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In this paper, we proceed to discuss the various implications and concepts related to the hardware and software used in our proposed system of fingerprint authentication for ATM card transactions. This paper refers to many different sources based on the techniques that are being used in the system, i.e. a RFID scanner, RFID tags, a Fingerprint scanner, the Adafruit library and RESTful APIs.

Metabolites are small molecules involved in cellular metabolism where they act as reaction substrates or products. The term ‘metabolomics’ refers to the comprehensive study of these molecules. The concentrations of metabolites in biological tissues are under genetic control, but this is limited by environmental factors such as diet. In adult mono- and dizygotic twin pairs, we estimated the contribution of genetic and shared environmental influences on metabolite levels by structural equation modeling and tested whether the familial resemblance for metabolite levels is mainly explained by genetic or by environmental factors that are shared by family members. Metabolites were measured across three platforms: two based on proton nuclear magnetic resonance techniques and one employing mass spectrometry. These three platforms comprised 237 single metabolic traits of several chemical classes. For the three platforms, metabolites were assessed in 1407, 1037 and 1116 twin pairs, respectively. We carried out power calculations to establish what percentage of shared environmental variance could be detected given these sample sizes. Our study did not find evidence for a systematic contribution of shared environment, defined as the influence of growing up together in the same household, on metabolites assessed in adulthood. Significant heritability was observed for nearly all 237 metabolites; significant contribution of the shared environment was limited to 6 metabolites. The top quartile of the heritability distribution was populated by 5 of the 11 investigated chemical classes. In this quartile, metabolites of the class lipoprotein were significantly overrepresented, whereas metabolites of classes glycerophospholipids and glycerolipids were significantly underrepresented.

The original version of the Supplementary Information associated with this Article included an incorrect Supplementary Data 1 file, in which additional delimiters were included in the first column for a number of rows, resulting in column shifts for some of these rows. The HTML has been updated to include a corrected version of Supplementary Data 1; the original incorrect version of Supplementary Data 1 can be found as Supplementary Information associated with this Correction. In addition, the original version of this Article contained an error in the author affiliations. An affiliation of Abdel Abdellaoui with Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands was inadvertently omitted. This has now been corrected in both the PDF and HTML versions of the Article.

Correction to: Nature Communications https://doi.org/10.1038/s41467-019-13770-6, published online 7 January 2020.The original version of the Supplementary Information associated with this Article included an incorrect Supplementary Data 1 file, in which additional delimiters were included in the first column for a number of rows, resulting in column shifts for some of these rows. The HTML has been updated to include a corrected version of Supplementary Data 1; the original incorrect version of Supplementary Data 1 can be found as Supplementary Information associated with this Correction.

The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently as new data become available.

Metabolomics examines the small molecules involved in cellular metabolism. Approximately 50% of total phenotypic differences in metabolite levels is due to genetic variance, but heritability estimates differ across metabolite classes. We perform a review of all genome-wide association and (exome-) sequencing studies published between November 2008 and October 2018, and identify >800 class-specific metabolite loci associated with metabolite levels. In a twin-family cohort (N = 5117), these metabolite loci are leveraged to simultaneously estimate total heritability (h2total), and the proportion of heritability captured by known metabolite loci (h2Metabolite-hits) for 309 lipids and 52 organic acids. Our study reveals significant differences in h2Metabolite-hits among different classes of lipids and organic acids. Furthermore, phosphatidylcholines with a high degree of unsaturation have higher h2Metabolite-hits estimates than phosphatidylcholines with low degrees of unsaturation. This study highlights the importance of common genetic variants for metabolite levels, and elucidates the genetic architecture of metabolite classes., Blood metabolite levels are under the influence of environmental and genetic factors. Here, Hagenbeek et al. perform heritability estimations for metabolite measures and determine the contribution of known metabolite loci to metabolite levels using data from 40 genome-wide association studies.

