Recipient pre-existing chronic hypotension is associated with delayed graft function and inferior graft survival in kidney transplantation from elderly donors

BackgroundPre-existing chronic hypotension affects a percentage of kidney transplanted patients (KTs). Although a relationship with delayed graft function (DGF) has been hypothesized, available data are still scarce and inconclusive.MethodsA monocentric retrospective observational study was performed on 1127 consecutive KTs from brain death donors over 11 years (2003-2013), classified according to their pre-transplant Mean Blood Pressure (MBP) as hypotensive (MBP ResultsUnivariate analysis showed that a pre-existing hypotension is associated to DGF occurrence (p50 years old donor.ConclusionsOur findings suggest that pre-existing recipient hypotension, and the subsequent hypotension-related DGF, could be considered a significant detrimental factor, especially when elderly donors are involved in the transplant procedure

ESTUDO EPIDEMIOLÓGICO DA EROSÃO DENTÁRIA EM ESCOLARES

A erosão dentária é caracterizada por um desgaste da estrutura dentária de caráter crônico e irreversível, mediante a exposição de ácidos exógenos ou endógenos sem envolvimento bacteriano. Este é um estudo epidemiológico do tipo transversal, que teve como objetivo realizar um levantamento epidemiológico em estudantes de 12 anos de idade, de escolas municipais de Joaçaba, Santa Catarina, buscando estimar a prevalência da erosão dentária, verificar a associação entre a erosão dentária e os fatores sociodemográficos e alimentares e identificar relatos de sintomatologia dolorosa decorrente da erosão dentária. Os dados foram analisados mediante estatística descritiva (nível de significância p<0,05), utilizando-se o programa estatístico EpiInfo. Os resultados revelaram que a prevalência de erosão dentária foi de 9,6%. Neste estudo foram fatores associados à presença de erosão dentária: o consumo de bebidas não alcoólicas que não sejam água durante a noite (p = 0,04) e o consumo diário de iogurte (p = 0,03). Não houve relatos de sintomatologia dolorosa relacionada à erosão dentária. Os resultados demonstram a necessidade de implementação de medidas educativas para prevenir ou limitar o dano entre escolares, e sugerem a ampliação da amostra para resultados mais conclusivos. O projeto foi encaminhado ao Comitê de Ética em Pesquisa Unoesc/HUST conforme Resolução n. 196/96 e aprovado sob Parecer n. 303528.Palavras-chave: Erosão dental. Escolares. Prevalência

On driver behavior recognition for increased safety:A roadmap

Advanced Driver-Assistance Systems (ADASs) are used for increasing safety in the automotive domain, yet current ADASs notably operate without taking into account drivers’ states, e.g., whether she/he is emotionally apt to drive. In this paper, we first review the state-of-the-art of emotional and cognitive analysis for ADAS: we consider psychological models, the sensors needed for capturing physiological signals, and the typical algorithms used for human emotion classification. Our investigation highlights a lack of advanced Driver Monitoring Systems (DMSs) for ADASs, which could increase driving quality and security for both drivers and passengers. We then provide our view on a novel perception architecture for driver monitoring, built around the concept of Driver Complex State (DCS). DCS relies on multiple non-obtrusive sensors and Artificial Intelligence (AI) for uncovering the driver state and uses it to implement innovative Human–Machine Interface (HMI) functionalities. This concept will be implemented and validated in the recently EU-funded NextPerception project, which is briefly introduced

Modeling acquired resistance to the second-generation androgen receptor antagonist enzalutamide in the TRAMP model of prostate cancer

Enzalutamide (MDV3100) is a potent second-generation androgen receptor antagonist approved for the treatment of castration-resistant prostate cancer (CRPC) in chemotherapy-naïve as well as in patients previously exposed to chemotherapy. However, resistance to enzalutamide and enzalutamide withdrawal syndrome have been reported. Thus, reliable and integrated preclinical models are required to elucidate the mechanisms of resistance and to assess therapeutic settings that may delay or prevent the onset of resistance. In this study, the prostate cancer multistage murine model TRAMP and TRAMP-derived cells have been used to extensively characterize in vitro and in vivo the response and resistance to enzalutamide. The therapeutic profile as well as the resistance onset were characterized and a multiscale stochastic mathematical model was proposed to link the in vitro and in vivo evolution of prostate cancer. The model showed that all therapeutic strategies that use enzalutamide result in the onset of resistance. The model also showed that combination therapies can delay the onset of resistance to enzalutamide, and in the best scenario, can eliminate the disease. These results set the basis for the exploitation of this "TRAMP-based platform" to test novel therapeutic approaches and build further mathematical models of combination therapies to treat prostate cancer and CRPC.Significance: Merging mathematical modeling with experimental data, this study presents the "TRAMP-based platform" as a novel experimental tool to study the in vitro and in vivo evolution of prostate cancer resistance to enzalutamide

