Towards a Security, Privacy, Dependability, Interoperability Framework for the Internet of Things

A popular application of ambient intelligence systems constitutes of assisting living services on smart buildings. As intelligence is imported in embedded equipment, the system becomes able to provide smart services (e.g. control lights, airconditioning, provide energy management services etc.). IoT is the main enabler of such environments. However, the interconnection of these cyber-physical systems and the processing of personal data raise serious security and privacy issues. In this paper we present a framework that can guarantee Security, Privacy, Dependability and Interoperability (SPDI) in IoT. Taking advantage of the underlying IoT deployment, the proposed framework not only implements the requested smart functionality but also provide modelling and administration that can guarantee those SPDI properties. Moreover, we provide an application example of the framework in a smart building scenario

The Interoperability of Things: Interoperable solutions as an enabler for IoT and Web 3.0

This paper presents an overview of the interoperability concepts along with the challenges for the IoT domain and the upcoming Web 3.0. We identify four levels of interoperability and the relevant solutions for accomplishing vertical and horizontal compatibility between the various layers of a modern IoT ecosystem, referred to as: technological, syntactic, semantic, and organizational interoperability. The goal is to achieve cross-domain interaction and facilitate the proper usage and management of the provided IoT services and applications. An interoperability framework is also proposed where the involved system components can cooperate and offer the seamless operation from the device to the backend framework. This by-design end-to-end interoperation enables the interplay of several complex service composition settings and the management of the system via patterns. The overall proposal is adopted by the EU funded project SEMIoTICS as an enabler towards the IoT and Web 3.0, even when products from different vendors are utilized

Developmental Regulation of an Adhesin Gene during Cellular Morphogenesis in the Fungal Pathogen Candida albicans

Peer reviewedPublisher PD

Fragmented in space: the oral history narrative of an Arab Christian from Antioch, Turkey

This study uses the case of Can Kılçıksız, an Arab Christian refugee youth from Antioch, Turkey, to argue that globalization may result in fragmented families and subjectivities and can also accelerate processes initiated by modernity and the construction of national identities. Can Kılçıksız and his siblings now live in Turkey, Germany, France and Finland. His life story suggests that males of Arab Christian origin from Antioch who had access to schooling are more likely to be involved in politics whereas females tend to be drawn to evangelical Christian organizations. The case also suggests that sibling ties might prove more durable in the course of transnational migration than conjugal ties. The case of Can Kılçıksız shows that the time/space linked to childhood through memory can play an important role in identity construction of subjects circulating in transnational space

Assessment of an Intervention to Reduce Aspirin Prescribing for Patients Receiving Warfarin for Anticoagulation

Importance: For some patients receiving warfarin, adding aspirin (acetylsalicylic acid) increases bleeding risk with unclear treatment benefit. Reducing excess aspirin use could be associated with improved clinical outcomes. Objective: To assess changes in aspirin use, bleeding, and thrombosis event rates among patients treated with warfarin. Design, Setting, and Participants: This pre-post observational quality improvement study was conducted from January 1, 2010, to December 31, 2019, at a 6-center quality improvement collaborative in Michigan among 6738 adults taking warfarin for atrial fibrillation and/or venous thromboembolism without an apparent indication for concomitant aspirin. Statistical analysis was conducted from November 26, 2020, to June 14, 2021. Intervention: Primary care professionals for patients taking aspirin were asked whether an ongoing combination aspirin and warfarin treatment was indicated. If not, then aspirin was discontinued with the approval of the managing clinician. Main Outcomes and Measures: Outcomes were assessed before and after intervention for the primary analysis and before and after 24 months before the intervention (when rates of aspirin use first began to decrease) for the secondary analysis. Outcomes included the rate of aspirin use, bleeding, and thrombotic outcomes. An interrupted time series analysis assessed cumulative monthly event rates over time. Results: A total of 6738 patients treated with warfarin (3160 men [46.9%]; mean [SD] age, 62.8 [16.2] years) were followed up for a median of 6.7 months (IQR, 3.2-19.3 months). Aspirin use decreased slightly from a baseline mean use of 29.4% (95% CI, 28.9%-29.9%) to 27.1% (95% CI, 26.1%-28.0%) during the 24 months before the intervention (P \u3c .001 for slope before and after 24 months before the intervention) with an accelerated decrease after the intervention (mean aspirin use, 15.7%; 95% CI, 14.8%-16.8%; P = .001 for slope before and after intervention). In the primary analysis, the intervention was associated with a significant decrease in major bleeding events per month (preintervention, 0.31%; 95% CI, 0.27%-0.34%; postintervention, 0.21%; 95% CI, 0.14%-0.28%; P = .03 for difference in slope before and after intervention). No change was observed in mean percentage of patients having a thrombotic event from before to after the intervention (0.21% vs 0.24%; P = .34 for difference in slope). In the secondary analysis, reducing aspirin use (starting 24 months before the intervention) was associated with decreases in mean percentage of patients having any bleeding event (2.3% vs 1.5%; P = .02 for change in slope before and after 24 months before the intervention), mean percentage of patients having a major bleeding event (0.31% vs 0.25%; P = .001 for change in slope before and after 24 months before the intervention), and mean percentage of patients with an emergency department visit for bleeding (0.99% vs 0.67%; P = .04 for change in slope before and after 24 months before the intervention), with no change in mean percentage of patients with a thrombotic event (0.20% vs 0.23%; P = .36 for change in slope before and after 24 months before the intervention). Conclusions and Relevance: This quality improvement intervention was associated with an acceleration of a preexisting decrease in aspirin use among patients taking warfarin for atrial fibrillation and/or venous thromboembolism without a clear indication for aspirin therapy. Reductions in aspirin use were associated with reduced bleeding. This study suggests that an anticoagulation clinic-based aspirin deimplementation intervention can improve guideline-concordant aspirin use

