Forecast model for the evaluation of economic resources employed in the health care of patients with HIV infection

BACKGROUND AND AIMS: The total health care cost for human immunodeficiency virus (HIV) patients has constantly grown in recent years. To date, there is no information about how this trend will behave over the next few years. The aim of the present study is to define a pharmacoeconomic model for the forecast of the costs of a group of chronically treated patients followed over the period 2004-2009.; METHODS: A pharmacoeconomics model was built to describe the probability of transition among different health states and to modify the therapy over time. A Markov model was applied to evaluate the temporal evolution of the average cost. The health care resources exploited during hospitalization were analyzed by using an "activity-based costing" method.; RESULTS: The Markov model showed that the mean total cost, after an initial increase, tended to remain stable. A total of 20 clinical records were examined. The average daily cost for each patient was EUR 484.42, with a cost for admission of EUR 6781.88.; CONCLUSION: The treatment of HIV infection in compliance with the guidelines is also effective from the payer perspective, as it allows a good health condition to be maintained and reduces the need and the costs of hospitalizations

Molecular analysis of the effects of Piroxicam and Cisplatin on mesothelioma cells growth and viability

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been proposed for prevention and treatment of a variety of human cancers. Piroxicam, in particular, has been recently shown to exert significant anti-tumoral activity in combination with cisplatin (CDDP) on mesothelioma cells. However, the mechanisms through which NSAIDs regulate the cell cycle as well as the signal pathways involved in the growth inhibition, remain unclear. In the present study, using two mesothelioma cell lines, MSTO-211H and NCI-H2452, we have investigated the influence of piroxicam alone and in association with CDDP on proliferation, cell cycle regulation and apoptosis. In both cell lines a significant effect on cell growth inhibition, respect to the control, was observed with all the drugs tested. Moreover, treatment with piroxicam or CDDP alone altered the cell cycle phase distribution as well as the expression of some cell cycle regulatory proteins in both cell lines. These effects were increased, even if in a not completely overlapping manner, after treatment with the association of piroxicam and CDDP. In particular, the two drugs in NCI cell line had a synergistic effect on apoptosis, probably through activation of caspase 8 and caspase 9, while the most evident targets among the cell cycle regulators were cyclin D1 and p21waf1. These results suggest that the association of piroxicam and CDDP specifically triggers cell cycle regulation and apoptosis in different mesothelioma cell lines and may hold promise in the treatment of mesothelioma

Volatile Organic Compound and Fatty Acid Profile of Milk from Cows and Buffaloes Fed Mycorrhizal or Nonmycorrhizal Ensiled Forage

Seed inoculation of forage crops by arbuscular mycorrhizal fungi (AMF) generally results in higher profitability, but also modifies the chemical composition of silage in terms of increased biomass, protein, and dry matter. Raw milk aroma is affected by the type of feed. This work investigated the influence of ensiled forage obtained by seed inoculation with AMF on the volatile fractions and fatty acid composition of milk. Two experiments were carried out: in the first, buffaloes were fed maize silage, and in the second, cows were fed sorghum silage. The volatile fractions of milk were quantified by headspace solid-phase micro-extraction (HS-SPME), combined with gas chromatography–mass spectrometry (GC-MS), and fatty acids by gas chromatography (GC). The ensiled forage obtained with AMF increased saturated fatty acids (SFAs), and decreased monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) in both experiments. The volatile fraction in milk samples obtained from bovines fed mycorrhizal ensiled forage showed an increase of free fatty acids and ketones, responsible for cheesy and fruity odors. Aldehydes, responsible for green and grassy notes, increased only in the milk from buffaloes fed ensiled maize. Our results suggest that inoculation of maize and sorghum seed with AMF, combined with a low rate of fertilizers, leads to ensiled forage that could slightly affect the FA profile and odor quality of milk

Clustering Cardiovascular Risk Trajectories of Patients with Type 2 Diabetes Using Process Mining

[EN] Patients with type 2 diabetes have a higher chance of developing cardiovascular diseases and an increased odds of mortality. Reliability of randomized clinical trials is continuously judged due to selection, attrition and reporting bias. Moreover, cardiovascular risk is frequently assessed in cross-sectional studies instead of observing the evolution of risk in longitudinal cohorts. In order to correctly assess the course of cardiovascular riskinpatientswithtype 2 diabetes, weappliedprocessminingtechniquesbasedontheprinciples of evidence-based medicine. Using a validated formulation of the cardiovascular risk, process mining allowed to cluster frequent risk pathways and produced 3 major trajectories related to risk management: high risk, medium risk and low risk.This enables the extractionofmeaningful distributions, such as the gender of the patients per cluster in a human understandable manner, leading to more insights to improve themanagementofcardiovasculardiseasesintype2diabetes patients.This work was supported by European Commission Grant No 600914 (MOSAIC Project).Pebesma, J.; Martinez-Millana, A.; Sacchi, L.; Fernández Llatas, C.; De Cata, P.; Chiovato, L.; Bellazzi, R.... (2019). Clustering Cardiovascular Risk Trajectories of Patients with Type 2 Diabetes Using Process Mining. IEEE. 341-344. https://doi.org/10.1109/EMBC.2019.8856507S34134

