The uncertainty in standardised sound power measurements: complying with ISO 17025

In the context of “testing laboratory” one of the most important aspect to deal with is the measurement result. Whenever decisions are based on measurement results, it is important to have some indication of the quality of the results. In every area concerning with noise measurement many standards are available but without an expression of uncertainty, it is impossible to judge whether two results are in compliance or not. ISO/IEC 17025 is an international standard related with the competence of calibration and testing laboratories. It contains the requirements that testing and calibration laboratories have to meet if they wish to demonstrate that they operate to a quality system, are technically competent and are able to generate technically valid results. ISO/IEC 17025 deals specifically with the requirements for the competence of laboratories performing testing and calibration and for the reporting of the results, which may or may not contain opinions and interpretations of the results. The standard requires appropriate methods of analysis to be used for estimating uncertainty of measurement. In this point of view, for a testing laboratory performing sound power measurement according to specific ISO standards and European Directives, the measurement of uncertainties is the most important factor to deal with. Sound power level measurement, according to ISO 3744:1994 , performed with a limited number of microphones distributed over a surface enveloping a source is affected by a certain systematic error and a related standard deviation. Making a comparison of measurement carried out with different microphone arrays is difficult because results are affected by systematic errors and standard deviation that are peculiarities of the number of microphones disposed on the surface, their spatial position and the complexity of the sound field. A statistical approach could give an overview of the difference between sound power level evaluated with different microphone arrays and an evaluation of errors that afflict this kind of measurement. Despite the classical approach that tend to follow the ISO GUM this thesis present a different point of view of the problem related to the comparison of result obtained from different microphone arrays.

Progetto di reti Sensori Wireless e tecniche di Fusione Sensoriale

Ambient Intelligence (AmI) envisions a world where smart, electronic environments are aware and responsive to their context. People moving into these settings engage many computational devices and systems simultaneously even if they are not aware of their presence. AmI stems from the convergence of three key technologies: ubiquitous computing, ubiquitous communication and natural interfaces. The dependence on a large amount of fixed and mobile sensors embedded into the environment makes of Wireless Sensor Networks one of the most relevant enabling technologies for AmI. WSN are complex systems made up of a number of sensor nodes, simple devices that typically embed a low power computational unit (microcontrollers, FPGAs etc.), a wireless communication unit, one or more sensors and a some form of energy supply (either batteries or energy scavenger modules). Low-cost, low-computational power, low energy consumption and small size are characteristics that must be taken into consideration when designing and dealing with WSNs. In order to handle the large amount of data generated by a WSN several multi sensor data fusion techniques have been developed. The aim of multisensor data fusion is to combine data to achieve better accuracy and inferences than could be achieved by the use of a single sensor alone. In this dissertation we present our results in building several AmI applications suitable for a WSN implementation. The work can be divided into two main areas: Multimodal Surveillance and Activity Recognition. Novel techniques to handle data from a network of low-cost, low-power Pyroelectric InfraRed (PIR) sensors are presented. Such techniques allow the detection of the number of people moving in the environment, their direction of movement and their position. We discuss how a mesh of PIR sensors can be integrated with a video surveillance system to increase its performance in people tracking. Furthermore we embed a PIR sensor within the design of a Wireless Video Sensor Node (WVSN) to extend its lifetime. Activity recognition is a fundamental block in natural interfaces. A challenging objective is to design an activity recognition system that is able to exploit a redundant but unreliable WSN. We present our activity in building a novel activity recognition architecture for such a dynamic system. The architecture has a hierarchical structure where simple nodes performs gesture classification and a high level meta classifiers fuses a changing number of classifier outputs. We demonstrate the benefit of such architecture in terms of increased recognition performance, and fault and noise robustness. Furthermore we show how we can extend network lifetime by performing a performance-power trade-off. Smart objects can enhance user experience within smart environments. We present our work in extending the capabilities of the Smart Micrel Cube (SMCube), a smart object used as tangible interface within a tangible computing framework, through the development of a gesture recognition algorithm suitable for this limited computational power device. Finally the development of activity recognition techniques can greatly benefit from the availability of shared dataset. We report our experience in building a dataset for activity recognition. Such dataset is freely available to the scientific community for research purposes and can be used as a testbench for developing, testing and comparing different activity recognition techniques.

