Towards Automatic Model Completion: from Requirements to SysML State Machines

Even if model-driven techniques have been enabled the centrality of the models in automated development processes, the majority of the industrial settings does not embrace such a paradigm due to the procedural complexity of managing model life cycle. This paper proposes a semi-automatic approach for the completion of high-level models of critical systems. The proposal suggests a specification guidelines that starts from a partial SysML (Systems Modeling Language) model of a system and on a set of requirements, expressed in the well-known Behaviour-Driven Design paradigm. On the base of such requirements, the approach enables the automatic generation of SysML state machines fragments. Once completed, the approach also enables the modeller to check the results improving the quality of the model and avoiding errors both coming from the mis-interpretation of the tool and from the modeller himself/herself. An example taken from the railway domain shows the approach.Comment: Editor: Ib\'eria Medeiros. 18th European Dependable Computing Conference (EDCC 2022), September 12-15, 2022, Zaragoza, Spain. Student Forum Proceedings - EDCC 202

Determinants of SARS-CoV-2 receptor gene expression in upper and lower airways

The recent outbreak of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has led to a worldwide pandemic. One week after initial symptoms develop, a subset of patients progresses to severe disease, with high mortality and limited treatment options. To design novel interventions aimed at preventing spread of the virus and reducing progression to severe disease, detailed knowledge of the cell types and regulating factors driving cellular entry is urgently needed. Here we assess the expression patterns in genes required for COVID-19 entry into cells and replication, and their regulation by genetic, epigenetic and environmental factors, throughout the respiratory tract using samples collected from the upper (nasal) and lower airways (bronchi). Matched samples from the upper and lower airways show a clear increased expression of these genes in the nose compared to the bronchi and parenchyma. Cellular deconvolution indicates a clear association of these genes with the proportion of secretory epithelial cells. Smoking status was found to increase the majority of COVID-19 related genes including ACE2 and TMPRSS2 but only in the lower airways, which was associated with a significant increase in the predicted proportion of goblet cells in bronchial samples of current smokers. Both acute and second hand smoke were found to increase ACE2 expression in the bronchus. Inhaled corticosteroids decrease ACE2 expression in the lower airways. No significant effect of genetics on ACE2 expression was observed, but a strong association of DNA- methylation with ACE2 and TMPRSS2- mRNA expression was identified in the bronchus.</p

Determinants of expression of SARS-CoV-2 entry-related genes in upper and lower airways.

Funder: Dutch Research Council (NWO)Funder: Cancer Research UK Cambridge CentreFunder: ATS Foundation/Boehringer Ingelheim Pharmaceuticals Inc. Research FellowshipFunder: The Netherlands Ministry of Spatial Planning, Housing, and the EnvironmentFunder: Chan Zuckerberg InitiativeFunder: The Netherlands Ministry of Health, Welfare, and SportFunder: Longfonds Junior FellowshipFunder: Cambridge BioresourceFunder: The Netherlands Organization for Health Research and DevelopmentFunder: Cambridge NIHR Biomedical Research CentreFunder: Parker B. Francis FellowshipFunder: China Scholarship Counci

Imigração, patrimônio cultural e turismo no Brasil

The heritage of immigration, like all cultural expression, has multiple forms and understanding permeates the approach to several issues, among them: the various manifestations of cultural heritage, the intentions of conservation actions and appreciation of the cultural heritage of immigrant groups and practices for the resonance of this heritage, such as tourism. The objective of this paper is to analyze the heritage of immigration as a phenomenon that was constituted in a particular environment, not only by the above issues, but also as a particular form of instituting the past in the present and its consequences for the construction of collective identitiesO patrimônio da imigração, como toda expressão cultural, possui múltiplas formas e sua compreensão perpassa pela abordagem de várias questões, dentre elas: as várias manifestações do patrimônio cultural; as intencionalidades das ações de preservação e valorização da herança cultural de grupos de imigrantes; e as práticas para a ressonância deste patrimônio, como é o caso do turismo. O objetivo deste artigo é analisar o patrimônio da imigração como fenômeno que se constituiu num ambiente determinado, não só pelas questões acima, mas também como uma forma particular de instituir o passado no presente e seus desdobramentos para a construção de identidades coletivas

