58 research outputs found
Development of Technologies for the Detection of (Cyber)Bullying Actions: The BullyBuster Project
Bullying and cyberbullying are harmful social phenomena that involve the intentional, repeated use of power to intimidate or harm others. The ramifications of these actions are felt not just at the individual level but also pervasively throughout society, necessitating immediate attention and practical solutions. The BullyBuster project pioneers a multi-disciplinary approach, integrating artificial intelligence (AI) techniques with psychological models to comprehensively understand and combat these issues. In particular, employing AI in the project allows the automatic identification of potentially harmful content by analyzing linguistic patterns and behaviors in various data sources, including photos and videos. This timely detection enables alerts to relevant authorities or moderators, allowing for rapid interventions and potential harm mitigation. This paper, a culmination of previous research and advancements, details the potential for significantly enhancing cyberbullying detection and prevention by focusing on the system’s design and the novel application of AI classifiers within an integrated framework. Our primary aim is to evaluate the feasibility and applicability of such a framework in a real-world application context. The proposed approach is shown to tackle the pervasive issue of cyberbullying effectively
GreeDi: Energy Efficient Routing Algorithm for Big Data on Cloud
The ever-increasing density in cloud computing parties, i.e. users, services, providers and data centres, has led to a significant exponential growth in: data produced and transferred among the cloud computing parties; network traffic; and the energy consumed by the cloud computing massive infrastructure, which is required to respond quickly and effectively to users requests. Transferring big data volume among the aforementioned parties requires a high bandwidth connection, which consumes larger amounts of energy than just processing and storing big data on cloud data centres, and hence producing high carbon dioxide emissions. This power consumption is highly significant when transferring big data into a data centre located relatively far from the users geographical location. Thus, it became high-necessity to locate the lowest energy consumption route between the user and the designated data centre, while making sure the users requirements, e.g. response time, are met. The main contribution of this paper is GreeDi, a network-based routing algorithm to find the most energy efficient path to the cloud data centre for processing and storing big data. The algorithm is, first, formalised by the situation calculus. The linear, goal and dynamic programming approaches used to model the algorithm. The algorithm is then evaluated against the baseline shortest path algorithm with minimum number of nodes traversed, using a real Italian ISP physical network topology
Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy
IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical
attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced
colorectal cancers at diagnosis.
OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced
oncologic stage and change in clinical presentation for patients with colorectal cancer.
DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all
17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December
31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period),
in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was
30 days from surgery.
EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery,
palliative procedures, and atypical or segmental resections.
MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer
at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as
cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding,
lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery,
and palliative surgery. The independent association between the pandemic period and the outcomes
was assessed using multivariate random-effects logistic regression, with hospital as the cluster
variable.
RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years)
underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142
(56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was
significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR],
1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic
lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03).
CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the
SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients
undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for
these patients
Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
"Resonance identification in a modern bell tower exhibiting high amplitude oscillations"
The paper illustrates how different dynamic identification techniques can be used to justify the significant vibration phenomena observed in modern bell tower during the swinging motion of the bells. First, the modal model of the tower is extracted from the structure ambient vibration. The results obtained by two output-only identification techniques, working in the frequency (EFDD) and the time domain (SSI), are compared. Then the bell excitation is characterized from the steady-state of the tower forced response to the bell swinging motion. The resonance between the fundamental tower frequency and the third harmonic of the horizontal dynamic force applied to the structure by the swinging bells is clearly recognized as the source of large oscillations. A finite element model is developed and updated to properly reproduce the tower spectral properties. Aiming to mitigate the identified phenomenon, the model allows the design of a stiffening intervention to properly shift the tower resonant frequency. The effectiveness of the designed solution is successfully verified by a post-intervention dynamic test campaig
"Dynamic identification of a modern bell tower: resonance cancellation through stiffening intervention"
The paper illustrates how the dynamic identification techniques can be used to justify significant vibration phenomena observed in modern bell tower during the swinging motion of the bells. First, the modal model of the tower is extracted from the structure response to ambient excitation, using different output-only identification procedures working in the frequency (EFDD) and the time domain (SSI). Then the bell excitation is characterized from the steady-state forced response to the bell swinging motion. The resonance between the fundamental tower frequency and the third harmonic of the horizontal dynamic force applied to the structure by the swinging bells is clearly recognized as source of large oscillations. A finite element model is developed and updated to properly reproduce the tower spectral properties. Aiming to mitigate the identified phenomenon, the model allows the design of a stiffening intervention to properly shift the tower resonant frequency. The effectiveness of the designed solution is successfully verified by a post-intervention dynamic test campaign
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