Aims
The growing incidence of diabetes and the need to contain healthcare costs empower the necessity to identify new models of care. Telemedicine offers an acknowledged instrument to provide ...clinical health care at a distance, increasing patient compliance and the achievement of therapeutical goals. The objective was to test the feasibility and the efficacy in the improvement of the glycemic control of the teleconsultation for patients with type 1 diabetes mellitus.
Methods
A randomized open-label, parallel arms, controlled trial was conducted in two diabetes centers in Italy. Participants affected by type 1 diabetes mellitus have been randomly (1:1) assigned to receive their visits as standard or a web-based care. Patients in the teleconsultation group can arrange their appointments on a Web site and can also have access to web educational courses or to nutritional and psychological counseling. The primary outcome was the assessment of glycemic control by HbA1c measurement after a 12-month follow-up.
Results
Overall 74 participants were followed for 1 year. HbA1c changes were not statistically different within (
p
= 0.56 for standard care group;
p
= 0.45 for telemedicine group) and between (
p
= 0.60) groups when considering differences from baseline to the end of the study. Patients randomized to teleconsultation reported reduced severe hypoglycemic episodes (
p
= 0.03). In addition, they were largely satisfied with the activities, perceived a good improvement in the self-management of the diabetes, and reported to have a time saving and a cost reduction.
Conclusions
In conclusion, TELEDIABE proposes a new system for the management of patients with type 1 diabetes mellitus.
In this paper an optimization problem designed to calculate electric grid specific indicators to be used within model-based methodologies for the definition of alternative electricity market bidding ...zone configurations is designed. The approach integrates within the framework of a bidding zone review process aligned to the specifications of the Commission Regulation (EU) 2015/1222 (CACM) and Regulation (EU) 2019/943 of the European Parliament and of the Council (CEP). The calculated solution of the optimization provides locational marginal prices and allows to determine, outside the optimization problem, the power transfer distribution factors for critical elements. Both indicators can be used as inputs by specially designed clustering algorithms to identify model-based electricity market bidding zone configurations, as alternative to the current experience-based configurations. The novelty of the optimization problem studied in this paper consists in integrating the N-1 security criteria for transmission network operation in an explicit manner, rather than in a simplified and inaccurate manner, as encountered in the literature. The optimization problem is evaluated on a set of historical and significant operating scenarios of the Italian transmission network, carefully selected by the Italian transmission system operator. The results show the optimization problem capability to produce insightful results for supporting a bidding zone review process and its advantages with respect to simplified methodologies encountered in the literature.
Mud volcanism is a process that leads to the extrusion of subsurface mud, fragments of country rocks, saline waters and gases. This mechanism is typically linked to hydrocarbon traps, and the ...extrusion of this material builds up a variety of conical edifices with a similar morphology to those of magmatic volcanoes, though smaller in size. The Differential Interferometry Synthetic Aperture Radar (DInSAR) technique has been used to investigate the ground deformation related to the activity of the mud volcanoes of Azerbaijan. The analysis of a set of wrapped and unwrapped interferograms, selected according to their coherence, allowed the detection of significant superficial deformation related to the activity of four mud volcanoes. The ground displacement patterns observed during the period spanning from October 2003 to November 2005 are dominated by uplift, which reach a cumulative value of up to 20 and 10cm at the Ayaz–Akhtarma and Khara-Zira Island mud volcanoes, respectively. However, some sectors of the mud volcano edifices are affected by subsidence, which might correspond to deflation zones that coexist with the inflation zones characterized by the dominant uplift. Important deformation events, caused by fluid pressure and volume variations, have been observed both (1) in connection with main eruptive events in the form of pre-eruptive uplift, and (2) in the form of short-lived deformation pulses that interrupt a period of quiescence. Both deformation patterns show important similarities to those identified in some magmatic systems. The pre-eruptive uplift has been observed in many magmatic volcanoes as a consequence of magma intrusion or hydrothermal fluid injection. Moreover, discrete short-duration pulses of deformation are also experienced by magmatic volcanoes and are repeated over time as multiple inflation and deflation events.
•A step forward in understanding mud volcano dynamics•Applying the DInSAR technique for the study of mud volcanoes of Azerbaijan•Detection of deformation events during both pre-eruptive and quiescence phases•Mud and magmatic volcanoes display similarities in ground deformation patterns.
