Real-time and long lasting Internet of Things through semantic wake-up radios

The world is going towards the Internet of Things (IoT) where trillions of objects that are common in our lives will be enhanced and revolutionized by adding them computational and networking capabilities. Examples are cars, street lamps, industrial machinery, electrical appliances. The corner- stone of Internet of Things research is Wireless Sensor Networks (WSNs). These networks are made of hundreds of low-cost, low-complexity devices endowed with sensors to monitor the surrounding environment or objects. Typically these devices (also called sensors, nodes or motes) are battery-powered, therefore they can operate for a limited amount of time (i.e., days) before running out of energy. This is the main challenge that applications of Wireless Sensor Networks have to face. Since one of the major power consumers in a node is the radio transceiver, a lot of research effort has been put into finding solutions that keep the radio in a low-power state as much as possible, while not harming the communication capability. While this approach brings the network lifetime, i.e. the time before battery-operated nodes die having depleted their energy, to years or more, it introduces significant latency, as the energy reduction comes at the cost of not being able to reach nodes in deep sleep for long period of times. The most promising solution to this problem is the wake-up radio, an additional ultra-low power transceiver used for the sole purpose of triggering the activation of the high power, high bandwidth radio. Wake-up radio enabled IoT systems maintain always on their wake up radio, which has a negligible energy consumption, in this way optimizing both energy and latency performance metrics. Most of the research so far focused on the design of wake-up receivers, while a limited amount of communication protocols that take advantage of this radio has been proposed. Moreover, almost all of these protocols have been evaluated only through simulations. In this thesis we set to start filling this gap. We first evaluate the range performance of an ultra-low power wake-up receiver integrated into a state- of-the-art Wireless Sensor Network mote, the MagoNode++. Based on the results of this evaluation we deploy an outdoor testbed made of MagoNode++ motes. The testbed allows to validate in a real-world scenario our implementation of CTP-WUR, an extension of the widely used Collection Tree Protocol (CTP) for wake-up radio-enabled Wireless Sensor Networks. The comparison between CTP-WUR and CTP demonstrates that wake-up radios can effectively reduce the power consumption and obtain, at the same time, end-to-end latencies in the order of milliseconds, enabling new time critical applications. Based on the results and on the insights gained dur- ing the testbed evaluation a new version of CTP-WUR is presented that improves its performance across all the metrics taken into consideration: end-to-end packet latency, energy consumption and Packet Delivery Ratio

Optimal design of a 6-DOF 4-4 parallel manipulator with uncoupled singularities

A 6-DOF 4-4 parallel manipulator is presented. Its forward kinematics can be solved by a sequence of three trilaterations and, as a consequence, its singularities can be described in geometric terms as the degeneration of three tetrahedra. Moreover, it is shown how the proposed manipulator belongs to the family of flagged parallel manipulators. This identification is useful because the topology of the singularity locus of flagged manipulators has been fully characterized and, what is more important, the singularities of flagged manipulators correspond to uncoupled translations and/or rotations in the workspace of the manipulator. An optimization of its workspace is carried out using Sequential Quadratic Programming and a virtual prototype of the optimal result has been implemented in SolidWorks.Peer Reviewe

Reduction of Metal Artifacts Caused by Titanium Peduncular Screws in the Spine by Means of Monoenergetic Images and the Metal Artifact Reduction Software in Dual-Energy Computed Tomography

Objectives: To evaluate the reduction of metal artifacts in patients with titanium peduncular screws in the spine using (1) conventional images (CI), (2) virtual monoenergetic reconstructions (VMRs), and (3) VMR + Metal Artifact Reduction Software (VMR + MARS), with dual-energy computed tomography (DECT). Materials and Methods: Twenty-four patients with titanium peduncular screws in the spine were studied using a 64-channel DECT. During the postprocessing phase, the CI, the VMRs from 100 to 140 keV, and the VMR at 140 keV + MARS were synthesized. All the images were considered, and a quantitative evaluation was performed measuring the attenuation values (in terms of Hounsfield Units) with region of interest, in correspondence with the most hyperdense and hypodense artifacts. All the values were then compared. A qualitative evaluation, in terms of image quality and extent of artifacts, was also performed by two radiologists. Results: In quantitative terms, the 140 keV + MARS reconstruction was able to significantly reduce both bright and dark metal artifacts, compared to CI and to VMRs. The VMR was capable of significantly reducing both dark and bright artifacts, compared to CI. In qualitative terms, the VMR at 140 keV proved to be the best, compared to CI and VMR + MARS images. Conclusions: The VMR + MARS image reduces metal artifacts from titanium peduncular screws more than VMRs alone and CI. Furthermore, the VMR can decrease metal artifacts from a quantitative and a qualitative point of view. Combining information from VMRs and VMR + MARS images could be the best way to solve the issue of metal artifacts on computed tomography images

Clinical Management of Critical COVID-19 Patients: Insights from the Literature and "On the Field" Experience

