Microfluidic Sample Preparation Methods for the Analysis of Milk Contaminants

In systems for food analysis, one of the major challenges is related to the quantification of specific species into the complex chemical and physical composition of foods, that is, the effect of "matrix"; the sample preparation is often the key to a successful application of biosensors to real measurements but little attention is traditionally paid to such aspects in sensor research. In this critical review, we discuss several microfluidic concepts that can play a significant role in sample preparation, highlighting the importance of sample preparation for efficient detection of food contamination. As a case study, we focus on the challenges related to the detection of aflatoxinM1in milk and we evaluate possible approaches based on inertial microfluidics, electrophoresis, and acoustic separation, compared with traditional laboratory and industrial methods for phase separation as a baseline of thrust and well-established techniques

Insegnanti alle prese con programmi educativi evidence-based: l’esperienza italiana del Promoting Alternative Thinking Strategies (PATHS®)

The paper introduces the first attempt at implementing, within the public primary school system, an evidence-based social-emotional learning program called Promoting Alternative Thinking Strategies (PATHS®). The program’s central implementation elements are described, and they are ascribable to a three year long European research that has seen the involvement of 5 different countries: Italy, Switzerland, Croatia, Slovenia. Particularly, the paper describes the stages of teacher training, monitoring of program implementation, experimentation and assessment which have seen the involvement of Italian schools, with a specific focus on the effects of social-emotional learning on inclusive process. The findings, though showing overall positive trends, highlight the need for further investigating some aspects ascribable to the contextual adjustment of an evidence-based program and the use of adequate assessment tools.The paper introduces the first attempt at implementing, within the public primary school system, an evidence-based social-emotional learning program called Promoting Alternative Thinking Strategies (PATHS®). The program’s central implementation elements are described, and they are ascribable to a three year long European research that has seen the involvement of 5 different countries: Italy, Switzerland, Croatia, Slovenia. Particularly, the paper describes the stages of teacher training, monitoring of program implementation, experimentation and assessment which have seen the involvement of Italian schools, with a specific focus on the effects of social-emotional learning on inclusive process. The findings, though showing overall positive trends, highlight the need for further investigating some aspects ascribable to the contextual adjustment of an evidence-based program and the use of adequate assessment tools

For an inclusive education: the innovative challenge of technologies for social emotional learning

The paper presents a collection of national, European and international evidence intended to identify the efficacy of social and emotional learning, of educational technologies, with a focus, in both cases, on inclusive processes. The paper, that is the outcome of the joint work of the authors, investigates the added, potential value given by technology to social and emotional learning, through different tiers of actions and the main features of ed-tech that can support such a use.Per un’educazione inclusiva: la sfida innovativa delle tecnologie per l’educazione socio-emotivaIl contributo presenta una raccolta di evidenze nazionali, europee ed internazionali, volte a individuare l’efficacia, dell’educazione socio-emotiva, delle tecnologie per la didattica, con un’attenzione, in entrambi i casi, ai processi inclusivi. Frutto del lavoro congiunto degli autori, il contributo indaga il valore aggiunto che la tecnologia può offrire all’educazione socio-emotiva, su differenti piani di azione e le principali caratteristiche ed-tech che possono supportarne tale utilizzo

Boosting emotional intelligence in the post-Covid. Flexible approaches in teaching social and emotional skills

The Covid pandemic has opened new challenges for education, especially for the social and emotional wellbeing of children and adolescents who had to face unprecedented and upsetting changes in their daily lives. The paper explores the possibilities offered by the social-emotional intelligence framework in helping children and youths develop the good emotional literacy needed for facing such a challenging time and growing as wholesome adults. This is done through an in-depth analysis of the concept of replication and generalization and by proposing a perspective working model for embedding social and emotional learning in daily teaching and learning activities. Promuovere l'intelligenza emotiva nel post-Covid. Approcci flessibili per insegnare le competenze sociali e emotive. La pandemia di Covid ha introdotto nuove sfide nel mondo dell'educazione, in modo particolare per quanto riguarda il benessere sociale e emotivo di bambini e adolescenti che hanno dovuto affrontare cambiamenti sconvolgenti senza precedenti nel loro vivere quotidiano. L'articolo esplora le possibilità offerte dal costrutto di educazione socio-emotiva a supporto dello sviluppo in bambini e ragazzi di un'alfabetizzazione emotiva solida, necessaria per affrontare un periodo così sfidante e per la loro crescita futura. Tutto questo è fatto attraverso un'analisi approfondita dei concetti di replicabilità e generalizzazione e attraverso la proposta di un nuovo modello di lavoro per integrare l'educazione socio-emotiva all'interno delle azioni didattiche quotidian

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study.

INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. METHODS: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. RESULTS: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. CONCLUSION: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches