50 research outputs found

    A Catalogue of Inter-Parameter Dependencies in RESTful Web APIs

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    Web services often impose dependency constraints that re strict the way in which two or more input parameters can be combined to form valid calls to the service. Unfortunately, current specification languages for web services like the OpenAPI Specification provide no support for the formal description of such dependencies, which makes it hardly possible to automatically discover and interact with services without human intervention. Researchers and practitioners are openly requesting support for modelling and validating dependencies among in put parameters in web APIs, but this is not possible unless we share a deep understanding of how dependencies emerge in practice—the aim of this work. In this paper, we present a thorough study on the presence of dependency constraints among input parameters in web APIs in in dustry. The study is based on a review of more than 2.5K operations from 40 real-world RESTful APIs from multiple application domains. Overall, our findings show that input dependencies are the norm, rather than the exception, with 85% of the reviewed APIs having some kind of dependency among their input parameters. As the main outcome of our study, we present a catalogue of seven types of dependencies consistently found in RESTful web APIsMinisterio de Economía y Competitividad BELI (TIN2015-70560-R)Ministerio de Ciencia, Innovación y Universidades Horatio RTI2018-101204-B-C21Ministerio de Educación, Cultura y Deporte FPU17/0407

    Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set

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    The primary cause of morbidity and mortality in patients with multiple myeloma(MM) is an infection. Therefore there is great concern about the susceptibility to the outcome of COVID-19 infected patients with MM. This retrospective study describes the baseline characteristics and outcome data of COVID-19 infection in 650 patients with plasma cell disorders, collected by the International Myeloma Society to understand the initial challenges faced by myeloma patients during COVID-19 pandemic. Analysis were performed for hospitalized MM patients. Among hospitalized patinets, the median age was 69 years, and nearly all patients(96%) had MM. Approximately 36% were recently diagnosed(2019-2020), and 54% of patients were receiving first-line therapy. Thirty-three percent of patients have died, with significant geographic variability, ranging from 27% to 57% of hospitalized patients. Univariate analysis identified age, ISS3, high-risk disease, renal disease, suboptimal myeloma control(active or progressive disease), and one or more comorbidities as risk factors for higher rates of death. Neither history of transplant, including within a year of COVID-19 diagnosis, nor other anti-MM treatments were associated with outcomes. Multivariate analysis found that only age, high-risk MM, renal disease, and suboptimal MM control remained independent predictors of adverse outcome with COVID-19 infection. The management of MM in the era of COVID-19 requires careful consideration of patient and disease-related factors to decrease the risk of acquiring COVID-19 infection, while not compromising disease control through appropriate MM treatment. This study provides initial data to develop recommendations for the management of MM patients with COVID-19 infection

    Comparative immunogenicity of an mRNA/LNP and a DNA vaccine targeting HIV gag conserved elements in macaques

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    Immunogenicity of HIV-1 mRNA vaccine regimens was analyzed in a non-human primate animal model. Rhesus macaques immunized with mRNA in lipid nanoparticle (mRNA/LNP) formulation expressing HIV-1 Gag and Gag conserved regions (CE) as immunogens developed robust, durable antibody responses but low adaptive T-cell responses. Augmentation of the dose resulted in modest increases in vaccine-induced cellular immunity, with no difference in humoral responses. The gag mRNA/lipid nanoparticle (LNP) vaccine provided suboptimal priming of T cell responses for a heterologous DNA booster vaccination regimen. In contrast, a single immunization with gag mRNA/LNP efficiently boosted both humoral and cellular responses in macaques previously primed by a gag DNA-based vaccine. These anamnestic cellular responses were mediated by activated CD8+ T cells with a phenotype of differentiated T-bet+ cytotoxic memory T lymphocytes. The heterologous prime/boost regimens combining DNA and mRNA/LNP vaccine modalities maximized vaccine-induced cellular and humoral immune responses. Analysis of cytokine responses revealed a transient systemic signature characterized by the release of type I interferon, IL-15 and IFN-related chemokines. The pro-inflammatory status induced by the mRNA/LNP vaccine was also characterized by IL-23 and IL-6, concomitant with the release of IL-17 family of cytokines. Overall, the strong boost of cellular and humoral immunity induced by the mRNA/LNP vaccine suggests that it could be useful as a prophylactic vaccine in heterologous prime/boost modality and in immune therapeutic interventions against HIV infection or other chronic human diseases

