6G to Take the Digital Divide by Storm: Key Technologies and Trends to Bridge the Gap

The pandemic caused by COVID-19 has shed light on the urgency of bridging the digital divide to guarantee equity in the fruition of different services by all citizens. The inability to access the digital world may be due to a lack of network infrastructure, which we refer to as service-delivery divide, or to the physical conditions, handicaps, age, or digital illiteracy of the citizens, that is mentioned as service-fruition divide. In this paper, we discuss the way how future sixth-generation (6G) systems can remedy actual limitations in the realization of a truly digital world. Hence, we introduce the key technologies for bridging the digital gap and show how they can work in two use cases of particular importance, namely eHealth and education, where digital inequalities have been dramatically augmented by the pandemic. Finally, considerations about the socio-economical impacts of future 6G solutions are drawn

Management of newly diagnosed patients with type 2 diabetes: What are the attitudes of physicians? A SUBITO!AMD survey on the early diabetes treatment in Italy

Early intensive therapy in type 2 diabetes can prevent complications. Nevertheless, metabolic control is often sub-optimal in newly diagnosed patients. This webbased survey aimed to evaluate opinions of physicians about treatment, priorities, and barriers in the care of patients first referred to diabetes clinics. Data on physician attitudes toward therapeutic preferences for two clinical case models (same clinical profile, except HbA1c levels of 8.6 and 7.3% at the first access, respectively) were collected. Participants were asked to rank from 1 (most important) to 6 (least important) a list of priorities and barriers associated with the care of new patients. Overall, 593 physicians participated. In both case models, metformin and education were primary options, although their combination with other classes of drugs varied substantially. Main priorities were ‘‘to teach the patient how to cope with the disease’’ and ‘‘to achieve HbA1c target’’; main barriers were ‘‘lack of time’’ and ‘‘long waiting list’’. At multivariate analyses, physicians from the South of Italy had a twofold higher likelihood to attribute a rank 1–2 to organizational barriers than those operating in the North (South vs. North: OR: 2.4; 95% CI 1.4–4.1; Center vs. North: OR: 2.4; 95% CI 0.9–3.2). In the absence of a widely accepted evidence-based therapeutic algorithm driving the therapeutic choices according to the patient characteristics, prescriptions vary according to physician preferences. Education is perceived as a key-strategy, but organizational barriers and geographic disparities are an obstacle. These findings can drive new strategies to reduce clinical inertia, attitudes variability, and geographic disparities

Insulin requirements and carbohydrate to insulin ratio in normal weight, overweight, and obese women with type 1 diabetes under pump treatment during pregnancy: a lesson from old technologies