Body ares networks for human motor assessment

Healthcare, Human Computer Interfaces (HCI), Security and Biometry are the most promising application scenario directly involved in the Body Area Networks (BANs) evolution. Both wearable devices and sensors directly integrated in garments envision a word in which each of us is supervised by an invisible assistant monitoring our health and daily-life activities. New opportunities are enabled because improvements in sensors miniaturization and transmission efficiency of the wireless protocols, that achieved the integration of high computational power aboard independent, energy-autonomous, small form factor devices. Application’s purposes are various: (I) data collection to achieve off-line knowledge discovery; (II) user notification of his/her activities or in case a danger occurs; (III) biofeedback rehabilitation; (IV) remote alarm activation in case the subject need assistance; (V) introduction of a more natural interaction with the surrounding computerized environment; (VI) users identification by physiological or behavioral characteristics. Telemedicine and mHealth [1] are two of the leading concepts directly related to healthcare. The capability to borne unobtrusiveness objects supports users’ autonomy. A new sense of freedom is shown to the user, not only supported by a psychological help but a real safety improvement. Furthermore, medical community aims the introduction of new devices to innovate patient treatments. In particular, the extension of the ambulatory analysis in the real life scenario by proving continuous acquisition. The wide diffusion of emerging wellness portable equipment extended the usability of wearable devices also for fitness and training by monitoring user performance on the working task. The learning of the right execution techniques related to work, sport, music can be supported by an electronic trainer furnishing the adequate aid. HCIs made real the concept of Ubiquitous, Pervasive Computing and Calm Technology introduced in the 1988 by Marc Weiser and John Seeley Brown. They promotes the creation of pervasive environments, enhancing the human experience. Context aware, adaptive and proactive environments serve and help people by becoming sensitive and reactive to their presence, since electronics is ubiquitous and deployed everywhere. In this thesis we pay attention to the integration of all the aspects involved in a BAN development. Starting from the choice of sensors we design the node, configure the radio network, implement real-time data analysis and provide a feedback to the user. We present algorithms to be implemented in wearable assistant for posture and gait analysis and to provide assistance on different walking conditions, preventing falls. Our aim, expressed by the idea to contribute at the development of a non proprietary solutions, driven us to integrate commercial and standard solutions in our devices. We use sensors available on the market and avoided to design specialized sensors in ASIC technologies. We employ standard radio protocol and open source projects when it was achieved. The specific contributions of the PhD research activities are presented and discussed in the following. • We have designed and build several wireless sensor node providing both sensing and actuator capability making the focus on the flexibility, small form factor and low power consumption. The key idea was to develop a simple and general purpose architecture for rapid analysis, prototyping and deployment of BAN solutions. Two different sensing units are integrated: kinematic (3D accelerometer and 3D gyroscopes) and kinetic (foot-floor contact pressure forces). Two kind of feedbacks were implemented: audio and vibrotactile. • Since the system built is a suitable platform for testing and measuring the features and the constraints of a sensor network (radio communication, network protocols, power consumption and autonomy), we made a comparison between Bluetooth and ZigBee performance in terms of throughput and energy efficiency. Test in the field evaluate the usability in the fall detection scenario. • To prove the flexibility of the architecture designed, we have implemented a wearable system for human posture rehabilitation. The application was developed in conjunction with biomedical engineers who provided the audio-algorithms to furnish a biofeedback to the user about his/her stability. • We explored off-line gait analysis of collected data, developing an algorithm to detect foot inclination in the sagittal plane, during walk. • In collaboration with the Wearable Lab – ETH, Zurich, we developed an algorithm to monitor the user during several walking condition where the user carry a load. The remainder of the thesis is organized as follows. Chapter I gives an overview about Body Area Networks (BANs), illustrating the relevant features of this technology and the key challenges still open. It concludes with a short list of the real solutions and prototypes proposed by academic research and manufacturers. The domain of the posture and gait analysis, the methodologies, and the technologies used to provide real-time feedback on detected events, are illustrated in Chapter II. The Chapter III and IV, respectively, shown BANs developed with the purpose to detect fall and monitor the gait taking advantage by two inertial measurement unit and baropodometric insoles. Chapter V reports an audio-biofeedback system to improve balance on the information provided by the use centre of mass. A walking assistant based on the KNN classifier to detect walking alteration on load carriage, is described in Chapter VI.