Introduction: To compare the outcomes of women who were initially managed by intrauterine balloon tamponade or uterine artery embolization because of persistent postpartum hemorrhage demanding an immediate intervention to control bleeding.Material and Methods: Propensity score-matched cohort study including women who had intrauterine balloon tamponade or uterine artery embolization as initial management strategy to control persistent postpartum hemorrhage, that is, refractory to first-line therapy combined with at least one uterotonic agent. The primary outcome measure was a composite of peripartum hysterectomy and/or maternal mortality. Secondary outcomes measures were total volume of blood loss and total number of packed red blood cells transfused.Results: Our 1:1 propensity score-matched cohort comprised of 50 women who had intrauterine balloon tamponade and 50 women who underwent uterine artery embolization at a blood loss between 1000 and 7000 mL. There was no statistically significant difference in the hysterectomy risk between the two groups (n = 6 in each group, odds ratio [OR] 1.00, 95% confidence interval [CI] .30-3.34), in total volume of blood loss (median 4500 mL, interquartile range [IQR] 3600-5400) for balloon vs 4000 mL (IQR 3250-5000) for embolization, P = 0.382) or in total units of packed red blood cells transfused (median 7 (IQR 5-10) for balloon vs 6 [IQR 4-9] for embolization, P = 0.319). Fifteen women (30%) who were initially managed by an intrauterine balloon still underwent uterine artery embolization, of whom one had an embolization-related thrombo-embolic event. Maternal mortality occurred in neither of the intervention groups.Conclusions: No difference in the risk of peripartum hysterectomy and/or maternal death was observed between women who had intrauterine balloon tamponade and women who underwent uterine artery embolization as an initial management for persistent postpartum hemorrhage. Although this study was underpowered to demonstrate equivalence, our study design provides a framework for future research in which intrauterine balloon tamponade may prove to be a suitable intervention of first choice in the management of persistent postpartum hemorrhage.

This cohort study examines the association of timing of receipt of plasma transfusions among women experiencing persistent postpartum hemorrhage with adverse maternal outcomes., Key Points Question Is plasma transfusion within the first 60 minutes of persistent postpartum hemorrhage (PPH) associated with incidence of maternal adverse outcomes? Findings In this cohort study of 114 propensity score–matched women with persistent PPH, plasma transfusion within the first 60 minutes of persistent PPH was not associated with incidence of maternal adverse outcomes compared with no or later plasma transfusion, independent of severity of PPH at the time of plasma transfusion. Meaning These findings do not support the theory that early plasma transfusion in women with persistent PPH is better than no or later plasma transfusion., Importance Early plasma transfusion for women with severe postpartum hemorrhage (PPH) is recommended to prevent coagulopathy. However, there is no comparative, quantitative evidence on the association of early plasma transfusion with maternal outcomes. Objective To compare the incidence of adverse maternal outcomes among women who received plasma during the first 60 minutes of persistent PPH vs women who did not receive plasma for similarly severe persistent PPH. Design, Setting, and Participants This multicenter cohort study used a consecutive sample of women with persistent PPH, defined as PPH refractory to first-line measures to control bleeding, between January 1, 2011, and January 1, 2013. Time-dependent propensity score matching was used to select women who received plasma during the first 60 minutes of persistent PPH and match each of them with a woman who had shown the same severity and received the same treatment of PPH but who had not received plasma at the moment of matching. Transfusions were not guided by coagulation tests. Statistical analysis was performed from June 2018 to June 2019. Exposures Transfusion of plasma during the first 60 minutes of persistent PPH vs no or later plasma transfusion. Main Outcomes and Measures Incidence of adverse maternal outcomes, defined as a composite of death, hysterectomy, or arterial embolization. Results This study included 1216 women (mean [SD] age, 31.6 [5.0] years) with persistent PPH, of whom 932 (76.6%) delivered vaginally and 780 (64.1%) had PPH caused by uterine atony. Seven women (0.6%) died because of PPH, 62 women (5.1%) had a hysterectomy, and 159 women (13.1%) had arterial embolizations. Among women who received plasma during the first 60 minutes of persistent PPH, 114 women could be matched with a comparable woman who had not received plasma at the moment of matching. The incidence of adverse maternal outcomes was similar between the women, with adverse outcomes recorded in 24 women (21.2%) who received early plasma transfusion and 23 women (19.9%) who did not receive early plasma transfusion (odds ratio, 1.09; 95% CI, 0.57-2.09). Results of sensitivity analyses were comparable to the primary results. Conclusions and Relevance In this cohort study, initiation of plasma transfusion during the first 60 minutes of persistent PPH was not associated with adverse maternal outcomes compared with no or later plasma transfusion, independent of severity of PPH.

