1,721,015 research outputs found
Analysis of the Sustainable Development Goal 3 index for Italian municipalities
Full text linkObjectives: Improving health at global and local scales is one of the 17 Sustainable Development Goals (SDGs) set by the United Nations (UN) for the period 2015–2030, specifically defined by SDG3, which includes 13 targets described by 28 indicators. In this context, the aim of the current study was to propose a protocol to infer SDG3 values at municipality level with the current openly available data. Study design: The study incorporated a quantitative research. Methods: To calculate the SDG3 index, defined as the average of all 13 target scores, official Italian data at five geographical granularities covering the period 2018–2022 were used, and a spatial downscaling strategy was implemented. The quality of matching between original and inferred indicators was assessed applying a specific standard (International Organisation for Standardisation [ISO]/TS 21564) that matches quality between terminology resources with regards to health care. The significance of regional/provincial differences was assessed by the Kruskal–Wallis test with Bonferroni correction, and the Moran's index with queen contiguity method was applied to evaluate clustering tendency. Results: The geographical distribution of scores varied considerably (and with statistical significance) across the targets, with municipalities in the central part of the country achieving relatively good overall performance. Matching quality also varied consistently across targets. Clustering tendency was observed and was likely due to regional differences in data collection protocols. Conclusions: The SDG3 index, as an internationally standardised measure of health, can be used to validate urban health indices; however, considerable improvement by official data providers in Italy is required to guarantee access to data at the municipal level
Evaluation of the Changes in RR and QT Circadian Rhythms in Bedridden Subjects
Full text linkProlonged bed rest (BR), often related to hospitalization, chronic diseases and ageing, as well as hospitalized COVid-19 patients, induces reduced functional capacity in multiple body systems and rhythms dysregulation, possibly leading to cardiovascular deconditioning and increased arrhythmogenic risk. In this study, we analyzed 24h Holter ECGs collected from 10 healthy subjects before, during, and after a 10-day BR, aiming at assessing the decline of the circadian rhythms of RR and ventricular repolarization intervals. Our results proved that a 10-day BR induced changes in the characteristics of cardiac circadian rhythms, in terms of midline value, oscillation amplitude and acrophase, offering a first insight for the formulation of appropriate countermeasures for improving homeostasis maintenance in hospitalized patients
Come gestire gli aspetti regolatori per le terapie digitali
No full textLe Terapie Digitali (DTx) possono essere definite come tecnologie
che “offrono interventi terapeutici che sono guidati da programmi software
di alta qualità, basati su evidenza scientifica ottenuta attraverso sperimentazione clinica metodologicamente rigorosa e confermatoria, per prevenire, gestire o trattare un ampio spettro di condizioni fisiche, mentali e comportamentali”. È possibile utilizzare le DTx in modalità indipendente o in associazione ad altri interventi terapeutici basati sulle evidenze, come ad esempio un farmaco. Le DTx non vanno confuse con le centinaia di migliaia di
applicazioni digitali per il benessere e la salute e con le più diverse finalità,
disponibili per cittadini e pazienti. Le DTx, come sopra definite, sono già
autorizzate e disponibili in alcuni Paesi, prescritte dal medico e rimborsate da servizi sanitari pubblici (Francia, Germania), o rimborsate da sistemi
assicurativi (USA). In Italia, al momento, non vi è alcuna DTx prescrivibile e/o utilizzabile in ambito clinico e/o riconosciuta dal Servizio Sanitario
Validation of CORE-MD PMS Support Tool: A Novel Strategy for Aggregating Information from Notices of Failures to Support Medical Devices’ Post-Market Surveillance
Full text linkIntroduction: The EU Medical Device Regulation 2017/745 defines new rules for the certification and post-market surveillance of medical devices (MD), including an additional review by Expert Panels of clinical evaluation data for high-risk MD if reports and alerts suggest possibly associated increased risks. Within the EU-funded CORE-MD project, our aim was to develop a tool to support such process in which web-accessible safety notices (SN) are automatically retrieved and aggregated based on their specific MD categories and the European Medical Device Nomenclature (EMDN) classification by applying an Entity Resolution (ER) approach to enrich data integrating different sources. The performance of such approach was tested through a pilot study on the Italian data. Methods: Information relevant to 7622 SN from 2009 to 2021 was retrieved from the Italian Ministry of Health website by Web scraping. For incomplete EMDN data (68%), the MD best match was searched within a list of about 1.5 M MD on the Italian market, using Natural Language Processing techniques and pairwise ER. The performance of this approach was tested on the 2440 SN (32%) already provided with the EMDN code as reference standard. Results: The implemented ER method was able to correctly assign the correct manufacturer to the MD in each SN in 99% of the cases. Moreover, the correct EMDN code at level 1 was assigned in 2382 SN (97.62%), at level 2 in 2366 SN (96.97%) and at level 3 in 2329 SN (95.45%). Conclusion: The proposed approach was able to cope with the incompleteness of the publicly available data in the SN. In this way, grouping of SN relevant to a specific MD category/group/type could be used as possible sentinel for increased rates in reported serious incidents in high-risk MD