The definition of bidding zones is a relevant question for electricity markets. The bidding zones can be identified starting from information on the nodal prices and network topology, considering the ...operational conditions that may lead to congestion of the transmission lines. A well-designed bidding zone configuration is a key milestone for an efficient market design and a secure power system operation, being the basis for capacity allocation and congestion management processes, as acknowledged in the relevant European regulation. Alternative bidding zone configurations can be identified in a process assisted by the application of clustering methods, which use a predefined set of features, objectives and constraints to determine the partitioning of the network nodes into groups. These groups are then analysed and validated to become candidate bidding zones. The content of the manuscript can be summarized as follows: (1) A novel probabilistic multi-scenario methodology was adopted. The approach needs the analysis of features that are computed considering a set of scenarios defined from solutions in normal operation and in planned maintenance cases. The weights of the scenarios are indicated by TSOs on the basis of the expected frequency of occurrence; (2) The relevant features considered are the Locational Marginal Prices (LMPs) and the Power Transfer Distribution Factors (PTDFs); (3) An innovative computation procedure based on clustering algorithms was developed to group nodes of the transmission electrical network into bidding zones considering topological constraints. Several settings and clustering algorithms were tested in order to evaluate the robustness of the identified solutions.
The ultraviolet (UV) component of solar radiation is the major driving force of skin carcinogenesis. Most of studies on UV carcinogenesis actually focus on DNA damage while their proteome-damaging ...ability and its contribution to skin carcinogenesis have remained largely underexplored. A redox proteomic analysis of oxidized proteins in solar-induced neoplastic skin lesion and perilesional areas has been conducted showing that the protein oxidative burden mostly concerns a selected number of proteins participating to a defined set of functions, namely: chaperoning and stress response; protein folding/refolding and protein quality control; proteasomal function; DNA damage repair; protein- and vesicle-trafficking; cell architecture, adhesion/extra-cellular matrix (ECM) interaction; proliferation/oncosuppression; apoptosis/survival, all of them ultimately concurring either to structural damage repair or to damage detoxication and stress response. In peri-neoplastic areas the oxidative alterations are conducive to the persistence of genetic alterations, dysfunctional apoptosis surveillance, and a disrupted extracellular environment, thus creating the condition for transformant clones to establish, expand and progress. A comparatively lower burden of oxidative damage is observed in neoplastic areas. Such a finding can reflect an adaptive selection of best fitting clones to the sharply pro-oxidant neoplastic environment. In this context the DNA damage response appears severely perturbed, thus sustaining an increased genomic instability and an accelerated rate of neoplastic evolution. In conclusion UV radiation, in addition to being a cancer-initiating agent, can act, through protein oxidation, as a cancer-promoting agent and as an inducer of genomic instability concurring with the neoplastic progression of established lesions.
Purpose
In obesity, metabolic and voluntary factors regulate appetite, and a dysregulation of the reward pathway was demonstrated in all addiction disorders. Deep transcranial magnetic stimulation ...(dTMS) is already used to modulate cerebral dopamine activation in neuro-psychiatric diseases. We presently assess the acute effect of high frequency (HF) and low frequency (LF) dTMS on the modulation of the main neuropeptides and neurotransmitters involved in the reward pathway in obese subjects.
Methods
This study was designed as a double-blind, sham-controlled, randomized clinical trial. Thirty-three obese patients (9 males, 24 females, age 48.1 ± 10.6, BMI 36.4 ± 4.7) were enrolled in the study. All patients were studied during a single dTMS session and blood aliquots were drawn before and after a single dTMS session. Metabolic and neuro-endocrine parameters were evaluated before and after: (1) 18 Hz dTMS (HF, 13 patients); (2) 1 Hz dTMS (LF, 10 patients); (3) Sham treatment (Sham, 10 patients).
Results
No statistically significant variations in metabolic parameters, systolic and diastolic blood pressure, and heart rate were shown acutely. HF showed a significant increase of β-endorphin compared to other groups (
p
= 0.048); a significant increase of ghrelin in LF (
p
= 0.041) was also demonstrated.
Conclusions
A single session of HF dTMS treatment determines in obese subjects an acute increase of β-endorphin level, indicating an activation of the reward pathway. The present findings constitute proof of principle for a potential application of this methodology in obesity treatment.
