Utilization of big data to improve management of the emergency departments. Results of a systematic review

Background. The emphasis on using big data is growing exponentially in several sectors including biomedicine, life sciences and scientific research, mainly due to advances in information technologies and data analysis techniques. Actually, medical sciences can rely on a large amount of biomedical information and Big Data can aggregate information around multiple scales, from the DNA to the ecosystems. Given these premises, we wondered if big data could be useful to analyze complex systems such as the Emergency Departments (EDs) to improve their management and eventually patient outcomes. Methods. We performed a systematic review of the literature to identify the studies that implemented the application of big data in EDs and to describe what have already been done and what are the expectations, issues and challenges in this field. Results. Globally, eight studies met our inclusion criteria concerning three main activities: the management of ED visits, the ED process and activities and, finally, the prediction of the outcome of ED patients. Although the results of the studies show good perspectives regarding the use of big data in the management of emergency departments, there are still some issues that make their use still difficult. Most of the predictive models and algorithms have been applied only in retrospective studies, not considering the challenge and the costs of a real-time use of big data. Only few studies highlight the possible usefulness of the large volume of clinical data stored into electronic health records to generate evidence in real time. Conclusion. The proper use of big data in this field still requires a better management information flow to allow real-time application

Aroma profile of Fuji apples treated with gelatin edible coating during their storage

This study aimed to detect possible changes in the volatile organic compounds (VOCs) of Fuji apples induced by gelatin-based edible coating (EC), during 21 days of storage at room temperature. VOCs were analyzed by solid-phase micro extraction-gas chromatography-mass spectrometry. Data were analyzed by one-way ANOVA and principal component analysis. Control apples showed a greater presence of total aldehydes and acids at 7 and 14 days, respectively, while coated apples were characterized by higher proportions of alcohols (from 1.3- to 2-fold) at 7 day till the end of the storage. The higher ethanol proportions detected in coated apples (154-fold higher after 7 days) indicate a likely partial anaerobiosis, confirmed by the lower CO2 emission (reaching -68% after 21 days). Esters responsible of the varietal aroma of Fuji were identified also in coated fruits, suggesting that gelatin did not modify the typical aroma extensively. Acetate esters, normally increasing with maturity, were less concentrated in coated apples (-78% 2-methylbutyl acetate and -73% hexyl acetate, after 1 and 7 days respectively), suggesting a likely slowdown of the ripening due to the EC. Further investigation is needed to improve this storage technology considering that aroma is an important determinant of food quality

Vitamin D and neurological diseases: An endocrine view

Vitamin D system comprises hormone precursors, active metabolites, carriers, enzymes, and receptors involved in genomic and non-genomic effects. In addition to classical bone-related effects, this system has also been shown to activate multiple molecular mediators and elicit many physiological functions. In vitro and in vivo studies have, in fact, increasingly focused on the "non-calcemic" actions of vitamin D, which are associated with the maintenance of glucose homeostasis, cardiovascular morbidity, autoimmunity, inflammation, and cancer. In parallel, growing evidence has recognized that a multimodal association links vitamin D system to brain development, functions and diseases. With vitamin D deficiency reaching epidemic proportions worldwide, there is now concern that optimal levels of vitamin D in the bloodstream are also necessary to preserve the neurological development and protect the adult brain. The aim of this review is to highlight the relationship between vitamin D and neurological diseases

A long-term treatment with taurine prevents cardiac dysfunction in mdx mice

Taurine is an amino acid abundantly present in heart and skeletal muscle. Duchenne muscular dystrophy (DMD) is a genetic disorder in which the absence of dystrophin leads to skeletal muscle wasting and heart failure. An altered taurine metabolism has been described in dystrophic animals and short-term taurine administration exerts promising amelioration of early muscular alterations in the mdx mouse model of DMD. To reinforce the therapeutic and nutraceutical taurine potential in DMD, we evaluated the effects of a long-term treatment on cardiac and skeletal muscle function of mdx mice in a later disease stage. Taurine was administered in drinking water (1 g/kg/day) to wt and mdx mice for 6 months, starting at 6 months of age. Ultrasonography evaluation of heart and hind limb was performed, in parallel with in vivo and ex vivo functional tests and biochemical, histological and gene expression analyses. 12-month-old mdx mice showed a significant worsening of left ventricular function parameters (shortening fraction, ejection fraction, stroke volume), which were significantly counteracted by the taurine treatment. In parallel, histologic signs of damage were reduced by taurine along with the expression of proinflammatory myocardial IL-6. Interestingly, no effects were observed on hind limb volume and percentage of vascularization or on in vivo and ex vivo muscle functional parameters, suggesting a tissue-specific action of taurine in relation to the disease phase. A trend toward increase in taurine was found in heart and quadriceps from treated animals, paralleled by a slight decrease in mdx mice plasma. Our study provides evidences that taurine can prevent late heart dysfunction in mdx mice, further corroborating the interest on this amino acid toward clinical trials

[Epidemiology and surveillance of hepatitis E in Italy: data from the SEIEVA surveillance system 2007-2019]

hepatitis E is a disease spread all over the world, with endemic levels varying according to ecological and socioeconomic factors. In developing countries, large epidemics spread mainly through contaminated water; in developed countries, hepatitis E has always been considered a sporadic disease, closely associated to the travels to endemic areas, especially in Southeastern Asia. In the last years, this perception is significantly changing, because of an increasing number of autochthonous cases reported in many European countries

Growth hormone secretagogues modulate inflammation and fibrosis in mdx mouse model of Duchenne muscular dystrophy

