The blockchain technology has revolutionized the digital currency space with the pioneering cryptocurrency platform named Bitcoin. From an abstract perspective, a blockchain is a distributed ledger capable of maintaining an immutable log of transactions happening in a network. In recent years, this technology has attracted significant scientific interest in research areas beyond the financial sector, one of them being the Internet of Things (IoT). In this context, the blockchain is seen as the missing link toward building a truly decentralized, trustless, and secure environment for the IoT and, in this survey, we aim to shape a coherent and comprehensive picture of the current state-of-the-art efforts in this direction. We start with fundamental working principles of blockchains and how blockchain-based systems achieve the characteristics of decentralization, security, and auditability. From there, we build our narrative on the challenges posed by the current centralized IoT models, followed by recent advances made both in industry and research to solve these challenges and effectively use blockchains to provide a decentralized, secure medium for the IoT.

No abstract

No abstract

Pulmonary embolism (PE) represents a common disease in emergency medicine and guidelines for diagnosis and treatment have had wide diffusion. However, PE morbidity and mortality remain high, especially when associated to hemodynamic instability or right ventricular dysfunction. Prognostic stratification to identify high risk patients needing to receive more aggressive pharmacological and closer monitoring is of utmost importance. Modern guidelines for management of acute PE are based on risk stratification using either clinical, radiological, or laboratory findings. This article reviews the modern treatment of acute PE, which is customized upon patient prognosis. Accordingly the current risk stratification tools described in the literature such as clinical scores, echocardiography, helical computer tomography, and biomarkers will be reviewed.

BackgroundBronchiolitis guidelines suggest that neither bronchodilators nor corticosteroids, antiviral and antibacterial agents should be routinely used. Although recommendations, many clinicians persistently prescribe drugs for bronchiolitis.Aim of the studyTo unravel main reasons of pediatricians in prescribing drugs to infants with bronchiolitis, and to possibly correlate therapeutic choices to the severity of clinical presentation. Also possible influence of socially deprived condition on therapeutic choices is analyzed.MethodsPatients admitted to Pediatric Division of 2 main Hospitals of Naples because of bronchiolitis in winter season 2008-2009 were prospectively analyzed. An RDAI (Respiratory Distress Assessment Instrument) score was assessed at different times from admission. Enrolment criteria were: age 1-12 months; 1st lower respiratory infection with cough and rhinitis with/without fever, wheezing, crackles, tachypnea, use of accessory muscles, and/or nasal flaring, low oxygen saturation, cyanosis. Social deprivation status was assessed by evaluating school graduation level of the origin area of the patients. A specific questionnaire was submitted to clinicians to unravel reasons of their therapeutic behavior.ResultsEighty-four children were enrolled in the study. Mean age was 3.5 months. Forty-four per cent of patients presented with increased respiratory rate, 70.2% with chest retractions, and 7.1% with low SaO2. Mean starting RDAI score was 8. Lung consolidation was found in 3.5% on chest roentgenogram. Data analysis also unraveled that 64.2% matched clinical admission criteria. Social deprivation status analysis revealed that 72.6% of patients were from areas "at social risk". Evaluation of length of stay vs. social deprivation status evidenced no difference between "at social risk" and "not at social risk" patients. Following therapeutic interventions were prescribed: nasal suction (64.2%), oxygen administration (7.1%), antibiotics (50%), corticosteroids (85.7%), bronchodilators (91.6%). Statistically significant association was not found for any used drug with neither RDAI score nor social deprivation status. The reasons of hospital pediatricians to prescribe drugs were mainly the perception of clinical severity of the disease, the clinical findings at chest examination, and the detection of some improvement after drug administration.ConclusionsWe strongly confirm the large use of drugs in bronchiolitis management by hospital pediatricians. Main reason of this wrong practice appears to be the fact that pediatricians recognize bronchiolitis as a severe condition, with consequent anxiety in curing so acutely ill children without drugs, and that sometimes they feel forced to prescribe drugs because of personal reassurance or parental pressure. We also found that social "at risk" condition represents a main reason for hospitalization, not correlated to clinical severity of the disease neither to drug prescription. Eventually, we suggest a "step-by-step" strategy to rich a more evidence based approach...

Within the Internet of Things (IoT) and blockchain research, there is a growing interest in decentralizing health monitoring systems, to provide improved privacy to patients, without relying on trusted third parties for handling patients’ sensitive health data. With public blockchain deployments being severely limited in their scalability, and inherently having latency in transaction processing, there is room for researching and developing new techniques to leverage the security features of blockchains within healthcare applications. This paper presents a solution for patients to share their biomedical data with their doctors without their data being handled by trusted third party entities. The solution is built on the Ethereum blockchain as a medium for negotiating and record-keeping, along with Tor for delivering data from patients to doctors. To highlight the applicability of the solution in various health monitoring scenarios, we have considered three use-cases, namely cardiac monitoring, sleep apnoea testing, and EEG following epileptic seizures. Following the discussion about the use cases, the paper outlines a security analysis performed on the proposed solution, based on multiple attack scenarios. Finally, the paper presents and discusses a performance evaluation in terms of data delivery time in comparison to existing centralized and decentralized solutions.

No abstract

We introduce Cloud4IoT, a platform offering automatic deployment, orchestration and dynamic configuration of IoT support software components and data-intensive applications for data processing and analytics, thus enabling plug-andplay integration of new sensor objects and dynamic workload scalability. Cloud4IoT enables the concept of Infrastructure as Code in the IoT context: it empowers IoT operations with the flexibility and elasticity of Cloud services. Furthermore it shifts traditionally centralized Cloud architectures towards a more distributed and decentralized computation paradigm, as required by IoT technologies, bridging the gap between Cloud Computing and IoT ecosystems. Thus, Cloud4IoT is playing a role similar to the one covered by solutions like Fog Computing, Cloudlets or Mobile Edge Cloud.The hierarchical architecture of Cloud4IoT hosts a central Cloud platform and multiple remote edge Cloud modules supporting dedicated devices, namely the IoT Gateways, through which new sensor objects are made accessible to the platform. Overall, the platform is designed in order to support systems where IoT-based and data intensive applications may pose specific requirements for low latency, restricted available bandwidth, or data locality.Cloud4IoT is built on several Open Source technologies for containerisation and implementations of standards, protocols and services for the IoT. We present the implementation of the platform and demonstrate it in two different use cases.