Patients requiring desensitization prior to renal transplantation are at risk for developing severe antibody‐mediated rejection (AMR) refractory to treatment with plasmapheresis and intravenous ...immunoglobulin (PP/IVIg). We have previously reported success at graft salvage, long‐term graft survival and protection against transplant glomerulopathy with the use of eculizumab and splenectomy in addition to PP/IVIg. Splenectomy may be an important component of this combination therapy and is itself associated with a marked reduction in donor‐specific antibody (DSA) production. However, splenectomy represents a major operation, and some patients with severe AMR have comorbid conditions that substantially increase their risk of complications during and after surgery. In an effort to spare recipients the morbidity of a second operation, we used splenic irradiation in lieu of splenectomy in two incompatible live donor kidney transplant recipients with severe AMR in addition to PP/IVIg, rituximab and eculizumab. This novel approach to the treatment of severe AMR was associated with allograft salvage, excellent graft function and no short‐ or medium‐term adverse effects of the radiation therapy. One‐year surveillance biopsies did not show transplant glomerulopathy (tg) on light microscopy, but microcirculation inflammation and tg were present on electron microscopy.
The authors report the novel use of splenic irradiation in lieu of splenectomy in two HLA‐incompatible live donor kidney transplant recipients with severe, plasmapheresis/IVIg‐refractory antibody‐mediated rejection, with successful allograft salvage, excellent graft function, and no adverse effects of radiation, though 1‐year protocol biopsies showed microcirculation injury.
The private Cloud at the Torino INFN computing centre offers IaaS services to different scientific computing applications. The infrastructure is managed with the OpenNebula cloud controller. The main ...stakeholders of the facility are a grid Tier-2 site for the ALICE collaboration at LHC, an interactive analysis facility for the same experiment and a grid Tier-2 site for the BES-III collaboration, plus an increasing number of other small tenants. Besides keeping track of the usage, the automation of dynamic allocation of resources to tenants requires detailed monitoring and accounting of the resource usage. As a first investigation towards this, we set up a monitoring system to inspect the site activities both in terms of IaaS and applications running on the hosted virtual instances. For this purpose we used the Elasticsearch, Logstash and Kibana stack. In the current implementation, the heterogeneous accounting information is fed to different MySQL databases and sent to Elasticsearch via a custom Logstash plugin. For the IaaS metering, we developed sensors for the OpenNebula API. The IaaS level information gathered through the API is sent to the MySQL database through an ad-hoc developed RESTful web service, which is also used for other accounting purposes. Concerning the application level, we used the Root plugin TProofMonSenderSQL to collect accounting data from the interactive analysis facility. The BES-III virtual instances used to be monitored with Zabbix, as a proof of concept we also retrieve the information contained in the Zabbix database. Each of these three cases is indexed separately in Elasticsearch. We are now starting to consider dismissing the intermediate level provided by the SQL database and evaluating a NoSQL option as a unique central database for all the monitoring information. We setup a set of Kibana dashboards with pre-defined queries in order to monitor the relevant information in each case. In this way we have achieved a uniform monitoring interface for both the IaaS and the scientific applications, mostly leveraging off-the-shelf tools.
This paper describes the achievements of the H2020 project INDIGO-DataCloud. The project has provided e-infrastructures with tools, applications and cloud framework enhancements to manage the ...demanding requirements of scientific communities, either locally or through enhanced interfaces. The middleware developed allows to federate hybrid resources, to easily write, port and run scientific applications to the cloud. In particular, we have extended existing PaaS (Platform as a Service) solutions, allowing public and private e-infrastructures, including those provided by EGI, EUDAT, and Helix Nebula, to integrate their existing services and make them available through AAI services compliant with GEANT interfederation policies, thus guaranteeing transparency and trust in the provisioning of such services. Our middleware facilitates the execution of applications using containers on Cloud and Grid based infrastructures, as well as on HPC clusters. Our developments are freely downloadable as open source components, and are already being integrated into many scientific applications.
We examined rejection outcome and graft survival in 58 adult patients with acute cellular rejection Banff type I (ARI) or II (ARII), within 1 year after transplantation, with or without CD20‐positive ...infiltrates. Antibody‐mediated rejection was not examined. Of the 74 allograft biopsies, performed from 1999 to 2001, 40 biopsies showed ARI and 34 biopsies showed ARII; 30% of all the biopsies showed CD20‐positive clusters with more than 100 cells, 9% with more than 200 cells and 5% with more than 275 cells. Patients with B cell‐rich (>100 or >200/HPF CD20‐positive cells) and B cell‐poor biopsies (<50 CD20‐positive cells/HPF) were compared. Serum creatinine and eGFR of B cell‐rich (CD20 > 100/HPF) and B cell‐poor were not significantly different at rejection, or at 1, 3, 6 and 12 months, and during additional 3 years follow‐up after rejection, although higher creatinine at 1 year was noted in the >200/HPF group. Graft survival was also not different between B cell‐rich and B cell‐poor groups (p = 0.8 for >100/HPF, p = 0.9 for >200/HPF CD20‐positive cells). Our data do not support association of B cell‐rich infiltrates in allograft biopsies and worse outcome in acute rejection type I or II, but do not exclude the possible contribution of B cells to allograft rejection.
