InTake Care: Development and Validation of an Innovative, Personalized Digital Health Solution for Medication Adherence Support in Cardiovascular Prevention

Inadequate medication adherence (MA) in chronic conditions, including cardiovascular prevention, represents an important risk factor. The use of new IT technologies in this setting is supposed to be useful to improve patients' adherence, but currently available solutions have significant limitations, including lack of personalization and reliance on expensive ad hoc systems.
This interdisciplinary project aims to verify the hypothesis that in patients on chronic antihypertensive treatment MA can be improved through the implementation of a novel digital health solution for MA monitoring and support, based on inexpensive and user-friendly, commercially available technology (voice assistant), connected with web interface for the physician. The intervention will be personalized based on the creation of Personas, intended as multidisciplinary-based representations of different user types. This approach will be tested in a randomized clinical trial.

开始日期2024-10-01

申办/合作机构

Istituto Auxologico Italiano

[+2]

NCT06309537 / Not yet recruitingN/AIIT

Chemoreflex Sensitivity in Heart Failure With Preserved Ejection Fraction

Patients with heart failure and a preserved left ventricular ejection fraction (HFpEF) almost invariably complain of exertional breathlessness. Abnormal cardiac hemodynamics with pulmonary congestion are believed to trigger dyspnea in this patients. However, some patients may complain of exertional breathlessness which seems to be out of proportion as compared with hemodynamic abnormalities.
Chemoreflex sensitivity accounts for the ventilatory responses to a variety of chemical stimuli, including carbon dioxide produced by the organism during exercise. Chemoreflex sensitivity can be augmented in heart failure with reduced left ventricular ejection fraction, and an increased chemoreflex sensitivity has been linked to symptoms, neurohumoral activation, breathing disturbances, and adverse prognosis.
However, the clinical correlates and implications of chemoreflex sensitivity in HFpEF have not been accurately studied.
We aim to characterize chemoreflex sensitivity in patients with a diagnosis of HFpEF, and to correlate chemoreflex sensitivity with clinical and hemodynamic characteristics.

开始日期2024-10-01

申办/合作机构

Istituto Auxologico Italiano

NCT06540820 / Not yet recruitingN/A

NEUROENDOCRINE REGULATION OF BONE-FAT CROSSTALK IN OBESITY

To study the effect of neuroendocrine dysfunctions on bone health in obesity

开始日期2024-09-01

申办/合作机构

Università degli Studi di Napoli Federico II

[+1]

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项与 Istituto Auxologico Italiano 相关的文献（医药）

2024-12-31·Computer Assisted Surgery

Feasibility of proton dosimetry overriding planning CT with daily CBCT elaborated through generative artificial intelligence tools

Article

作者: Cerveri, Pietro ; Belotti, Gabriele ; Rossi, Matteo ; Mainardi, Luca ; Baroni, Guido

Radiotherapy commonly utilizes cone beam computed tomography (CBCT) for patient positioning and treatment monitoring. CBCT is deemed to be secure for patients, making it suitable for the delivery of fractional doses. However, limitations such as a narrow field of view, beam hardening, scattered radiation artifacts, and variability in pixel intensity hinder the direct use of raw CBCT for dose recalculation during treatment. To address this issue, reliable correction techniques are necessary to remove artifacts and remap pixel intensity into Hounsfield Units (HU) values. This study proposes a deep-learning framework for calibrating CBCT images acquired with narrow field of view (FOV) systems and demonstrates its potential use in proton treatment planning updates. Cycle-consistent generative adversarial networks (cGAN) processes raw CBCT to reduce scatter and remap HU. Monte Carlo simulation is used to generate CBCT scans, enabling the possibility to focus solely on the algorithm's ability to reduce artifacts and cupping effects without considering intra-patient longitudinal variability and producing a fair comparison between planning CT (pCT) and calibrated CBCT dosimetry. To showcase the viability of the approach using real-world data, experiments were also conducted using real CBCT. Tests were performed on a publicly available dataset of 40 patients who received ablative radiation therapy for pancreatic cancer. The simulated CBCT calibration led to a difference in proton dosimetry of less than 2%, compared to the planning CT. The potential toxicity effect on the organs at risk decreased from about 50% (uncalibrated) up the 2% (calibrated). The gamma pass rate at 3%/2 mm produced an improvement of about 37% in replicating the prescribed dose before and after calibration (53.78% vs 90.26%). Real data also confirmed this with slightly inferior performances for the same criteria (65.36% vs 87.20%). These results may confirm that generative artificial intelligence brings the use of narrow FOV CBCT scans incrementally closer to clinical translation in proton therapy planning updates.

