Chronic otitis media (COM) and chronic rhinosinusitis (CRS) are two of the most common otolaryngological disorders. CRS and COM share pathophysiological mechanisms such as bacterial infection, ...biofilm, and the persistence of the obstruction state of ventilation routes. The purpose of this systematic review was to evaluate all available information on the association between COM and CRS.
: The protocol of this investigation was registered on PROSPERO in November 2022. Pubmed, Scopus, Web of Science, and Cochrane databases were systematically searched according to the PRISMA statement.
After the application of inclusion-exclusion criteria, four manuscripts with adequate relevance to this topic were included in the review. The study population consisted of 20,867 patients with a diagnosis of CRS, of whom 991 were also diagnosed with COM (4.75%).
: The included studies have shown that CRS has become significantly associated with COMas: a global inflammatory process that involves the epithelium in both the middle ear and upper airway. The identification of a relationship between CRS and COM may contribute to preventing chronic inflammatory conditions through the early management of the associated disease. Further, carefully designed studies are necessary to demonstrate the relationship between COM and CRS.
Background
The exploitation of routinely collected clinical health information is warranted to optimize the case detection and diagnostic workout of Alzheimer’s disease (AD). We aimed to derive an AD ...prediction score based on routinely collected primary care data.
Methods
We built a cohort selecting 199,978 primary care patients 60 + part of the Health Search Database between January 2002 and 2009, followed up until 2019 to detect incident AD cases. The cohort was randomly divided into a derivation and validation sub-cohort. To identify AD and non-AD cases, we applied a clinical algorithm that involved two clinicians. According to a nested case–control design, AD cases were matched with up to 10 controls based on age, sex, calendar period, and follow-up duration. Using the derivation sub-cohort, 32 potential AD predictors (sociodemographic, clinical, drug-related, etc.) were tested in a logistic regression and selected to build a prediction model. The predictive performance of this model was tested on the validation sub-cohort by mean of explained variation, calibration, and discrimination measurements.
Results
We identified 3223 AD cases. The presence of memory disorders, hallucinations, anxiety, and depression and the use of NSAIDs were associated with future AD. The combination of the predictors allowed the production of a predictive score that showed an explained variation (pseudo-
R
2
) for AD occurrence of 13.4%, good calibration parameters, and an area under the curve of 0.73 (95% CI: 0.71–0.75). In accordance with this model, 7% of patients presented with a high-risk score for developing AD over 15 years.
Conclusion
An automated risk score for AD based on routinely collected clinical data is a promising tool for the early case detection and timely management of patients by the general practitioners.
The use of bacteriophages for the treatment of bacterial infections has been extensively studied. Nonetheless, the stress response regarding bacteriophage infection and the expression of virulence ...factors of Pseudomonas aeruginosa after phage infection is poorly discussed. In this study, we evaluated biofilm formation capacity and expression of virulence factors of P. aeruginosa after bacteriophage infection. Biofilm growth rates, biofilm morphology, pyocyanin production and elastase activity were evaluated after 2, 8, 24 and 48 h of co-cultivation with bacteriophages that was recently characterized and showed to be infective towards clinical isolates. In parallel, quantitative real-time polymerase chain reactions were carried out to verify the expression of virulence-related genes. Bacteriophages promoted substantial changes in P. aeruginosa biofilm growth at early co-culture time. In addition, at 8 h, we observed that some cultures developed filaments. Although bacteriophages did not alter both pyocyanin and protease activity, changes on the expression level of genes related to virulence factors were detected. Usually, lasI, pslA, lasB and phzH genes were upregulated after 2 and 48 h of co-culture. These results highlight the need for extensive investigation of pathways and molecules involved in phage infection, since the transcriptional changes would suggest a response activation by P. aeruginosa.
•Phages promoted changes in P. aeruginosa biofilm growth at early co-culture time.•Bacteriophages did not alter both pyocyanin and protease activity.•pslA, lasI, lasB and phzH genes were upregulated after 2 and 48 h of co-culture.•The transcriptional changes would suggest a response activation by P. aeruginosa.
