Risk Factors in Fatal Cases of Anaphylaxis due to Contrast Media: A Forensic Evaluation.

BACKGROUND: Fatalities following contrast medium exposure are extremely rare in clinical routine, though they may occur as an exception. Some may fall under the purview of the inquiring authorities and forensic pathologists due to their in-hospital occurrence. The purpose of this study was to assess the risk factors for anaphylaxis due to contrast medium administration that can be identified in fatal cases. METHODS: Fatalities occurred during the course of clinical investigations with contrast media described in the literature and fatal reactions to contrast agents that had undergone forensic investigations in our medicolegal center were reviewed with respect to patient characteristics, administered contrast medium, performed biochemical investigations and potential risk factors identified based on clinical history and medical records. RESULTS: Biochemical investigations into the fatal cases examined in our facility revealed increased mast cell tryptase, total IgE and activated mast cells in all subjects. Data obtained from the literature and our own investigations indicated that in only a minority of the fatal cases had there been previous exposure to contrast compounds, while most cases of severe anaphylaxis involved patients who apparently reacted on initial exposure. CONCLUSIONS: Most fatal cases failed to present any identifiable predisposing conditions out of those traditionally considered as risk factors for an anaphylactic reaction to contrast compounds in the medical histories of the patients. Comprehensive clinical histories and thorough reviews of medical data, along with exhaustive forensic investigations, provide information that is relevant in order to better appreciate the interwoven relationships linking all factors potentially involved in the pathogenesis of fatal anaphylaxis to contrast media. © 2014 S. Karger AG, Basel.

Activismo digital y social como innovación metodológica universitària

En la actualidad son numerosos los medios de interacción personal individual o entre organizaciones. La oferta de plataformas es prácticamente incontable y la oferta de contenidos es prácticamente infinita. La experiencia que presentamos pretende que los estudiantes universitarios tengan una experiencia de comunicación mediante las nuevas tecnologías con la finalidad de poder generar un trabajo colaborativo que posibilite, en parte, el cambio social.

Is there an advantage to be gained from adding digital image cytometry of brush cytology to a standard biopsy protocol in patients with Barrett's esophagus?

BACKGROUND AND STUDY AIMS: The current gold standard in Barrett's esophagus monitoring consists of four-quadrant biopsies every 1-2 cm in accordance with the Seattle protocol. Adding brush cytology processed by digital image cytometry (DICM) may further increase the detection of patients with Barrett's esophagus who are at risk of neoplasia. The aim of the present study was to assess the additional diagnostic value and accuracy of DICM when added to the standard histological analysis in a cross-sectional multicenter study of patients with Barrett's esophagus in Switzerland. METHODS: One hundred sixty-four patients with Barrett's esophagus underwent 239 endoscopies with biopsy and brush cytology. DICM was carried out on 239 cytology specimens. Measures of the test accuracy of DICM (relative risk, sensitivity, specificity, likelihood ratios) were obtained by dichotomizing the histopathology results (high-grade dysplasia or adenocarcinoma vs. all others) and DICM results (aneuploidy/intermediate pattern vs. diploidy). RESULTS: DICM revealed diploidy in 83% of 239 endoscopies, an intermediate pattern in 8.8%, and aneuploidy in 8.4%. An intermediate DICM result carried a relative risk (RR) of 12 and aneuploidy a RR of 27 for high-grade dysplasia/adenocarcinoma. Adding DICM to the standard biopsy protocol, a pathological cytometry result (aneuploid or intermediate) was found in 25 of 239 endoscopies (11%; 18 patients) with low-risk histology (no high-grade dysplasia or adenocarcinoma). During follow-up of 14 of these 18 patients, histological deterioration was seen in 3 (21%). CONCLUSION: DICM from brush cytology may add important information to a standard biopsy protocol by identifying a subgroup of BE-patients with high-risk cellular abnormalities.

A semantic model of selective dissemination of information for digital libraries

In this paper we present the theoretical and methodologicalfoundations for the development of a multi-agentSelective Dissemination of Information (SDI) servicemodel that applies Semantic Web technologies for specializeddigital libraries. These technologies make possibleachieving more efficient information management,improving agent–user communication processes, andfacilitating accurate access to relevant resources. Othertools used are fuzzy linguistic modelling techniques(which make possible easing the interaction betweenusers and system) and natural language processing(NLP) techniques for semiautomatic thesaurus generation.Also, RSS feeds are used as “current awareness bulletins”to generate personalized bibliographic alerts.