    Superior antigen-specific CD4+ T-cell response with AS03-adjuvantation of a trivalent influenza vaccine in a randomised trial of adults aged 65 and older

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    BACKGROUND: The effectiveness of trivalent influenza vaccines may be reduced in older versus younger adults because of age-related immunosenescence. The use of an adjuvant in such a vaccine is one strategy that may combat immunosenescence, potentially by bolstering T-cell mediated responses. METHODS: This observer-blind study, conducted in the United States (US) and Spain during the 2008-2009 influenza season, evaluated the effect of Adjuvant System AS03 on specific T-cell responses to a seasonal trivalent influenza vaccine (TIV) in >/=65 year-old adults.Medically-stable adults aged >/=65 years were randomly allocated to receive a single dose of AS03-adjuvanted TIV (TIV/AS03) or TIV. Healthy adults aged 18-40 years received only TIV. Blood samples were collected on Day 0, Day 21, Day 42 and Day 180. Influenza-specific CD4+ T cells, defined by the induction of the immune markers CD40L, IL-2, IFN-gamma, or TNF-alpha, were measured in ex vivo cultures of antigen-stimulated peripheral blood mononuclear cells. RESULTS: A total of 192 adults were vaccinated: sixty nine and seventy three >/=65 year olds received TIV/AS03 and TIV, respectively; and fifty 18 - 40 year olds received TIV. In the >/=65 year-old group on Day 21, the frequency of CD4+ T cells specific to the three vaccine strains was superior in the TIV/AS03 recipients to the frequency in TIV (p /=65 year-old recipients of TIV/AS03 than in the 18 - 40 year old recipients of TIV on Days 21 (p = 0.006) and 42 (p = 0.011). CONCLUSION: This positive effect of AS03 Adjuvant System on the CD4+ T-cell response to influenza vaccine strains in older adults could confer benefit in protection against clinical influenza disease in this population. TRIAL REGISTRATION: (Clinicaltrials.gov.). NCT00765076

    Changes in parental smoking during pregnancy and risks of adverse birth outcomes and childhood overweight in Europe and North America: An individual participant data meta-analysis of 229,000 singleton births

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    Background. Fetal smoke exposure is a common and key avoidable risk factor for birth complications and seems to influence later risk of overweight. It is unclear whether this increased risk is also present if mothers smoke during the first trimester only or reduce the number of cigarettes during pregnancy, or when only fathers smoke. We aimed to assess the associations of parental smoking during pregnancy, specifically of quitting or reducing smoking and maternal and paternal smoking combined, with preterm birth, small size for gestational age, and childhood overweight. Methods and findings. We performed an individual participant data meta-analysis among 229,158 families from 28 pregnancy/birth cohorts from Europe and North America. All 28 cohorts had information on maternal smoking, and 16 also had information on paternal smoking. In total, 22 cohorts were population-based, with birth years ranging from 1991 to 2015. The mothers’ median age was 30.0 years, and most mothers were medium or highly educated. We used multilevel binary logistic regression models adjusted for maternal and paternal sociodemographic and lifestyle-related characteristics. Compared with nonsmoking mothers, maternal first trimester smoking only was not associated with adverse birth outcomes but was associated with a higher risk of childhood overweight (odds ratio [OR] 1.17 [95% CI 1.02–1.35], P value = 0.030). Children from mothers who continued smoking during pregnancy had higher risks of preterm birth (OR 1.08 [95% CI 1.02–1.15], P value = 0.012), small size for gestational age (OR 2.15 [95% CI 2.07–2.23], P value < 0.001), and childhood overweight (OR 1.42 [95% CI 1.35–1.48], P value < 0.001). Mothers who reduced the number of cigarettes between the first and third trimester, without quitting, still had a higher risk of small size for gestational age. However, the corresponding risk estimates were smaller than for women who continued the same amount of cigarettes throughout pregnancy (OR 1.89 [95% CI 1.52–2.34] instead of OR 2.20 [95% CI 2.02–2.42] when reducing from 5–9 to ≤4 cigarettes/day; OR 2.79 [95% CI 2.39–3.25] and OR 1.93 [95% CI 1.46–2.57] instead of OR 2.95 [95% CI 2.75–3.15] when reducing from ≥10 to 5–9 and ≤4 cigarettes/day, respectively [P values < 0.001]). Reducing the number of cigarettes during pregnancy did not affect the risks of preterm birth and childhood overweight. Among nonsmoking mothers, paternal smoking was associated with childhood overweight (OR 1.21 [95% CI 1.16–1.27], P value < 0.001) but not with adverse birth outcomes. Limitations of this study include the self-report of parental smoking information and the possibility of residual confounding. As this study only included participants from Europe and North America, results need to be carefully interpreted regarding other populations. Conclusions. We observed that as compared to nonsmoking during pregnancy, quitting smoking in the first trimester is associated with the same risk of preterm birth and small size for gestational age, but with a higher risk of childhood overweight. Reducing the number of cigarettes, without quitting, has limited beneficial effects. Paternal smoking seems to be associated, independently of maternal smoking, with the risk of childhood overweight. Population strategies should focus on parental smoking prevention before or at the start, rather than during, pregnancy.This collaborative project received funding from the European Union’s Horizon 2020 research and innovation programme (Grant Agreement No. 733206 LifeCycle). EMP and LT were supported by grant R01ES022972 from the National Institutes of Health, USA. LC was supported by the National Institute for Environmental Health Sciences: P30ES007048, R21ES029681, R01ES029944, R01ES030364, R21ES028903. DAL works in a unit that receives UK MRC funding (MC_UU_12013/5) and is an NIHR senior investigator (NF-SI-0611-10196). ACS holds an FCT Investigator contract IF/01060/2015. RG received funding from the Dutch Heart Foundation (grant number 2017T013), the Dutch Diabetes Foundation (grant number 2017.81.002) and the Netherlands Organization for Health Research and Development (ZonMW, 543003109). VWVJ received grant from the European Research Council (Consolidator Grant, ERC-2014-CoG-648916)

