Low-Power Wearable ECG Monitoring System for Multiple-Patient Remote Monitoring

Many devices and solutions for remote electrocardiogram (ECG) monitoring have been proposed in the literature. These solutions typically have a large marginal cost per added sensor and are not seamlessly integrated with other smart home solutions. Here, we propose an ECG remote monitoring system that is dedicated to non-technical users in need of long-term health monitoring in residential environments and is integrated in a broader Internet-of-Things (IoT) infrastructure. Our prototype consists of a complete vertical solution with a series of advantages with respect to the state of the art, considering both the prototypes with integrated front end and prototypes realized with off-the-shelf components: 1) ECG prototype sensors with record-low energy per effective number of quantized levels; 2) an architecture providing low marginal cost per added sensor/user; and 3) the possibility of seamless integration with other smart home systems through a single IoT infrastructure

Last-Meter Smart Grid Embedded in an Internet-of-Things Platform

The customer domain of the smart grid natu- rally blends with smart home and smart building systems, but typical proposed approaches are “distributor-centric” rather than “customer-centric,” undermining user acceptance, and are often poorly scalable. To solve this problem, we propose a detailed architecture and an implementation of a “last-meter” smart grid—the portion of the smart grid on customer premises—embedded in an internet-of-things (IoT) platform. Our approach has four aspects of novelty and advantages with respect to the state of the art: 1) seamless integration of smart grid with smart home applications in the same infrastructure; 2) data gathering from heterogeneous sensor communication protocols; 3) secure and customized data access; and 4) univocal sensor and actuator mapping to a common abstraction layer on which additional concurrent applications can be built. A demonstrator has been built and tested with purposely-developed ZigBee smart meters and gateways, a distributed IoT server, and a flexible user interface

An Innovative Cloud-based Supervision System for the Integration of RPAS in Urban Environments

This paper proposes the outline of a Cloud-based supervision system for Remotely Piloted Aircraft Systems (RPAS), which are operating in urban environments. The novelty of this proposed concept is dual: (i) a Cloud-based supervision system focusing on safety and robustness, (ii) the definition of technical requirements allowing the RPAS to fly over urban areas, as a possible evolution of drone use in future smart cities. A new concept for the regulatory issues is also proposed, compared with existing worldwide regulations. The Cloud framework is intended to be an automated system for path planning and control of RPAS flying under its coverage, and not limited to conventional remote control as if supervised by a human pilot. Future works will be based on the experimental validation of the proposed concept in an urban area of Turin (Italy)

Fumarate-loaded electrospun nanofibers with anti-inflammatory activity for fast recovery of mild skin burns

In the biomedical sector the availability of engineered scaffolds and dressings that control and reduce inflammatory states is highly desired, particularly for the management of burn wounds. In this work, we demonstrate for the first time, to the best of our knowledge, that electrospun fibrous dressings of poly(octyl cyanoacrylate) (POCA) combined with polypropylene fumarate (PPF) possess anti-inflammatory activity and promote the fast and effective healing of mild skin burns in an animal model. The fibers produced had an average diameter of (0.8  ±  0.1) µm and they were able to provide a conformal coverage of the injured tissue. The application of the fibrous mats on the burned tissue effectively reduced around 80% of the levels of pro-inflammatory cytokines in the first 48 h in comparison with un-treated animals, and enhanced skin epithelialization. From histological analysis, the skin thickness of the animals treated with POCA : PPF dressings appeared similar to that of one of the naïve animals: (13.7  ±  1.4) µm and (14.3  ±  2.5) µm for naïve and treated animals, respectively. The density of dermal cells was comparable as well: (1100  ±  112) cells mm−2 and (1358  ±  255) cells mm−2 for naïve and treated mice, respectively. The results demonstrate the suitability of the electrospun dressings in accelerating and effectively promoting the burn healing process

Chemico-biological characterization of Torpedino Di Fondi® tomato fruits. A comparison with San Marzano cultivar at two ripeness stages