The migration towards Digital Terrestrial Television: challenges for public policy and public broadcasters

This paper initially identifies the main transformations of the television system that are caused by digitalization. Its development in several broadcasting platforms is analyzed as well as the particular obstacles and requirements that are detected for each of them. Due to its technical characteristics and its historical link to the public services, the terrestrial network requires migration strategies different from those strictly commercial, and public intervention might be needed. The paper focuses on such migration strategies towards DTT and identifies the main issues for public intervention in the areas of the digital scenario: technology, business and market transformation and the reception field. Moreover, it describes and classifies the challenges that public broadcasters should confront due to digitalization. This paper finally concludes that the leadership of the public broadcasters during the migration towards DTT is an interesting tool for public policy. The need for foster the digitalization of the terrestrial platform and to achieve certain social and public goal besides the market interest brings an opportunity for public institutions and public broadcasters to work together. That leading role could also be positive for the public service to face its necessary redefinition and reallocation within the digital context.

Forensic science on trial - what is the law of the land ?

Based on a plenary lecture presented at the Tenth ANZFSS meeting of Forensic science in Sydney (September 2010), this article identifies some of the difficulties arising from the confrontation of forensic science with the law : a science defined by its specialities rather its object (the trace) and through the eyes of the law rather than those of science. This situation has historical roots that are highlighted and potential solutions for the future lie in fundamental and cultural developments within forensic science itself.

Quantifying urban attractiveness from the distribution and density of digital footprints

In the past, sensors networks in cities have been limited to fixed sensors, embedded in particular locations, under centralised control. Today, new applications can leverage wireless devices and use them as sensors to create aggregated information. In this paper, we show that the emerging patterns unveiled through the analysis of large sets of aggregated digital footprints can provide novel insights into how people experience the city and into some of the drivers behind these emerging patterns. We particularly explore the capacity to quantify the evolution of the attractiveness of urban space with a case study of in the area of the New York City Waterfalls, a public art project of four man-made waterfalls rising from the New York Harbor. Methods to study the impact of an event of this nature are traditionally based on the collection of static information such as surveys and ticket-based people counts, which allow to generate estimates about visitors’ presence in specific areas over time. In contrast, our contribution makes use of the dynamic data that visitors generate, such as the density and distribution of aggregate phone calls and photos taken in different areas of interest and over time. Our analysis provides novel ways to quantify the impact of a public event on the distribution of visitors and on the evolution of the attractiveness of the points of interest in proximity. This information has potential uses for local authorities, researchers, as well as service providers such as mobile network operators.

Coupling digital and physical worlds in an AR magic show performance: lessons learned

“Magic for a Pixeloscope” is a one hour show conceived to berepresented in a theater scenario that merges mixed and augmented reality (MR/AR) and full-body interaction with classical magic to create new tricks. The show was conceived by an interdisciplinary team composed by a magician, twointeraction designers, a theater director and a stage designer. Themagician uses custom based hardware and software to createnew illusions which are a starting point to explore new languagefor magical expression. In this paper we introduce a conceptualframework used to inform the design of different tricks; weexplore the design and production of some tricks included in theshow and we describe the feedback received on the world premiere and some of the conclusions obtained.

Forensic identification of urine samples: a comparison between nuclear and mitochondrial DNA markers.

Urine samples from 20 male volunteers of European Caucasian origin were stored at 4 degrees C over a 4-month period in order to compare the identification potential of nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) markers. The amount of nDNA recovered from urines dramatically declined over time. Consequently, nDNA likelihood ratios (LRs) greater than 1,000 were obtained for 100, 70 and 55% of the urines analysed after 6, 60 and 120 days, respectively. For the mtDNA, HVI and HVII sequences were obtained for all samples tested, whatever the period considered. Nevertheless, the highest mtDNA LR of 435 was relatively low compared to its nDNA equivalent. Indeed, LRs obtained with only three nDNA loci could easily exceed this value and are quite easier to obtain. Overall, the joint use of nDNA and mtDNA markers enabled the 20 urine samples to be identified, even after the 4-month period.