Aim:The primary aim of this study was to assess insulin requirements and carbohydrateto insulin ratio (CHO/IR) in normal weight, overweight, and obese pregnant women withtype 1 diabetes across early, middle, and late pregnancy.Methods:In this multicenter, retrospective, observational study we evaluated 86 of 101pregnant Caucasian women with type 1 diabetes under pump treatment. The womenwere trained to calculate CHO/IR daily by dividing CHO grams of every single meal byinsulin units injected. Since the purpose of the study was to identify the CHO/IR able toreach the glycemic target, we only selected the CHO/IR obtained when glycemic valueswere at target. Statistics: SPSS 20.Results:We studied 45 normal weight, 31 overweight, and 10 obese women. Insulinrequirements increased throughout pregnancy (p < 0.0001 and <0.001 respectively) inthe normal and overweight women, while it remained unchanged in the obese women.Insulin requirements were different between groups when expressed as an absolute value,but not when adjusted for body weight. Breakfast CHO/IR decreased progressivelythroughout pregnancy in the normal weight women, from 13.3 (9.8–6.7) at thefirst stageof pregnancy to 6.2 (3.8–8.6) (p = 0.01) at the end stage, and in the overweight womenFrontiers in Endocrinology | www.frontiersin.orgFebruary 2021 | Volume 12 | Article 6108771Edited by:Elena Succurro,University of Magna Graecia, ItalyReviewed by:Cristina Bianchi,Azienda Ospedaliero-UniversitariaPisana, ItalyMaria Grazia Dalfra’,University of Padua, Italy*Correspondence:Camilla [email protected] section:This article was submitted toObesity,a section of the journalFrontiers in EndocrinologyReceived:27 September 2020Accepted:14 January 2021Published:25 February 2021Citation:Festa C,Fresa R,Visalli N,Bitterman O,Giuliani C,Suraci C,Bongiovanni M andNapoli A (2021)Insulin Requirements andCarbohydrate to Insulin Ratio inNormal Weight, Overweight, andObese Women With Type 1Diabetes Under Pump TreatmentDuring Pregnancy: A LessonFrom Old Technologies.Front. Endocrinol. 12:610877.doi: 10.3389/fendo.2021.610877ORIGINAL RESEARCHpublished: 25 February 2021doi: 10.3389/fendo.2021.610877 from 8.5 (7.1–12.6) to 5.2 (4.0–8.1) (p = 0.001), while in the obese women it remainedstable, moving from 6.0 (5.0–7.9) to 5.1 (4.1–7.4) (p = 0.7). Likewise, lunch and dinnerCHO/IR decreased in the normal weight and overweight women (p < 0.03) and not in theobese women. The obese women gained less weight than the others, especially in earlypregnancy when they even lost a median of 1.25 (−1−1.1) kg (p = 0.005). In earlypregnancy, we found a correlation between pregestational BMI and insulin requirements(IU/day) or CHO/IR at each meal (p < 0.001 and p = 0.001, respectively). In latepregnancy, a relationship between pre-gestational BMI and CHO/IR change was found(P = 0.004), as well as between weight gain and CHO/IR change (p=0.02). Thesignificance was lost when both variables were included in the multiple regressionanalysis. There was no difference in pregnancy outcomes except for a higher pre-termdelivery rate in the obese women.Conclusion:Pre-gestational BMI and weight gain may play a role in determining CHO/IRduring pregnancy in women with type 1 diabetes under pump treatment

Marine phycotoxin levels in shellfish-14 years of data gathered along the Italian coast

Along the Italian coasts, toxins of algal origin in wild and cultivated shellfish have been reported since the 1970s. In this study, we used data gathered by the Veterinary Public Health Institutes (IZS) and the Italian Environmental Health Protection Agencies (ARPA) from 2006 to 2019 to investigate toxicity events along the Italian coasts and relate them to the distribution of potentially toxic species. Among the detected toxins (OA and analogs, YTXs, PTXs, STXs, DAs, AZAs), OA and YTX were those most frequently reported. Levels exceeding regulatory limits in the case of OA (≤2,448 μg equivalent kg-1) were associated with high abundances of Dinophysis spp., and in the case of YTXs (≤22 mg equivalent kg-1) with blooms of Gonyaulax spinifera, Lingulodinium polyedra, and Protoceratium reticulatum. Seasonal blooms of Pseudo-nitzschia spp. occur all along the Italian coast, but DA has only occasionally been detected in shellfish at concentrations always below the regulatory limit (≤18 mg kg-1). Alexandrium spp. were recorded in several areas, although STXs (≤13,782 μg equivalent kg-1) rarely and only in few sites exceeded the regulatory limit in shellfish. Azadinium spp. have been sporadically recorded, and AZAs have been sometimes detected but always in low concentrations (≤7 μg equivalent kg-1). Among the emerging toxins, PLTX-like toxins (≤971 μg kg-1 OVTX-a) have often been detected mainly in wild mussels and sea urchins from rocky shores due to the presence of Ostreopsis cf. ovata. Overall, Italian coastal waters harbour a high number of potentially toxic species, with a few HAB hotspots mainly related to DSP toxins. Nevertheless, rare cases of intoxications have occurred so far, reflecting the whole Mediterranean Sea conditions

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Business-Oriented Security Analysis of 6G for eHealth: An Impact Assessment Approach

