Big data in health IoE in emergency situations: between the right to privacy and digital health innovation

The chapters of the thesis focus on a limited variety of selected themes in EU privacy and data protection law. Chapter 1 sets out the general introduction on the research topic. Chapter 2 touches upon the methodology used in the research. Chapter 3 conceptualises the basic notions from a legal standpoint. Chapter 4 examines the current regulatory regime applicable to digital health technologies, healthcare emergencies, privacy, and data protection. Chapter 5 provides case studies on the application deployed in the Covid-19 scenario, from the perspective of privacy and data protection. Chapter 6 addresses the post-Covid European regulatory initiatives on the subject matter, and its potential effects on privacy and data protection. Chapter 7 is the outcome of a six-month internship with a company in Italy and focuses on the protection of fundamental rights through common standardisation and certification, demonstrating that such standards can serve as supporting tools to guarantee the right to privacy and data protection in digital health technologies. The thesis concludes with the observation that finding and transposing European privacy and data protection standards into scenarios, such as public healthcare emergencies where digital health technologies are deployed, requires rapid coordination between the European Data Protection Authorities and the Member States guarantee that individual privacy and data protection rights are ensured.

Integration of heterogeneous data sources and automated reasoning in healthcare and domotic IoT systems

In recent years, IoT technology has radically transformed many crucial industrial and service sectors such as healthcare. The multi-facets heterogeneity of the devices and the collected information provides important opportunities to develop innovative systems and services. However, the ubiquitous presence of data silos and the poor semantic interoperability in the IoT landscape constitute a significant obstacle in the pursuit of this goal. Moreover, achieving actionable knowledge from the collected data requires IoT information sources to be analysed using appropriate artificial intelligence techniques such as automated reasoning. In this thesis work, Semantic Web technologies have been investigated as an approach to address both the data integration and reasoning aspect in modern IoT systems. In particular, the contributions presented in this thesis are the following: (1) the IoT Fitness Ontology, an OWL ontology that has been developed in order to overcome the issue of data silos and enable semantic interoperability in the IoT fitness domain; (2) a Linked Open Data web portal for collecting and sharing IoT health datasets with the research community; (3) a novel methodology for embedding knowledge in rule-defined IoT smart home scenarios; and (4) a knowledge-based IoT home automation system that supports a seamless integration of heterogeneous devices and data sources.

Untangle sustainable development goal 8 through data visualization and HCI methods

Following the approval of the 2030 Agenda for Sustainable Development in 2015, sustainability became a hotly debated topic. In order to build a better and more sustainable future by 2030, this agenda addressed several global issues, including inequality, climate change, peace, and justice, in the form of 17 Sustainable Development Goals (SDGs), that should be understood and pursued by nations, corporations, institutions, and individuals. In this thesis, we researched how to exploit and integrate Human-Computer Interaction (HCI) and Data Visualization to promote knowledge and awareness about SDG 8, which wants to encourage lasting, inclusive, and sustainable economic growth, full and productive employment, and decent work for all. In particular, we focused on three targets: green economy, sustainable tourism, employment, decent work for all, and social protection. The primary goal of this research is to determine whether HCI approaches may be used to create and validate interactive data visualization that can serve as helpful decision-making aids for specific groups and raise their knowledge of public-interest issues. To accomplish this goal, we analyzed four case studies. In the first two, we wanted to promote knowledge and awareness about green economy issues: we investigated the Human-Building Interaction inside a Smart Campus and the dematerialization process inside a University. In the third, we focused on smart tourism, investigating the relationship between locals and tourists to create meaningful connections and promote more sustainable tourism. In the fourth, we explored the industry context to highlight sustainability policies inside well-known companies. This research focuses on the hypothesis that interactive data visualization tools can make communities aware of sustainability aspects related to SDG8 and its targets. The research questions addressed are two: "how to promote awareness about SDG8 and its targets through interactive data visualizations?" and "to what extent are these interactive data visualizations effective?".

Decentralized systems for the protection and portability of personal data

The General Data Protection Regulation (GDPR) has been designed to help promote a view in favor of the interests of individuals instead of large corporations. However, there is the need of more dedicated technologies that can help companies comply with GDPR while enabling people to exercise their rights. We argue that such a dedicated solution must address two main issues: the need for more transparency towards individuals regarding the management of their personal information and their often hindered ability to access and make interoperable personal data in a way that the exercise of one's rights would result in straightforward. We aim to provide a system that helps to push personal data management towards the individual's control, i.e., a personal information management system (PIMS). By using distributed storage and decentralized computing networks to control online services, users' personal information could be shifted towards those directly concerned, i.e., the data subjects. The use of Distributed Ledger Technologies (DLTs) and Decentralized File Storage (DFS) as an implementation of decentralized systems is of paramount importance in this case. The structure of this dissertation follows an incremental approach to describing a set of decentralized systems and models that revolves around personal data and their subjects. Each chapter of this dissertation builds up the previous one and discusses the technical implementation of a system and its relation with the corresponding regulations. We refer to the EU regulatory framework, including GDPR, eIDAS, and Data Governance Act, to build our final system architecture's functional and non-functional drivers. In our PIMS design, personal data is kept in a Personal Data Space (PDS) consisting of encrypted personal data referring to the subject stored in a DFS. On top of that, a network of authorization servers acts as a data intermediary to provide access to potential data recipients through smart contracts.