Gamma Knife surgery (GKS) has been reported as an effective modality for treating brain metastases from renal cell carcinoma (RCC). The authors aimed to determine if targeted agents such as tyrosine ...kinase inhibitors, mammalian target of rapamycin inhibitors, and bevacizumab affect the patterns of failure of RCC after GKS.
Between 1999 and 2010, 61 patients with brain metastases from RCC were treated with GKS. A median dose of 20 Gy (range 13-24 Gy) was prescribed to the margin of each metastasis. Kaplan-Meier analysis was used to determine local control, distant failure, and overall survival rates. Cox proportional hazard regression was performed to determine the association between disease-related factors and survival.
Overall survival at 1, 2, and 3 years was 38%, 17%, and 9%, respectively. Freedom from local failure at 1, 2, and 3 years was 74%, 61%, and 40%, respectively. The distant failure rate at 1, 2, and 3 years was 51%, 79%, and 89%, respectively. Twenty-seven percent of patients died of neurological disease. The median survival for patients receiving targeted agents (n = 24) was 16.6 months compared with 7.2 months (n = 37) for those not receiving targeted therapy (p = 0.04). Freedom from local failure at 1 year was 93% versus 60% for patients receiving and those not receiving targeted agents, respectively (p = 0.01). Multivariate analysis showed that the use of targeted agents (hazard ratio 3.02, p = 0.003) was the only factor that predicted for improved survival. Two patients experienced post-GKS hemorrhage within the treated volume.
Targeted agents appear to improve local control and overall survival in patients treated with GKS for metastastic RCC.
Static Identification of Injection Attacks in Java Spoto, Fausto; Burato, Elisa; Ernst, Michael D. ...
ACM transactions on programming languages and systems,
07/2019, Letnik:
41, Številka:
3
Journal Article
Recenzirano
Odprti dostop
The most dangerous security-related software errors, according to the OWASP Top Ten 2017 list, affect web applications. They are potential injection attacks that exploit user-provided data to execute ...undesired operations: database access and updates (SQL injection); generation of malicious web pages (cross-site scripting injection); redirection to user-specified web pages (redirect injection); execution of OS commands and arbitrary scripts (command injection); loading of user-specified, possibly heavy or dangerous classes at run time (reflection injection); access to arbitrary files on the file system (path-traversal); and storing user-provided data into heap regions normally assumed to be shielded from the outside world (trust boundary violation). All these attacks exploit the same weakness: unconstrained propagation of data from sources that the user of a web application controls into sinks whose activation might trigger dangerous operations. Although web applications are written in a variety of languages, Java remains a frequent choice, in particular for banking applications, where security has tangible relevance. This article defines a unified, sound protection mechanism against such attacks, based on the identification of all possible explicit flows of tainted data in Java code. Such flows can be arbitrarily complex, passing through dynamically allocated data structures in the heap. The analysis is based on abstract interpretation and is interprocedural, flow-sensitive, and context-sensitive. Its notion of taint applies to reference (non-primitive) types dynamically allocated in the heap and is object-sensitive and field-sensitive. The analysis works by translating the program into Boolean formulas that model all possible data flows. Its implementation, within the Julia analyzer for Java and Android, found injection security vulnerabilities in the Internet banking service and in the customer relationship management of large Italian banks, as well as in a set of open-source third-party applications. It found the command injection, which is at the origin of the 2017 Equifax data breach, one of the worst data breaches ever. For objective, repeatable results, this article also evaluates the implementation on two open-source security benchmarks: the Juliet Suite and the OWASP Benchmark for the automatic comparison of static analyzers for cybersecurity. We compared this technique against more than 10 other static analyzers, both free and commercial. The result of these experiments is that ours is the only analysis for injection that is sound (up to well-stated limitations such as multithreading and native code) and works on industrial code, and it is also much more precise than other tools.
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