Following the COVID-19 outbreak, the health sector is undergoing a deep transformation that is increasingly pushing it towards the exploitation of technology, thus fostering the growth of digital health (eHealth). Cellular networks play a pivotal role in promoting the digitalization of healthcare, and researchers are banking on beyond fifth-generation (B5G) and sixth-generation (6G) technologies to reach the turning point, given that, according to forecasts, 5G will not be able to meet future expectations. Security is an aspect that definitely should not be overlooked for the success of eHealth to occur. This work aims to address the security issue from a poorly explored viewpoint, namely that of economics. In this paper, we first describe the main eHealth services, highlighting the key stakeholders involved. Then, we discuss how next-generation technologies could support these services to identify possible business relationships and, therefore, to realize an innovative business-oriented security analysis. A qualitative assessment of the impact of specific security breaches in diverse business conditions is provided. Moreover, we examine a case study in order to show the effects of security attacks in a definite scenario and discuss their impact on business dynamics

A stakeholder-oriented security analysis in virtualized 5G cellular networks

Besides significantly outperforming past generations in terms of capacity and throughput, 5G networks and systems will provide an infrastructure for the support of highly diversified services and ‘‘verticals’’. Indeed, the major paradigm shift with respect to previous cellular network generations, specifically oriented to one class of terminals (namely, people’s cell phones), is the largely heterogeneous nature of the multiplicity of end systems supported. Within a 5G infrastructure, playing the role of ‘‘network of networks’’, traditionally independent technical and business stakeholders are now called to cooperate in the deployment of crucial infrastructure components relying on innovative (for the Telecom world) technologies such as virtualization, not in the traditional operators’ portfolio, and eventually placed in security-critical parts of the network — think e.g. to Multi Access Edge Computing systems. Goal of this survey is to analyze the complex threat landscape of 5G systems, by taking the point of view of the involved stakeholders. The motivation behind our proposed analysis revolves on the observation that, in complex and virtualized systems such as the 5G infrastructure, an attack to a system component under the responsibility of a given stakeholder may yield a dramatic impact to a completely different player. Therefore, while reviewing the many 5G security risks and relevant threats which the main stakeholders operating in virtualized 5G cellular networks are exposed to, we will try to showcase the sometimes non-obvious relation between impact and responsibility, as well as identify shared responsibilities

6G to Take the Digital Divide by Storm: Key Technologies and Trends to Bridge the Gap

The pandemic caused by COVID-19 has shed light on the urgency of bridging the digital divide to guarantee equity in the fruition of different services by all citizens. The inability to access the digital world may be due to a lack of network infrastructure, which we refer to as service-delivery divide, or to the physical conditions, handicaps, age, or digital illiteracy of the citizens, that is mentioned as service-fruition divide. In this paper, we discuss the way how future sixth-generation (6G) systems can remedy actual limitations in the realization of a truly digital world. Hence, we introduce the key technologies for bridging the digital gap and show how they can work in two use cases of particular importance, namely eHealth and education, where digital inequalities have been dramatically augmented by the pandemic. Finally, considerations about the socio-economical impacts of future 6G solutions are drawn

Enabling Trustworthy Multicast Wireless Services through D2D Communications in 5G Networks

Device-to-device (D2D) communication is considered as one of the key enabling technologies for fifth-generation (5G) networks as it allows data offloading generated by the huge number of connected devices. In this respect, group-oriented services are among the most interesting usage scenarios. Indeed, D2D can improve the performance of the conventional multicast scheme (CMS) in cellular networks, which is known to suffer from low spectral efficiency. Security is a further key field of investigation for 5G systems, as any threat to privacy and security may lead to both deteriorated user experience and inefficient network resources’ utilization. Security issues are even more in focus for D2D connections between devices that are in mutual proximity. To improve the CMS performance and also sustain security requirements of the 5G network, this work proposes a secure D2D data transmission algorithm. Making use of mechanisms such as encryption and signature, this algorithm aims to protect the exchanged data and the privacy of the devices involved in the communication. A simulation campaign conducted using MATLAB shows the ability of the proposed solution to take advantage of the establishment of secure D2D communications and efficiently utilize network resources