The urban population increases by about 60 million people/year. Urbanization, unhealthy lifestyle and aging of the population are reflected in a constant growth in the prevalence of diabetes. In ...2014, Steno Diabetes Centre in Copenhagen, University College London and Novo Nordisk, launched the Cities Changing Diabetes® program with the aim of creating a unified movement that would stimulate policy-makers to prioritize urban diabetes.AIMThe urban population increases by about 60 million people/year. Urbanization, unhealthy lifestyle and aging of the population are reflected in a constant growth in the prevalence of diabetes. In 2014, Steno Diabetes Centre in Copenhagen, University College London and Novo Nordisk, launched the Cities Changing Diabetes® program with the aim of creating a unified movement that would stimulate policy-makers to prioritize urban diabetes.The socio-demographic data derive from (1) ISTAT (National Institute of Statistics of Italy), (2) ATS Metropolitan City of Milan, (3) ATS Val Padana-Cremona, (4) ATS Insubria-Varese, (5) The unemployment rates of the various municipalities have been extrapolated from an ISTAT-MEF elaboration published by Sole 24 Ore journal.METHODSThe socio-demographic data derive from (1) ISTAT (National Institute of Statistics of Italy), (2) ATS Metropolitan City of Milan, (3) ATS Val Padana-Cremona, (4) ATS Insubria-Varese, (5) The unemployment rates of the various municipalities have been extrapolated from an ISTAT-MEF elaboration published by Sole 24 Ore journal.In the different sanitary districts of the Metropolitan City of Milan, a strong linear correlation was found between the prevalence of diabetes and the prevalence of heart disease (R = 0.695, p < 0.001), as well as between the prevalence of diabetes and of nephropathies (R = 0.316, p < 0.001). The analysis concerning the province of Cremona showed a fair correlation between the prevalence of diabetes and cardiovascular disease (R = 0.658, p < 0.001). Even for the municipalities of Varese, the analysis documented a good correlation between the prevalence of diabetes and heart disease (R = 0.419, p < 0.001), but not between diabetes and nephropathies.RESULTSIn the different sanitary districts of the Metropolitan City of Milan, a strong linear correlation was found between the prevalence of diabetes and the prevalence of heart disease (R = 0.695, p < 0.001), as well as between the prevalence of diabetes and of nephropathies (R = 0.316, p < 0.001). The analysis concerning the province of Cremona showed a fair correlation between the prevalence of diabetes and cardiovascular disease (R = 0.658, p < 0.001). Even for the municipalities of Varese, the analysis documented a good correlation between the prevalence of diabetes and heart disease (R = 0.419, p < 0.001), but not between diabetes and nephropathies.Interesting differences in the relationship of diabetes prevalence with several diseases and socio-demographic factors have been found when comparing the metropolitan City of Milan with two smaller size cities as Varese and Cremona. Our present data confirm the hypothesis that urban diabetes will be the challenge for our society during the next decades.CONCLUSIONSInteresting differences in the relationship of diabetes prevalence with several diseases and socio-demographic factors have been found when comparing the metropolitan City of Milan with two smaller size cities as Varese and Cremona. Our present data confirm the hypothesis that urban diabetes will be the challenge for our society during the next decades.
(1) Background: Parkinson's disease (PD) is one of the most frequent causes of disability among older people. Recently, virtual reality and exergaming have been emerged as promising tools for gait ...and balance rehabilitation in PD patients. Our purpose is to evaluate an innovative treatment for older patients with PD, based on non-immersive virtual reality exergames, improving gait and balance and reducing falling risk. (2) Methods: Thirty PD patients were recruited and randomly divided into two groups, to receive a traditional rehabilitation (CG) or a technological rehabilitation (TG). (3) Results: A statistical improvement of balance at the end of treatments was observed in both groups (CG: 12.4 ± 0.7 vs. 13.5 ± 0.8,
= 0.017; TG: 13.8 ± 0.5 vs. 14.7 ± 0.4,
= 0.004), while the overall risk of falling was significantly reduced only in the TG (POMA Total: 24.6 ± 0.9 vs. 25.9 ± 0.7,
= 0.010). The results between groups shows that all POMA scores differ in a statistically significant manner in the TG, emphasizing improvement not only in balance but also in gait characteristics (9.7 ± 0.8 vs. 11.4 ± 0.2,
= 0.003). Moreover, TG also improves the psychological sphere, measured thorough MSC-(17.1 ± 0.4 vs. 16.5 ± 0.4,
= 0.034). Although an improvement in FES-I and Gait Speed can be observed, this increase does not turn out to be significant. (4) Conclusions: Results suggest how non-immersive virtual reality exergaming technology offers the opportunity to effectively train cognitive and physical domains at the same time.
The aim of this paper is to describe the results collected with the Italian study conducted within eWare project, aimed at supporting the autonomy and health of the older people affected by dementia ...and their informal caregivers, through the use of an innovative system based on a social robot and a sensorized environmental infrastructure. Nine dyads of older participants with their caregivers were enrolled in testing the system for 6 months. The results show a positive impact of the system in supporting the achievement of personal goals of the participants, as well as in supporting the quality of life of the informal caregivers. Nevertheless, the impact of the system in reducing the caregivers' burden needs to be deeply investigated. This research highlights the potential of the eWare system but modifications will have to be made, especially on the interactivity capabilities, in order to meet the peculiar needs and wishes of older people with dementia and to favor the long-term use of the system.
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