CARE 1000: randomized controlled trial for the evaluation of the effectiveness of a mHealth app for supporting the first 1000 days of life

Background Recent developments in eHealth and mobile health (mHealth), as well as the introduction of information and communication technology innovations in clinical practice, such as telemedicine, telemonitoring, and remote examinations, are already changing the current scenario and will continue to generate innovations in the coming decades. The widespread use of mobile devices, with an estimated nearly 30 billion devices and more than 325,000 apps worldwide, will provide various opportunities for people to take control of their own health. Already in 2017, most of the apps available were focused on pregnancy support, more than any other medical field. There have been some reported experiences with social media and mHealth that could benefit the promotion of maternal physical and mental health during pregnancy. However, many apps targeting the first 1000 days of a child's life do not consider the continuity between the prenatal and postnatal periods and their joint impact on maternal and child health. The aim of this study is to evaluate the effectiveness of this mHealth app to support women during the first 1000 days (from conception to 24 months of age) and to improve health prevention behaviours such as immunizations during pregnancy, weight gain during pregnancy, abstinence from smoking and alcohol consumption, and adherence to the routine childhood immunization schedule. In addition, the study aims to understand the level of appreciation of this mHealth app as a tool to overcome information and communication gaps between patients and institutions. MethodsConduction of a randomized controlled trial. DiscussionOur results will be relevant for improving this mHealth app to promote health and prevention and to support the first 1000 days of life for both mother and child. Our results will be relevant to the future expansion of such an mHealth app to promote positive health-related outcomes in patients and co-user satisfaction and to support the organization of health services

Checklist of macro-invertebrates of the special conservation area “Poggi di prata”(Grosseto, Central Italy) through a citizen-science and expert-based approach

The assessment of species composition in a certain area may become outdated over time due to community dynamics including species range expansion, but also to local extinctions, species introductions and taxonomic redefinition. Therefore, updated checklists are required for animal conservation and management. Exhaustive checklists of invertebrate species may be challenging, as species determination often requires the analysis by specialists, but they are fundamental for local conservation practices. In this work, we provided an annotated preliminary checklist of invertebrates of the Special Conservation Area “Poggi di Prata” (province of Grosseto, southern Tuscany), detected through field samplings with experts, and a permanent Bioblitz set out on an online citizen-science platform (iNaturalist.org). The final dataset (1898-2020) included 329 records of 282 species (217 insects, 34 gastropods, 30 arachnids and 1 chilopod). Most records were uploaded on iNaturalist (about 56.5%), others came from observations or sampling collections (37%) and were determined by specialists. Only the remaining 6.5% of records came from published studies. Three species were protected by the Habitat Directive, 15 by the Tuscan Regional Law. We also detected two endemic or near-endemic taxa of this area: the beetle Paramaurops diecki massetanus and the land snail Marmorana saxetana. The unexpected (Italian southernmost) record of Gaurotes virginea needs to be deepened. Furthermore, 12 alien species, including insects affecting human economy and wellness (e.g., Rhinchophorous ferrugineus, Aedes albopictus, Halyomorpha halys, Dryocosmus kuriphilus and Cydalima perspectalis), were also detected. With our work, we confirmed that citizen-science platforms (e.g. iNaturalist) are valuable tools, complementary to field-work by specialists, to map local biodiversity and they may help to improve biogeographical knowledge

From shallow to very shallow image of the highly active Kefalonia - Zakynthos fault system

4 pages, 2 figuresIn May 2022 and June 2023 two oceanographic cruises were carried out around the Ionian Islands with the aim of defining the real geometry of the strike-slip fault system of Kefalonia and of the reverse faults present south of Zakynthos. The acquired multidisciplinary and multiresolution data will also allow to understand the dynamics of the area offshore the Peoloponnese peninsula, the deformation of the surface sediments at the transition of the two systems, i.e. from reverse fault system to strike-slip fault system, and the relationship between the recorded seismicity and mapped fault activity. To date, the analysis of the processed data has allowed us to define the tectonic and morphological complexity of the fault system affecting the investigated area. [...]Thanks to the CNR for supporting the cruise with time ship, IONIANS 2022 project. Interpretation of seismic profile has been done using the Kindgom IHS Markit. Poseidon project has been supported by Eurofleet+ SEA02_13_POSEIDONPeer reviewe

