Content Accessibility guidelines by W3C (W3C Recommendation, May 1999. http://www.w3.org/TR/WCAG10/) provide several suggestions for Web designers regarding how to author Web pages in order to make them accessible to everyone. In this context, this paper proposes the use of edge services as an efficient and general solution to promote accessibility and breaking down the digital barriers that inhibit users with disabilities to actively participate to any aspect of society. The idea behind edge services mainly affect the advantages of a personalized navigation in which contents are tailored according to different issues, such as client’s devices capabilities, communication systems and network conditions and, finally, preferences and/or abilities of the growing number of users that access the Web. To meet these requirements, Web designers have to efficiently provide content adaptation and personalization functionalities mechanisms in order to guarantee universal access to the Internet content. The so far dominant paradigm of communication on theWWW, due to its simple request/responsemodel, cannot efficiently address such requirements. Therefore, it must be augmented with new components that attempt to enhance the scalability, the performances and the ubiquity of the Web. Edge servers, acting on the HTTP data flow exchanged between client and server, allow on-the-fly content adaptation as well as other complex functionalities beyond the traditional caching and content replication services. These value-added services are called edge services and include personalization and customization, aggregation from multiple sources, geographical personalization of the navigation of pages (with insertion/emphasis of content that can be related to the user’s geographical location), translation services, group navigation and awareness for social navigation, advanced services for bandwidth optimization such as adaptive compression and format transcoding, mobility, and ubiquitous access to Internet content. This paper presents Personalizable Accessible Navigation (PAN) that is a set of edge services designed to improveWeb pages accessibility, developed and deployed on top of a programmable intermediary framework. The characteristics and the location of the services, i.e., provided by intermediaries, as well as the personalization and the opportunities to select multiple profiles make PAN a platform that is especially suitable for accessing the Web seamlessly also from mobile terminals

Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia.

BACKGROUND: To use more representative sample size to evaluate whether computed tomography (CT) scan evidence of the concomitant presence of pneumatosis and portomesenteric venous gas is a predictor of transmural bowel necrosis. METHODS: Data from 208 patients who were referred for a diagnosis of bowel ischemia were retrospectively reviewed. Only patients who underwent a surgical intervention following a diagnosis of bowel ischemia who also had a post-operative histological confirmation of such a diagnosis were included. Patients were split into two groups according to the presence of histological evidence of transmural bowel ischemia (case group) or partial bowel ischemia (control group). CT images were reviewed for findings of ischemia, including mural thickening, pneumatosis, bowel distension, portomesenteric venous gas and arterial or venous thrombi. RESULTS: A total of 248 subjects who underwent surgery for bowel ischemia were identified. Among the 208 subjects enrolled in our study, transmural bowel necrosis was identified in 121 subjects (case group), and partial bowel necrosis was identified in 87 subjects (control group). Based on CT findings, including mural thickening, bowel distension, pneumatosis, pneumatosis plus portomesenteric venous gas and presence of thrombi or emboli, there were no significant differences between the case and control groups. The concomitant presence of pneumatosis and porto-mesenteric venous gas showed an odds ratio of 1.95 (95%CI: 0.491-7.775, P = 0.342) for the presence of transmural necrosis. The presence of pneumatosis plus porto-mesenteric venous gas exhibited good specificity (83%) but low sensitivity (17%) in the identification of transmural bowel infarction. Accordingly, the positive and negative predictive values were 60% and 17%, respectively. CONCLUSION: Although pneumatosis plus porto-mesenteric venous gas is associated with bowel ischemia, we have demonstrated that their co-occurrence cannot be used as diagnostic signs of transmural necrosis

Anti-phosphatidyl-serine/prothrombin antibodies (aPS/PT) in isolated lupus anticoagulant (LA): is their presence linked to dual test positivity?

Abstract Objectives Anti phosphatidylserine/prothrombin antibodies (aPS/PT) are often present in patients with antiphospholipid syndrome (APS) and might be relevant in the pathogenesis of this condition. They are major determinant of lupus anticoagulant (LA) in triple-positive antiphospholipid (aPL) profile. Whether they are present and pathogenic in patients with isolated LA [negative anticardiolipin (aCL) and anti β2-glycoprotein I (aβ2GPI) antibodies] is a matter of debate. Methods We measured aPS/PT in a large number of isolated LA with the aim to ascertain whether there is a link between the way isolated LA is assessed and the presence of these antibodies. APS/PT were measured in 86 patients with isolated LA (aCL- and abeta2GPI-). LA was assessed by two test systems, the dilute Russell Viper Venom Time (dRVVT) and the Silica Clotting Time (SCT). Results Sixty-six (77%) individuals with isolated LA were positive for aPS/PT (IgM 44, IgG and IgM 15, IgG in 7). Diagnosis of LA was made based on positive results in both dRVVT and SCT in 40 patients (Group 1) and based on only one positive test in the remaining 46 patients (Group 2). The rate of positive aPS/PT antibodies was significantly higher in Group 1 (OR=7.2, 95% CI 1.9–27.0, p<0.002). Moreover, the titre of IgM aPS/PT was significantly increased in Group 1 as compared to Group 2 (137 U, IQR 64–179 vs. 43 U, IQR 11–120, p=0.008). Conclusions These data indicate an association between LA based on two positive coagulation tests and the presence of aPS/PT antibodies, especially of IgM isotype