O fotojornalismo depois da fotografia: Modelos de configuração da cadeia produtiva do fotojornalismo em tempos de convergência digital

This research report concerns about the post-doctoral activities, conducted betweenSeptember 2010 and March 2011 at the University Pompeu Fabra, Barcelona. It comes to identify the consequences of the convergence phenomenon on photojournalism.Thus, in a more general approach, the effort is to to recovery the structural elements of the convergence concept in journalism. It aims to map, as well, the current debates about the repositioning of photographic practices linked to the news produced in a widespread adoption of digital devices in contemporary workflow. It is also specified,the analysis of photographic collectives as a result of the convergence frameworkapplied to photojournalism; the debate on ways of funding; alternatives facing thealleged crisis of press photography and, finally, proposes to create qualifying stages ofdevelopment of photojournalism in the digital age as well as the proposition of hypotheses concerning the structure of the productive routines. In addition, we present three cases to be analyzed in order to explore and verify the occurrence ofcharacteristics that may identify the object of research in the state of practice. Finally,we work in a series of conclusions, revisiting the main hypotheses. With this strategy, ispossible to define an sequence of analysis capable of addressing the characteristics present in the studied cases and other ones in future, thus, be able to affirm this stage as a step, in the continuous historical course of photojournalism.

Fluência digital e uso de ambientes virtuais: caracterização de alunos de enfermagem

O objetivo do estudo foi caracterizar o perfil de licenciandos de enfermagem, identificar a fluência digital, o conhecimento, a habilidade e o interesse no uso de ambientes virtuais de aprendizagem. Trata-se de uma pesquisa quantitativa, exploratório-descritiva realizada com 51 licenciandos de enfermagem por meio de questionário. Dos participantes do estudo 51 (100%) afirmam ter conhecimento em informática, sendo que 26 (49%) indicam um nível intermediário; 47 (92%) fazem uso diário da Internet; 51 (100%) navegam em redes sociais e possuem e-mail; 51(100%) utilizam MSN e 32 (62,7%) Skype; 41 (82%) acessam Chats, 33 (64,7%) Fóruns de discussão e 22 (43%) Blogs; 33 (64,7%) utilizam frequentemente o Moodle e 26 (51%) o COL; e a grande maioria (45- 88,2%) relatou interesse no uso de ambientes virtuais de aprendizagem. Os alunos foram considerados fluentes digitais e apresentaram conhecimento, habilidade e expressivo interesse no uso de ambientes virtuais de aprendizagem em sua formação acadêmica.

Medical and legal professionals' attitudes towards confidentiality and disclosure of clinical information in forensic settings: a survey using case vignettes.

OBJECTIVE: When potentially dangerous patients reveal criminal fantasies to their therapists, the latter must decide whether this information has to be transmitted to a third person in order to protect potential victims. We were interested in how medical and legal professionals handle such situations in the context of prison medicine and forensic evaluations. We aimed to explore the motives behind their actions and to compare these professional groups. METHOD: A mail survey was conducted among medical and legal professionals using five fictitious case vignettes. For each vignette, participants were asked to answer questions exploring what the professional should do in the situation and to explain their justification for the chosen response. RESULTS: A total of 147 questionnaires were analysed. Agreement between participants varied from one scenario to another. Overall, legal professionals tended to disclose information to a third party more easily than medical professionals, the latter tending to privilege confidentiality and patient autonomy over security. Perception of potential danger in a given situation was not consistently associated with actions. CONCLUSION: Professionals' opinions and attitudes regarding the confidentiality of potentially dangerous patients differ widely and appear to be subjectively determined. Shared discussions about clinical situations could enhance knowledge and competencies and reduce differences between professional groups.

Digital storytelling: un’applicazione didattica per ripensare ai media attraverso i media

El presente trabajo de investigación propone un proyecto de investigación centrado en los pre-adolescentes para estudiar, a través deautobiografías digitales (digital storytelling, DST) producidas por ellos, laspracticas cultural-medial y las representaciones que ellos han construido sobre los medios, en relación con los contextos de uso significativos, como el hogar, la escuela o su grupo de par. Los medios forman parte de las actividades cotidianas de los niños quien los emplean en prácticas de socialización, aprendizaje, juego y de construcción de la identidad y del conocimiento. Los digital storytelling,insertados en el contexto escolar, serán empleados como metodología didácticapara la adquisición de competencias tecnológicas y como instrumento de lainvestigación. Los DST, como practica cultural de los chicos, constituirán nuestrocampo para la observación de las modalidades de uso de los medios por parte delos jóvenes y sus capacidad de recombinar lenguajes y construir contenidos. LosDST proporcionaran, además, la posibilidad de acceder al universo simbólicoinfantil para comprender el significado que las tecnologías tienen en sus cotidianidad