A Remote Monitoring System to Optimize the Home Management of Oral Anticancer Therapies (ONCO-TreC): Prospective Training-Validation Trial

Background: A platform designed to support the home management of oral anticancer treatments and provide a secure web-based patient–health care professional communication modality, ONCO-TreC, was tested in 3 cancer centers in Italy. Objective: The overall aims of the trial are to customize the platform; assess the system’s ability to facilitate the shared management of oral anticancer therapies by patients and health professionals; and evaluate system usability and acceptability by patients, caregivers, and health care professionals. Methods: Patients aged ≥18 years who were candidates for oral anticancer treatment as monotherapy with an Eastern Cooperative Oncology Group performance status score of 0 to 1 and a sufficient level of familiarity with mobile devices were eligible. ONCO-TreC consisted of a mobile app for patients and a web-based dashboard for health care professionals. Adherence to treatment (pill count) and toxicities reported by patients through the app were compared with those reported by physicians in medical records. Usability and acceptability were evaluated using questionnaires. Results: A total of 40 patients were enrolled, 38 (95%) of whom were evaluable for adherence to treatment. The ability of the system to measure adherence to treatment was high, with a concordance of 97.3% (95% CI 86.1%-99.9%) between the investigator and system pill count. Only 60% (3/5) of grade 3, 54% (13/24) of grade 2, and 19% (7/36) of grade 1 adverse events reported by physicians in the case report forms were also reported in the app directly by patients. In total, 94% (33/35) of patients had ≥1 app launch each week, and the median number of daily accesses per patient was 2. Approximately 71% (27/38) and 68% (26/38) of patients used the app for messages and vital sign entering, respectively, at least once during the study period. Conclusions: ONCO-TreC is an important tool for measuring and monitoring adherence to oral anticancer drugs. System usability and acceptability were very high, whereas its reliability in registering toxicity could be improved

Scrutinising multidimensional challenges in the Maloti-Drakensberg (Lesotho/South Africa)

The Maloti-Drakensberg (MD) is the largest and highest-elevation mountain system in southern Africa. Covering 40,000 km2 and reaching 3500 m, the MD provides a range of ecosystem services (ES) to the entire southern African region—benefitting diverse users and extending well beyond the mountains. Rapid socioecological change threatens the provision of ES and presents multidimensional challenges to sustainable development. However, the continued land degradation and persisting socioeconomic problems indicate that development policy has not been effective in tackling these issues. In this paper, a multidisciplinary literature review forms the basis of a discussion which takes an ES framing to scrutinise the multidimensional social, political, economic and cultural issues in the study area. Three critical management systems are presented, and their associated ES are discussed, namely, water transfer, rangelands and conservation and tourism. In particular, the diversity of ES uses and values in the MD is considered. The results reveal the main drivers of continued unsustainable development and highlight important information gaps.https://www.mdpi.com/journal/sustainabilityPlant Production and Soil Scienc

Fixed and Mobile Low-Cost Sensing Approaches for Microclimate Monitoring in Urban Areas: A Preliminary Study in the City of Bolzano (Italy)

In the current scenario of massive urbanization and global climate change, an intelligent monitoring of the environmental variables is becoming fundamental to ensure good living conditions in cities. Indeed, the acquisition of data with high spatiotemporal resolution can enable the assessment of environmental vulnerabilities in urban areas towards the definition of responsive adaptation and mitigation strategies. In this context, the current work presents a two-fold approach based on low-cost cloud-connected sensors for (i) fixed and (ii) mobile monitoring of several environmental parameters. This paper, which focuses on the measurement aspects of the urban micro-climate, describes in detail the hardware and software components of both approaches, and how to exploit them for setting up a field campaign. The methods were tested in the city of Bolzano (Italy), demonstrating their suitability for identifying the spatial variability of the microclimate in relation to the urban morphology, and for highlighting the presence of the urban heat island and estimating its intensity

Urban microclimate monitoring and modelling through an open-source distributed network of wireless low-cost sensors and numerical simulations