Torpedino di Fondi (TF) is a hybrid tomato landrace developed in Sicily and recently introduced in the south Lazio area along with the classical San Marzano (SM) cultivar. The present study aimed at characterizing TF tomatoes at both pink and red ripening stages, and at comparing them with traditional SM tomatoes. A multidisciplinary approach consisting of morphological, chemical (FT‐ICR MS, NMR, HPLC, and spectrophotometric methods), and biological (antioxidant and antifungal in vitro activity) analyses was applied. Morphological analysis confirmed the mini‐ San Marzano nature and the peculiar crunchy and solid consistency of TF fruits. Pink TF tomatoes displayed the highest content of hydrophilic antioxidants, like total polyphenols (0.192 mg/g), tannins (0.013 mg/g), flavonoids (0.204 mg/g), and chlorophylls a (0.344 mg/g) and b (0.161 mg/g), whereas red TF fruits were characterized by the highest levels of fructose (3000 mg/100 g), glucose (2000 mg/100 g), tryptophan (2.7 mg/100 g), phenylalanine (13 mg/100 g), alanine (25 mg/100 g), and total tri‐unsaturated fatty acids (13% mol). Red SM fruits revealed the greatest content of lipophilic antioxidants, with 1234 mg/g of total carotenoids. In agreement with phenolics content, TF cultivar showed the greatest antioxidant activity. Lastly, red TF inhibited Candida species (albicans, glabrata and krusei) growth

Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study

Introduction Information on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice. Method In a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group. Results SGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale. Conclusion Our study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time. Methods: The STAR Network \u201cDepot Study\u201d was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS 65 41). Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions\u2014conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently\u2014showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline. Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Design and implementation of wireless sensors and applications for the Internet of Things

In the internet of things vision, devices and objects will be connected to the Internet and will be able to communicate with each other and with humans in real time and to make autonomous decisions. While continuous communication capabilities improve, wireless sensor networks and smart devices usually communicate and share data with a central base station and using a dedicated platform developed for a specific application. Developing a new application that is interoperable with existing devices or integrating composite applications into an existing platform is today a hard and challenging task requiring advanced development experience. The lack of a common platform with well-defined interoperability interfaces has made heterogeneous sensors networks and smart devices hard to integrate into composite applications and into the Internet, slowing the diffusion of Internet of Things applications. This research focuses on the design of wireless sensors and applications based on a new open, complete, flexible and scalable platform for the Internet of Things. The main contributions of this thesis are: 1. The proposal of a platform able to integrate heterogeneous devices and sensor networks, communication protocols and multiple applications and to be easily deployed and reconfigured with no need of modifying the existing infrastructure. 2. The design and implementation of a Smart Grid power metering system allowing non-technical users to control energy consumption and production, and to securely exchange power usage data at the proper level of granularity with energy providers and distributors. 3. The design and implementation of a Remote Health monitoring for long-term high-quality non-intrusive ECG monitoring, where a wide coverage and a low cost is required (at home or in a nursing home). Based on the IoT platform the system offers the possibility to combine and integrate health sensors with smart home sensors, while ensuring secure and differentiated access to data. It also provides access to historical data and to real-time data

Microbial community dynamics during ripening of fermented sausage produced in Apulia region (Italy).

Microbial changes during meat fermentation (salami), made without commercial starter cultures, were followed at two artisanal factories, A and B, in Apulia region (South Italy). Fermentation was governed by an active lactic flora (> 107 CFU g-1) and salt tolerant, catalase positive cocci (> 105 CFU g-1). Total enterobacteria decreased from 4.5x103 CFU g-1 (0 day) to 2.2x101 CFU g-1 (28th day) in salami of the factory A, where the terminal values of pH and aw were 5.0 and 0.86, respectively. In the salami produced in factory B, Enterobacteriaceae showed a minor decrease [from 4.8x104 (0 day) to 1.2x103 (28th day)] probably due to minor decreases in pH (5.6) and aw (0.87) at the end of ripening (28th day). Enterococci exceeded 105 CFU g-1 at the end of ripening (28th day). The microbiological significance of each bacterial group was discussed