In 58 kidneys with acute T‐cell‐mediated cell rejection, CD20‐positive B‐cell rich infiltrates in biopsies were not associated with worse GFR or outcomes, failing to support previous reports of association between B‐cell rich infiltrates and worse outcomes.
We reviewed 116 surveillance biopsies obtained approximately 1, 3, 6 and 12 months posttransplantation from 50 +XM live donor kidney transplant recipients to determine the frequency of subclinical ...cell‐mediated rejection (CMR) and antibody‐mediated rejection (AMR). Subclinical CMR was present in 39.7% of the biopsies at 1 month and >20% at all other time points. The presence of diffuse C4d on biopsies obtained at each time interval ranged from 20 to 30%. In every case, where histological and immunohistological findings were diagnostic for AMR, donor‐specific antibody was found in the blood, challenging the long‐held belief that low‐level antibody could evade detection due to absorption on the graft. Among clinical factors, only recipient age was associated with subclinical CMR. Clinical factors associated with subclinical AMR were recipient age, positive cytotoxic crossmatch prior to desensitization and two mismatches of HLA DR 51, 52 and 53 alleles. Surveillance biopsies during the first year post‐transplantation for these high‐risk patients uncover clinically occult processes and phenotypes, which without intervention diminish allograft survival and function.
This retrospective case series of surveillance biopsies of 95 live donor clinically stable positive crossmatch kidney transplant recipients obtained during the first postoperative year demonstrates a > 20% frequency of subclinical cellular rejection and a 20–30% frequency of diffuse C4d+ at all time points.
Triple GEM performance in magnetic field Alexeev, M.; Amoroso, A.; Bagnasco, S. ...
Journal of instrumentation,
08/2019, Letnik:
14, Številka:
8
Journal Article
Recenzirano
Odprti dostop
Performance of triple GEM prototypes in strong magnetic field has been evaluated by means of a muon beam at the H4 line of the SPS test area at CERN. Data have been reconstructed and analyzed offline ...with two reconstruction methods: the charge centroid and the micro-Time-Projection-Chamber exploiting the charge and the time measurement respectively. Depending on the combination of the particle incident angle and magnetic filed, there's always one of the two algorithms achieving a spatial resolution of 100–120 μm.
A dashboard devoted to the computing in the Italian sites for the ALICE experiment at the LHC has been deployed. A combination of different complementary monitoring tools is typically used in most of ...the Tier-2 sites: this makes somewhat difficult to figure out at a glance the status of the site and to compare information extracted from different sources for debugging purposes. To overcome these limitations a dedicated ALICE dashboard has been designed and implemented in each of the ALICE Tier-2 sites in Italy: in particular, it provides a single, interactive and easily customizable graphical interface where heterogeneous data are presented. The dashboard is based on two main ingredients: an open source time-series database and a dashboard builder tool for visualizing time-series metrics. Various sensors, able to collect data from the multiple data sources, have been also written. A first version of a national computing dashboard has been implemented using a specific instance of the builder to gather data from all the local databases.
Micro Pattern Gas Detectors (MPGD) are the new frontier in gas trackers. Among this kind of devices, the Gas Electron Multiplier (GEM) chambers are widely used. The experimental signals acquired with ...the detector must obviously be reconstructed and analysed. In this contribution, a new offline software to perform reconstruction, alignment and analysis on the data collected with APV-25 and TIGER ASICs will be presented. GRAAL (Gem Reconstruction And Analysis Library) is able to measure the performance of a MPGD detector with a strip segmented anode (presently). The code is divided in three parts: reconstruction, where the hits are digitized and clusterized; tracking, where a procedure fits the points from the tracking system and uses that information to align the chamber with rotations and shifts; analysis, where the performance is evaluated (e.g. efficiency, spatial resolution,etc.). The user must set the geometry of the setup and then the program returns automatically the analysis results, taking care of different conditions of gas mixture, electric field, magnetic field, geometries, strip orientation, dead strip, misalignment and many others.
Elastic cloud computing applications, i.e. applications that automatically scale according to computing needs, work on the ideal assumption of infinite resources. While large public cloud ...infrastructures may be a reasonable approximation of this condition, scientific computing centres like WLCG Grid sites usually work in a saturated regime, in which applications compete for scarce resources through queues, priorities and scheduling policies, and keeping a fraction of the computing cores idle to allow for headroom is usually not an option. In our particular environment one of the applications (a WLCG Tier-2 Grid site) is much larger than all the others and cannot autoscale easily. Nevertheless, other smaller applications can benefit of automatic elasticity; the implementation of this property in our infrastructure, based on the OpenNebula cloud stack, will be described and the very first operational experiences with a small number of strategies for timely allocation and release of resources will be discussed.
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