Telemedicine and home care: controversies and opportunities

Summary This review focuses on the prospects, and possible drawbacks, of a new innovative instrument of care known as "home telehealth", "telecare" or "telemedicine". The main results from utilising telemedicine in respiratory diseases (asthma and chronic obstructive pulmonary disease (COPD) as the illustrative conditions) are presented. A principal goal of telemedicine is to improve access to healthcare services. During this process, savings in time and travel costs should be achieved, thereby rationalising access to medical care. The field of telemedicine is relatively new and expanding. In order to establish evidencebased guidelines for the design and implementation of disease management plans that employ telemedicine, further research is required. Telemedicine is not simply "technology" but an innovative medical approach (based more on a dedicated healthcare team than on high-tech instruments) that will help the medical team to care for patients and their families. In the future, it is hoped that telemedicine will form a valuable part of the disease management process, because, when used intelligently, home telehealth should supplement conventional delivery techniques and not replace them

1951–2017 changes in the frequency of days with visibility higher than 10 km and 20 km in Italy

Daily visibility records of the Italian Air Force synoptic stations over the 1951\u20132017 period have been used to set up a monthly quality/homogeneity checked dataset of fraction of days with visibility higher than or equal to 10 km (fVV10) and 20 km (fVV20) at 12 UTC. This dataset has been used to calculate regional average fVV10 and fVV20 records for 5 Italian climatic regions. The fVV10 and fVV20 averages show a strong spatial variability with the lowest values in the Po plain, one of the most polluted areas of Europe. In agreement with the results reported in literature for Europe, fVV10 and fVV20 show a positive trend over the whole considered period due to a strong increase starting in the 1980s. Differently, in the previous period, visibility decreases. Moreover, moving from low level areas to mid and high level ones the trends become much weaker, highlighting how the signal decreases with elevation. The analyses performed removing the days with high relative humidity or considering only the clear-sky days show that relative humidity and cloudiness do not have any effect on the observed trends, suggesting that the main driving factor is aerosol load. This hypothesis is supported by the comparison of visibility records with modelled aerosol concentrations, atmospheric optical depth values and emission records. Finally, the trends of fVV10 and fVV20 are in very good agreement with Italian regional records of other variables linked to atmospheric turbidity, like sunshine duration and surface solar radiation

Prebiotic synthesis of cysteine peptides that catalyze peptide ligation in neutral water

Peptide biosynthesis is performed by ribosomes and several other classes of enzymes, but a simple chemical synthesis may have created the first peptides at the origins of life. a-Aminonitriles—prebiotic a–amino acid precursors—are generally produced by Strecker reactions. However, cysteine’s aminothiol is incompatible with nitriles. Consequently, cysteine nitrile is not stable, and cysteine has been proposed to be a product of evolution, not prebiotic chemistry. We now report a high-yielding, prebiotic synthesis of cysteine peptides. Our biomimetic pathway converts serine to cysteine by nitrile-activated dehydroalanine synthesis. We also demonstrate that N-acylcysteines catalyze peptide ligation, directly coupling kinetically stable—but energy-rich—a-amidonitriles to proteinogenic amines. This rare example of selective and efficient organocatalysis in water implicates cysteine as both catalyst and precursor in prebiotic peptide synthesis

Nitrate, sulphate and chloride contents in public drinking water supplies in Sicily, Italy

Water samples collected from public drinking water supplies in Sicily were analysed for electric conductivity and for their chloride, sulphate and nitrate contents. The samples were collected as uniformly as possible from throughout the Sicilian territory, with an average sampling density of about one sample for every 7,600 inhabitants. Chloride contents that ranged from 5.53 to 1,302 mg/l were correlated strongly with electric conductivity, a parameter used as a proxy for water salinity. The highest values are attributable to seawater contamination along the coasts of the island. High chloride and sulphate values attributable to evaporitic rock dissolution were found in the central part of Sicily. The nitrate concentrations ranged from 0.05 to 296 mg/l, with 31 samples (4.7% of the total) exceeding the maximum admissible concentration of 50 mg/l. Anomalous samples always came from areas of intensive agricultural usage, indicating a clear anthropogenic origin. The same parameters were also measured in bottled water sold in Sicily, and they all were within the ranges for public drinking water supplies. The calculated mean nitrate intake from consuming public water supplies (16.1 mg/l) did not differ significantly from that of bottled water (15.2 mg/l). Although the quality of public water supplies needs to be improved by eliminating those that do not comply with the current drinking water limits, at present it does not justify the high consumption of bottled water (at least for nitrate contents)

Determinants of Metabolic Health Across Body Mass Index Categories in Central Europe: A Comparison Between Swiss and Czech Populations.

Comparisons among countries can help to identify opportunities for the reduction of inequalities in cardiometabolic health. The present cross-sectional analysis and meta-analysis aim to address to what extent obesity traits, socioeconomic, and behavioral factors determine poor metabolic health across body mass index (BMI) categories in two urban population-based samples from Central Europe. Data from the CoLaus (~6,000 participants; Lausanne, Switzerland) and the Kardiovize Brno 2030 (~2,000 participants; Brno, Czech Republic) cohorts. For each cohort, logistic regression analyses were performed to identify the main determinants of poor metabolic health overall and stratified by body mass index (BMI) categories. The results of each cohort were then combined in a meta-analysis. We first observed that waist circumference and body fat mass were associated with metabolic health, especially in non-obese individuals. Moreover, increasing age, being male, having low-medium educational level, abdominal obesity, and high body fat mass were the main determinants of the metabolically unhealthy profile in both cohorts. Meta-analysis stratified by BMI categories confirmed the previous results with slight differences across BMI categories. In fact, increasing age and being male were the main determinants of poor metabolic health independent of obesity status. In contrast, low educational level and current smoking were associated with poor metabolic health only in non-obese individuals. In line, public health strategies against obesity and related comorbidities should aim to improve social conditions and to promote healthy lifestyles before the progression of metabolic disorders

