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The role of non-steroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid in the occurrence of diverticular bleeding (DB), complicated diverticulitis (CD), and acute diverticulitis (AD) is not yet defined.Update a systematic review and meta-analyses of case-control and cohort studies to evaluate the association between NSAIDs or acetylsalicylic acid with DB, CD, or AD.The study included were identified through MEDLINE, Scopus, Web of Science, and Cochrane Library databases. Sizes were pooled across studies to obtain the overall effect size. A random-effects model was used to account for different sources of variation among studies. Odds ratio (OR) with 95% confidence interval (CI) was used as a measure of effect size.Thirteen studies were included in the systematic review and meta-analysis. NSAIDs and acetylsalicylic acid use were associated with an increased risk of DB (OR: 6.90, 95% CI 3.86 to 12.35, P ˂ 0.00001, and OR 2.84, 95% CI 2.19 to 3.67, P 0.00001, respectively). NSAIDs and acetylsalicylic acid use were also associated with increased risk of CD occurrence (OR 3.13, 95% CI 1.73 to 5.68, P = 0.0002, and OR 1.49, 95% CI 1.02 to 2.17, P = 0.04, respectively). The only study found about AD occurrence showed that NSAIDs use was not associated with AD and acetylsalicylic acid use had a low risk of AD.NSAIDs and acetylsalicylic acid significantly increase the risk of DB and CD. Further studies are needed to clarify the role of NSAIDs and acetylsalicylic acid in AD. However, increasing evidence suggests caution in the use of such medications in patients with colonic diverticula.

Background It was not yet fully established whether the use of antiplatelet agents (APAs) is associated with an increased risk of colorectal post-polypectomy bleeding (PPB). Temporarily, discontinuation of APAs could reduce the risk of PPB, but at the same time, it could increase the risk of cardiovascular disease recurrence. This study aimed to assess the PPB risk in patients using APAs compared to patients without APAs or anticoagulant therapy who had undergone colonoscopy with polypectomy. Methods A systematic electronic search of the literature was performed using PubMed/MEDLINE, Scopus, and CENTRAL, to assess the risk of bleeding in patients who do not interrupt single antiplatelet therapy (P2Y12 inhibitors or aspirin) and undergone colonoscopy with polypectomy. Results Of 2417 identified articles, 8 articles (all of them were non-randomized studies of interventions (NRSI); no randomized controlled trials (RCT) were available on this topic) were selected for the meta-analysis, including 1620 patients on antiplatelet therapy and 13,321 controls. Uninterrupted APAs single therapy was associated with an increased risk of PPB compared to the control group (OR 2.31; CI 1.37–3.91). Patients on P2Y12i single therapy had a higher risk of both immediate (OR 4.43; CI 1.40–14.00) and delayed PPB (OR 10.80; CI 4.63–25.16) compared to the control group, while patients on aspirin single therapy may have a little to no difference increase in the number of both immediate and delayed PPB events. Conclusions Uninterrupted single antiplatelet therapy may increase the risk of PPB, but the evidence is very uncertain. The risk may be higher in delayed PPB. However, in deciding to discontinue APAs before colonoscopy with polypectomy, the potential higher risk of major adverse cardiovascular events should always be assessed.

During pregnancy, a percentage of the cell-free DNA circulating in the maternal blood is represented by the cell-free fetal DNA (cffDNA), constituting an accessible source for noninvasive prenatal genetic screening. The coexistence of the maternal DNA, the dominant fraction of cell-free DNA, together with the cffDNA component and the scarcity of the cffDNA itself make applying traditional methods of genetics and molecular biology impossible. Next-generation sequencing methods are widely used to study fetal aneuploidies. However, in monogenic disorders, there have been relatively few studies that analyzed single mutations. We present a method for the analysis of an extended group of gene variants associated with recessive and dominant autosomal disorders using next-generation sequencing. The proposed test should allow a complete analysis of common genetic disorders and pathogen-associated variants for diagnostic use. The analysis of cffDNA for single gene disorders may replace invasive prenatal diagnosis methods, associated with the risk of spontaneous abortion and psychological stress for patients. The proposed test should assess reproductive risk for both genetic family disorders and de novo occurrences of the disease. The application of this method to a case of beta-thalassemia is also discussed.