In-situ Messung großer Hydrometeore mit Hilfe der In-line-Holographie

In-situ Messung großer Hydrometeore mit Hilfe derIn-line-Holographie Diese Dissertation beschreibt die Entwicklung und Erprobungeiner Apparatur zur holographischen In-situ-Messung großerHydrometeore (HODAR). Dazu wird eine dreidimensionaleMomentaufnahme eines etwa 500 dm³ großes Meßvolumen derfreien Atmosphäre mittels der In-line-Holographieaufgezeichnet. In dieser Aufnahme kann die Größe und Formeinzelner Hydrometeore, aber auch ihre Position imMeßvolumen ausgemessen werden. Daraus sind Größen- undAbstandsverteilungen der Hydrometeore zu bestimmen. MitHilfe von Doppelbelichtungen lassen sich zusätzlich auchihre Geschwindigkeiten ermitteln.Im Verlauf dieser Arbeit werden zunächst die Hydrometeorevorgestellt. Die theoretischen Möglichkeiten einer Apparaturzur In-situ-Messung werden aus den Eigenschaften desholographischen Bildes entwickelt. Anschließend wird derverwirklichte Aufbau des HODAR erläutert. Kalibrierung undTest, sowie Messungen, die die Fähigkeiten des HODAR unterBeweis stellen, werden beschrieben.

Zentrale cholinerge Wirkungen von Hyperforin, einem Inhaltsstoff des Johanniskrauts

Die vorliegende Arbeit beschreibt die Wirkung von Hyperforin, einem Johanniskraut-Inhaltsstoff, auf das zentrale cholinerge System. Da der HACU Na+-abhängig operiert und Hyperforin den transmembranären Na+-Gradienten verringert, wurde an Rattenkortex-Synaptosomen in vitro geprüft, ob der HACU durch Hyperforin gehemmt wird. Es wurde gefunden, dass Hyperforin den HACU mit einer Hemmkonstante IC50 von 8.5 µM inhibiert. Da die de novo-ACh-Synthese direkt HACU-Aktivitäts-abhängig ist, wurde in vivo mittels Mikrodialyse-Technik verifziert, ob die cholinerge Transmission beeinflusst wird. Lokale Infusionen von 100 µM Hyperforin in das Striatum resultierten in einer Reduktion der ACh-Freisetzung bei parallelem Ch-Spiegel-Anstieg bedingt durch die HACU-Inhibition. Infusionen niedrigerer Konzentration (10 und 30 µM) führten hingegen zu einer konzentrations-abhängigen Stimulation der ACh-Freisetzung bei simultaner Ch-Spiegel-Senkung. Systemische Applikation von 1 und 10 mg/kg i.p. resultierten in einer verstärkten ACh-Freisetzung im Striatum und im Hippokampus; diese Dosen führen zu therapeutisch relevanten Plasmaspiegeln. Die Ergebnisse im Striatum und im Hippokampus erklären die motilitätsverringernden Effekte im Tierexperiment bzw. die benignen Effekte in Verhaltensmodellen für Lernen und Gedächtnis. Die vergleichende Analyse der Mikrodialyse-Experimente ergab, dass eine antidepressive Johanniskraut-Begleitmedikation bei Parkinson ungünstig, jedoch Alzheimer günstig zu bewerten ist.

