Integrated Care for Chronic Diseases – State of the Art

Chronic diseases represent a high cost for healthcare systems, for individuals, families, businesses and governments. The World Health Organization (WHO) estimates that an increase of 10% of chronic diseases is associated with a reduction of 0.5% of annual economic growth. Primary care has proven to ensure high levels of efficiency, effectiveness, equity, safety, timely and centrality of the patient achieving better health outcomes and lower costs. The Chronic Care Model (CCM) proposes a proactive approach in assisting the empowerment of patients and their community. The CCM contributes to improving the quality of care and health outcomes and the reduction of inequalities (e.g., ethnicity, social status) too

A Method for Determining the Shape Similarity of Complex Three-Dimensional Structures to Aid Decay Restoration and Digitization Error Correction

none5noThis paper introduces a new method for determining the shape similarity of complex three-dimensional (3D) mesh structures based on extracting a vector of important vertices, ordered according to a matrix of their most important geometrical and topological features. The correlation of ordered matrix vectors is combined with perceptual definition of salient regions in order to aid detection, distinguishing, measurement and restoration of real degradation and digitization errors. The case study is the digital 3D structure of the Camino Degli Angeli, in the Urbino’s Ducal Palace, acquired by the structure from motion (SfM) technique. In order to obtain an accurate, featured representation of the matching shape, the strong mesh processing computations are performed over the mesh surface while preserving real shape and geometric structure. In addition to perceptually based feature ranking, the new theoretical approach for ranking the evaluation criteria by employing neural networks (NNs) has been proposed to reduce the probability of deleting shape points, subject to optimization. Numerical analysis and simulations in combination with the developed virtual reality (VR) application serve as an assurance to restoration specialists providing visual and feature-based comparison of damaged parts with correct similar examples. The procedure also distinguishes mesh irregularities resulting from the photogrammetry process.openVasic I.; Quattrini R.; Pierdicca R.; Frontoni E.; Vasic B.Vasic, I.; Quattrini, R.; Pierdicca, R.; Frontoni, E.; Vasic, B

Nonlinear integral equations for finite volume excited state energies of the O(3) and O(4) nonlinear sigma-models

We propose nonlinear integral equations for the finite volume one-particle energies in the O(3) and O(4) nonlinear sigma-models. The equations are written in terms of a finite number of components and are therefore easier to solve numerically than the infinite component excited state TBA equations proposed earlier. Results of numerical calculations based on the nonlinear integral equations and the excited state TBA equations agree within numerical precision.Comment: numerical results adde

DIGITAL HERITAGE&DESIGN THINKING: THE RAILTOLAND WORKSHOP AS AN INNOVATIVE PRACTICE IN THE HIGHER EDUCATION SCENARIO

The higher education scenario is constantly evolving and COVID-19 restrictions traced a demarcation line with previous behaviours and practices. Even though the European Commission spends many efforts to monitor the progresses, indicate the challenges as well as to give the perspectives, innovating the way in which we teach, especially about heritage & design, is rarely a priority.The article presents an interdisciplinary learning activity carried out within the RAILtoLAND (RtL) project, a co-funded Erasmus+ project under the Key Action 2 “Cooperation for innovation”. RtL is a collective ideation platform to develop innovative tools to communicate the European Cultural Landscapes by train and it has the goal to explore the social and educational value of the railway landscape as a common heritage and as a catalyst for European identity.The workshop was carried out in the Sub-Apennine area dealing with two complementary and fundamental topics “Digital Heritage & Design Thinking”, experiencing virtual events and innovative practices for the knowledge, narrative and design of heritage and landscape. The workshop stemmed from an interdisciplinary approach: experts in digital cultural heritage, survey and representation techniques, geomatics, and urban and landscape designers brought together their expertise and performed a ground-breaking study activity. The learning activities involved areas in the Marche Region (Italy) through on field activities, and the Porto-Vigo railway line (Portugal-Spain) through the experience of a virtual trip.</p

Sea fennel (Crithmum maritimum L.) leaves and flowers: Bioactive compounds, antioxidant activity and hypoglycaemic potential

Sea fennel (Crithmum maritimum L.) leaves and flowers from Italian wild and cultivated populations were herein investigated for their content of carotenoids and tocopherols using ultra-high-performance liquid chromatography coupled with the photodiode array and fluorimeter detectors to assess their functional value. Moreover, aqueous extracts were prepared to explore in vitro bioactivities never tested in this halophyte herb. Thus, chlorogenic acid-enriched sea fennel extracts were evaluated for their major bioactive compounds, antioxidant potential, pancreatic lipase, and carbohydrate hydrolase inhibitors. Neoxanthin, violaxanthin, lutein, zeaxanthin, β-carotene, and α- and γ-tocopherols were identified. C. maritimum can be considered a high source of lutein, vitamin A, and vitamin E up to 19.1, 1.85 and 52.81 mg/100 g of dried leaves, respectively. Despite a low TPC content, a promising ABTS+. radical scavenging activity (CON-L-WT, IC50 value of 3.83 μg/mL) and the highest FRAP value were observed in the wild leaves extract of Conero Park of Marche Region. The water extract from the wild Sicilian leaves was the most active against pancreatic lipase. The evidence herein suggests that sea fennel extract might be potentially used in the formulation of nutraceuticals for the prevention of diseases associated with oxidative stress and hyperglycemic conditions

Complexing the Marine Sesquiterpene Euplotin C by Means of Cyclodextrin-Based Nanosponges: A Preliminary Investigation

