Strategic Intelligence Monitor on Personal Health Systems (SIMPHS): Structure of Available Data and New Measurement Framework with Selected Indicators

This policy brief provides findings from empirical research on market and innovation dynamics regarding Personal Health Systems (PHS) in Europe. Even the already most consolidated of all PHS segments (i.e. RMT) is found to be radically different than the initial assumptions. The research has revealed that the market is in a state far from being mature and as a result there is little standardised data available. RMT contributes only a tiny fraction of the eHealth market revenues. Pilots are still dominating the form of implemented cases. The market is fragmented also in terms of players without distinct segments. This policy brief recognise a huge potential in a modified approach towards evaluation and measurement of eHealth.JRC.DDG.J.4-Information Societ

Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) - Operational Guidelines for ICT-supported Integrated Care and Independent Living

The guidelines in this report have been developed as part of the Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS3) project. Twenty-four ICT-supported integrated care initiatives in the EU were identified which supported integrated care and/or independent living and were either deployed or promising large scale pilots. The aim of this report is to define a set of recommendations to guide the process of developing and implementing ICT-supported integrated care and independent living, based on the experiences made in these 24 initiatives. The intended audience for this guidance document are those who work on the development and implementation of initiatives at an operational level, such as professionals, managers in healthcare organisations, regional managers of health or social care, health insurers, professionals’ organisations, etc.JRC.J.3-Information Societ

Strategic Intelligence Monitor on Personal Health Systems (SIMPHS): Market Structure and Innovation Dynamics

Personal Health Systems (PHS) and Remote Patient Monitoring and Treatment (RMT) have the potential to alter the way healthcare is provided by increasing the quantity and quality of care. This report explores the current status of PHS and, more specifically of the RMT market in Europe. It addresses the question of how these technologies can contribute facing some of the challenges standing in front of the European healthcare delivery systems causes by higher demand pressures through chronic diseases and demographic change combined with diminishing resources for health care. An uptake and diffusion of these services would potentially lead to benefits through a reduction in death rates, and avoid recurring hospitalisation in a cost-effective manner. Yet the report identifies different categories of barriers hampering a full deployment of RMT in Europe. In the concluding part the reports provides a number of tentative policy options specifically aimed at fostering EU-wide deployment of RMT/PHS.JRC.DDG.J.4-Information Societ

Strategic Intelligence Monitor on Personal Health Systems (SIMPHS): Report on Typology/Segmentation of the PHS Market

This market segmentation reports for Personal Health Systems (PHS) describes the methodological background and illustrates the principles of classification and typology regarding different fragments forming this market. It discusses different aspects of the market for PHS and highlights challenges towards a stringent and clear-cut typology or defining market segmentation. Based on these findings a preliminary hybrid typology and indications and insights are created in order to be used in the continuation of the SIMPHS project. It concludes with an annex containing examples and cases studies.JRC.DDG.J.4-Information Societ

Estimating weights for the active ageing index (AAI) from stated preferences: Proposal for a discrete choice experiment (DCE)

This chapter outlines how Discrete Choice Experiments (DCEs) could be used to estimate alternative weights for the Active Ageing Index (AAI) based on stated preferences. The approach is based on Random Utility Theory and could provide valuable information on marginal substitution rates between AAI indicators and domains. Complementing the current AAI methodology with preference-based weights may also allow assessing preference variation across different social, cultural or geographic contexts. This would help define more targeted active and healthy ageing policies and interventions, incorporate stakeholders’ views in the valuation of policy outcomes and enhance the acceptance of the Index as a tool for policy analysis

Carbonyl sulfide : comparing a mechanistic representation of the vegetation uptake in a land surface model and the leaf relative uptake approach