The use of wireless sensor networks (WSN) to address and improve the environmental quality of the built environment is gaining more and more prominence in modern cities. In this scope, our work aims to assess the spatial variability of local climate in relation to the urban morphology and the distribution of materials and vegetation. Furthermore, on-site measured data have been exploited to run and benchmark numerical models for the simulation and visualization of multiple climate parameters such as outdoor thermal comfort

Automatic Initialization Methods for Photonic Components on a Silicon-Based Optical Switch

In this work we showed the optimization of the spectral response of several optical elements in a silicon-based optical switch. Integrated thermal resistors induced a local heating of the components. The temperature increase, in turn, caused a thermal shift of the optical response of the component. In this manner, we aligned interleavers and micro-ring resonators to the International Telecommunication Union (ITU) channels, by using a stochastic method named Globalized Bounded Nelder-Mead (GBNM) to determine the proper temperatures. The optimization engine relied on the optical feedback from on-chip monitor photodiodes to drive these photonic elements into the wanted functioning condition. This method is suited for restoring the spectral response of optical elements impaired by fabrication inaccuracies. In the same way, it can be applied to tune in resonance active components, whose transfer function has one or more local optima. We proved the reliability of the GBNM method for the optimization of an integrated optical switch, with more than thousand optical components, each one interfaced with a thermal resistor driven by a dedicated electronic circuit. On the one hand, the GBNM guaranteed the automatic alignment of all active components on the chip, over multiple instances. On the other hand, the method allowed for the proper working of such a complex device

Methods for Low Crosstalk and Wavelength Tunability in Arrayed-Waveguide Grating for On-Silicon Optical Network

International audienceArrayed waveguide gratings (AWGs) are used to accomplish complex functionalities in dense wavelength division multiplexing networks, as well as in signal processing, measurement, characterization or sensing. In this work, we discuss the design and the experimental characterization of a 6 x 400 GHz channel-spaced AWG to be used as wavelength multiplexer/demultiplexer in a silicon-on-insulator based optical transport network. We adopted a whiskered-shaped star coupler design to investigate how the reduction in the reflectivity of the free propagation region boundaries affects the overall performances of the AWG. We demonstrated 2.9 dB insertionloss, which does not include fiber coupling loss, and (-24.4 +/- 0.1) dB crosstalk for a design realized with a single etching technique. Moreover, we demonstrated an efficient fine-tuning (7.5 nm/W) of the spectral position of the AWG output channels

Peculiar Electrocardiographic Aspects of Wide QRS Complex Tachycardia: When Differential Diagnosis Is Difficult

Wide complex tachycardia may represent a challenge for correct interpretation of standard electrocardiogram, which is crucial for proper patient management. For this reason, algorithms based on electrocardiographic criteria have been developed to guide interpretation in a step-by-step approach. Despite their greater accuracy, some cases of wide QRS complex tachycardia are a challenge. Some peculiar forms of ventricular tachycardia, and complex supraventricular substrate or particular clinical condition, may originate a challenging electrocardiographic pattern. In this article, a series of peculiar cases of wide QRS complex tachycardia is presented as paradigm of how important a comprehensive clinical approach is in these patients

Scrutinising Multidimensional Challenges in the Maloti-Drakensberg (Lesotho/South Africa)

The Maloti-Drakensberg (MD) is the largest and highest-elevation mountain system in southern Africa. Covering 40,000 km2 and reaching 3500 m, the MD provides a range of ecosystem services (ES) to the entire southern African region—benefitting diverse users and extending well beyond the mountains. Rapid socioecological change threatens the provision of ES and presents multidimensional challenges to sustainable development. However, the continued land degradation and persisting socioeconomic problems indicate that development policy has not been effective in tackling these issues. In this paper, a multidisciplinary literature review forms the basis of a discussion which takes an ES framing to scrutinise the multidimensional social, political, economic and cultural issues in the study area. Three critical management systems are presented, and their associated ES are discussed, namely, water transfer, rangelands and conservation and tourism. In particular, the diversity of ES uses and values in the MD is considered. The results reveal the main drivers of continued unsustainable development and highlight important information gaps