The My Active and Healthy Aging (My-AHA) ICT platform to detect and prevent frailty in older adults: Randomized control trial design and protocol

[EN] Introduction Frailty increases the risk of poor health outcomes, disability, hospitalization, and death in older adults and affects 7%¿12% of the aging population. Secondary impacts of frailty on psychological health and socialization are significant negative contributors to poor outcomes for frail older adults. Method The My Active and Healthy Aging (My-AHA) consortium has developed an information and communications technology¿based platform to support active and healthy aging through early detection of prefrailty and provision of individually tailored interventions, targeting multidomain risks for frailty across physical activity, cognitive activity, diet and nutrition, sleep, and psychosocial activities. Six hundred adults aged 60 years and older will be recruited to participate in a multinational, multisite 18-month randomized controlled trial to test the efficacy of the My-AHA platform to detect prefrailty and the efficacy of individually tailored interventions to prevent development of clinical frailty in this cohort. A total of 10 centers from Italy, Germany, Austria, Spain, United Kingdom, Belgium, Sweden, Japan, South Korea, and Australia will participate in the randomized controlled trial. Results Pilot testing (Alpha Wave) of the My-AHA platform and all ancillary systems has been completed with a small group of older adults in Europe with the full randomized controlled trial scheduled to commence in 2018. Discussion The My-AHA study will expand the understanding of antecedent risk factors for clinical frailty so as to deliver targeted interventions to adults with prefrailty. Through the use of an information and communications technology platform that can connect with multiple devices within the older adult's own home, the My-AHA platform is designed to measure an individual's risk factors for frailty across multiple domains and then deliver personalized domain-specific interventions to the individual. The My-AHA platform is technology-agnostic, enabling the integration of new devices and sensor platforms as they emerge.This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 689582 and the Australian National Health and Medical Research Council (NHRMC) European Union grant scheme (1115818). M.J.S. reports personal fees from Eli Lilly (Australia) Pty Ltd and grants from Novotech Pty Ltd, outside the submitted work. All other authors report nothing to disclose.Summers, MJ.; Rainero, I.; Vercelli, AE.; Aumayr, GA.; De Rosario Martínez, H.; Mönter, M.; Kawashima, R. (2018). 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Urban surfaces analysis with remote sensing data for the evaluation of UHI mitigation scenarios

Considering the new IPCC report and its recent suggestions, it is important to pay serious attention to the Urban Heat Island issue. In this study, satellite images acquired by the Worldview3 sensor (WV3) were processed to classify the different kinds of urban surface and to compute the albedo value for each surface. Then several UHI mitigation scenarios were analyzed, varying selectively the surface albedo by choosing solar reflective materials. Clay tile pitched roofs, dark roofs and parking areas were considered as \u201cmodifiable surfaces\u201d and their albedo values were increased on the basis of the literature and of data made available by product manufacturers. For each proposed scenario, the reduction of intensity of the Urban Heat Island effect (ATD), the energy saving brought by lower absorption of air conditioning systems (\u394E) and the consequent cost savings were calculated. All the scenarios proved to be convenient and with a relatively fast return on investment. In particular, two scenarios involving the modification of several surfaces at the same time proved to be the most promising ones from the perspective of a public administration, with significant benefits on the well-being of the population, as well as with similar and relatively short payback periods

Radon hazard in shallow groundwaters: Amplification and long term variability induced by rainfall

222Rn concentrations have been determined with a RAD7 radon detector in shallow groundwaters of the Pietramelara Plain, north-western Campania, southern Italy, where pyroclastic deposits, along with recent stream alluvial sediments, come in contact with Mesozoic carbonate reservoirs. The aim of this study has been to study the annual variation of 222Rn concentration in the shallow groundwaters, scarcely considered in the literature and of obvious relevance for radon hazard evaluation. Our results definitely show that 222Rn levels are characterized by a clear annual periodicity, strictly related to rainfall and water table levels, with a pronounced difference between the dry and the wet season. In this last case with concentrations increasing up to two orders of magnitude (up to two times the lower threshold given in the Recommendation 2001/928/EURATOM for public waters). In relation to this, experimental field data will be presented to demonstrate that this variability is due to purely hydrological mechanisms, mainly rinse out and discharge that control leaching efficiency. The detected cycle (Radon Hydrological Amplification Cycle, RHAC) has been generalized for the Mediterranean Tyrrhenian climate. The marked and seasonally persistent amplification in 222Rn levels poses the problem of evaluating the epidemiological risk brought up by this previously not yet reported mechanism. This mechanism, occurring in shallow groundwaters, very likely should strongly influence indoor radon levels via groundwater-soil-building exchange. © 2009 Elsevier B.V. All rights reserved