Deploying and processing neural representations of signals

Neural representations (NR) have emerged in the last few years as a powerful tool to represent signals from several domains, such as images, 3D shapes, or audio. Indeed, deep neural networks have been shown capable of approximating continuous functions that describe a given signal with theoretical infinite resolution. This finding allows obtaining representations whose memory footprint is fixed and decoupled from the resolution at which the underlying signal can be sampled, something that is not possible with traditional discrete representations, e.g., grids of pixels for images or voxels for 3D shapes. During the last two years, many techniques have been proposed to improve the capability of NR to approximate high-frequency details and to make the optimization procedures required to obtain NR less demanding both in terms of time and data requirements, motivating many researchers to deploy NR as the main form of data representation for complex pipelines. Following this line of research, we first show that NR can approximate precisely Unsigned Distance Functions, providing an effective way to represent garments that feature open 3D surfaces and unknown topology. Then, we present a pipeline to obtain in a few minutes a compact Neural Twin® for a given object, by exploiting the recent advances in modeling neural radiance fields. Furthermore, we move a step in the direction of adopting NR as a standalone representation, by considering the possibility of performing downstream tasks by processing directly the NR weights. We first show that deep neural networks can be compressed into compact latent codes. Then, we show how this technique can be exploited to perform deep learning on implicit neural representations (INR) of 3D shapes, by only looking at the weights of the networks.

Neo-commodification of persons: exploitation of personal data and impact on the sharing economy

The notion of commodification is a fascinating one. It entails many facets, ranging from subjective debates on desirability of commodification to in depth economic analyses of objects of value and their corresponding markets. Commodity theory is therefore not just defined by a single debate, but spans a plethora of different discussions. This thesis maps and situates those theories and debates and selects one specific strain to investigate further. This thesis argues that commodity theory in its optima forma deals with the investigation into what sets commodities apart from non-commodities. It proceeds to examine the many given answers to this question by scholars ranging from the mid 1800’s to the late 2000’s. Ultimately, commodification is defined as a process in which an object becomes an element of the total wealth of societies in which the capitalist mode of production prevails. In doing so, objects must meet observables, or indicia, of commodification provided by commodity theories. Problems arise when objects are clearly part of the total wealth in societies without meeting established commodity indicia. In such cases, objects are part of the total wealth of a society without counting as a commodity. This thesis examines this phenomenon in relation to the novel commodities of audiences and data. It explains how these non-commodities (according to classical theories) are still essential elements of industry. The thesis then takes a deep dive into commodity theory using the theory on the construction of social reality by John Searle.

Patient data sharing for the improvement of healthcare and medical research: towards a moral duty of patients to share health-related data?

The project answers to the following central research question: ‘How would a moral duty of patients to transfer (health) data for the benefit of health care improvement, research, and public health in the eHealth sector sit within the existing confidentiality, privacy, and data protection legislations?’. The improvement of healthcare services, research, and public health relies on patient data, which is why one might raise the question concerning a potential moral responsibility of patients to transfer data concerning health. Such a responsibility logically would have subsequent consequences for care providers concerning the further transferring of health data with other healthcare providers or researchers and other organisations (who also possibly transfer the data further with others and other organisations). Otherwise, the purpose of the patients’ moral duty, i.e. to improve the care system and research, would be undermined. Albeit the arguments that may exist in favour of a moral responsibility of patients to share health-related data, there are also some moral hurdles that come with such a moral responsibility. Furthermore, the existing European and national confidentiality, privacy and data protection legislations appear to hamper such a possible moral duty, and they may need to be reconsidered to unlock the full use of data for healthcare and research.

Correlation Between The Friedman Staging System And The Upper Airway Volume In Patients With Obstructive Sleep Apnea.

This study was designed to evaluate the correlation between computed tomography findings and data from the physical examination and the Friedman Staging System (FSS) in patients with obstructive sleep apnea (OSA). We performed a retrospective evaluation by reviewing the medical records of 33 patients (19 male and 14 female patients) with a mean body mass index of 30.38 kg/m(2) and mean age of 49.35 years. Among these patients, 14 presented with severe OSA, 7 had moderate OSA, 7 had mild OSA, and 5 were healthy. The patients were divided into 2 groups according to the FSS: Group A comprised patients with FSS stage I or II, and group B comprised patients with FSS stage III. By use of the Fisher exact test, a positive relationship between the FSS stage and apnea-hypopnea index (P = .011) and between the FSS stage and body mass index (P = .012) was found. There was no correlation between age (P = .55) and gender (P = .53) with the FSS stage. The analysis of variance test comparing the upper airway volume between the 2 groups showed P = .018. In this sample the FSS and upper airway volume showed an inverse correlation and were useful in analyzing the mechanisms of airway collapse in patients with OSA.