Mediterranean Diet as a Shield against Male Infertility and Cancer Risk Induced by Environmental Pollutants: A Focus on Flavonoids

The role of environmental factors in influencing health status is well documented. Heavy metals, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, dioxins, pesticides, ultrafine particles, produced by human activities put a strain on the body’s entire defense system. Therefore, together with public health measures, evidence-based individual resilience measures are necessary to mitigate cancer risk under environmental stress and to prevent reproductive dysfunction and non-communicable diseases; this is especially relevant for workers occupationally exposed to pollutants and/or populations residing in highly polluted areas. The Mediterranean diet is characterized by a high intake of fruits and vegetables rich in flavonoids, that can promote the elimination of pollutants in tissues and fluids and/or mitigate their effects through different mechanisms. In this review, we collected evidence from pre-clinical and clinical studies showing that the impairment of male fertility and gonadal development, as well as cancers of reproductive system, due to the exposure of organic and inorganic pollutants, may be counteracted by flavonoids

Neuroprotective Effects of Physical Activity via the Adaptation of Astrocytes

The multifold benefits of regular physical exercise have been largely demonstrated in human and animal models. Several studies have reported the beneficial effects of physical activity, both in peripheral tissues and in the central nervous system (CNS). Regular exercise improves cognition, brain plasticity, neurogenesis and reduces the symptoms of neurodegenerative diseases, making timeless the principle of "mens sana in corpore sano" (i.e., a healthy mind in a healthy body). Physical exercise promotes morphological and functional changes in the brain, acting not only in neurons but also in astrocytes, which represent the most numerous glial cells in the brain. The multiple effects of exercise on astrocytes comprise the increased number of new astrocytes, the maintenance of basal levels of catecholamine, the increase in glutamate uptake, the major release of trophic factors and better astrocytic coverage of cerebral blood vessels. The purpose of this review is to highlight the effects of exercise on brain function, emphasize the role of astrocytes in the healthy CNS, and provide an update for a better understanding of the effects of physical exercise in the modulation of astrocyte function

One year of COVID-19 pandemic in Italy: Effect of sedentary behavior on physical activity levels and musculoskeletal pain among university students

The COVID-19 outbreak forced Italian students to reduce their daily activities, inducing a seden-tary attitude that was worsened by distanced learning. This study aimed to survey the physical activity levels that were maintained before and during the social restrictions following the pan-demic, their correlation to musculoskeletal pain, as well as analyzing the impact of these COVID-19 restrictions on pain and fatigue that affects daily life activities. A total of 2044 students completed the online questionnaire, of which the results of 1654 participants were eligible. Before the pandemic, the levels of physical activity were distributed as: 19.9% no activity, 30.1% light ac-tivity, 21.5% moderate activity, and 28.5% high activity. After one year of the pandemic, 30.6% of the participants were inactive, 48.1%, 10.9%, and 10.5% stated as maintaining, respectively, light, moderate and high levels of physical activity. Furthermore, 43.5% reported neck pain and 33.5% stated to experience low back pain. Physical activity levels lower than 150 min/week may have predisposed students to suffer from neck pain (1.95 OR at 95% CI, 1.44–2.64) and low back pain (1.79 OR at 95% CI, 1.29–2.49). A positive correlation between physical activity levels, Verbal Descriptive Scale (VDS), and pain frequency have been observed for neck and low back pain (p-value < 0.05). Finally, low physical activity levels were associated with musculoskeletal pain onset and pain worsening

Sulfur gas monitoring in volcanic/geothermal areas with passive samplers: human health implications

Volcanic and geothermal areas are one of the major natural sources of sulphur gases to the atmosphere. Hydrogen sulphide (H2S) is a toxic gas mainly associated to geothermal systems while sulphur dioxide (SO2) is released in huge quantities from volcanoes characterized by open conduit activity. Apart from being one of the most impressive geodynamic expressions, volcanoes are also an important tourist attraction. During the summer season the number of tourists visiting the crateric areas each day is on average many tens at Stromboli, hundreds at Vulcano, Santorini and Nisyros and thousands at Etna. Touristic exploitation of active volcanic areas cannot exempt from warranting a reasonable security to the visiting persons. But while many risks in these areas have been since long time considered, gas hazard, a very subtle risk, is often disregarded. The atmospheric concentrations and dispersion pattern of naturally emitted SO2 were measured at three volcanoes of southern Italy (Etna, Vulcano and Stromboli) while that of H2S at four volcanic/geothermal areas of Greece (Sousaki, Milos, Santorini and Nisyros). Measurements were made with a network of passive samplers positioned at about 1.5 m above the ground, which gave time-integrated values for periods from few days to 1 month. Samplers were placed in zones of the volcanoes with high tourist frequentation. Measured concentrations and dispersion pattern depend on the strength of the source (craters, fumaroles), meteorological conditions and geomorphology of the area. At Etna, Vulcano, Stromboli and Nisyros measured concentrations reach values that are absolutely dangerous to people affected by bronchial asthma or lung diseases. But considering that these are average values over periods from few days up to one month, concentrations could have reached much higher peak values dangerous also to healthy people. The present study evidences a peculiar volcanic risk connected to the touristic exploitation of volcanic areas. Such risk is particularly enhanced at Etna where elderly and not perfectly healthy people can easily reach, with cableway and off-road vehicles, areas with dangerous SO2 concentrations