    Impact of maternal body mass index and gestational weight gain on pregnancy complications : an individual participant data meta-analysis of European, North American and Australian cohorts

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    Objective To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact. Design Individual participant data meta-analysis of 39 cohorts. Setting Europe, North America, and Oceania. Population 265 270 births. Methods Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used. Main outcome measures Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth. Results Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain. Conclusions Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity.Peer reviewe

    Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania

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    BackgroundGestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies.MethodsWe used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape.ResultsWe observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40weeks was 14.2kg (11.4-17.4) for underweight women, 14.5kg (11.5-17.7) for normal weight women, 13.9kg (10.1-17.9) for overweight women, and 11.2kg (7.0-15.7), 8.7kg (4.3-13.4) and 6.3kg (1.9-11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications.ConclusionsGestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice

    Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis

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    Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact</p

    In search of the optimal platform for Post-Allogeneic SCT immunotherapy in relapsed multiple myeloma : a systematic review

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    Allogeneic stem cell transplantation (allo-SCT) has the potential to induce sustained remissions in patients with multiple myeloma (MM). Currently, allo-SCT is primarily performed in high-risk MM patients, most often in the setting of early relapse after first-line therapy with autologous SCT. However, the implementation of allo-SCT for MM is jeopardized by high treatment-related mortality (TRM) rates as well as high relapse rates. In this systematic review, we aimed to identify a safe allo-SCT strategy that has optimal 1-year results regarding mortality, relapse and severe GvHD, creating opportunities for post-transplantation strategies to maintain remissions in the high-risk group of relapsed MM patients. Eleven studies were included. Median PFS ranged from 5.2 to 36.8 months and OS was 13.0 to 63.0 months. The relapse related mortality at 1 year varied between 0 and 50% and TRM between 8 and 40%. Lowest GvHD incidences were reported for conditioning regimens with T-cell depletion using ATG or graft CD34+ selection. Similar strategies could lay the foundation for a post-transplant immune platform, this should be further evaluated in prospective clinical trials

    Bijwerkingen van het Rijksvaccinatieprogramma : Meldingen in 2010 en overzicht 1994-2010