Euplotin C is a sesquiterpene of marine origin endowed with significant anti-microbial and anti-tumor properties. Despite the promising functional profile, its progress as a novel drug candidate has failed so far, due to its scarce solubility and poor stability in aqueous media, such as biological fluids. Therefore, overcoming these limits is an intriguing challenge for the scientific community. In this work, we synthesized β-cyclodextrin-based nanosponges and investigated their use as colloidal carriers for stably complex euplotin C. Results obtained proved the ability of the carrier to include the natural compound, showing remarkable values of both loading efficiency and capacity. Moreover, it also allowed us to preserve the chemical structure of the loaded compound, which was recovered unaltered once extracted from the complex. Therefore, the use of β-cyclodextrin-based nanosponges represents a viable option to vehiculate euplotin C, thus opening up its possible use as pharmacologically active compound

The dynamics of circulating tumour DNA (ctDNA) during treatment reflects tumour response in advanced melanoma patients

Despite the introduction of targeted (BRAFi/MEKi) and immune checkpoint inhibitors (ICIs) has significantly reduced the recurrence rate and improved the overall survival (OS) of patients with Stage III and IV melanoma, only a percentage will benefit of durable disease control. The aim of this study was to examine whether the levels of circulating tumour DNA (ctDNA) in plasma of advanced melanoma patients undergoing BRAFi/MEKi or ICIs vary according to the patients' survival outcomes (i.e. progression-free survival (PFS) and OS) and disease progression. Plasma samples of Stage III-IV melanoma patients were collected at baseline (treatment initiation) and thereafter every 3 months. Circulating BRAFV600E/K and NRASQ61R/K mutations were analysed through droplet digital PCR (ddPCR, Bio-Rad) in a total of 177 plasma samples from 48 melanoma patients (19 Stage III, 29 Stage IV). Baseline ctDNA concentration was significantly associated with OS (HR = 1.003, 95% CI = 1.000–1.006, p = 0.043) and PFS (HR = 1.004, 95% CI = 1.000–1.007, p = 0.029) independent of clinical-prognostic confounders. For each unit increase in the ∆ctDNA (concentration difference between the last follow-up and baseline) there was a 24% increased risk of disease progression, irrespective of treatment type and stage at diagnosis (OR = 1.24, 95% CI = 1.03–1.49, p = 0.020, AUC = 0.93). Patients with reduction of ctDNA level from baseline to the last follow-up had longer OS (HR = 0.14; 95% CI = 0.05–0.44, p = 0.001) and PFS (HR = 0.08; 95% CI = 0.03–0.27, p < 0.0001) compared to patients with increased ctDNA, including adjustment for confounding factors. Our findings suggest that variation of ctDNA over time during melanoma treatment reflects the clinical outcome and tumour response to therapy and might be helpful in clinical monitoring

An inter-laboratory comparison to evaluate the suitability of EN 1787 standard to detect irradiation in plant-origin foods with health benefits

This paper reports the results of a study carried out to verify the applicability of the EN 1787 method, which uses the Electron Spin Resonance (ESR) technique for the identification of irradiated plant-origin foods with health benefits. The method was tested on samples of herbal ingredients of Plant Food Supplements (PFSs), nuts and fresh blueberries. Untreated and irradiated samples of Camellia sinensis (leaves) Ginkgo biloba (leaves), Glycine max (seeds), Silybum marianum (fruits), Vaccinium myrtillus (fruits), almonds, hazelnuts, peanuts, pistachios, walnuts and fresh blueberries were analysed. The work includes an inter-laboratory blind test involving five Italian laboratories that perform routine analyses for the official control of irradiated food. A total of 180 untreated and irradiated samples of PFS ingredients, nuts and fresh blueberries were analysed. The analyses on the irradiated samples were replicated even a long time after irradiation (up to two years depending on the matrix) to test the reliability of the method throughout the shelf life of the products. The results were matrix-dependent: all the 5 kGy irradiated nuts and the 1 kGy-irradiated blueberries were correctly classified, whereas herbal ingredients showed complex ESR spectra with spurious signals which often prevented the correct classification of the sample

Impaired Distal Thermoregulation in Diabetes and Diabetic Polyneuropathy

Objective: To determine how thermoregulation of the feet is affected by diabetes and diabetic polyneuropathy in both wakefulness and sleep. Research Design and Methods: Normal subjects, diabetic subjects without neuropathy, diabetic subjects with small-fiber diabetic polyneuropathy, and those with advanced diabetic polyneuropathy were categorized based on neurological examination, nerve conduction studies, and quantitative sensory testing. Subjects underwent foot temperature monitoring using an iButton device attached to the foot and a second iButton for recording of ambient temperature. Socks and footwear were standardized, and subjects maintained an activity diary. Data were collected over a 32-h period and analyzed. Results: A total of 39 normal subjects, 28 patients with diabetes but without diabetic polyneuropathy, 14 patients with isolated small-fiber diabetic polyneuropathy, and 27 patients with more advanced diabetic polyneuropathy participated. No consistent differences in foot temperature regulation between the four groups were identified during wakefulness. During sleep, however, multiple metrics revealed significant abnormalities in the diabetic patients. These included reduced mean foot temperature (P < 0.001), reduced maximal temperature (P < 0.001), increased rate of cooling (P < 0.001), as well as increased frequency of variation (P = 0.005), supporting that patients with diabetic polyneuropathy and even those with only diabetes but no diabetic polyneuropathy have impaired nocturnal thermoregulation. Conclusions: Nocturnal foot thermoregulation is impaired in patients with diabetes and diabetic polyneuropathy. Because neurons are highly temperature sensitive and because foot warming is part of the normal biology of sleep onset and maintenance, these findings suggest new potentially treatable mechanisms of diabetes-associated nocturnal pain and sleep disturbance