An overview of Fintech applications to solve the puzzle of health care funding: state-of-the-art in medical crowdfunding

Crowdfunding is emerging as an alternative form of funding for medical purposes, with capital being raised directly from a broader and more diverse audience of investors. In this paper, we have systematically researched and reviewed the literature on medical crowdfunding to determine how crowdfunding connects with the health care industry. The health care industry has been struggling to develop sustainable research and business models for economic systems and investors alike, especially in pharmaceuticals. The research results have revealed a wealth of evidence concerning the way crowdfunding is applied in real life. Patients and caregivers utilize web platform–based campaigns all over the world to fund their medical expenses, generally on a spot basis, using donation-based or even reward-based schemes, regardless of the health care system archetype (public, private insurance-based or hybrid). Academics have also focused on funding campaigns and the predictors of success (which range from social behaviour and environment to the basic demographics of the campaigners and their diseases) and on social and regulatory concerns, including heightened social inequality and stigma. While equity crowdfunding is disrupting the way many ventures/businesses seek capital in the market, our research indicates that there are no relevant or consistent data on the practice of medical equity crowdfunding in health care, apart from a few anecdotal cases

An Attempted Suicide with Copper Sulphate injected intravenously:Pathopsysiology and Therapy about a case report

Acute copper sulphate poisoning is an unusual event, rarely following parenteral exposure, complicated by toxicological effects as haemolytic anaemia, methaemoglobinaemia , hepato-renal damage and acute rhabdomyolysis. Currently, the therapeutic management ignores unique classes of evidence and is mainly based on supportive and chelation therapies. Case details. This case report describes acute copper sulphate poisoning in a 37-year-old man who attempted suicide by self-injecting an unknown amount of copper sulphate. Within three days the patient developed severe intravascular haemolysis and rhabdomyolysis. Initial therapy relied on intensive supportive care with fluids administration, electrolyte correction and packed red blood cells transfusion. The D-penicillamine (30 mg/Kg/day per os) was prescribed as chelation therapy by the poison control centre. The N-acetilcysteine and ascorbic acid were administered to prevent further oxidative stress. Later on, two sessions of therapeutic plasma exchange were performed in order to support the drug therapy. Haemolysis and rhabdomyolysis reversed throughout the hospital stay. Discussion. In this case the antidotic and antioxidant therapy resulted effective to reverse haemolysis and rhabdomyolysis and to prevent hepatic and renal damage. Moreover, this case underlies that therapeutic plasma exchange should be considered as an additive measure to undertake since the earlier stages of the emergency intervention. Acute copper sulphate poisoning is an event complicated by toxicological effects: haemolytic anaemia, methaemoglobinaemia, hepato-renal damage, acute rhabdomyolysis. The therapeutic management ignores unique classes of evidence and is based on supportive and chelation therapies. In this case: i) the antidotic and antioxidant therapy resulted effective to reverse haemolysis and rhabdomyolysis and to prevent hepatic and renal damage, ii) therapeutic plasma exchange should be considered as an additive measure to undertake

A case of infant botulism in a 4-month-old baby

This case-report highlights: i) the difficulty of IB diagnosis as it is a rare syndrome with subclinical onset, ii) the need for an accurate training for physicians involved in IB management, iii) the efficacy and safety of TEqA in IB treatment, iv) homemade honey is not the only cause of IB

Telemonitoraggio domiciliare per pazienti affetti da scompenso cardiaco: indagine osservazionale su compliance e gradimento degli utenti

