SMART-M3 v.0.9: A semantic event processing engine supporting information level interoperability in ambient intelligence

This tutorial is addressed to all students in Electronic Engineering and Information Engineering at the Scuola di Ingegneria e Architettura of the University of Bologna attending the following courses: Laboratory of Interoperability of Embedded Systems, "Calcolatori Elettronici M" and "Attività Progettuale di Calcolatori Elettronici M". This tutorial includes the guidelines to build distributed applications where clients may interact with physical space. Inter-client interaction occurs through a semantic event processing engine. Information interoperability is based on a shared knowledge representation model named ontology. This tutorial is focused on client design and on the SPARQL primitives that provide the means for client-event processing engine interaction

An Integrated Framework to Achieve Interoperability in Person-Centric Health Management

The need for high-quality out-of-hospital healthcare is a known socioeconomic problem. Exploiting ICT's evolution, ad-hoc telemedicine solutions have been proposed in the past. Integrating such ad-hoc solutions in order to cost-effectively support the entire healthcare cycle is still a research challenge. In order to handle the heterogeneity of relevant information and to overcome the fragmentation of out-of-hospital instrumentation in person-centric healthcare systems, a shared and open source interoperability component can be adopted, which is ontology driven and based on the semantic web data model. The feasibility and the advantages of the proposed approach are demonstrated by presenting the use case of real-time monitoring of patients' health and their environmental context

AUTOMATED SEMANTIC AND SYNTACTIC BIM DATA VALIDATION USING VISUAL PROGRAMMING LANGUAGE

Building Information Modeling (BIM) is part of a digitalization process that, in recent years, has been revolutionizing the way buildings and infrastructures are designed, built, and maintained. Compared to traditional processes, BIM enhances the production and the management of data related to buildings and infrastructures throughout their life cycle. It is founded on a three-dimensional graphical model based on the specificity of project goals following the “level of information need” defined in BIM procurement documents. In this framework, an automated process for checking information within a BIM model plays a role of fundamental importance. Although this increases the model’s reliability, on the other hand, it decreases the time of working. Therefore, this research aims to develop a working methodology based on Visual Programming Language (VPL) for an automated BIM Data Validation process. This workflow aims to meet the growing need of owners to centralize data relating to their real estate assets to always have the appropriate one at the operational level. This methodology has been tested in different case studies to evaluate the strengths and weaknesses of using a standardization protocol in a large portfolio and complex buildings. This allows the huge amount of data from BIM models to be checked and summary reports to be produced, sharing with the various stakeholders involved in the knowledge process

RedSib: A smart-M3 semantic information broker implementation

Smart-M3 is an open source middleware solution originally released by Nokia as a prototype reference infrastructure to support context-aware ontology-driven smart applications. This paper proposes a renewedSmart-M3 Semantic Information Broker implementation with increased performance and usability levels. In the proposed solution many features have been added or modified, preserving compatibility with the previous release. The major changes are related to the subscription mechanism, the RDF store and the supported encodings for information representation and query. SPARQL query language replaces Wilbur. This paper enlightens the analysis carried out on the original implementation and discusses the choices made to increase its maturity level. The work done is a step forward towards a stable and efficient open interoperability platform for the emerging market of smart space based services

FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years

Background: Surgical treatment of anal fistulas is still a challenge. The aims of this study were to evaluate the adoption and healing rates for the different surgical techniques used in Italy over the past 15 years. Methods: This was a multicenter retrospective observational study of patients affected by simple and complex anal fistulas of cryptoglandular origin who were surgically treated in the period 2003-2017. Surgical techniques were grouped as sphincter-cutting or sphincter-sparing and as technology-assisted or techno-free. All patients included in the study were followed for at least 12 months. Results: A total of 9,536 patients (5,520 simple; 4,016 complex fistulas) entered the study. For simple fistulas, fistulotomy was the most frequently used procedure, although its adoption significantly decreased over the years (P < .0005), with an increase in sphincter-sparing approaches; the overall healing rate in simple fistulas was 81.1%, with a significant difference between sphincter-cutting (91.9%) and sphincter-sparing (65.1%) techniques (P = .001). For complex fistulas, the adoption of sphincter-cutting approaches decreased, while sphincter-sparing techniques were mildly preferred (P < .0005). Moreover, there was a significant trend toward the use of technology-assisted procedures. The overall healing rate for complex fistulas was 69.0%, with a measurable difference between sphincter-cutting (81.1%) and sphincter-sparing (61.4%; P = .001) techniques and between techno-free and technology-assisted techniques (72.5% and 55.0%, respectively; P = .001). Conclusion: Surgical treatment of anal fistulas has changed, with a trend toward the use of sphincter-sparing techniques. The overall cure rate has remained stable, even if the most innovative procedures have achieved a lower success rate

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

A Standardized SOA for Clinical Data Interchange in a Cardiac Telemonitoring Environment

Care of chronic cardiac patients requires information interchange between patients\u2019 homes, clinical environments and the Electronic Health Record (EHR). Standards are emerging to support clinical information collection, exchange and management and to overcome information fragmentation and actors delocalization. Heterogeneity of information sources at patients\u2019 homes calls for open solutions to collect and accommodate multi-domain information, including environmental data. Based on the experience gained in a European Research Program, this paper presents an integrated and open approach for clinical data interchange in cardiac telemonitoring applications. This interchange is supported by the use of standards following the indications provided by the national authorities of the countries involved. Taking into account the requirements provided by the medical staff involved in the project the authors designed and implemented a prototypal middleware, based on a Service Oriented Architecture (SOA) approach, to give a structured and robust tool to CHF (Congestive Heart Failure) patients for their personalized telemonitoring. The middleware is represented by a Health Record Management Service (HRMS), whose interface is compliant to the HSSP (Healthcare Services Specification Project) RLUS (Retrieve, Locate and Update Service) standard (Level 0), which allows communication between the agents involved through the exchange of CDA R2 (Clinical Document Architecture Release 2) documents. Three performance tests were carried out and showed that the prototype completely fulfilled all requirements indicated by the medical staff, however certain aspects, such as authentication, security and scalability, should be deeply analyzed within a future engineering phase

Trifluoromethyl-modified dipeptides by ZrCl4-promoted aza-Henry reactions

Chiral (R)-1-phenylethylamine was successfully employed in a tandem aza-Henry addition-reduction reaction to give chiral β-nitro α-trifluoromethyl amines. A subsequent coupling reaction with N-Boc-protected amino acids leads to obtain optically pure CF 3-modified dipeptides carrying two different N-protecting groups. These peptidomimetic units are characterized by the presence of the [CH(CF 3)NH] group as mimetic of the natural [CONH] peptidic bond and can be used for the synthesis of more complex CF3-modified peptides after selective deprotection of one of the two amine functions. 2D NMR spectral analyses were employed to determine the absolute configurations of all newly synthesized chiral compounds. © 2014 Springer-Verlag