Efficacy of a new technique - INtubate-RECruit-SURfactant-Extubate - "IN-REC-SUR-E" - in preterm neonates with respiratory distress syndrome: Study protocol for a randomized controlled trial

Background: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs. Therefore, the aim of this study is to compare the application of a recruitment maneuver using the high-frequency oscillatory ventilation (HFOV) modality just before the surfactant administration followed by rapid extubation (INtubate-RECruit-SURfactant-Extubate: IN-REC-SUR-E) with IN-SUR-E alone in spontaneously breathing preterm infants requiring nasal continuous positive airway pressure (nCPAP) as initial respiratory support and reaching pre-defined CPAP failure criteria. Methods/design: In this study, 206 spontaneously breathing infants born at 24+0-27+6 weeks' gestation and failing nCPAP during the first 24 h of life, will be randomized to receive an HFOV recruitment maneuver (IN-REC-SUR-E) or no recruitment maneuver (IN-SUR-E) just prior to surfactant administration followed by prompt extubation. The primary outcome is the need for mechanical ventilation within the first 3 days of life. Infants in both groups will be considered to have reached the primary outcome when they are not extubated within 30 min after surfactant administration or when they meet the nCPAP failure criteria after extubation. Discussion: From all available data no definitive evidence exists about a positive effect of recruitment before surfactant instillation, but a rationale exists for testing the following hypothesis: a lung recruitment maneuver performed with a step-by-step Continuous Distending Pressure increase during High-Frequency Oscillatory Ventilation (and not with a sustained inflation) could have a positive effects in terms of improved surfactant distribution and consequent its major efficacy in preterm newborns with respiratory distress syndrome. This represents our challenge. Trial registration: ClinicalTrials.gov identifier: NCT02482766. Registered on 1 June 2015

Real-time and content-aware applications and infrastructure: a holistic approach dealing with architectural, performance and security issues

This thesis has been carried out in the field of Computer Networks. We have looked after two challenging and popular multimedia applications over the Internet, namely Real-time Multimedia Applications, considering Multimedia Conferencing and Voice over IP (VoIP) services in general, and Content-Oriented Applications, that are multimedia web services such as User Generated Contents (UGC) platforms and Online Social Networks. We have conducted our studies starting from a thorough review of both functional and non-functional issues related to the above mentioned application families. We first consider a number of different facets of Real-time Multimedia Applications, dealing with architectural, performance and security issues. We embrace an engineering approach, by involving modeling, implementation and simulation. We try and adhere to standard architectures by also actively contributing to them, arriving at the definition and completion of a fullyfledged standards-compliant web conferencing platform. We propose original contributions to face performance and security issues. With respect to the former aspect, we address scalability and performance analysis by leveraging formal methods. As to the latter point, we design an effective profiling system for VoIP users which is able to detect an interesting class of VoIP threats represented by “social” attacks. In the second part of the thesis, we focus on Content-Oriented Applications, once again basing our work on a study of current architectural and performance challenges. We propose a framework for the performance optimization of content-delivery based on the awareness of the contents to be delivered, as well as of the users’ behavior in terms of mobility, request patterns and content preferences

How Can App Design Improve Lexicographic Outcomes? Examples from an Italian Idiom Dictionary

Despite the growing number of smartphone apps used in everyday tasks, lexicographic applications are still rarely discussed. Studies focus mainly on the usability of available tools, but contributions concerning the development of dictionary apps are almost non-existent. In this paper, three different design solutions are presented to implement a dictionary app for Italian idioms, having foreign learners as prospective users. Prototypes were sketched according to Human-centred design principles and by applying a participatory approach in which users contribute to the design process. To offer a trustworthy tool, special attention was also paid to the lexicographic data provided. To this end, the OWID Sprichwörterbuch model was enriched with specific information to support foreign speakers, whose communicative needs had been tested in a production task with Italian idioms. The presentation of three prototypes is specifically addressed to highlight design solutions which can guarantee descriptive richness

How Can App Design Improve Lexicographic Outcomes? Examples from an Italian Idiom Dictionary

Despite the growing number of smartphone apps used in everyday tasks, lexicographic applications are still rarely discussed. Studies focus mainly on the usability of available tools, but contributions concerning the development of dictionary apps are almost non-existent. In this paper, three different design solutions are presented to implement a dictionary app for Italian idioms, having foreign learners as prospective users. Prototypes were sketched according to Human-centred design principles and by applying a participatory approach in which users contribute to the design process. To offer a trustworthy tool, special attention was also paid to the lexicographic data provided. To this end, the OWID Sprichwörterbuch model was enriched with specific information to support foreign speakers, whose communicative needs had been tested in a production task with Italian idioms. The presentation of three prototypes is specifically addressed to highlight design solutions which can guarantee descriptive richness