Architettura e verità. Emil Steffann architetto di chiese

La ricerca pone al suo centro lo studio dell'opera architettonica di Emil Steffann (1899-1968) la cui produzione realizzata consta, nel breve arco temporale che va dal 1950 al 1968, del ragguardevole numero di trentanove chiese, rappresentando un caso emblematico di progettazione e costruzione di edifici per il culto cristiano in grado di raffigurarne concretamente i principi fondativi liturgici, estetici e morfologici. L'architettura di Steffann, profondamente ispirata dallo spirito religioso, legata a figure primigenie che plasmano lo stare-insieme della comunità nella qualità corporea della materia, dove la presenza liturgica e monumentale si esprime nel silenzio e nella disponibilità di uno spazio circoscritto dai muri e direzionato dalla luce, concorre a definire nell'oggettivo amore per il vero la percezione estetico-teologica e la poetica formativa che connaturano, a nostro parere, progetto e segno della chiesa. Il testo concretizza il primo studio monografico completo di questo corpus architettonico e si basa sulla ricognizione diretta delle opere di Steffann; ne è derivata una narrazione non conseguente a un ordine cronologico o di presupposta importanza degli edifici, bensì che ricerca ed evidenzia corrispondenze tra nodi di una rete ideativa la quale, con diversi gradi di finitezza, in punti non sempre omogenei del tempo e dello spazio, denota un'esperienza autentica del comporre e del costruire. Il racconto individua gli oggetti architettonici, ne discute la consistenza aprendosi a riferimenti altri (in particolare il pensiero ecclesiologico-liturgico di Romano Guardini e quello estetico-teologico di Hans Urs von Balthasar) in grado di illuminarne la genesi e la manifestazione, li lega infine in sequenze analogiche. Una serie di tavole fotografiche originali, parte ineludibile e integrante della ricerca, testimonia dello stato attuale dei luoghi, connotando ulteriormente l'aspetto info-rappresentativo della loro composizione architettonica. In chiusura, la sintesi architetturale vuole essere uno strumento di verifica e progetto, quindi di trasposizione futura, correlato all'elaborazione documentaria.

Numerical methods for the dispersion analysis of Guided Waves

The use of guided ultrasonic waves (GUW) has increased considerably in the fields of non-destructive (NDE) testing and structural health monitoring (SHM) due to their ability to perform long range inspections, to probe hidden areas as well as to provide a complete monitoring of the entire waveguide. Guided waves can be fully exploited only once their dispersive properties are known for the given waveguide. In this context, well stated analytical and numerical methods are represented by the Matrix family methods and the Semi Analytical Finite Element (SAFE) methods. However, while the former are limited to simple geometries of finite or infinite extent, the latter can model arbitrary cross-section waveguides of finite domain only. This thesis is aimed at developing three different numerical methods for modelling wave propagation in complex translational invariant systems. First, a classical SAFE formulation for viscoelastic waveguides is extended to account for a three dimensional translational invariant static prestress state. The effect of prestress, residual stress and applied loads on the dispersion properties of the guided waves is shown. Next, a two-and-a-half Boundary Element Method (2.5D BEM) for the dispersion analysis of damped guided waves in waveguides and cavities of arbitrary cross-section is proposed. The attenuation dispersive spectrum due to material damping and geometrical spreading of cavities with arbitrary shape is shown for the first time. Finally, a coupled SAFE-2.5D BEM framework is developed to study the dispersion characteristics of waves in viscoelastic waveguides of arbitrary geometry embedded in infinite solid or liquid media. Dispersion of leaky and non-leaky guided waves in terms of speed and attenuation, as well as the radiated wavefields, can be computed. The results obtained in this thesis can be helpful for the design of both actuation and sensing systems in practical application, as well as to tune experimental setup.

Differential expression analysis for sequence count data via mixtures of negative binomials

The recent advent of Next-generation sequencing technologies has revolutionized the way of analyzing the genome. This innovation allows to get deeper information at a lower cost and in less time, and provides data that are discrete measurements. One of the most important applications with these data is the differential analysis, that is investigating if one gene exhibit a different expression level in correspondence of two (or more) biological conditions (such as disease states, treatments received and so on). As for the statistical analysis, the final aim will be statistical testing and for modeling these data the Negative Binomial distribution is considered the most adequate one especially because it allows for "over dispersion". However, the estimation of the dispersion parameter is a very delicate issue because few information are usually available for estimating it. Many strategies have been proposed, but they often result in procedures based on plug-in estimates, and in this thesis we show that this discrepancy between the estimation and the testing framework can lead to uncontrolled first-type errors. We propose a mixture model that allows each gene to share information with other genes that exhibit similar variability. Afterwards, three consistent statistical tests are developed for differential expression analysis. We show that the proposed method improves the sensitivity of detecting differentially expressed genes with respect to the common procedures, since it is the best one in reaching the nominal value for the first-type error, while keeping elevate power. The method is finally illustrated on prostate cancer RNA-seq data.