Outcomes of Direct Oral Anticoagulants with Aspirin Versus Warfarin with Aspirin for Atrial Fibrillation and/or Venous Thromboembolic Disease

Introduction: The direct oral anticoagulants (DOACs) including apixaban, dabigatran, edoxaban, and rivaroxaban are increasingly utilized for the management of venous thromboembolic disease (VTE) and/or non-valvular atrial fibrillation (NVAF). Adding aspirin (ASA) to warfarin or DOAC therapy increases bleeding risk. Patients on combination therapy with ASA and an anticoagulant were not well represented in clinical trials comparing DOACs to warfarin. We sought to compare bleeding and thrombotic outcomes with DOACs and ASA compared to warfarin and ASA in a non-trial setting. Methods: We conducted a retrospective registry-based cohort study of adults on DOAC or warfarin therapy for VTE and/or NVAF. Warfarin treated patients were followed by six anticoagulation clinics. Four out of the six clinics contributed data on their patients that were on DOACs in the Michigan Anticoagulation Quality Improvement Initiative (MAQI 2) from January 2009 to June 2021. Patients were excluded if they had a history of heart valve replacement, recent myocardial infarction, or less than 3 months of follow-up. Two propensity matched cohorts (warfarin+ASA vs DOAC+ASA) of patients were analyzed based on ASA use at the time of study enrollment. The primary outcome was any new bleeding event. Secondary outcomes included new episodes of arterial or venous thrombosis, bleeding event type (major, fatal, life threatening, central nervous system, and non-major bleeding), emergency room visits, hospitalizations, transfusions, and death. Random chart audits were done to confirm the accuracy of the abstracted data. Event rates were compared using Poisson regression. Results: We identified a total of 1,139 patients on DOACs plus ASA and 4,422 patients on warfarin plus ASA. After propensity matching, we compared two groups of 1,114 matched patients. DOAC treated patients were predominately on apixaban (62.3%) and rivaroxaban (30.4%), most often at therapeutic doses (Table 1). Patients were largely (90.5%) on low dose ASA (≤ 100 mg). Patient demographics, co-morbidities, indication for anticoagulation, history of bleeding or clotting, medications, and duration of follow-up were well-balanced after matching. Patients were followed for a median of 11.7 months (interquartile range 4.4 and 34 months). Patients treated with DOAC+ASA had 2.4 thrombotic events per 100 patient years compared to 2.2 thrombotic events per 100 patient years with warfarin+ASA (P=0.78). There were no significant differences observed between groups by thrombotic subtype (stroke, transient ischemic attack, pulmonary embolism, deep vein thrombosis, table 1). Bleeding was also similar with 30.1 bleeding events per 100 patient years with DOAC+ASA compared to 27.8 bleeds per 100 patient years with warfarin+ASA (P=0.24). There were no significant differences by bleeding subtype (table 1). Hospitalizations for clotting occurred less frequently with DOAC+ASA (0.9 hospitalizations per 100 patient years) compared to warfarin+ASA (1.7 hospitalizations per 100 patient years, P=0.03). Mortality, transfusions, and healthcare utilization were otherwise similar between the two groups. Conclusions: For patients on a DOAC versus warfarin with ASA for atrial fibrillation and/or venous thromboembolic disease without a recent myocardial infarction or heart valve replacement, bleeding and thrombotic outcomes were similar

Adverse Events Associated With the Addition of Aspirin to Direct Oral Anticoagulant Therapy Without a Clear Indication