ITALIAN CANCER FIGURES - REPORT 2015: The burden of rare cancers in Italy = I TUMORI IN ITALIA - RAPPORTO 2015: I tumori rari in Italia

OBJECTIVES: This collaborative study, based on data collected by the network of Italian Cancer Registries (AIRTUM), describes the burden of rare cancers in Italy. Estimated number of new rare cancer cases yearly diagnosed (incidence), proportion of patients alive after diagnosis (survival), and estimated number of people still alive after a new cancer diagnosis (prevalence) are provided for about 200 different cancer entities. MATERIALS AND METHODS: Data herein presented were provided by AIRTUM population- based cancer registries (CRs), covering nowadays 52% of the Italian population. This monograph uses the AIRTUM database (January 2015), which includes all malignant cancer cases diagnosed between 1976 and 2010. All cases are coded according to the International Classification of Diseases for Oncology (ICD-O-3). Data underwent standard quality checks (described in the AIRTUM data management protocol) and were checked against rare-cancer specific quality indicators proposed and published by RARECARE and HAEMACARE (www.rarecarenet.eu; www.haemacare.eu). The definition and list of rare cancers proposed by the RARECAREnet "Information Network on Rare Cancers" project were adopted: rare cancers are entities (defined as a combination of topographical and morphological codes of the ICD-O-3) having an incidence rate of less than 6 per 100,000 per year in the European population. This monograph presents 198 rare cancers grouped in 14 major groups. Crude incidence rates were estimated as the number of all new cancers occurring in 2000-2010 divided by the overall population at risk, for males and females (also for gender-specific tumours).The proportion of rare cancers out of the total cancers (rare and common) by site was also calculated. Incidence rates by sex and age are reported. The expected number of new cases in 2015 in Italy was estimated assuming the incidence in Italy to be the same as in the AIRTUM area. One- and 5-year relative survival estimates of cases aged 0-99 years diagnosed between 2000 and 2008 in the AIRTUM database, and followed up to 31 December 2009, were calculated using complete cohort survival analysis. To estimate the observed prevalence in Italy, incidence and follow-up data from 11 CRs for the period 1992-2006 were used, with a prevalence index date of 1 January 2007. Observed prevalence in the general population was disentangled by time prior to the reference date (≤2 years, 2-5 years, ≤15 years). To calculate the complete prevalence proportion at 1 January 2007 in Italy, the 15-year observed prevalence was corrected by the completeness index, in order to account for those cancer survivors diagnosed before the cancer registry activity started. The completeness index by cancer and age was obtained by means of statistical regression models, using incidence and survival data available in the European RARECAREnet data. RESULTS: In total, 339,403 tumours were included in the incidence analysis. The annual incidence rate (IR) of all 198 rare cancers in the period 2000-2010 was 147 per 100,000 per year, corresponding to about 89,000 new diagnoses in Italy each year, accounting for 25% of all cancer. Five cancers, rare at European level, were not rare in Italy because their IR was higher than 6 per 100,000; these tumours were: diffuse large B-cell lymphoma and squamous cell carcinoma of larynx (whose IRs in Italy were 7 per 100,000), multiple myeloma (IR: 8 per 100,000), hepatocellular carcinoma (IR: 9 per 100,000) and carcinoma of thyroid gland (IR: 14 per 100,000). Among the remaining 193 rare cancers, more than two thirds (No. 139) had an annual IR <0.5 per 100,000, accounting for about 7,100 new cancers cases; for 25 cancer types, the IR ranged between 0.5 and 1 per 100,000, accounting for about 10,000 new diagnoses; while for 29 cancer types the IR was between 1 and 6 per 100,000, accounting for about 41,000 new cancer cases. Among all rare cancers diagnosed in Italy, 7% were rare haematological diseases (IR: 41 per 100,000), 18% were solid rare cancers. Among the latter, the rare epithelial tumours of the digestive system were the most common (23%, IR: 26 per 100,000), followed by epithelial tumours of head and neck (17%, IR: 19) and rare cancers of the female genital system (17%, IR: 17), endocrine tumours (13% including thyroid carcinomas and less than 1% with an IR of 0.4 excluding thyroid carcinomas), sarcomas (8%, IR: 9 per 100,000), central nervous system tumours and rare epithelial tumours of the thoracic cavity (5%with an IR equal to 6 and 5 per 100,000, respectively). The