The scintillating fiber focal plane detector for the use of Kaos as a double arm spectrometer

The upgrade of the Mainz Mikrotron (MAMI) electron accelerator facility in 2007 which raised the beam energy up to 1.5,GeV, gives the opportunity to study strangeness production channels through electromagnetic process. The Kaon Spectrometer (KAOS) managed by the A1 Collaboration, enables the efficient detection of the kaons associated with strangeness electroproduction. Used as a single arm spectrometer, it can be combined with the existing high-resolution spectrometers for exclusive measurements in the kinematic domain accessible to them.rnrnFor studying hypernuclear production in the ^A Z(e,e'K^+) _Lambda ^A(Z-1) reaction, the detection of electrons at very forward angles is needed. Therefore, the use of KAOS as a double-arm spectrometer for detection of kaons and the electrons at the same time is mandatory. Thus, the electron arm should be provided with a new detector package, with high counting rate capability and high granularity for a good spatial resolution. To this end, a new state-of-the-art scintillating fiber hodoscope has been developed as an electron detector.rnrnThe hodoscope is made of two planes with a total of 18432 scintillating double-clad fibers of 0.83 mm diameter. Each plane is formed by 72 modules. Each module is formed from a 60deg slanted multi-layer bundle, where 4 fibers of a tilted column are connected to a common read out. The read-out is made with 32 channels of linear array multianode photomultipliers. Signal processing makes use of newly developed double-threshold discriminators. The discriminated signal is sent in parallel to dead-time free time-to-digital modules and to logic modules for triggering purposes.rnrnTwo fiber modules were tested with a carbon beam at GSI, showing a time resolution of 220 ps (FWHM) and a position residual of 270 microm m (FWHM) with a detection efficiency epsilon>99%.rnrnThe characterization of the spectrometer arm has been achieved through simulations calculating the transfer matrix of track parameters from the fiber detector focal plane to the primary vertex. This transfer matrix has been calculated to first order using beam transport optics and has been checked by quasielastic scattering off a carbon target, where the full kinematics is determined by measuring the recoil proton momentum. The reconstruction accuracy for the emission parameters at the quasielastic vertex was found to be on the order of 0.3 % in first test realized.rnrnThe design, construction process, commissioning, testing and characterization of the fiber hodoscope are presented in this work which has been developed at the Institut für Kernphysik of the Johannes Gutenberg - Universität Mainz.

L’effetto “età della Terra”. Contratto didattico e principi regolativi dell’azione degli studenti in matematica.

L’oggetto di questa tesi è un fenomeno didattico osservato in due valutazioni standardizzate nazionali INVALSI, legato all’atteggiamento degli studenti mentre svolgono task di matematica. L’effetto, che abbiamo denotato effetto “età della Terra”, è stato interpretato in questa ricerca attraverso l’interazione e il confronto di diversi costrutti teorici che spiegano come questo effetto, che può essere considerato come una tipica situazione di contratto didattico, è generato dalla relazione studente-insegnante ma può diventare più strettamente legato al rapporto che hanno gli studenti con la matematica. Inizialmente abbiamo condotto uno studio dei risultati statistici delle valutazioni standardizzate nazionali (Rash Analysis). Il primo step della sperimentazione è consistito nella preparazione, validazione e somministrazione di 612 questionari a studenti di diversi livelli scolastici e basandoci sui risultati dei questionari abbiamo condotto interviste di gruppo. L’analisi quantitativa e qualitativa dei risultati ha confermato la presenza dell’effetto “età della Terra” e ha mostrato che questo effetto è indipendente dal livello scolastico e dall’età degli studenti, dal contenuto matematico e dal contesto dei task proposti. La seconda parte della ricerca è stata volta ad indagare la cause di questo effetto. Abbiamo infatti individuato un principio regolativo che condizione l’azione degli studenti mentre fanno attività matematica e abbiamo condotto molte interviste individuali per indagarlo. Il comportamento degli studenti intervistati è stato così studiato e classificato con i costrutti del quadro teorico.