IntroductionGrowth hormone secretagogues (GHSs) exert multiple actions, being able to activate GHS-receptor 1a, control inflammation and metabolism, to enhance GH/insulin-like growth factor-1 (IGF-1)-mediated myogenesis, and to inhibit angiotensin-converting enzyme. These mechanisms are of interest for potentially targeting multiple steps of pathogenic cascade in Duchenne muscular dystrophy (DMD).MethodsHere, we aimed to provide preclinical evidence for potential benefits of GHSs in DMD, via a multidisciplinary in vivo and ex vivo comparison in mdx mice, of two ad hoc synthesized compounds (EP80317 and JMV2894), with a wide but different profile. 4-week-old mdx mice were treated for 8 weeks with EP80317 or JMV2894 (320 µg/kg/d, s.c.).ResultsIn vivo, both GHSs increased mice forelimb force (recovery score, RS towards WT: 20% for EP80317 and 32% for JMV2894 at week 8). In parallel, GHSs also reduced diaphragm (DIA) and gastrocnemius (GC) ultrasound echodensity, a fibrosis-related parameter (RS: ranging between 26% and 75%). Ex vivo, both drugs ameliorated DIA isometric force and calcium-related indices (e.g., RS: 40% for tetanic force). Histological analysis highlighted a relevant reduction of fibrosis in GC and DIA muscles of treated mice, paralleled by a decrease in gene expression of TGF-β1 and Col1a1. Also, decreased levels of pro-inflammatory genes (IL-6, CD68), accompanied by an increment in Sirt-1, PGC-1α and MEF2c expression, were observed in response to treatments, suggesting an overall improvement of myofiber metabolism. No detectable transcript levels of GHS receptor-1a, nor an increase of circulating IGF-1 were found, suggesting the presence of a novel receptor-independent mechanism in skeletal muscle. Preliminary docking studies revealed a potential binding capability of JMV2894 on metalloproteases involved in extracellular matrix remodeling and cytokine production, such as ADAMTS-5 and MMP-9, overactivated in DMD.DiscussionOur results support the interest of GHSs as modulators of pathology progression in mdx mice, disclosing a direct anti-fibrotic action that may prove beneficial to contrast pathological remodeling

L'integrazione socio-sanitaria e le reti sociali nel nuovo Welfare : un'esperienza di e-Care a Napoli

Già dal 1992 in Italia si inizia a parlare dell’integrazione socio-sanitaria cercando di mettere a fattor comune risorse finanziarie, esperienze e culture di due universi totalmente complementari, se l’ottica dell’approccio metodologico è l’orientamento al cliente-paziente, ma non banalmente complementari ed integrabili se l’analisi viene fatta dal lato istituzionale e politico. Nel corso degli ultimi decenni, ed in particolare dall’istituzione del Servizio Sanitario Nazionale con la legge 833 del 1978, una serie di fattori hanno profondamente mutato il quadro sociale, culturale ed organizzativo in cui si sono trovate ad operare le strutture tradizionalmente dedite all’assistenza sanitaria. Il miglioramento del tenore di vita e del livello di istruzione, l’estensione dei regimi di sicurezza sociale e, in generale, l’evoluzione del concetto stesso di salute intesa non come assenza di malattia, ma come stato completo di benessere fisico

Brugada Syndrome: More than a Monogenic Channelopathy

Brugada syndrome (BrS) is an inherited cardiac channelopathy first diagnosed in 1992 but still considered a challenging disease in terms of diagnosis, arrhythmia risk prediction, pathophysiology and management. Despite about 20% of individuals carrying pathogenic variants in the SCN5A gene, the identification of a polygenic origin for BrS and the potential role of common genetic variants provide the basis for applying polygenic risk scores for individual risk prediction. The pathophysiological mechanisms are still unclear, and the initial thinking of this syndrome as a primary electrical disease is evolving towards a partly structural disease. This review focuses on the main scientific advancements in the identification of biomarkers for diagnosis, risk stratification, pathophysiology and therapy of BrS. A comprehensive model that integrates clinical and genetic factors, comorbidities, age and gender, and perhaps environmental influences may provide the opportunity to enhance patients' quality of life and improve the therapeutic approach

RNA isolation from the milk of dairy ewes for transcriptome analysis

Different diet regimens induce changes in milk composition. For example, linseed supplementation is a reliable feeding strategy to increase polyunsaturated fatty acid content in milk fat from sheep, improving milk quality and its nutraceutical value. The identification of genes regulating milk secretion by mammary glands is a key-step for identifying molecular bases of diet induced differences in milk composition. In this work we describe a method for isolation of RNA from sheep milk. In fact, the milk of dairy ewes contains somatic cells mostly derived by mammary glands. We collected milk from dairy ewes at 90 day of lactation and after 3 weeks of diet supplementation with extruded linseed. Milk somatic cells were isolated by centrifugation and RNAs were purified from these cells. To estimate reliability of this method we performed Illumina RNA sequencing and started an analysis of RNA synthesis

Transcript profiling in the milk of dairy ewes fed extruded linseed

The identification of genes regulating milk secretion by mammary glands is a key-step for exploiting changes in milk composition induced by different diet regimens. Linseed supplementation is a reliable feeding strategy to enhance polyunsaturated fatty acid content in milk fat from sheep, increasing milk quality and nutraceutical value. To investigate the molecular bases of diet induced differences in milk composition, we collected milk from dairy ewes at 90 day of lactation and after 3 weeks of diet supplementation with extruded linseed. The milk of dairy ewes contains milk somatic cells mostly derived by mammary glands. After isolating milk somatic cells by centrifugation, RNAs were purified from these cells, and Illumina RNA sequencing was performed to analyze RNA synthesis. Our data provide a resource (available at Gene Expression Omnibus database under GSE89163) to be employed for comparative analyses of gene expression in milk somatic cells in different breeds and different diets, with the long-term aim of developing strategies to improve sheep milk quality