The development of colorectal cancer, responsible for 9% of cancer-related deaths, is favored by a combination of genetic and environmental factors. The modification of diet and lifestyle may modify the risk of colorectal cancer (CRC) and prevent neoplasia in up to 50% of cases. The Western diet, characterized by a high intake of fat, red meat and processed meat has emerged as an important contributor. Conversely, a high intake of dietary fiber partially counteracts the unfavorable effects of meat through multiple mechanisms, including reduced intestinal transit time and dilution of carcinogenic compounds. Providing antioxidants (e.g., vitamins C and E) and leading to increased intraluminal production of protective fermentation products, like butyrate, represent other beneficial and useful effects of a fiber-rich diet. Protective effects on the risk of developing colorectal cancer have been also advocated for some specific micronutrients like vitamin D, selenium, and calcium. Diet-induced modifications of the gut microbiota modulate colonic epithelial cell homeostasis and carcinogenesis. This can have, under different conditions, opposite effects on the risk of CRC, through the production of mutagenic and carcinogenic agents or, conversely, of protective compounds. The aim of this review is to summarize the most recent evidence on the role of diet as a potential risk factor for the development of colorectal malignancies, as well as providing possible prevention dietary strategies.

IntroductionNon-invasive prenatal testing (NIPT) using cell-free foetal DNA has been widely accepted in recent years for detecting common foetal chromosome aneuploidies, such as trisomies 13, 18 and 21, and sex chromosome aneuploidies. In this study, the practical clinical performance of our foetal DNA testing was evaluated for analysing all chromosome aberrations among 7113 pregnancies in Italy.MethodsThis study was a retrospective analysis of collected NIPT data from the Ion S5 next-generation sequencing platform obtained from Altamedica Medical Centre in Rome, Italy.ResultsIn this study, NIPT showed 100% sensitivity and 99.9% specificity for trisomies 13, 18 and 21. Out of the 7113 samples analysed, 74 cases (1%) were positive by NIPT testing; foetal karyotyping and follow-up results validated 2 trisomy 13 cases, 5 trisomy 18 cases, 58 trisomy 21 cases and 10 sex chromosome aneuploidy cases. There were no false-negative results.ConclusionIn our hands, NIPT had high sensitivity and specificity for common chromosomal aneuploidies such as trisomies 13, 18 and 21.

Simple Summary Early diagnosis is crucial for reducing colorectal cancer-related mortality in both the general population and inflammatory bowel disease. Volatile organic compound (VOC) analysis is a promising alternative to the gold standard procedure, endoscopy, for early detection and surveillance of colorectal diseases. This review aimed to provide a general overview of the most recent evidence in this area on VOC testing in breath, stool, and urine samples. Abstract Colorectal cancer (CRC) is one of the leading causes of cancer-related death in the Western world. Early detection decreases incidence and mortality. Screening programs based on fecal occult blood testing help identify patients requiring endoscopic examination, but accuracy is far from optimal. Among the alternative strategies, volatile organic compounds (VOCs) represent novel potentially useful biomarkers of colorectal cancer. They also represent a promising tool for the screening of both intestinal inflammation and related CRC. The review is focused on the diagnostic potential of VOCs in sporadic CRC and in inflammatory bowel diseases (IBD), which increase the risk of CRC, analyzing future clinical applications. Despite limitations related to inadequate strength of evidence, differing analytical platforms identify different VOCs, and this unconventional approach for diagnosing colorectal cancer is promising. Some VOC profiles, besides identifying inflammation, seem disease-specific in inflammatory bowel diseases. Thus, breath, urine, and fecal VOCs provide a new and promising clinical approach to differential diagnosis, evaluation of the inflammatory status, and possibly the assessment of treatment efficacy in IBD. Conversely, specific VOC patterns correlating inflammatory bowel disease and cancer risk are still lacking, and studies focused on this issue are strongly encouraged. No prospective studies have assessed the risk of CRC development by using VOCs in samples collected before the onset of disease, both in the general population and in patients with IBD.

Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. Iron deficiency anemia (IDA) is a common sign in CD, being the only abnormality in approximately 40% of celiac patients. A multifactorial etiology leads to IDA in CD. The two main causes are the villous atrophy of the mucosa at the site of iron absorption (the duodenum) and the resulting inflammation, which triggers the mechanism that leads to the anemia of chronic disease. Until now, it has been unclear why some patients with CD continue to have IDA despite a careful gluten-free diet (GFD) and the normalization of villous atrophy. Furthermore, some celiac patients are refractory to oral iron supplementation despite the healing of the mucosa, and they thus require periodic intravenous iron administration. The Marsh classification evaluates the degree of inflammation and villous atrophy, but it does not assess the possible persistence of ultrastructural and molecular alterations in enterocytes. The latter was found in CD in remission after adopting a GFD and could be responsible for the persistently reduced absorption of iron and IDA. Even in non-celiac gluten sensitivity, anemia is present in 18.5–22% of patients and appears to be related to ultrastructural and molecular alterations in intestinal microvilli. It is possible that a genetic component may also play a role in IDA. In this review, we evaluate and discuss the main mechanisms of IDA in CD and the possible causes of its persistence after adopting a GFD, as well as their therapeutic implications.