Personalizable edge services for Web accessibility

Web Content Accessibility guidelines by W3C (W3C Recommendation, May 1999. http://www.w3.org/TR/WCAG10/) provide several suggestions for Web designers regarding how to author Web pages in order to make them accessible to everyone. In this context, this paper proposes the use of edge services as an efficient and general solution to promote accessibility and breaking down the digital barriers that inhibit users with disabilities to actively participate to any aspect of society. The idea behind edge services mainly affect the advantages of a personalized navigation in which contents are tailored according to different issues, such as client’s devices capabilities, communication systems and network conditions and, finally, preferences and/or abilities of the growing number of users that access the Web. To meet these requirements, Web designers have to efficiently provide content adaptation and personalization functionalities mechanisms in order to guarantee universal access to the Internet content. The so far dominant paradigm of communication on the WWW, due to its simple request/response model, cannot efficiently address such requirements. Therefore, it must be augmented with new components that attempt to enhance the scalability, the performances and the ubiquity of the Web. Edge servers, acting on the HTTP data flow exchanged between client and server, allow on-the-fly content adaptation as well as other complex functionalities beyond the traditional caching and content replication services. These value-added services are called edge services and include personalization and customization, aggregation from multiple sources, geographical personalization of the navigation of pages (with insertion/emphasis of content that can be related to the user’s geographical location), translation services, group navigation and awareness for social navigation, advanced services for bandwidth optimization such as adaptive compression and format transcoding, mobility, and ubiquitous access to Internet content. This paper presents Personalizable Accessible Navigation (Pan) that is a set of edge services designed to improve Web pages accessibility, developed and deployed on top of a programmable intermediary framework. The characteristics and the location of the services, i.e., provided by intermediaries, as well as the personalization and the opportunities to select multiple profiles make Pan a platform that is especially suitable for accessing the Web seamlessly also from mobile terminals

Iodine Intake from Food and Iodized Salt as Related to Dietary Salt Consumption in the Italian Adult General Population

Since the Italian iodoprophylaxis strategy is based on the use of iodized salt, we assessed the relationship between dietary salt consumption and iodine intake in the Italian adult population. We estimated the relative contribution given by the use of iodized salt and by the iodine introduced by foods to the total iodine intake. The study population included 2219 adults aged 25–79 years (1138 men and 1081 women) from all Italian regions, participating to the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 2008–2012 (OEC/HES), and examined for sodium and iodine intake in the framework of the MINISAL-GIRCSI Programme. Dietary sodium and total iodine intake were assessed by the measurement of 24 h urinary excretion, while the EPIC questionnaire was used to evaluate the iodine intake from food. Sodium and iodine intake were significantly and directly associated, upon accounting for age, sex, and BMI (Spearman rho = 0.298; p < 0.001). The iodine intake increased gradually across quintiles of salt consumption in both men and women (p < 0.001). The European Food Safety Authority (EFSA) adequacy level for iodine intake was met by men, but not women, only in the highest quintile of salt consumption. We estimated that approximately 57% of the iodine intake is derived from food and 43% from salt. Iodized salt contributed 24% of the total salt intake, including both discretionary and non-discretionary salt consumption. In conclusion, in this random sample of the Italian general adult population examined in 2008–2012, the total iodine intake secured by iodized salt and the iodine provision by food was insufficient to meet the EFSA adequate iodine intake

What are the implications of the spontaneous spleno-renal shunts in liver cirrhosis?

<p>Abstract</p> <p>Background</p> <p>Although significant advances are expected to be made in the assessment of the portal hypertension-related complications, the prognostic role of spleno-renal shunts has not been fully explored so far. Clarifying this aspect could help tackle the life-treating events occurring in patients suffering from liver cirrhosis. The aim of the study was to analyze the relationships between the spleno-renal shunts presence at doppler ultrasound and the liver cirrhosis complications.</p> <p>Methods</p> <p>Design: eighty one patients out of 129 formed the study population (35 females). Chronic liver damage in these patients was caused by HCV (66), HBV (2), alcohol abuse (2) or unknown etiology, likely non-alcoholic steatohepatitis (11). Setting: two Liver Units of university/primary hospitals in Southern Italy. Main outcome measures: grading of esofageal varices; detection of ascites: assessment of hepatic encephalopathy; evaluation of liver cirrhosis severity; tracking hepatocellular carcinoma; doppler features of spleno-renal shunts and splenic flow velocity; spleen longitudinal diameter at sonography.</p> <p>Results</p> <p>The prevalence of spleno-renal shunts was 18.5%, without no difference concerning the etiology (HCV versus non-HCV, p = 0.870); the prevalence of hepatocellular carcinoma in patients with spleno-renal shunts was superior to that of patients without them (Pearson Chi-square, p = 0.006, power of sample size 74%), also after adjustment for liver decompensation (p = 0.024). The median score of hepatic encephalopathy in patients with and without spleno-renal shunts was similar, i.e., 0 (range, 0-2) versus 0 (0 - 3), p = 0.67. The median splenic vein flow velocity in patients with spleno-renal shunts was significantly inferior to that of patients without them, i.e., 13 cm/sec (95% confidence intervals, 6-18) versus 21 cm/sec (17-24), p < 0.0001. By far the largest percentage of large esophageal varices was in patients without spleno-renal shunts (p = 0.005). In contrast, the frequency of ascites and hepatic encephalopathy severity was overlapping in the two groups. BMI values but not Child-Pugh's classification predicted spleno-renal shunts (Ors = 1.84, 95% confidence intervals = 1.28-2.64, p = 0.001 and 1.145, 95% confidence intervals = 0.77-1.51, p = 0.66).</p> <p>Conclusion</p> <p>Taking into consideration the relatively small sample size, patients with spleno-renal shunts are burdened by an increased incidence of hepatocellular carcinoma. BMI predicted the spleno-renal shunts presence.</p