Radon hazard in shallow groundwaters II: Dry season fracture drainage and alluvial fan upwelling

222Rn concentrations have been measured in a well located on the edge of a large Pleistocene-Holocene fan and belonging to the shallow pyroclastic aquifer of the Pietramelara Plain, southern Italy. The aim of this study has been both to characterise the hydrological inputs that determine the influx of 222Rn to the shallow aquifer and to understand the correlations between 222Rn, major ions, physical-chemical parameters and rainfall. Results obtained from the time series indicate that the studied well shows a 222Rn variability that is inconsistent with a mechanism of pure hydrological amplification, such as described in Radon hazard in shallow groundwaters: Amplification and long term variability induced by rainfall (De Francesco et al., 2010a). On the contrary, in this well hydrological amplification appears to be mainly tied to the upwelling of alluvial fan waters, rich in radon, in response to pistoning from recharge in the carbonate substrate. This upwelling of alluvial fan waters occurs during almost the whole period of the annual recharge and is also responsible of the constant increase in 222Rn levels during the autumn-spring period, when both the water table level and weekly rainfall totals drop. Furthermore, a rapid delivery mechanism for 222Rn likely operates through fracture drainage in concomitance with the very first late summer-early autumn rains, when rainfall totals appear largely insufficient to saturate the soil storage capacity. Results obtained from this study appear to be particularly significant in both radon hazard zoning in relation to the shallow aquifer and possibly also for indoor radon, owing to possible shallow aquifer-soil-building exchanges. Moreover, both the spike-like events and the long wave monthly scale background fluctuations detected can also have potential significance in interpreting 222Rn time series data as seismic and/or volcanic precursors. Finally, 222Rn has proved to be an excellent tracer for hydrological inputs to the shallow aquifer when combined with major ions, physical-chemical data and geological and geomorphological controls. © 2011 Elsevier B.V

Impact of Intracoronary Aspiration Thrombectomy During Primary Angioplasty on Left Ventricular Remodeling in Patients with Anterior ST-Elevation Myocardial Infarction.

Objective: To evaluate prospectively the impact on left ventricular (LV) remodelling of an intracoronary aspiration thrombectomy device as adjunctive therapy in primary percutaneous coronary intervention (PCI) in patients with anterior ST elevation myocardial infarction (STEMI). Methods: 76 consecutive patients with anterior STEMI (65.3 (11.2) years, 48 men) were randomly assigned to intracoronary thrombectomy and stent placement (n = 38) or to conventional stenting (n = 38) of the infarct related artery. Each patient underwent transthoracic echocardiography immediately after PCI and at six months. At the time of echocardiographic control, major adverse cardiovascular events (MACE) in terms of death, new onset of myocardial infarction, and hospitalisation for heart failure were also evaluated. Results: After a successful primary PCI, patients in the thrombectomy group achieved a higher rate of postprocedure myocardial blush grade 3 (36.8% v 13.1%, p = 0.03) and effective ST segment resolution at 90 minutes (81.6% v 55.3%, p = 0.02). Six months after the index intervention, 19 patients (26.8%) developed LV dilatation, defined as an increase in end diastolic volume (EDV) > 20%: 15 in the conventional group and four in the thrombectomy group (p = 0.006). Accordingly, at six months patients treated conventionally had significantly higher end systolic volumes (82 (7.7) ml v 75.3 (4.9) ml, p , 0.0001) and EDV (152.5 (18.1) ml v 138.1 (10.7) ml, p , 0.0001) than patients treated with thrombectomy. No differences in cumulative MACE were observed (10.5% in the conventional group v 8.6% in the thrombectomy group, not significant). Conclusion: Compared with conventional stenting, adjunctive aspiration thrombectomy in successful primary PCI seems to be associated with a significantly lower incidence of LV remodelling at six months in patients with anterior STEMI