As one of the popular topics to ensure public safety, crowd estimation has attracted lots of attentions from both industry and academia. Most of traditional crowd estimation approaches rely on sophisticated computer vision algorithms to estimate crowd based on camera data, therefore suffering from privacy issues and high deployment and data processing cost. In this paper we present a sensor fusion based approach to real-time crowd estimation based on privacy-conscious and inexpensive sensors. The approach has been implemented and verified first by a small scale deployment at our lab, and then tested based on a 3-month trial at a shopping mall in Singapore. A deep analysis has been carried out based on the data sets collected from the trial, showing promising results: 1) the data from CO2, sound pressure and infrared sensors are influential in estimating crowd levels for indoor environments, 2) Random Forest and C4.5 are identified as the more suitable supervised learning models, 3) an accuracy of 95% can be achieved by our crowd estimation system in a real scenario. In contrast to the state of the art, our approach is privacy preserving and can provide comparable estimation accuracy with lower deployment and processing cost and better applicability for large scale setups. It can be used either as an alternative solution when user privacy must be enforced or as a complementary solution to camera-based crowd estimation when privacy is less concerned because of pubic safety.

Web Service discovery a fundamental operation in SOA-based systems. In a landscape of Web Services that is growing in size and complexity, discovering a suitable atomic or composite Service for a given task requires a considerable amount of computation and communication resources, including semantic reasoning, the use of composition algorithms, and communication with multiple Service repositories. We study the approach of introducing a cache for Service discovery results to reduce the load on the backend discovery system. In this setting the bottleneck is the cache refresh frequency rather than the cache size, thus the caching algorithm needs to decide in which order to refresh the cached contents. We derive a theoretical upper bound on the number of cache hits possible to achieve for a given set of discovery queries, and we propose a number of heuristics for this caching problem, some of which turn out to have provable approximation guarantees. In an extensive experimental study we evaluate these methods. Our findings are that the best algorithms lead to a cache performance of more than 95 percent of the theoretical upper bound in all tested scenarios.

The Internet of Things (IoT) is now shaping our cities to make them more connected, convenient, and intelligent. However, this change will highly rely on extracted values and insights from the big data generated by our cities via sensors, devices, and human activities. Many existing studies and projects have been done to make our cities smart, focusing more on how to deploy various sensors and devices and then collect data from them. However, this is just the first step towards smart cities and next step will be to make good use of the collected data and enable context-awareness and intelligence into all kinds of applications and services via a flexible big data platform. In this paper, we introduce the system architecture and the major design issues of a live City Data and Analytics Platform, namely CiDAP. More importantly, we share our experience and lessons learned from building this practical system for a large scale running smart city test bed, SmartSantander. Our work provides a valuable example to future Smart City platform designers so that they can foresee some practice issues and refer to our solution when building their own smart city data platforms.

As sensors are getting cheaper and being widely deployed in cities, the Internet of Things (IoT) is providing us great potential to make cities not only smart but also safer. However, how to utilize the information sensed from physical environments to improve civil safety is still a challenging issue. In this paper we present a methodology to estimate the crowd level for indoor scenarios based on data collected from inexpensive and privacy conscious sensors. Our method can be widely applied into many applications for Safer Cities, ranging from facility monitoring to emergency handling. Different from camera-based approaches, our solution can preserve user privacy, scaling better in terms of costs than existing solutions. Using the data collected from real environments, we examine different supervised learning algorithms and identify that Random Forest is the best model. Our solution has been deployed and tested in a Singapore shopping mall, showing that 95% of the overcrowded situations can be detected.

In the Internet of Things vision, physical things become part of the Internet and, . as a result, the Internet extends into the physical world. Applications start to be aware of the users’ environment and users can have mediated interactions with the physical world through the Internet of Things. Within the physical world, the spatial structure, which can be described by geographical coordinates, is relevant for finding services. Thus geographic service discovery becomes a core part of an Internet of Things infrastructure. The key problem to solve is how to efficiently extract the set of services whose geographic service area overlaps with the geographic scope of the request from the potentially huge number of services in the Internet of Things.