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    In 2010, 800,000 children received one or more vaccines on 1.3 million dates, with more than 7 million vaccine components. There is always some chance of adverse reactions but these are usually not severe, though sometimes frightening. This year, RIVM received 1380 reports of adverse events following immunisation (AEFI). This is 16% less than in 2009 when 2 vaccination campaigns raised considerable adverse publicity with subsequent increase in reports. Data show that the benefit of the vaccination programme outweighs the risk of adverse reactions by far. Safety surveillance: necessary part of the vaccination programme. Enhanced safety surveillance has been an integral part of the vaccination programme since 1962. Annual reports have been published since 1983, following independent reevaluation. The surveillance system of the Netherlands enjoys very high reporting rates and is highly sensitive for signals. It allows individual follow-up because of name-based reporting. In this last year of safety surveillance in this setting, we present an overview of results since 1994. This brings some new insights. Careful reporting and validation system. All reports were validated and complemented, preferably also with eyewitness accounts (92%). Final assessment followed according to case definitions and causality criteria. The embedding of the safety surveillance in the telephone consultation service has contributed to the quality of the reports. Reported adverse events. In 2010, 78% of reports (1082) had possible causal relation with the vaccination. These concerned major adverse reactions in 48% (523), including very high fever (>40.5 °C), persistent screaming, collapse, discoloured legs, febrile convulsions or atypical attacks with chills, myoclonics or hyper/hypo-tonicity. Altogether 22% (296) of reports were chance occurrences. Reported severe infections and epilepsy had no causal relation with the vaccinations. In addition, none of the 5 reports on death was related to vaccination. An independent expert committee has reassessed these severe adverse events.In 2010 kregen 800.000 kinderen in Nederland vaccinaties binnen het Rijksvaccinatieprogramma (RVP). In het totaal is ruim 1,3 miljoen keer gevaccineerd, met meer dan 7 miljoen vaccins - de meeste prikken bevatten meerdere vaccins. Dit jaar zijn 1380 vermoede bijwerkingen gemeld. Dat is 16 procent minder dan in 2009, een jaar waarin de twee grootschalige vaccinatiecampagnes tegen baarmoederhalskanker en pandemische griep aanzienlijke onrust veroorzaakten, waardoor het aantal meldingen van bijwerkingen toenam. De grote gezondheidswinst van het RVP weegt op tegen de bijwerkingen, ook al zijn deze soms heftig en schrikaanjagend. Veiligheidsbewaking: noodzakelijk onderdeel RVP: Intensieve veiligheidsbewaking is sinds 1962 een vast en noodzakelijk onderdeel van het vaccinatieprogramma. Vanaf 1983 is jaarlijks hierover gerapporteerd, waarbij een onafhankelijke partij meldingen herbeoordeeld. Het gestimuleerde bewakingssysteem heeft een uitermate hoge meldgraad en is door de jaren heen steeds gevoelig gebleken voor signalen. Het laat bovendien toe dat meldingen op langere termijn worden gevolgd, omdat bijwerkingen op naam worden gemeld. In dit laatste jaar van de veiligheidsbewaking bij het RIVM wordt naast de meldingen van 2010 een overzicht gegeven van bevindingen vanaf 1994. Dit toont diverse nieuwe inzichten. Zorgvuldig meldings- en validatiesysteem: Alle meldingen worden gevalideerd en aangevuld met gegevens die nodig zijn om een juist beeld van de situatie te krijgen. Dit gebeurt bij voorkeur ook met een ooggetuigenverslag (92 procent). Daarna worden de meldingen getoetst aan definities voor diagnoses en wordt beoordeeld of er een oorzakelijk verband is met de vaccinaties. De telefonische adviesdienst is een belangrijk instrument van de bijwerkingenbewaking en heeft aanzienlijk bijgedragen aan de kwaliteit van de meldingen. Gemelde bijwerkingen: In 2010 werd 78 procent (1082) van de meldingen daadwerkelijk als bijwerking beschouwd. Daarvan betrof het in 48 procent (523) zogenoemde major ziektebeelden, zoals zeer hoge koorts (vanaf 40,5 °C), langdurig huilen, collapsreacties, verkleurde benen, koortsstuipen of atypische aanvallen met rillingen, schrikschokken, gespannenheid of slapte. Bij 296 meldingen (22 procent) was er een toevallige samenloop van omstandigheden en geen oorzakelijk verband met de vaccinatie. Ook de gemelde ernstige infecties en epilepsie stonden los van de vaccinaties. Bij de vijf kinderen die na een vaccinatie zijn overleden, zijn de vaccinaties daarvan evenmin de oorzaak geweest. Dergelijke ernstige beelden zijn herbeoordeeld door een groep van externe deskundigen.VW
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