Modeling a Consortium-based Distributed Ledger Network with Applications for Intelligent Transportation Infrastructure

Emerging distributed-ledger networks are changing the landscape for environments of low trust among participating entities. Implementing such technologies in transportation infrastructure communications and operations would enable, in a secure fashion, decentralized collaboration among entities who do not fully trust each other. This work models a transportation records and events data collection system enabled by a Hyperledger Fabric blockchain network and simulated using a transportation environment modeling tool. A distributed vehicle records management use case is shown with the capability to detect and prevent unauthorized vehicle odometer tampering. Another use case studied is that of vehicular data collected during the event of an accident. It relies on broadcast data collected from the Vehicle Ad-hoc Network (VANET) and submitted as witness reports from nearby vehicles or road-side units who observed the event taking place or detected misbehaving activity by vehicles involved in the accident. Mechanisms for the collection, validation, and corroboration of the reported data which may prove crucial for vehicle accident forensics are described and their implementation is discussed. A performance analysis of the network under various loads is conducted with results suggesting that tailored endorsement policies are an effective mechanism to improve overall network throughput for a given channel. The experimental testbed shows that Hyperledger Fabric and other distributed ledger technologies hold promise for the collection of transportation data and the collaboration of applications and services that consume it

Means, Intent, Lethality, Behaviors, and Psychiatric Diagnosis in Latina Adolescent Suicide Attempters

This article describes the means, intent, lethality, behavioral profiles, and psychiatric diagnoses of adolescent Latina suicide attempters. From a large, mixed-method project studying the sociocultural processes of Latina suicide attempts, we selected 76 participants for this report. In addition to quantitative research data, medical records were available for all 76 participants, as was qualitative data from in-depth interviews for 34 of them. Using the qualitative and quantitative research data, we explored intent and behavioral profiles of the suicidal adolescents. Medical records provided additional information about the means the adolescents used in their attempts, and about their psychiatric diagnoses. The lethality of suicide attempts was coded using the Lethality of Suicide Attempt Rating Scale (LSARS) and the Lethality of Suicide Attempt Rating Scale—Updated (LSARS-II). Findings showed that Latina adolescent suicide attempts are low in lethality. Consistent with the literature, most adolescents reported that they attempted by using means available in their homes (cutting and overdosing with medications were the predominant methods). Interesting discrepancies emerged when comparing adolescents’ self-reported behavioral profiles with clinicians’ psychiatric diagnoses. This report has implications for diagnosis and treatment approaches for both inpatient and outpatient service providers

Means, intent, lethality, behaviors, and psychiatric diagnosis in Latina adolescent suicide attempters.

This article describes the means, intent, lethality, behavioral profiles, and psychiatric diagnoses of adolescent Latina suicide attempters. From a large, mixed-method project studying the sociocultural processes of Latina suicide attempts, we selected 76 participants for this report. In addition to quantitative research data, medical records were available for all 76 participants, as was qualitative data from in-depth interviews for 34 of them. Using the qualitative and quantitative research data, we explored intent and behavioral profiles of the suicidal adolescents. Medical records provided additional information about the means the adolescents used in their attempts, and about their psychiatric diagnoses. The lethality of suicide attempts was coded using the Lethality of Suicide Attempt Rating Scale (LSARS) and the Lethality of Suicide Attempt Rating Scale—Updated (LSARS-II). Findings showed that Latina adolescent suicide attempts are low in lethality. Consistent with the literature, most adolescents reported that they attempted by using means available in their homes (cutting and overdosing with medications were the predominant methods). Interesting discrepancies emerged when comparing adolescents’ self-reported behavioral profiles with clinicians’ psychiatric diagnoses. This report has implications for diagnosis and treatment approaches for both inpatient and outpatient service providers

Impaired BKCa channel function in native vascular smooth muscle from humans with type 2 diabetes

Large-conductance Ca2+-activated potassium (BKCa) channels are key determinants of vascular smooth muscle excitability. Impaired BKCa channel function through remodeling of BKCa beta 1 expression and function contributes to vascular complications in animal models of diabetes. Yet, whether similar alterations occur in native vascular smooth muscle from humans with type 2 diabetes is unclear. In this study, we evaluated BKCa function in vascular smooth muscle from small resistance adipose arteries of non-diabetic and clinically diagnosed type 2 diabetic patients. We found that BKCa channel activity opposes pressure-induced constriction in human small resistance adipose arteries, and this is compromised in arteries from diabetic patients. Consistent with impairment of BKCa channel function, the amplitude and frequency of spontaneous BKCa currents, but not Ca2+ sparks were lower in cells from diabetic patients. BKCa channels in diabetic cells exhibited reduced Ca2+ sensitivity, single-channel open probability and tamoxifen sensitivity. These effects were associated with decreased functional coupling between BKCa a and beta 1 subunits, but no change in total protein abundance. Overall, results suggest impairment in BKCa channel function in vascular smooth muscle from diabetic patients through unique mechanisms, which may contribute to vascular complications in humans with type 2 diabetes

A G(s)-coupled purinergic receptor boosts Ca2+ influx and vascular contractility during diabetic hyperglycemia