Neuroglobin is a neuron-specific hexacoordinated globin capable of binding various ligands, including O2, NO, and CO, the biological function of which is still uncertain. Various studies seem to indicate that neuroglobin is a neuroprotective agent when overexpressed, acting as a potent inhibitor of oxidative and nitrosative stress. In this study, we evaluated the pathophysiological response of the neuroglobin gene and protein expression in the cerebral tissue of rats sustaining traumatic brain injury of differing severity, while simultaneously measuring the oxidant/antioxidant balance. Two levels of trauma (mild and severe) were induced in anesthetized animals using the weight-drop model of diffuse axonal injury. Rats were then sacrificed at 6, 12, 24, 48, and 120h after traumatic brain injury, and the gene and protein expression of neuroglobin and the concentrations of malondialdehyde (as a parameter representative of reactive oxygen species-mediated damage), nitrite + nitrate (indicative of NO metabolism), ascorbate, and glutathione (GSH) were determined in the brain tissue. Results indicated that mild traumatic brain injury, although causing a reversible increase in oxidative/nitrosative stress (increase in malondialdehyde and nitrite + nitrate) and an imbalance in antioxidants (decrease in ascorbate and GSH), did not induce any change in neuroglobin. Conversely, severe traumatic brain injury caused an over nine- and a fivefold increase in neuroglobin gene and protein expression, respectively, as well as a remarkable increase in oxidative/nitrosative stress and depletion of antioxidants. The results of this study, showing a lack of effect in mild traumatic brain injury as well as asynchronous time course changes in neuroglobin expression, oxidative/nitrosative stress, and antioxidants in severe traumatic brain injury, do not seem to support the role of neuroglobin as an endogenous neuroprotective antioxidant agent, at least under pathophysiological conditions.

Brick and Mortar stores have been facing unrelenting competition from online retailers. An enhanced shopping experience is often perceived as a decisive factor in regaining market share, aiming at novel multi-channel online and offline sales strategies. Technologies aimed at this goal, promote interaction, personalization and reaction measurement based on Internet of Things and networked display technologies. There exist, however, a plethora of standards and application platforms which constitute a considerable barrier for integrators both in terms of time and man power. This paper proposes an integrated approach for cost-effective development of innovative in-shop-experience applications leveraging the Internet of Things, HTML5 and Pervasive Display Networks.

It is extremely difficult and expensive to determine the flight attitude and aimpoint of small maneuvering miniature air vehicles from ground based fixed or tracking photography. Telemetry alone cannot provide sufficient information bandwidth on 'what' the ground tracking is seeing and consequently 'why' it did or did not function properly. Additionally, it is anticipated that 'smart' and 'brilliant' guided vehicles now in development will require a high resolution imaging support system to determine which target and which part of a ground feature is being used for navigation or targeting. Other requirements include support of sub-component separation from developmental supersonic vehicles, where the clean separation from the container is not determinable from ground based film systems and film cameras do not survive vehicle breakup and impact. Hence, the requirement is to develop and demonstrate an imaging support system for development/testing that can provide the flight vehicle developer/analyst with imagery (combined with miniature telemetry sources) sufficient to recreate the trajectory, terminal navigation, and flight termination events. This project is a development and demonstration of a real-time, launch-rated, shuttered, electronic imager, transmitter, and analysis system. This effort demonstrated boresighted imagery from inside small flight vehicles for post flight analysis of trajectory, and capture of ground imagery during random triggered vehicle functions. The initial studies for this capability have been accomplished by the Experimental Dynamics Section of the Air Force Wright Laboratory, Armament Directorate, Eglin AFB, Florida, and the Telemetry Support Branch of the Army Material Research and Development Center at Picatinny Arsenal, New Jersey. It has been determined that at 1/10,000 of a second exposure time, new ultra-miniature CCD sensors have sufficient sensitivity to image key ground target features without blur, thereby providing data for trajectory, timing, and advanced sensor development. This system will be used for ground tracking data reduction in support of small air vehicle and munition testing. It will provide a means of integrating the imagery and telemetry data from the item with ground based photographic support. The technique we have designed will exploit off-the-shelf software and analysis components. A differential GPS survey instrument will establish a photogrammetric calibration grid throughout the range and reference targets along the flight path. Images from the on-board sensor will be used to calibrate the ortho- rectification model in the analysis software. The projectile images will be transmitted and recorded on several tape recorders to insure complete capture of each video field. The images will be combined with a non-linear video editor into a time-correlated record. Each correlated video field will be written to video disk. The files will be converted to DMA compatible format and then analyzed for determination of the projectile altitude, attitude and position in space. The resulting data file will be used to create a photomosaic of the ground the projectile flew over and the targets it saw. The data will be then transformed to a trajectory file and used to generate a graphic overlay that will merge digital photo data of the range with actual images captured. The plan is to superimpose the flight path of the projectile, the path of the weapons aimpoint, and annotation of each internal sequence event. With tools used to produce state-of-the-art computer graphics, we now think it will be possible to reconstruct the test event from the viewpoint of the warhead, the target, and a 'God's-Eye' view looking over the shoulder of the projectile.

In previous studies we have shown that hemodiafiltration with postdilution hypertonic reinjection, ∼ 220 mEq/1 of Na (H HDF) is able to reduce intra and intersession morbidity and provide a satisfacto