Introduzione e scopo. I servizi di telemedicina possono svolgere un ruolo chiave nel rivedere il flusso di erogazione delle prestazioni e nel ridisegnare l'attuale assetto sanitario, con indubbi vantaggi economici e miglioramenti nella qualità di vita percepita, specialmente per le patologie cronico-degenerative, in evidente aumento per l’invecchiamento generale della popolazione. Nella letteratura poco è riportato sulla percezione che ha il paziente riguardo ai dispositivi di telemonitoraggio nonostante sia riconosciuto necessario considerare il gradimento degli utenti come indicatore atto a descrivere le performance dei sistemi di telesalute. Lo scopo di questo studio è analizzare la compliance e il gradimento dei pazienti con scompenso cardiaco rispetto l’uso degli strumenti di telemonitoraggio domiciliare. Materiali e metodi. È stata condotta un’indagine osservazionale quantitativa e qualitativa sui parametri rilevati dai pazienti con i devices di telemonitoraggio, consultando il portale sanitario del software medicale ed è stata calcolata la compliance in termini di giorni di trasmissione, dati inviati e completezza degli stessi. Per valutare il gradimento è stato somministrato un apposito questionario telefonico con risposte chiuse. Risultati. Poco più della metà dei pazienti intervistati ha inviato più dell’85% dei parametri richiesti e la maggioranza ha dimostrato una compliance verso l’uso del telemonitoraggio domiciliare ≥ al 75% dei giorni. La completezza dei dati si è rivelata ≥ al 70% solo per circa metà degli utenti. Dall’analisi delle risposte del questionario, complessivamente emerge un livello di gradimento soddisfacente, soprattutto per quanto riguardo il senso di sicurezza dato dal costante controllo clinico. Discussione e conclusioni. Gli attuali punti deboli del telemonitoraggio rilevati in questo studio sono l’incompetenza nell’uso di moderne tecnologie da parte di pazienti anziani e difetti nella strumentazione, fattori che sicuramente saranno facilmente superati nei prossimi anni. Per prevenire e limitare questi problemi, che possono diventare principale motivo di insoddisfazione del telemonitoraggio, è necessario prevedere follow-up a distanza di sei mesi – un anno, che valutino il grado di compliance e gradimento rispetto all’uso degli strumenti stessi; ciò permetterà di migliorare l’effetto positivo di questo sistema di telemedicina, ottimizzandone l’efficacia e l’efficienza.ope

Sulfurous thermal waters stimulate the osteogenic differentiation of human mesenchymal stromal cells - An in vitro study.

Strategies aimed at delaying the onset of bone tissue degeneration and the resulting skeletal fragility are key to decrease the risk of bone fracture correlated to ageing. The therapeutic properties of sulfurous thermal waters (STWs), rich in hydrogen sulfide (H2S), have been claimed for centuries. However, the direct regulation of bone cells by STWs has not been investigated yet. Here we aimed at analyzing the effect of STWs on cultured human mesenchymal stromal cells (hMSCs) derived from bone tissue. Two concentrations of STWs from 2 health spa centers in Italy (here named STW-1 and STW-2) containing, respectively, high and moderate quantities of H2S, were added to the culture media. Cytotoxicity and osteogenic differentiation were evaluated. We provided first evidence that treatment of hMSCs with STWs results in a sharp increase in intracellular H2S content, coherent with the different concentrations of H2S, thereby reveling that STWs-released H2S is internalized by cells. STWs treatment significantly induced osteogenic differentiation of hMSCs. In particular, mineral apposition was increased with a similar pattern by the two STWs, while mRNA expression of osteogenic markers (BSP, OC, RUNX-2, OPN) was differently affected. Only STW-2 induced a significant, dose-dependent increase in these gene expression. These findings support the rationale for the use of STWs as a complementary treatment of bone wasting diseases

An epistatic mini-circuitry between the transcription factors Snail and HNF4a controls liver stem cell and hepatocyte features exhorting opposite regulation on stemness-inhibiting microRNAs

Preservation of the epithelial state involves the stable repression of EMT program while maintenance of the stem compartment requires the inhibition of differentiation processes. A simple and direct molecular mini-circuitry between master elements of these biological processes, may provide the best device to keep balanced such complex phenomena. In this work, we show that in hepatic stem cell Snail, a transcriptional repressor of the hepatocyte differentiation master gene HNF4, directly represses the expression of the epithelial microRNAs-200c and -34a, which in turn target several stem cell genes. Notably, in differentiated hepatocytes HNF4, previously identified as a transcriptional repressor of Snail, induces the microRNAs-34a and -200a, b, c that, when silenced, causes epithelial dedifferentiation and reacquisition of stem traits. Altogether these data unveiled Snail, HNF4 and microRNAs -200a, b, c and -34a as epistatic elements controlling hepatic stem cell maintenance/differentiation