Etablierung eines high content imaging-basierten in vitro Testsystems zur Evaluierung genotoxischer Substanzen

Zur Registrierung von Pharmazeutika ist eine umfassende Analyse ihres genotoxischen Potentials von Nöten. Aufgrund der Vielzahl genotoxischer Mechanismen und deren resultierenden Schäden wird ein gestaffeltes Testdesign durch die ICH-Richtlinie S2(R1) „Guidance on genotoxicity testing and data interpretation for pharmaceuticals intended for human use S2(R1)“ definiert, um alle genotoxischen Substanzen zu identifizieren. Die Standardtestbatterie ist in der frühen Phase der Arzneimittelentwicklung aufgrund des geringen Durchsatzes und des Mangels an verfügbarer Substanzmenge vermindert anwendbar. Darüber hinaus verfügen in vitro Genotoxizitätstests in Säugerzellen über eine relativ geringe Spezifität. Für eine vollständige Sicherheitsbeurteilung wird eine in vivo Testung auf Kanzerogenität benötigt. Allerdings sind diese Testsysteme kosten- und zeitintensiv. Aufgrund dessen zielen neue Forschungsansätze auf die Verbesserung der Prädiktivität und die Erfassung des genotoxischen Potentials bereits in der frühen Phase der Arzneimittelentwicklung ab. Die high content imaging (HCI)-Technologie offeriert einen Ansatz zur Verbesserung des Durchsatzes verglichen mit der Standardtestbatterie. Zusätzlich hat ein Zell-basiertes Modell den Vorteil Daten relativ schnell bei gleichzeitig geringem Bedarf an Substanzmenge zu generieren. Demzufolge ermöglichen HCI-basierte Testsysteme eine Prüfung in der frühen Phase der pharmazeutischen Arzneimittelentwicklung. Das Ziel dieser Studie ist die Entwicklung eines neuen, spezifischen und sensitiven HCI-basierten Testsytems für Genotoxine und Progenotoxine in vitro unter Verwendung von HepG2-Zellen gewesen. Aufgrund ihrer begrenzten metabolischen Kapazität wurde ein kombiniertes System bestehend aus HepG2-Zellen und einem metabolischen Aktivierungssystem zur Testung progenotoxischer Substanzen etabliert. Basierend auf einer vorherigen Genomexpressionsprofilierung (Boehme et al., 2011) und einer Literaturrecherche wurden die folgenden neun unterschiedlichen Proteine der DNA-Schadensantwort als putative Marker der Substanz-induzierten Genotoxizität ausgewählt: p-p53 (Ser15), p21, p-H2AX (Ser139), p-Chk1 (Ser345) p-ATM (Ser1981), p-ATR (Ser428), p-CDC2 (Thr14/Tyr15), GADD45A und p-Chk2 (Thr68). Die Expression bzw. Aktivierung dieser Proteine wurde 48 h nach Behandlung mit den (pro-) genotoxischen Substanzen (Cyclophosphamid, 7,12-Dimethylbenz[a]anthracen, Aflatoxin B1, 2-Acetylaminofluoren, Methylmethansulfonat, Actinomycin D, Etoposid) und den nicht-genotoxischen Substanzen (D-Mannitol, Phenforminhydrochlorid, Progesteron) unter Verwendung der HCI-Technologie ermittelt. Die beste Klassifizierung wurde bei Verwendung der folgenden fünf der ursprünglichen neun putativen Markerproteine erreicht: p-p53 (Ser15), p21, p-H2AX (Ser139), p-Chk1 (Ser345) und p-ATM (Ser1981). In einem zweiten Teil dieser Arbeit wurden die fünf ausgewählten Proteine mit Substanzen, welche von dem European Centre for the Validation of Alternative Methods (ECVAM) zur Beurteilung der Leistung neuer oder modifizierter in vitro Genotoxizitätstests empfohlen sind, getestet. Dieses neue Testsystem erzielte eine Sensitivität von 80 % und eine Spezifität von 86 %, was in einer Prädiktivität von 84 % resultierte. Der synergetische Effekt dieser fünf Proteine ermöglicht die Identifizierung von genotoxischen Substanzen, welche DNA-Schädigungen durch eine Vielzahl von unterschiedlichen Mechanismen induzieren, mit einem hohen Erfolg. Zusammenfassend konnte ein hochprädiktives Prüfungssystem mit metabolischer Aktivierung für ein breites Spektrum potenziell genotoxischer Substanzen generiert werden, welches sich aufgrund des hohen Durchsatzes, des geringen Zeitaufwandes und der geringen Menge benötigter Substanz zur Substanzpriorisierung und -selektion in der Phase der Leitstrukturoptimierung eignet und darüber hinaus mechanistische Hinweise auf die genotoxische Wirkung der Testsubstanz liefert.