Background and Objectives: In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA-1a antibodies. HPA-1a typing followed by screening for anti-HPA-1a antibodies in HPA-1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA-1a could be used to identify high-risk pregnancies. Materials and Methods: The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. Results: Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected cases of FNAIT. In 8 studies samples for antibody measurement, performed by the monoclonal antibody immobilization of platelet antigen (MAIPA) assay, and samples for determining fetal/neonatal platelet count were collected simultaneously. In these 8 studies, the maternal antibody level correlated with the risk of severe thrombocytopenia. The prospective studies reported high negative predictive values (88–95%), which would allow for the use of maternal anti-HPA-1a antibody level as a predictive tool in a screening setting, in order to identify cases at low risk for FNAIT. However, due to low positive predictive values reported in prospective as well as retrospective studies (54–97%), the maternal antibody level is less suited for the final diagnosis and for guiding antenatal treatment. Conclusion: HPA-1a antibody level has the potential to predict the severity of FNAIT. (Less)

Cynthia So-Osman Department of Transfusion Medicine, Sanquin Blood Supply, Leiden, the Netherlands Abstract: In elective hip and knee replacement surgery, the use of red blood cell transfusion alternatives has been widely accepted. However, nowadays, more evidence is accumulating that suggests some transfusion alternatives may no longer be cost effective. In this review, an evidence-based overview of the applied transfusion alternatives is provided, aiming for optimal and cost-effective patient blood management in elective hip and knee replacement surgery. Keywords: patient blood management, erythropoietin, autologous blood, cell salvage&nbsp

Objectives Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. Design Cross-sectional medical record review study. Setting Data were gathered in 23 Dutch hospitals. Participants 1163 THA and 986 TKA patient admissions. Outcomes Hospitals were ranked based on their observed/expected (O/E) ratios regarding allogeneic transfusion and extended LoS percentages (extended LoS was defined by postoperative stay >4 days). To assess the reliability of these rankings, we calculated which percentage of the existing variation was based on differences between hospitals as compared with random variation (after adjustment for variation in patient characteristics). Associations between hospital-specific factors and O/E ratios were used to explore potential sources of differences. Results The variation in O/E ratios between hospitals ranged from 0 to 4.4 for allogeneic transfusion, and from 0.08 to 2.7 for extended LoS. Variation in transfusion could in 21% be explained by hospital differences in THA and 34% in TKA. For extended LoS this was 71% in THA and 78% in TKA. Better performance (low O/E ratios) in transfusion was associated with more frequent tranexamic acid (TXA) use in TKA (R=−0.43, p=0.04). Better performance in extended LoS was associated with more frequent TXA use in THA (R=−0.45, p=0.03) and TKA (R=−0.65, p

Objectives Electronic forms of data collection have gained interest in recent years. In orthopaedics, little is known about patient preference regarding pen-and-paper or electronic questionnaires. We aimed to determine whether patients undergoing total hip (THR) or total knee replacement (TKR) prefer pen-and-paper or electronic questionnaires and to identify variables that predict preference for electronic questionnaires. Methods We asked patients who participated in a multi-centre cohort study investigating improvement in health-related quality of life (HRQoL) after THR and TKR using pen-and-paper questionnaires, which mode of questionnaire they preferred. Patient age, gender, highest completed level of schooling, body mass index (BMI), comorbidities, indication for joint replacement and pre-operative HRQoL were compared between the groups preferring different modes of questionnaire. We then performed logistic regression analyses to investigate which variables independently predicted preference of electronic questionnaires. Results A total of 565 THR patients and 387 TKR patients completed the preference question. Of the THR patients, 81.8% (95% confidence interval (CI) 78.4 to 84.7) preferred pen-and-paper questionnaires to electronic questionnaires, as did 86.8% (95% CI 83.1 to 89.8) of TKR patients. Younger age, male gender, higher completed level of schooling and higher BMI independently predicted preference of electronic questionnaires in THR patients. Younger age and higher completed level of schooling independently predicted preference of electronic questionnaires in TKR patients. Conclusions The majority of THR and TKR patients prefer pen-and-paper questionnaires. Patients who preferred electronic questionnaires differed from patients who preferred pen-and-paper questionnaires. Restricting the mode of patient-reported outcome measures to electronic questionnaires might introduce selection bias. Cite this article: Bone Joint Res 2013;2:238–44.

Los 10,6 millones de cabezas de ganado de Turquia comprenden un amplio abanico de razas y tipos; sin embargo, estos estan sufriendo una mayor erosion por el uso indiscriminado de genotipos foraneos. La estructura de la agricultura es tal que la mayoria de las explotaciones estan orientadas a la subsistencia, de pequeno tamano, manteniendo muy pocos animales y llevando a cabo una inversion minima. Las razas autoctonas se han desarrollado para satisfacer estas condiciones y, en general, estan muy bien adaptadas al medio en que se desarrollan, a una alimentacion pobre y desequilibrada y a diferentes enfermedades. A lo largo de los ultimos 80 anos se han producido grandes modificaciones del acervo genetico, motivo por el cual muchas de estas razas se encuentran en peligro de extincion o han llegado a extinguirse. Este trabajo describe algunas de los principales recursos geneticos de los animales domesticos que quedan y su estado conservacion. Actualmente el gobierno es consciente del peligro de empobrecimiento o de la perdida de esta importante parte de la biodiversidad y, para ello, ha puesto en marcha programas de conservacion y preservacion de varias razas autoctonas. Tanto el gobierno como los centros de investigacion, asi como los productores, deben trabajar conjuntamente para asegurar que el acervo genetico local se mantenga, y poder contribuir asi al desarrollo de la biodiversidad y a la produccion sostenible del ganado.