A coordinate deregulation of microRNAs expressed in mucosa adjacent to tumor predicts relapse after resection in localized colon cancer

Up to 20% of colorectal cancer (CRC) node-negative patients develop loco-regional or distant recurrences within 5 years from surgery. No predictive biomarker able to identify the node-negative subjects at high risk of relapse after curative treatment is presently available.Forty-eight localized (i.e. stage I-II) colon cancer patients who underwent radical tumor resection were considered. The expression of five miRNAs, involved in CRC progression, was investigated by qRT-PCR in both tumor tissue and matched normal colon mucosa.Interestingly, we found that the coordinate deregulation of four miRNAs (i.e. miR-18a, miR-21, miR-182 and miR-183), evaluated in the normal mucosa adjacent to tumor, is predictive of relapse within 55 months from curative surgery.Our results, if confirmed in independent studies, may help to identify high-risk patients who could benefit most from adjuvant therapy. Moreover, this work highlights the importance of extending the search for tissue biomarkers also to the tumor-adjacent mucosa

Do we still need financial intermediation? The case of decentralized finance – DeFi

Purpose Decentralized finance (DeFi), enabled by blockchain, could bring about a new financial system, where peers will interact directly, with little or no place for traditional intermediation. However, some crucial tasks cannot be left solely to an algorithm and, consequently, most DeFi applications still require human decisions. The aim of this research is to assess the role of intermediation in the light of DeFi, analysing how humans and algorithms will interact. Design/methodology/approach The authors based their work on a twofold qualitative methodology, first analysing publicly available secondary data, particularly from white papers and DeFi Pulse (a website providing data on DeFi solutions) and then running two focus group discussions. Findings DeFi does not eliminate financial intermediation, but enables it to be performed in new ways, where decentralization means that no single entity can hold too much power or monopoly. DeFi has, however, inherited risks from the underlying technologies that unintentionally facilitate illegal behaviour and can hamper the authorities' supervision. The complex duality algorithm- vs human-based actions will not be solved indisputably in favour of the former, as DeFi solutions can range from requiring algorithms to play a dominant role, to enabling greater human interaction by actively involving more people. Originality/value This research contributes to the emerging debate between algorithm- and human-based intermediation, especially in relation to the standing literature on financial intermediation, where considerations made in the light of the newest theories on blockchain and DeFi are still scarce

Evaluation of Dental Surface after De-Bonding Orthodontic Bracket Bonded with a Novel Fluorescent Composite: In Vitro Comparative Study

The use of a new fluorescent composite can reduce some of the problems related to procedures of de-bonding orthodontic bracket (enamel damage, dentine lesions, and composite residuals). The aim of the presented study was to compare the effect of fluorescent and conventional non-fluorescent composite on dental surface and composite remnants by in vitro de-bonding tests. De-bonding of florescent composite (DFC) and the de-bonding of standard composite (DSC) were performed by operators on an in vitro sample of 48 teeth under UV light (360–370 nm min 20 mW/cm2). Modified ARI (Adhesive Remnant Index), scored under 5.0×/235 magnification, was used for evaluation of dental surface after the procedure, and the duration required for de-bonding was measured. Significant differences in ARI between the two groups were observed (Pearson two-tailed p = 0.006 1.4 ± 0.1 95% C.I.), and the average duration of de-bonding was 38 s (DFC) and 77 s (DSC) per tooth, respectively (Mann–Whitney test p = 0.015; 57.7 ± 19.9 95% C.I.). The use of fluorescent composite could significantly improve the quality of de-bonding by reducing the quantity of composite residuals and visible enamel damage, while reducing time needed for successful procedure performance