Prioritising prevention strategies for patients in antiretroviral treatment programmes in resource-limited settings

Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely.

Risk stratification of normotensive patients with acute symptomatic pulmonary embolism

Treatment guidelines recommend strong consideration of thrombolysis in patients with acute symptomatic pulmonary embolism (PE) that present with arterial hypotension or shock because of the high risk of death in this setting. For haemodynamically stable patients with PE, the categorization of risk for subgroups may assist with decision-making regarding PE therapy. Clinical models [e.g. Pulmonary Embolism Severity Index (PESI)] may accurately identify those at low risk of overall death in the first 3 months after the diagnosis of PE, and such patients might benefit from an abbreviated hospital stay or outpatient therapy. Though some evidence suggests that a subset of high-risk normotensive patients with PE may have a reasonable risk to benefit ratio for thrombolytic therapy, single markers of right ventricular dysfunction (e.g. echocardiography, spiral computed tomography, or brain natriuretic peptide testing) and myocardial injury (e.g. cardiac troponin T or I testing) have an insufficient positive predictive value for PE-specific mortality to drive decision-making toward such therapy. Recommendations for outpatient treatment or thrombolytic therapy for patients with PE necessitate further development of prognostic models and conduct of clinical trials that assess various treatment strategies.

Identification of selective norbornane-type aspartate analogue inhibitors of the glutamate transporter 1 (GLT-1) from the chemical universe generated database (GDB)

A variety of conformationally constrained aspartate and glutamate analogues inhibit the glutamate transporter 1 (GLT-1, also known as EAAT2). To expand the search for such analogues, a virtual library of aliphatic aspartate and glutamate analogues was generated starting from the chemical universe database GDB-11, which contains 26.4 million possible molecules up to 11 atoms of C, N, O, F, resulting in 101026 aspartate analogues and 151285 glutamate analogues. Virtual screening was realized by high-throughput docking to the glutamate binding site of the glutamate transporter homologue from Pyrococcus horikoshii (PDB code: 1XFH ) using Autodock. Norbornane-type aspartate analogues were selected from the top-scoring virtual hits and synthesized. Testing and optimization led to the identification of (1R*,2R*,3S*,4R*,6R*)-2-amino-6-phenethyl-bicyclo[2.2.1]heptane-2,3-dicarboxylic acid as a new inhibitor of GLT-1 with IC(50) = 1.4 ?M against GLT-1 and no inhibition of the related transporter EAAC1. The systematic diversification of known ligands by enumeration with help of GDB followed by virtual screening, synthesis, and testing as exemplified here provides a general strategy for drug discovery.

Immediate Search in the IDE as an Example of Socio-Technical Congruence in Search-Driven Development

Search-driven development is mainly concerned with code reuse but also with code navigation and debugging. In this essay we look at search-driven navigation in the IDE. We consider Smalltalk-80 as an example of a programming system with search-driven navigation capabilities and explore its human factors. We present how immediate search results lead to a user experience of code browsing rather than one of waiting for and clicking through search results. We explore the socio-technical congruence of immediate search, ie unification of tasks and breakpoints with method calls, which leads to simpler and more extensible development tools. Eventually we conclude with remarks on the socio-technical congruence of search-driven development.