Retention force of T-bar clasps for titanium and cobalt-chromium removable partial dentures

The objective of this study was to evaluate the retention force of T-bar clasps made from commercially pure titanium (CP Ti) and cobalt-chromium (Co-Cr) alloy by the insertion/removal test simulating 5 years use. Thirty-six frameworks were cast from CP Ti (n=18) and Co-Cr alloy (n=18) with identical prefabricated patterns on refractory casts from a distal extension mandibular hemi-arch segment. The castings were made on a vacuum-pressure machine, under vacuum and argon atmosphere. Each group was subdivided in three, corresponding to 0.25 mm, 0.50 mm and 0.75 mm undercuts, respectively. No polishing procedures were performed to ensure uniformity. The specimens were subjected to an insertion/removal test and data was analyzed statistically to compare CP Ti and Co-Cr alloy in the same undercut (Student's t-test for independent samples) and each material in different undercuts (one-way ANOVA) (p=0.05). Comparisons between materials revealed significant differences (p=0.017) only for the 0.50-mm undercut. No significant differences (p>0.05) were found when comparing the same material for the undercuts. It may be concluded that for different undercuts, both Co-Cr alloy and CP Ti had no significant differences for T-bar clasps; CP Ti showed the lowest retention force values when compared to Co-Cr alloy in each undercut, but with significant difference only for the 0.50-mm undercut; and both materials maintained the retentive capacity during the simulation test.

Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer

The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001) and decreased xerostomia-related symptoms (VAS, p < 0.05) compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

Tendência e diferenciais socioeconômicos da mortalidade por câncer de colo de útero no Estado do Paraná (Brasil), 1980-2000

O objetivo deste artigo é discutir a evolução da mortalidade por câncer de colo de útero no Estado do Paraná entre 1980 e 2000 e analisar seus diferenciais socioeconômicos em cada região. Taxas de mortalidade ajustadas por idade foram calculadas para as 22 regionais de saúde do Estado a cada ano. Análises comparativas avaliaram indicadores socioeconômicos associados com regiões que apresentaram tendência estacionária e crescente de mortalidade. A mortalidade por câncer de colo uterino cresceu no Estado como um todo a uma taxa de 1,68% (IC 1,20-2,17) ao ano. A maior parte das regiões apresentou tendência estacionária de mortalidade por câncer de colo de útero. As regionais com tendência de aumento na mortalidade apresentaram proporção significativamente mais elevada de analfabetismo (p<0,001) e de adultos (15 anos ou mais) com menos de 4 anos de estudo (p=0,001), e renda per capita (p=0,025) e IDH (p=0,023) inferiores. Houve tendência de aumento na mortalidade em todo o Estado; as regiões que contribuíram para o aumento experimentaram piores indicadores socioeconômicos.

Tendência temporal e desigualdades na mortalidade por diarreias em menores de 5 anos

OBJETIVO: Analisar a tendência da mortalidade por diarreia entre menores de 5 anos, no município de Osasco (SP), entre 1980 e 2000. MÉTODOS: Trata-se de estudo observacional com dois delineamentos. Um descritivo, que toma o indivíduo como unidade do estudo, e outro ecológico, analisando agregado populacional que incluiu análise de séries temporais. A fonte de dados foi o sistema de informação de mortalidade do Estado de São Paulo e censos de 1980, 1991 e 2000. Descreveu-se a variação sazonal e para a análise de tendência aplicaram-se modelos log lineares de regressão polinomiais, utilizando-se variáveis sociodemográficas da criança e da mãe. Foram analisadas a evolução de indicadores sociodemográficos do município de 1980 a 2000, as taxas médias de mortalidade por diarreia nos menores de 5 anos e seus diferenciais por distrito nos anos 90. RESULTADOS: Dos 1.360 óbitos, 94,3 e 75,3% atingiram, respectivamente, menores de 1 ano e de 6 meses. O declínio da mortalidade foi de 98,3%, com deslocamento da sazonalidade do verão para o outono. A mediana da idade elevou-se de 2 meses nos primeiros períodos para 3 meses no último. O resíduo de óbitos manteve-se entre filhos de mães de 20 a 29 anos e escolaridade < 8 anos. O risco relativo entre o distrito mais atingido e a taxa média do município diminuiu de 3,4 para 1,3 do primeiro para o segundo quinquênio dos anos 90. CONCLUSÃO: Nossos resultados apontam uma elevação da idade mais vulnerável e a provável mudança do agente mais frequentemente associado ao óbito por diarreia.