AbstractThe recent outbreak of the coronavirus disease (COVID-19) is a health emergency all over the world. Several health care professionals are currently putting their best efforts to deal with this situation. The aim of this review is to report insights from the literature and "on the field" experience in clinical management of critical COVID-19 patients. Respiratory support varies from high flow nasal cannula (HFNC) to noninvasive and invasive mechanical ventilation, often associated with nitric oxide, prone position, and extracorporeal membrane oxygenation (ECMO). Experienced specialists have to manage the airways minimizing any contamination and virus spread. The hemodynamic management of critical COVID-19 patients requires not only an accurate fluid strategy, but also an appropriate use of vasopressors and inotropes. Various adjuvant treatments have been proposed: antiviral drugs, immunomodulators, anticoagulants, antibiotics, and nutrition

Integrated Network Pharmacology Approach for Drug Combination Discovery : A Multi-Cancer Case Study

Simple Summary Current treatments for complex diseases, including cancer, are generally characterized by high toxicity due to their low selectivity for target cells. Moreover, patients often develop drug resistance, hence becoming less sensitive to the therapy. For this reason, novel, improved, and more specific pharmacological therapies are needed. The high cost and the time required to develop new drugs poses the attention on the development of computational methods for drug repositioning and combination therapy prediction. In this study, we developed an integrated network pharmacology framework that combines mechanistic and chemocentric approaches in order to predict potential drug combinations for cancer therapy. We applied our paradigm in five cancer types, which we used as case studies. Our strategy can be applied to the study of any complex disease by guiding the prioritization of drug combinations. Despite remarkable efforts of computational and predictive pharmacology to improve therapeutic strategies for complex diseases, only in a few cases have the predictions been eventually employed in the clinics. One of the reasons behind this drawback is that current predictive approaches are based only on the integration of molecular perturbation of a certain disease with drug sensitivity signatures, neglecting intrinsic properties of the drugs. Here we integrate mechanistic and chemocentric approaches to drug repositioning by developing an innovative network pharmacology strategy. We developed a multilayer network-based computational framework integrating perturbational signatures of the disease as well as intrinsic characteristics of the drugs, such as their mechanism of action and chemical structure. We present five case studies carried out on public data from The Cancer Genome Atlas, including invasive breast cancer, colon adenocarcinoma, lung squamous cell carcinoma, hepatocellular carcinoma and prostate adenocarcinoma. Our results highlight paclitaxel as a suitable drug for combination therapy for many of the considered cancer types. In addition, several non-cancer-related genes representing unusual drug targets were identified as potential candidates for pharmacological treatment of cancer.Peer reviewe

Phase II trial of neoadjuvant pemetrexed plus cisplatin followed by surgery and radiation in the treatment of pleural mesothelioma

BACKGROUND: Malignant pleural mesothelioma is an aggressive tumor that has a poor prognosis and is resistant to unimodal approaches. Multimodal treatment has provided encouraging results. METHODS: Phase II, open-label study of the combination of chemotherapy (pemetrexed 500 mg/m(2)+cisplatin 75 mg/m(2) IV every 21 days × 3 cycles), followed by surgery (en-bloc extrapleural pneumonectomy, 3–8 weeks after chemotherapy) and hemithoracic radiation (total radiation beam 54 Gy, received 4–8 weeks post-surgery). The primary endpoint was event-free survival, defined as the time from enrollment to time of first observation of disease progression, death due to any cause, or early treatment discontinuation. RESULTS: Fifty-four treatment-naïve patients with T1-3 N0-2 malignant pleural mesothelioma were enrolled, 52 (96.3%) completed chemotherapy, 45 (83.3%) underwent surgery, 22 (40.7%) completed the whole treatment including 90-day post-radiation follow-up. The median event-free survival was 6.9 months (95%CI: 5.0-10.5), median overall survival was 15.5 months (95%CI 11.0-NA) while median time-to-tumor response was 4.8 months (95%CI: 2.5-8.0). Eighteen (33.3%) and 13 (24.1%) patients were still event-free after 1 and 2 years, respectively. The most common treatment-emergent adverse events were nausea (63.0%), anemia (51.9%) and hypertension (42.6%). Following two cardiopulmonary radiation-related deaths the protocol was amended (21 [38.9%] patients were already enrolled in the study): the total radiation beam was reduced from 54 Gy to 50.4 Gy and a more accurate selection of patients was recommended. CONCLUSIONS: The combination of pemetrexed plus cisplatin followed by surgery and hemithoracic radiation is feasible and has a manageable toxicity profile in carefully selected patients. It may be worthy of further investigation. TRIAL REGISTRATION: Clinicaltrial.com registrationID #NCT00087698

Rapid Atlantification along the Fram Strait at the beginning of the 20th century.