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Exploring the contribution of genetic and environmental factors to cancer risk and development

Krebs entsteht durch das Zusammenspiel von Keimbahn- und somatischen Mutationen sowie Umweltfaktoren. Für Fortschritte in Prävention, Früherkennung und Behandlung von Krebs ist es essenziell die phänotypischen Folgen dieser Mutationen und die Rolle von Umweltfaktoren bei der Steigerung des Krebsrisikos zu verstehen. In dieser Arbeit untersuche ich zunächst die Auswirkungen von Mutationen in einfachen Sequenzwiederholungsregionen (SSRs) auf das Zellwachstum in einem Hefemodell. In einem Mutationsakkumulationsexperiment in Stämmen mit defektem Mismatch-Reparatursystem zeige ich, dass die Störung von MutSβ zu einer erhöhten SSR-Mutationsrate führt, insbesondere bei SSR-Loci die länger als 8 bp sind. Meine Ergebnisse legen nahe, dass MutSβ hauptsächlich für die Reparatur an längeren Repeat-Loci verantwortlich ist. Schließlich zeige ich, dass SSR-Mutationen meist geringfügige, negative Auswirkungen auf das Zellwachstum haben. Als Nächstes untersuche ich die Auswirkungen von Zigarettenrauch auf das Transkriptom von zugänglichem Atemwegsgewebe am Beispiel des Nasenepithels von gesunden Freiwilligen und Patienten mit Verdacht auf oder diagnostiziertem Lungenkrebs. Ich stelle fest, dass Gene und biologische Funktionen, die durch das Rauchen beeinträchtigt werden, bei Patienten langsamer auf ein gesundes Ausgangsniveau zurückkehren. Zudem zeige ich, dass Patienten durch anhaltende, Rauch-assoziierte Immunveränderungen gekennzeichnet sind. Schließlich präsentiere ich einen innovativen Lungenkrebs-Klassifikator, der durch die Berücksichtigung der nasalen Genexpression von Rauch-assoziierten Genen eindeutig bessere Ergebnisse erzielt als ein Modell, das ausschließlich auf klinischen Informationen basiert. Damit belege ich das Potenzial der Genexpression des Nasenepithels zur Verbesserung der Risikostratifizierung auf Bevölkerungsebene anhand eines nicht-invasiven Tests.Cancer is initiated and sustained by the interplay of germline and somatic mutations and environmental factors. Understanding the phenotypic consequences of mutations and the role of environmental factors in increasing cancer risk is key to improving cancer prevention, early detection, and treatment. In this thesis, I first take advantage of a yeast model to investigate the effects of mutations in simple sequence repeat regions (SSRs) on cell growth. I describe a mutation accumulation experiment conducted in strains with a deletion of the MutSβ gene, a component of the mismatch repair system (MMR). I show that abrogating MutSβ function leads to an increased SSR mutation rate, with a bias towards deletions. I also report a drastic increase in mutation rate in SSR loci longer that 8-bp, suggesting MutSβ is primarily responsible for repair at longer repeat loci. Finally, I show that many SSR mutations have small deleterious effects on cell growth. Next, I investigate the effects of cigarette smoke on the transcriptome of an accessible airway tissue, nasal epithelium, in a cohort of healthy volunteers and patients with suspected or diagnosed lung cancer. I find that smoke injury response is strikingly different in healthy individuals and clinic patients, with genes and biological functions affected by smoking showing a slower reversal to healthy baseline level in clinic patients. I find persistent smoking-associated immune alterations to be a hallmark of the clinic patients. Finally, I show that a lung cancer classifier including nasal expression of smoke-injury-associated genes performs better than a model based exclusively on clinical information, providing evidence for the potential of nasal epithelial gene expression to improve population-level risk stratification with the use of a non-invasive test