Evaluation of Cardiac Circadian Rhythm Deconditioning Induced by 5-to-60 Days of Head-Down Bed Rest
Full text linkHead-down tilt (HDT) bed rest elicits changes in cardiac circadian rhythms, generating possible adverse health outcomes such as increased arrhythmic risk. Our aim was to study the impact of HDT duration on the circadian rhythms of heart beat (RR) and ventricular repolarization (QTend) duration intervals from 24-h Holter ECG recordings acquired in 63 subjects during six different HDT bed rest campaigns of different duration (two 5-day, two 21-day, and two 60-day). Circadian rhythms of RR and QTend intervals series were evaluated by Cosinor analysis, resulting in a value of midline (MESOR), oscillation amplitude (OA) and acrophase (φ). In addition, the QTc (with Bazett correction) was computed, and day-time, night-time, maximum and minimum RR, QTend and QTc intervals were calculated. Statistical analysis was conducted, comparing: (1) the effects at 5 (HDT5), 21 (HDT21) and 58 (HDT58) days of HDT with baseline (PRE); (2) trends in recovery period at post-HDT epochs (R) in 5-day, 21-day, and 60-day HDT separately vs. PRE; (3) differences at R + 0 due to bed rest duration; (4) changes between the last HDT acquisition and the respective R + 0 in 5-day, 21-day, and 60-day HDT. During HDT, major changes were observed at HDT5, with increased RR and QTend intervals’ MESOR, mostly related to day-time lengthening and increased minima, while the QTc shortened. Afterward, a progressive trend toward baseline values was observed with HDT progression. Additionally, the φ anticipated, and the OA was reduced during HDT, decreasing system’s ability to react to incoming stimuli. Consequently, the restoration of the orthostatic position elicited the shortening of RR and QTend intervals together with QTc prolongation, notwithstanding the period spent in HDT. However, the magnitude of post-HDT changes, as well as the difference between the last HDT day and R + 0, showed a trend to increase with increasing HDT duration, and 5/7 days were not sufficient for recovering after 60-day HDT. Additionally, the φ postponed and the OA significantly increased at R + 0 compared to PRE after 5-day and 60-day HDT, possibly increasing the arrhythmic risk. These results provide evidence that continuous monitoring of astronauts’ circadian rhythms, and further investigations on possible measures for counteracting the observed modifications, will be key for future missions including long periods of weightlessness and gravity transitions, for preserving astronauts’ health and mission success
Land use influence on ambient PM2.5 and ammonia concentrations: Correlation analyses in the Lombardy region, Italy
Full text linkAir pollution is identified as the primary environmental risk to health worldwide. Although most of the anthropic emissions are due to combustion processes, intensive farming activities may also contribute significantly, especially as a source of particulate matter 2.5 and ammonia. Investigations on particulate matter and precursors dynamics, identifying the most relevant environmental factors influencing their emissions, are critical to improving local and regional air quality policies. This work presents an analysis of the correlation between particulate matter 2.5 and ammonia concentrations, obtained from the Copernicus Atmosphere Monitoring Service, and local land use characteristics, to investigate the influence of agricultural activities on the space-time pollutant concentration patterns. The selected study area is the Lombardy region, northern Italy. Correlation is evaluated through Spearman’s coefficient. Agricultural areas resulted in a significant factor for high ammonia concentrations, while particulate matter 2.5 was strongly correlated with built-up areas. Natural areas resulted instead a protective factor for both pollutants. Results provide data-driven evidence of the land use effect on air quality, also quantifying such effects in terms of correlation coefficients magnitude
Validazione tecnica delle terapie digitali
No full textAnalogamente a quanto accade per gli altri dispositivi medici, le Terapie Digitali (Digital Therapeutics - DTx) devono rispettare i Requisiti Essenziali previsti dalle norme europee. Questi requisiti sono stati definiti
nella attuale Direttiva e riconfermati, pur se con delle importanti novità
per quanto riguarda la dimostrazione di beneficio clinico, dal nuovo Regolamento 2017/745/CE. Questi possono essere riassunti da tre parole chiave: sicurezza, efficacia, qualità. I fabbricanti possono dimostrare di aver
adempiuto agli obblighi definiti dai Requisiti Essenziali per mezzo dell’applicazione di standard internazionali.
In questo testo gli autori si sono concentrati sul processo di sviluppo e
validazione tecnica delle DTx come definito dagli standard ISO 13485 e IEC
62304, fino alla fase immediatamente precedente la validazione clinica
The Cultural Side of Populism: Politics, Emotions, Music and Subcultures in Populist Times
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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