The recent expansion of Atlantic waters into the Arctic Ocean represents undisputable evidence of the rapid changes occurring in this region. Understanding the past variability of this “Atlantification” is thus crucial in providing a longer perspective on the modern Arctic changes. Here, we reconstruct the history of Atlantification along the eastern Fram Strait during the past 800 years using precisely dated paleoceanographic records based on organic biomarkers and benthic foraminiferal data. Our results show rapid changes in water mass properties that commenced in the early 20th century—several decades before the documented Atlantification by instrumental records. Comparison with regional records suggests a poleward expansion of subtropical waters since the end of the Little Ice Age in response to a rapid hydrographic reorganization in the North Atlantic. Understanding of this mechanism will require further investigations using climate model simulations

Educación y Chagas: sistematización de experiencias innovadoras en la Región de La Plata (Buenos Aires, Argentina)

Considerando las características multidimensionales de la problemática del Chagas, se requieren aproximaciones de investigación, prevención, control y tratamiento que brinden respuestas integrales, interdisciplinarias e intersectoriales acordes a las particularidades de los escenarios actuales (Briceño-León y Galván, 2007). En este sentido, desarrollar un abordaje integral del Chagas requiere considerar simultáneamente cuatro grandes dimensiones -biomédica, epidemiológica, sociocultural y política- cuyos elementos se conjugan dinámicamente para constituir el entramado que expresa toda la complejidad de la problemática. Este planteo nos conduce a la necesidad de instalar el tema en diferentes contextos y profundizar sobre las diferentes maneras de hacerlo. Por este motivo, creemos que no hay un solo lenguaje para hablar de Chagas, tampoco un solo puñado de personas autorizadas para hacerlo, ni determinados lugares más adecuados que otros para abordar el tema, ni un solo perfil de destinatarios/as. Desde este marco venimos desarrollando una serie de propuestas educativas a partir de una perspectiva que hemos dado en llamar caleidoscópica (por las múltiples miradas involucradas) (Sanmartino et al., 2012). Trabajamos en diferentes escenarios y con diversos actores sociales, como parte de las actividades de investigación, docencia y extensión llevadas a cabo por los/as integrantes de un grupo multidisciplinario al que denominamos ¿De qué hablamos cuando hablamos de Chagas? (CONICET, UNLP, CIIE). En la propuesta que aquí presentamos buscamos analizar y sistematizar las estrategias y recursos desarrollados en estas experiencias ya que consideramos que constituyen ejemplos que aportarán al diseño y desarrollo de manerascontextualizadas de abordar el Chagas. En este sentido, cabe aclarar que, al igual que Torres y Cendales (2006), asumimos la sistematización como una práctica investigativa con identidad propia y no un momento o fase de toda investigación (?). Tampoco es una evaluación, pues su intención no es valorar el cumplimiento de lo planeado ni su impacto, sino recuperar los saberes y significados de la experiencia para potenciarla. Compartiremos algunos resultados de un camino que apunta a la optimización de las políticas y prácticas educativas y de comunicación de manerainnovadora, así como a recuperar diversos saberes y abrir nuevos interrogantes que permitan la construcción de un paradigma integrador necesario para abordar esta problemática compleja.Instituto de Física de Líquidos y Sistemas BiológicosCentro de Estudios Parasitológicos y de Vectore

Robotic surgery in emergency setting : 2021 WSES position paper

Background Robotics represents the most technologically advanced approach in minimally invasive surgery (MIS). Its application in general surgery has increased progressively, with some early experience reported in emergency settings. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a systematic review of the literature to develop consensus statements about the potential use of robotics in emergency general surgery. Methods This position paper was conducted according to the WSES methodology. A steering committee was constituted to draft the position paper according to the literature review. An international expert panel then critically revised the manuscript. Each statement was voted through a web survey to reach a consensus. Results Ten studies (3 case reports, 3 case series, and 4 retrospective comparative cohort studies) have been published regarding the applications of robotics for emergency general surgery procedures. Due to the paucity and overall low quality of evidence, 6 statements are proposed as expert opinions. In general, the experts claim for a strict patient selection while approaching emergent general surgery procedures with robotics, eventually considering it for hemodynamically stable patients only. An emergency setting should not be seen as an absolute contraindication for robotic surgery if an adequate training of the operating surgical team is available. In such conditions, robotic surgery can be considered safe, feasible, and associated with surgical outcomes related to an MIS approach. However, there are some concerns regarding the adoption of robotic surgery for emergency surgeries associated with the following: (i) the availability and accessibility of the robotic platform for emergency units and during night shifts, (ii) expected longer operative times, and (iii) increased costs. Further research is necessary to investigate the role of robotic surgery in emergency settings and to explore the possibility of performing telementoring and telesurgery, which are particularly valuable in emergency situations. Conclusions Many hospitals are currently equipped with a robotic surgical platform which needs to be implemented efficiently. The role of robotic surgery for emergency procedures remains under investigation. However, its use is expanding with a careful assessment of costs and timeliness of operations. The proposed statements should be seen as a preliminary guide for the surgical community stressing the need for reevaluation and update processes as evidence expands in the relevant literature.Peer reviewe