Land surface modellers need measurable proxies to constrain the quantity of carbon dioxide (CO2) assimilated by continental plants through photosynthesis, known as gross primary production (GPP). Carbonyl sulfide (COS), which is taken up by leaves through their stomates and then hydrolysed by photosynthetic enzymes, is a candidate GPP proxy. A former study with the ORCHIDEE land surface model used a fixed ratio of COS uptake to CO2 uptake normalised to respective ambient concentrations for each vegetation type (leaf relative uptake, LRU) to compute vegetation COS fluxes from GPP. The LRU approach is known to have limited accuracy since the LRU ratio changes with variables such as photosynthetically active radiation (PAR): while CO2 uptake slows under low light, COS uptake is not light limited. However, the LRU approach has been popular for COS-GPP proxy studies because of its ease of application and apparent low contribution to uncertainty for regional-scale applications. In this study we refined the COS-GPP relationship and implemented in ORCHIDEE a mechanistic model that describes COS uptake by continental vegetation. We compared the simulated COS fluxes against measured hourly COS fluxes at two sites and studied the model behaviour and links with environmental drivers. We performed simulations at a global scale, and we estimated the global COS uptake by vegetation to be -756 Gg S yr(-1) , in the middle range of former studies (-490 to -1335 Gg S yr(-1)). Based on monthly mean fluxes simulated by the mechanistic approach in ORCHIDEE, we derived new LRU values for the different vegetation types, ranging between 0.92 and 1.72, close to recently published averages for observed values of 1.21 for C-4 and 1.68 for C-3 plants. We transported the COS using the monthly vegetation COS fluxes derived from both the mechanistic and the LRU approaches, and we evaluated the simulated COS concentrations at NOAA sites. Although the mechanistic approach was more appropriate when comparing to high-temporal-resolution COS flux measurements, both approaches gave similar results when transporting with monthly COS fluxes and evaluating COS concentrations at stations. In our study, uncertainties between these two approaches are of secondary importance compared to the uncertainties in the COS global budget, which are currently a limiting factor to the potential of COS concentrations to constrain GPP simulated by land surface models on the global scale.Peer reviewe

Intercomparison of atmospheric Carbonyl Sulfide (TransCom-COS; Part one): Evaluating the impact of transport and emissions on tropospheric variability using ground-based and aircraft data

We present a comparison of atmospheric transport model simulations for carbonyl sulfide (COS), within the framework of the ongoing atmospheric tracer transport model intercomparison project “TransCom”. Seven atmospheric transport models participated in the inter-comparison experiment and provided simulations of COS mixing ratios in the troposphere over a 9-year period (2010–2018), using prescribed state-of-the-art surface fluxes for various components of the atmospheric COS budget: biospheric sink, oceanic source, sources from fire and industry. Since the biosphere is the largest sink of COS, we tested sink estimates produced by two different biosphere models. The main goals of TransCom-COS are (a) to investigate the impact of the transport uncertainty and emission distribution in simulating the spatio-temporal variability of COS mixing ratios in the troposphere, and (b) to assess the sensitivity of simulated tropospheric COS mixing ratios to the seasonal and diurnal variability of the COS biosphere fluxes. To this end, a control case with state-of-the-art seasonal fluxes of COS was constructed. Models were run with the same fluxes and without chemistry to isolate transport differences. Further, two COS flux scenarios were compared: one using a biosphere flux with a monthly time resolution and the other using a biosphere flux with a three-hourly time resolution. In addition, we investigated the sensitivity of the simulated concentrations to different biosphere fluxes and to indirect oceanic emissions through dimethylsulfide (DMS) and carbon disulfide (CS2). The modelled COS mixing ratios were assessed against in-situ observations from surface stations and aircraft

Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition)

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. For example, a key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process versus those that measure fl ux through the autophagy pathway (i.e., the complete process including the amount and rate of cargo sequestered and degraded). In particular, a block in macroautophagy that results in autophagosome accumulation must be differentiated from stimuli that increase autophagic activity, defi ned as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (inmost higher eukaryotes and some protists such as Dictyostelium ) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the fi eld understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. It is worth emphasizing here that lysosomal digestion is a stage of autophagy and evaluating its competence is a crucial part of the evaluation of autophagic flux, or complete autophagy. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. Along these lines, because of the potential for pleiotropic effects due to blocking autophagy through genetic manipulation it is imperative to delete or knock down more than one autophagy-related gene. In addition, some individual Atg proteins, or groups of proteins, are involved in other cellular pathways so not all Atg proteins can be used as a specific marker for an autophagic process. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field