remaining (rare male genital tumours, IR: 4 per 100,000; tumours of eye, IR: 0.7 per 100,000; neuroendocrine tumours, IR: 4 per 100,000; embryonal tumours, IR: 0.4 per 100,000; rare skin tumours and malignant melanoma of mucosae, IR: 0.8 per 100,000) each constituted <4% of all solid rare cancers. Patients with rare cancers were on average younger than those with common cancers. Essentially, all childhood cancers were rare, while after age 40 years, the common cancers (breast, prostate, colon, rectum, and lung) became increasingly more frequent. For 254,821 rare cancers diagnosed in 2000-2008, 5-year RS was on average 55%, lower than the corresponding figures for patients with common cancers (68%). RS was lower for rare cancers than for common cancers at 1 year and continued to diverge up to 3 years, while the gap remained constant from 3 to 5 years after diagnosis. For rare and common cancers, survival decreased with increasing age. Five-year RS was similar and high for both rare and common cancers up to 54 years; it decreased with age, especially after 54 years, with the elderly (75+ years) having a 37% and 20% lower survival than those aged 55-64 years for rare and common cancers, respectively. We estimated that about 900,000 people were alive in Italy with a previous diagnosis of a rare cancer in 2010 (prevalence). The highest prevalence was observed for rare haematological diseases (278 per 100,000) and rare tumours of the female genital system (265 per 100,000). Very low prevalence (<10 prt 100,000) was observed for rare epithelial skin cancers, for rare epithelial tumours of the digestive system and rare epithelial tumours of the thoracic cavity. COMMENTS: One in four cancers cases diagnosed in Italy is a rare cancer, in agreement with estimates of 24% calculated in Europe overall. In Italy, the group of all rare cancers combined, include 5 cancer types with an IR>6 per 100,000 in Italy, in particular thyroid cancer (IR: 14 per 100,000).The exclusion of thyroid carcinoma from rare cancers reduces the proportion of them in Italy in 2010 to 22%. Differences in incidence across population can be due to the different distribution of risk factors (whether environmental, lifestyle, occupational, or genetic), heterogeneous diagnostic intensity activity, as well as different diagnostic capacity; moreover heterogeneity in accuracy of registration may determine some minor differences in the account of rare cancers. Rare cancers had worse prognosis than common cancers at 1, 3, and 5 years from diagnosis. Differences between rare and common cancers were small 1 year after diagnosis, but survival for rare cancers declined more markedly thereafter, consistent with the idea that treatments for rare cancers are less effective than those for common cancers. However, differences in stage at diagnosis could not be excluded, as 1- and 3-year RS for rare cancers was lower than the corresponding figures for common cancers. Moreover, rare cancers include many cancer entities with a bad prognosis (5-year RS <50%): cancer of head and neck, oesophagus, small intestine, ovary, brain, biliary tract, liver, pleura, multiple myeloma, acute myeloid and lymphatic leukaemia; in contrast, most common cancer cases are breast, prostate, and colorectal cancers, which have a good prognosis. The high prevalence observed for rare haematological diseases and rare tumours of the female genital system is due to their high incidence (the majority of haematological diseases are rare and gynaecological cancers added up to fairly high incidence rates) and relatively good prognosis. The low prevalence of rare epithelial tumours of the digestive system was due to the low survival rates of the majority of tumours included in this group (oesophagus, stomach, small intestine, pancreas, and liver), regardless of the high incidence rate of rare epithelial cancers of these sites. This AIRTUM study confirms that rare cancers are a major public health problem in Italy and provides quantitative estimations, for the first time in Italy, to a problem long known to exist. This monograph provides detailed epidemiologic indicators for almost 200 rare cancers, the majority of which (72%) are very rare (IR<0.5 per 100,000). These data are of major interest for different stakeholders. Health care planners can find useful information herein to properly plan and think of how to reorganise health care services. Researchers now have numbers to design clinical trials considering alternative study designs and statistical approaches. Population-based cancer registries with good quality data are the best source of information to describe the rare cancer burden in a population