Importance: It is unclear how many patients treated with a direct oral anticoagulant (DOAC) are using concomitant acetylsalicylic acid (ASA, or aspirin) and how this affects clinical outcomes. Objective: To evaluate the frequency and outcomes of prescription of concomitant ASA and DOAC therapy for patients with atrial fibrillation (AF) or venous thromboembolic disease (VTE). Design, Setting, and Participants: This registry-based cohort study took place at 4 anticoagulation clinics in Michigan from January 2015 to December 2019. Eligible participants were adults undergoing treatment with a DOAC for AF or VTE, without a recent myocardial infarction (MI) or history of heart valve replacement, with at least 3 months of follow-up. Exposures: Use of ASA concomitant with DOAC therapy. Main Outcomes and Measures: Rates of bleeding (any, nonmajor, major), rates of thrombosis (stroke, VTE, MI), emergency department visits, hospitalizations, and death. Results: Of the study cohort of 3280 patients (1673 [51.0%] men; mean [SD] age 68.2 [13.3] years), 1107 (33.8%) patients without a clear indication for ASA were being treated with DOACs and ASA. Two propensity score-matched cohorts, each with 1047 patients, were analyzed (DOAC plus ASA and DOAC only). Patients were followed up for a mean (SD) of 20.9 (19.0) months. Patients taking DOAC and ASA experienced more bleeding events compared with DOAC monotherapy (26.0 bleeds vs 31.6 bleeds per 100 patient years, P = .01). Specifically, patients undergoing combination therapy had significantly higher rates of nonmajor bleeding (26.1 bleeds vs 21.7 bleeds per 100 patient years, P = .02) compared with DOAC monotherapy. Major bleeding rates were similar between the 2 cohorts. Thrombotic event rates were also similar between the cohorts (2.5 events vs 2.3 events per 100 patient years for patients treated with DOAC and ASA compared with DOAC monotherapy, P = .80). Patients were more often hospitalized while undergoing combination therapy (9.1 vs 6.5 admissions per 100 patient years, P = .02). Conclusion and Relevance: Nearly one-third of patients with AF and/or VTE who were treated with a DOAC received ASA without a clear indication. Compared with DOAC monotherapy, concurrent DOAC and ASA use was associated with increased bleeding and hospitalizations but similar observed thrombosis rate. Future research should identify and deprescribe ASA for patients when the risk exceeds the anticipated benefit

Co-Package Technology Platform for Low-Power and Low-Cost Data Centers

We report recent advances in photonic–electronic integration developed in the European research project L3MATRIX. The aim of the project was to demonstrate the basic building blocks of a co-packaged optical system. Two-dimensional silicon photonics arrays with 64 modulators were fabricated. Novel modulation schemes based on slow light modulation were developed to assist in achieving an efficient performance of the module. Integration of DFB laser sources within each cell in the matrix was demonstrated as well using wafer bonding between the InP and SOI wafers. Improved semiconductor quantum dot MBE growth, characterization and gain stack designs were developed. Packaging of these 2D photonic arrays in a chiplet configuration was demonstrated using a vertical integration approach in which the optical interconnect matrix was flip-chip assembled on top of a CMOS mimic chip with 2D vertical fiber coupling. The optical chiplet was further assembled on a substrate to facilitate integration with the multi-chip module of the co-packaged system with a switch surrounded by several such optical chiplets. We summarize the features of the L3MATRIX co-package technology platform and its holistic toolbox of technologies to address the next generation of computing challenges

An examination of intentions of recommending fitness centers by user members

The goal of this study was to examine what experiences members have with fitness centers that influence their intentions for recommendation. After item generation and content validity, as well as a pilot test, a survey was conducted among members of five different clubs (n=1750). The questionnaire included measures of service quality attributes, accessibility, well-being in life, well-being in a club, and intentions to recommend a fitness center. Results using a structural equation model provide evidence that only service quality attributes and well-being in a club have positive effect on intentions of users to recommend it. Well-being in life has a negative effect on the intentions for recommendation, while accessibility shows no predictive effect. These findings suggest implications for the management of a club, such as the need to create a pleasant environment and to provide a personalized service directed towards the members’ goals in order to improve well-being in a club and contribute to increase the intentions to recommend the fitness centers to others.O objetivo deste estudo foi examinar como as experiências de usuários de centros de atividade física interferem nas intenções em recomendar serviços. Depois de gerar itens e validar o conteúdo, aplicou-se um pré-teste, o questionário final foi aplicado a sócios de cinco clubes de fitness (n=1.750). O questionário incluiu atributos da qualidade do serviço, acessibilidade, bem-estar na vida, bem-estar no clube e intenção de recomendar. O modelo de equações estruturais mostrou que apenas os atributos da qualidade do serviço e bem-estar no clube têm um efeito positivo sobre as intenções de recomendar. O bem-estar na vida tem um efeito negativo sobre as intenções para recomendar, enquanto que a acessibilidade não mostra nenhum efeito preditivo. Estas conclusões sugerem a necessidade de criar um ambiente agradável nos clubes e de oferecer um serviço personalizado para os objetivos dos sócios, a fim de melhorar o bem-estar no clube e contribuir para a intenção de recomendar o ginásio. Palavras-chave: intenção de recomendar, atributos da qualSin financiación0.191 SJR (2014) Q3, posición 172/231 Health (social science), 1027/1811 Medicine (miscellaneous); Q4, 112/128 Sports scienceUE