An Extract from Ficus carica Cell Cultures Works as an Anti-Stress Ingredient for the Skin

Psychological stress activates catecholamine production, determines oxidation processes, and alters the lipid barrier functions in the skin. Scientific evidence associated with the detoxifying effect of fruits and vegetables, the growing awareness of the long-term issues related to the use of chemical-filled cosmetics, the aging of the population, and the increase in living standards are the factors responsible for the growth of food-derived ingredients in the cosmetics market. A Ficus carica cell suspension culture extract (FcHEx) was tested in vitro (on keratinocytes cells) and in vivo to evaluate its ability to manage the stress-hormone-induced damage in skin. The FcHEx reduced the epinephrine (−43% and −24% at the concentrations of 0.002% and 0.006%, respectively), interleukin 6 (−38% and −36% at the concentrations of 0.002% and 0.006%, respectively), lipid peroxide (−25%), and protein carbonylation (−50%) productions; FcHEx also induced ceramide synthesis (+150%) and ameliorated the lipid barrier performance. The in vivo experiments confirmed the in vitro test results. Transepidermal water loss (TEWL; −12.2%), sebum flow (−46.6% after two weeks and −73.8% after four weeks; on the forehead −56.4% after two weeks and −80.1% after four weeks), and skin lightness (+1.9% after two weeks and +2.7% after four weeks) defined the extract’s effects on the skin barrier. The extract of the Ficus carica cell suspension cultures reduced the transepidermal water loss, the sebum production, the desquamation, and facial skin turning to a pale color from acute stress, suggesting its role as an ingredient to fight the signs of psychological stress in the skin

Enhancing guideline-based decision support with distributed computation through local mobile application

We introduce the need for a distributed guideline-based decision support (DSS) process, describe its characteristics, and explain how we implemented this process within the European Union’s MobiGuide project. In particular, we have developed a mechanism of sequential, piecemeal projection, i.e., 'downloading' small portions of the guideline from the central DSS server, to the local DSS in the patient's mobile device, which then applies that portion, using the mobile device's local resources. The mobile device sends a callback to the central DSS when it encounters a triggering pattern predefined in the projected module, which leads to an appropriate predefined action by the central DSS, including sending a new projected module, or directly controlling the rest of the workflow. We suggest that such a distributed architecture that explicitly defines a dialog between a central DSS server and a local DSS module, better balances the computational load and exploits the relative advantages of the central server and of the local mobile device

Maternal Oct-4 is a potential key regulator of the developmental competence of mouse oocytes

Background The maternal contribution of transcripts and proteins supplied to the zygote is crucial for the progression from a gametic to an embryonic control of preimplantation development. Here we compared the transcriptional profiles of two types of mouse MII oocytes, one which is developmentally competent (MIISN oocyte), the other that ceases development at the 2-cell stage (MIINSN oocyte), with the aim of identifying genes and gene expression networks whose misregulated expression would contribute to a reduced developmental competence. Results We report that: 1) the transcription factor Oct-4 is absent in MIINSN oocytes, accounting for 2) the down-regulation of Stella, a maternal-effect factor required for the oocyte-to-embryo transition and of which Oct-4 is a positive regulator; 3) eighteen Oct-4-regulated genes are up-regulated in MIINSN oocytes and are part of gene expression networks implicated in the activation of adverse biochemical pathways such as oxidative phosphorylation, mitochondrial dysfunction and apoptosis. Conclusion The down-regulation of Oct-4 plays a crucial function in a sequence of molecular processes that leads to the developmental arrest of MIINSN oocytes. The use of a model study in which the MII oocyte ceases development consistently at the 2-cell stage has allowed to attribute a role to the maternal Oct-4 that has never been described before. Oct-4 emerges as a key regulator of the molecular events that govern the establishment of the developmental competence of mouse oocytes

OCT4 and the acquisition of oocyte developmental competence during folliculogenesis

The role that the transcription factor OCT4 plays during oocyte growth is yet unknown. In this review, we summarise the data on its potential role in the acquisition of oocyte developmental competence in the mouse. These studies describe the presence in MII oocytes and 2-cell embryos of an OCT4 transcriptional network that might be part of the molecular signature of maternal origin on which the inner cell mass and the embryonic stem cell-associated pluripotency is assembled and shaped. The Oct4-gene regulatory network thus provides a connection between eggs, early preimplantation embryos and embryonic stem cells

Automatic Data Transfer from OMOP-CDM to REDCap: A Semantically-Enriched Framework.

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pMineR: An Innovative R Library for Performing Process Mining in Medicine

Process Mining is an emerging discipline investigating tasks related with the automated identification of process models, given realworld data (Process Discovery). The analysis of such models can provide useful insights to domain experts. In addition, models of processes can be used to test if a given process complies (Conformance Checking) with specifications. For these capabilities, Process Mining is gaining importance and attention in healthcare. In this paper we introduce pMineR, an R library specifically designed for performing Process Mining in the medical domain, and supporting human experts by presenting processes in a human-readable way