A novel extension of the SYNTHSEP methodology for the optimal synthesis and design of supercritical CO2 cycles in waste heat recovery applications

The reduction of anthropogenic emissions of greenhouse gases requires decreasing the overall consumption of primary energy. Thus, waste heat recovery at medium-to-high temperature is an opportunity for generating electricity while reducing the need for primary resources. Recently, supercritical carbon dioxide power cycles (S-CO2) are emerging as a promising solution. However, a method lacks to simultaneously optimize their layout and design parameters, without relying on superstructures defined a priori. To this end, this paper suggests a novel extension of the superstructure free SYNTHSEP methodology, a bottom-up approach for the optimal synthesis and design of thermodynamic cycles, to handle also super-and transcritical cycles. An Evolutionary Algorithm combining elementary cycles makes it possible to define optimal S-CO2 configurations without limiting the search space of the optimization problem. The objective consists in finding the S-CO2 topology and design pa-rameters that maximize the mechanical power extractable from waste heat streams in the temperature range from 200 to 700 degrees C, typical of the industrial sector. Results demonstrate the capability of the method to find optimal cycle layouts for any given waste heat temperature, and to achieve, at the same conditions, cycle effi-ciencies up to 5 % higher in relative terms than the best ones in the literature

High-level Integrated Design Environment for

For most systems, especially dependable, real-time systems for critical applications, an effective design process requires an early validation of the concepts and architectural choices, without wasting time and resources prior of checking whether the system fulfils its objectives or needs some re-design. Although a thorough system specification surely increases the level of confidence that can be put on a system, it is insufficient to guarantee that the system will adequately perform its tasks during its entire life-cycle. The early evaluation of system characteristics like dependability, timeliness, and correctness, is thus necessary to assess the conformance of the system under development to its targets. This paper presents some activities currently performed towards an integrated environment for the design and the validation of dependable systems.

Benzylaminopurine Application on Two Different Apple Cultivars (Malus domestica) Displays New and Unexpected Fruitlet Abscission Features

Background and Aims: It has been previously shown that abscission of apple fruitlets is preceded by an increase in ethylene evolution and in the amount of transcripts for 1-aminocyclopropane-1-carboxylate oxidase (ACO), an enzyme catalysing the final step in ethylene biosynthesis. These events are concomitant with shedding induction and chemical thinning. There are several thinners but their mode of action and efficacy is poorly understood. One of them is benzylaminopurine (BA), a cytokinin believed to act by enhancing vegetative activity and stressing the competition between shoots and fruitlets, thus leading to fruitlet shedding. Nevertheless, the specific mechanism of action of BA and the variable effect depending on apple cultivar (easy or difficult to thin) are poorly understood. Methods: Abscission, the amount of MdACO1 transcripts and other parameters were followed in immature apple fruits during the period of physiological drop. The cultivars studied were \u2018Golden Delicious\u2019 and the \u2018spur\u2019 type \u2018Red Delicious\u2019. BA was used as a thinning agent and was sprayed 14 d after petal fall (DAPF). Fruitlets were divided into central (C) and lateral (L) fruitlet populations. Key Results: Fruitlet size was significantly different between C and L fruitlets but it did not differ much between the populations within the same cultivar. C fruitlets were characterized by basal ethylene evolution while L fruitlets displayed an increase in hormone biosynthesis during abscission induction. Cluster composition evaluated by the L/C ratio differed in the two varieties, being almost unchanged throughout abscission induction in \u2018Golden Delicious\u2019 and progressively decreasing in \u2018Red Delicious\u2019. Shoot growth activity evaluated at the end of the season indicated a possible connection with both the ongoing abscission and BA application. MDACO1 transcripts were mainly detected in L fruitlets and the accumulation was related to total abscission in \u2018Golden Delicious\u2019, while in \u2018Red Delicious\u2019 expression was observed in both C and L fruitlets. Conclusions: BA probably exerts its thinning effect through vegetative growth. In the \u2018spur\u2019 type \u2018Red Delicious\u2019 the chemical is ineffective, probably due to a limited action on shoot growth due to genetic characteristics. The amount of MdACO1 transcripts in seeds is a good indicator of abscission