Elevated glucose increases vascular reactivity by promoting L-type Ca(V)1.2 channel (LTCC) activity by protein kinase A (PKA). Yet, how glucose activates PKA is unknown. We hypothesized that a G(s)-coupled P2Y receptor is an upstream activator of PKA mediating LTCC potentiation during diabetic hyperglycemia. Experiments in apyrase-treated cells suggested involvement of a P2Y receptor underlying the glucose effects on LTTCs. Using human tissue, expression for P2Y(11), the only G(s)-coupled P2Y receptor, was detected in nanometer proximity to Ca(V)1.2 and PKA. FRET-based experiments revealed that the selective P2Y(11) agonist NF546 and elevated glucose stimulate cAMP production resulting in enhanced PKA-dependent LTCC activity. These changes were blocked by the selective P2Y(11) inhibitor NF340. Comparable results were observed in mouse tissue, suggesting that a P2Y(11)-like receptor is mediating the glucose response in these cells. These findings established a key role for P2Y(11) in regulating PKA-dependent LTCC function and vascular reactivity during diabetic hyperglycemia

Enteroparasitoses em gestantes e puérperas no Rio de Janeiro Enteroparasitosis in pregnant and post-partem women in Rio de Janeiro

A prevalência de parasitoses intestinais foi determinada em 795 mulheres distribuídas em grupos de 490 gestantes, 201 não-gestantes (controle) e 104 puérperas, no período de novembro de 1989 a maio de 1991, no Rio de Janeiro, Brasil. Exames coproparasitológicos foram realizados pelos métodos de Sedimentação por Centrifugação, Faust, Kato-Katz e Baermann-Moraes. A prevalência de enteroparasitoses entre os grupos de gestantes (37,6%) e o grupo-controle (38,3%) pelo método de sedimentação por centrifugação foi praticamente igual, apesar de estar o primeiro grupo regularmente assistido por serviços especializados de saúde. Ascaris lumbricoides e Trichuris trichiura foram os parasitos mais freqüentes (em torno de 30,0%). Quando métodos mais específicos foram aplicados em 168 amostras de gestantes, o percentual foi elevado para 53,6%. Houve diferença estatística significativa entre a taxa de gestantes e puérperas (69,2%). Estes achados mostram a pouca atenção dispensada a estas infecções durante a gestação, não obstante relatos anteriores das possíveis repercussões para o feto e o recém-nascido.<br>From November 1989 to May 1991, in Rio de Janeiro, Brazil, the prevalence of intestinal parasitosis was investigated in 795 women coming from the Public Health Services, who were divided into three groups: 490 pregnant women in pre-natal care period, 104 after-delivery women and 201 non-pregnant women (control). Coproparasitologic tests were run using the Sedimentation through Centrifugation, Faust, Kato-Katz and Baermann-Moraes methods. Positivities were found ranging from 37.6% to 53.6% for pregnant women, 38.3% for non-pregnant women and 69.2% for after-delivery women, with statistically significant differences between the rates of pregnant women and after-delivery women, and with no statistic difference between the groups of pregnant and non-pregnant women. The most frequent parasites found were A. lumbricoides and T. trichiura. The conclusion was that the control of intestinal parasitosis is not a priority in the pregnant population studied because, in spite of the regular assistance provided during the pre-natal care period, they keep on infected

Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients

BACKGROUND: The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia. METHODS: We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor. RESULTS: At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non-community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P &lt; .001). CONCLUSIONS: Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

Background and objective Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when >= 3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP

Bacterial etiology of community-acquired pneumonia in immunocompetent hospitalized patients and appropriateness of empirical treatment recommendations: an international point-prevalence study

An accurate knowledge of the epidemiology of community-acquired pneumonia (CAP) is key for selecting appropriate antimicrobial treatments. Very few etiological studies assessed the appropriateness of empiric guideline recommendations at a multinational level. This study aims at the following: (i) describing the bacterial etiologic distribution of CAP and (ii) assessing the appropriateness of the empirical treatment recommendations by clinical practice guidelines (CPGs) for CAP in light of the bacterial pathogens diagnosed as causative agents of CAP. Secondary analysis of the GLIMP, a point-prevalence international study which enrolled adults hospitalized with CAP in 2015. The analysis was limited to immunocompetent patients tested for bacterial CAP agents within 24 h of admission. The CAP CPGs evaluated included the following: the 2007 and 2019 American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA), the European Respiratory Society (ERS), and selected country-specific CPGs. Among 2564 patients enrolled, 35.3% had an identifiable pathogen. Streptococcus pneumoniae (8.2%) was the most frequently identified pathogen, followed by Pseudomonas aeruginosa (4.1%) and Klebsiella pneumoniae (3.4%). CPGs appropriately recommend covering more than 90% of all the potential pathogens causing CAP, with the exception of patients enrolled from Germany, Pakistan, and Croatia. The 2019 ATS/IDSA CPGs appropriately recommend covering 93.6% of the cases compared with 90.3% of the ERS CPGs (p < 0.01). S. pneumoniae remains the most common pathogen in patients hospitalized with CAP. Multinational CPG recommendations for patients with CAP seem to appropriately cover the most common pathogens and should be strongly encouraged for the management of CAP patients.info:eu-repo/semantics/publishedVersio