Muchos paises han implementado la crioconservacion para ayudar a que se gestionen mejor sus recursos zoogeneticos (AnGR por sus siglas en ingles). Un banco de germoplasma compuesto de varios paises puede desempenar un papel relevante en el esfuerzo ejercido a nivel internacional para la gestion de los AnGR. Para valorar mejor estas actividades, el Grupo de Trabajo Tecnico Intergubernamental de la Comision de Recursos Geneticos para la Alimentacion y la Agricultura, invito a la FAO a que informara acerca de la situacion de los programas nacionales e internacionales para el almacenamiento de AnGR. Por consiguiente, la FAO puso en marcha una encuesta sobre este tema en enero de 2010. El cuestionario estaba compuesto por 16 preguntas sobre varias materias relacionadas con la conservacion de los AnGR, incluyendo los bancos de germoplasma compuestos de varios paises. Se recibieron respuestas validas de 166 personas desde 90 paises. Muchos paises llevan a cabo la conservacion de AnGR, siendo los programas de conservacion in situ los mas comunes. El numero de programas de crioconservacion es aproximadamente la mitad del numero de programas de conservacion in situ para la mayoria de las especies de ganado. Se informo que en el 20% de los paises, aproximadamente, existen bancos de germoplasma totalmente operativos, y existen planes para la puesta en marcha de bancos de germoplasma a lo largo de los proximos cinco anos en un 50% adicional de los paises. La falta de apoyo financiero y la baja prioridad dentro de las politicas nacionales relativas al ganado fueron los obstaculos mas comunmente mencionados para la creacion de los bancos de germoplasma. Se tuvo conocimiento acerca de un reducido numero de bancos de germoplasma compuestos de varios paises; sin embargo, el interes en dichas actividades fue alto. Solo alrededor del 10% de los paises senalo tener aversion por los bancos de germoplasma compuestos de varios paises. Entre los factores que contribuyen a la falta de bancos de germoplasma compuestos de varios paises se encuentran la falta de financiacion, reglamentacion sobre el intercambio internacional de material genetico y la falta de consenso acerca del funcionamiento de los bancos de germoplasma.

The statistical properties of sequences of Waiting Times generated by Non-Homogeneous Poisson Processes are investigated by means of Renewal Aging, i.e. a statistical analysis being able to detect the presence of genuine renewal events with non-Poisson statistics. The Renewal Aging features of two non-homogeneous Poisson models with different prescriptions of the rate modulation are compared. Both prescriptions are essentially periodic. In the first model, the rate is a totally deterministic and smooth harmonic function. In the second model, the rate modulation is deterministic and smooth almost everywhere, except in some singular points occurring with a periodicity affected by weak random fluctuations. The main parameter of both models is the modulation speed, defined as the ratio between the modulation period and the average Waiting Time. This allows to distinguish between slow, intermediate and fast modulation of the rate. As expected, in the very slow modulation case both models have a strongly reduced Renewal Aging, practically zero, because the analysis is affected by local clusters of Waiting Times with the same Poisson rate. In the intermediate range of modulation speeds, both models show non-zero Renewal Aging and the behavior of the two models tends to be more different as the modulation speed decreases. Going towards the fast modulation regime, the behavior of the two models becomes completely different from one another. Model I does not show a definite global Renewal Aging. On the time scale of the modulation period, local oscillations arise in the Probability Density Function and an apparent oscillating aging is also observed. However, this form of aging is not the manifestation of genuine renewal non-Poisson events, but it is related to the local oscillations. On the contrary, Model II displays Renewal Aging features in agreement with a homogeneous Renewal non-Poisson Process. It is argued that this is related to the singular points in the rate modulation of Model II, which, due to their random occurrence, could be identified with genuine critical non-Poisson events. The approach presented here could have interesting applications in problems involving dichotomous noise and, in particular, in the statistical characterization of ON–OFF fluorescence intermittency experimentally observed in complex systems, such as nano-crystals and single bio-molecules stimulated by laser fields.

The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at ∈ European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better fu treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap. The EHA Roadmap identifies nine ‘sections’ in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders. The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients. © 2016 Ferrata Storti Foundation.