94 research outputs found

    PaaSword: A Holistic Data Privacy and Security by Design Framework for Cloud Services

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    Enterprises increasingly recognize the compelling economic and operational benefits from virtualizing and pooling IT resources in the cloud. Nevertheless, the significant and valuable transformation of organizations that adopt cloud computing is accompanied by a number of security threats that should be considered. In this position paper, we outline significant security challenges presented when migrating to a cloud environment and propose PaaSword - a novel holistic framework that aspires to alleviate these challenges. Specifically, this proposed framework involves a context-aware security model, the necessary policies enforcement mechanism along with a physical distribution, encryption and query middleware

    Brokerage for Quality Assurance and Optimisation of Cloud Services: An Analysis of Key Requirements

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    As the number of cloud service providers grows and the requirements of cloud service consumers become more complex, the latter will come to depend more and more on the intermediation services of cloud service brokers. Continuous quality assurance and optimisation of services is becoming a mission-critical objective that many consumers will find difficult to address without help from cloud service intermediaries. The Broker@Cloud project envisages a software framework that will make it easier for cloud service intermediaries to address this need, and this paper provides an analysis of key requirements for this framework. We discuss the methodology that we followed to capture these requirements, which involved defining a conceptual service lifecycle model, carrying out a series of Design Thinking workshops, and formalising requirements based on an agile requirements information model. Then, we present the key requirements identified through this process in the form of summarised results

    Design, development and orchestration of 5G-ready applications over sliced programmable infrastructure

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    5G networks design and evolution is considered as a key to support the introduction of digital technologies in economic and societal processes. Towards this direction, vertical industries' needs should be considered as drivers of 5G networks design and development with high priority. In the current manuscript, MATILDA is presented, as a holistic 5G end-to-end services operational framework tackling the overall lifecycle of design, development and orchestration of 5G-ready applications and 5G network services over programmable infrastructure, following a unified programmability model and a set of control abstractions

    The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

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    Total mesorectal excision (TME) is considered standard of care for rectal cancer treatment. Failure to remove the mesorectal fat envelope entirely may explain part of observed local and distant recurrences. Several studies suggest quality of the mesorectum after TME surgery as determined by pathological evaluation may influence prognosis. We aimed to determine the prognostic value of the plane of surgery as well as factors influencing the likelihood of a high-quality specimen by reviewing the literature. A pooled meta-analysis of relevant outcome data was performed where appropriate. A muscularis propria resection plane was found to increase the risk of local recurrence (RR 2.72 [95 % CI 1.36 to 5.44]) and overall recurrence (RR 2.00 [95 % CI 1.17 to 3.42]) compared to an (intra)mesorectal plane. Plane of surgery is an important factor in rectal cancer treatment and the documentation by pathologists is essential for the improvement of TME quality and patient outcome

    Factors predicting hospital length-of-stay and readmission after colorectal resection: a population-based study of elective and emergency admissions

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    <p>Abstract</p> <p>Background</p> <p>The impact of developments in colorectal cancer surgery on length-of-stay (LOS) and re-admission have not been well described. In a population-based analysis, we investigated predictors of LOS and emergency readmission after the initial surgery episode.</p> <p>Methods</p> <p>Incident colorectal cancers (ICD-O2: C18-C20), diagnosed 2002-2008, were identified from the National Cancer Registry Ireland, and linked to hospital in-patient episodes. For those who underwent colorectal resection, the associated hospital episode was identified. Factors predicting longer LOS (upper-quartile, > 24 days) for elective and emergency admissions separately, and whether LOS predicted emergency readmission within 28 days of discharge, were investigated using logistic regression.</p> <p>Results</p> <p>8197 patients underwent resection, 63% (n = 5133) elective and 37% (n = 3063) emergency admissions. Median LOS was 14 days (inter-quartile range (IQR) = 11-20) for elective and 21 (15-33) for emergency admissions. For both emergency and elective admissions, likelihood of longer LOS was significantly higher in patients who were older, had co-morbidities and were unmarried; it was reduced for private patients. For emergency patients only the likelihood of longer LOS was lower for patients admitted to higher-volume hospitals. Longer LOS was associated with increased risk of emergency readmission.</p> <p>Conclusions</p> <p>One quarter of patients stay in hospital for at least 25 days following colorectal resection. Over one third of resected patients are emergency admissions and these have a significantly longer median LOS. Patient- and health service-related factors were associated with prolonged LOS. Longer LOS was associated with increased risk of emergency readmission. The cost implications of these findings are significant.</p

    Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

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    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 &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 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

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study