2024-10-01·Medicine & Science in Sports & Exercise

Impaired Endothelial And Microvascular Functions In Obese Patients: Analysis Of Blood Flow In The Femoral Artery During Passive Leg Movements

作者: Caroli, Diana ; De Micheli, Roberta ; Sartorio, Alessandro ; Tringali, Gabriella ; Zuccarelli, Lucrezia ; Favaretto, Thomas ; Baldassarre, Giovanni ; Grassi, Bruno ; Zoladz, Jerzy ; Majerczak, Joanna ; Bondesan, Adele

2024-10-01·Heart Rhythm

An international multicenter cohort study on implantable cardioverter-defibrillators for the treatment of symptomatic children with catecholaminergic polymorphic ventricular tachycardia

Article

作者: Tavacova, Terezia ; Backhoff, David ; Wilde, Arthur A M ; Knight, Linda ; Atallah, Joseph ; Tisma-Dupanovic, Svjetlana ; Aiba, Takeshi ; Schwartz, Peter J ; Drago, Fabrizio ; Roston, Thomas M ; Peltenburg, Puck J ; Semsarian, Christopher ; van der Werf, Christian ; Horie, Minoru ; Perry, James ; Leenhardt, Antoine ; LaPage, Martin J ; Rudic, Boris ; Swan, Heikki ; Sarquella-Brugada, Georgia ; Brugada, Ramon ; Denjoy, Isabelle ; Kamp, Anna ; Lamba, Avani ; Sanatani, Shubhayan ; Borggrefe, Martin ; Blom, Nico A ; Kallas, Dania ; Till, Jan ; Robyns, Tomas ; Batra, Anjan S ; Ackerman, Michael J ; Probst, Vincent ; Kannankeril, Prince J ; Roberts, Jason D ; Chorin, Ehud ; Tfelt-Hansen, Jacob ; Lieve, Krystien V V ; Franciosi, Sonia ; Kwok, Sit-Yee ; Kammeraad, Janneke ; Haugaa, Kristina ; Fischbach, Peter ; Krahn, Andrew D ; Ohno, Seiko ; Hill, Allison ; Skinner, Jonathan R ; Law, Ian

BACKGROUNDCatecholaminergic polymorphic ventricular tachycardia (CPVT) may cause sudden cardiac death (SCD) despite medical therapy. Therefore, implantable cardioverter-defibrillators (ICDs) are commonly advised. However, there is limited data on the outcomes of ICD use in children.OBJECTIVEThe purpose of this study was to compare the risk of arrhythmic events in pediatric patients with CPVT with and without an ICD.METHODSWe compared the risk of SCD in patients with RYR2 (ryanodine receptor 2) variants and phenotype-positive symptomatic CPVT patients with and without an ICD who were younger than 19 years and had no history of sudden cardiac arrest at phenotype diagnosis. The primary outcome was SCD; secondary outcomes were composite end points of SCD, sudden cardiac arrest, or appropriate ICD shocks with or without arrhythmic syncope.RESULTSThe study included 235 patients, 73 with an ICD (31.1%) and 162 without an ICD (68.9%). Over a median follow-up of 8.0 years (interquartile range 4.3-13.4 years), SCD occurred in 7 patients (3.0%), of whom 4 (57.1%) were noncompliant with medications and none had an ICD. Patients with ICD had a higher risk of both secondary composite outcomes (without syncope: hazard ratio 5.85; 95% confidence interval 3.40-10.09; P < .0001; with syncope: hazard ratio 2.55; 95% confidence interval 1.50-4.34; P = .0005). Thirty-one patients with ICD (42.5%) experienced appropriate shocks, 18 (24.7%) inappropriate shocks, and 21 (28.8%) device-related complications.CONCLUSIONSCD events occurred only in patients without an ICD and mostly in those not on optimal medical therapy. Patients with an ICD had a high risk of appropriate and inappropriate shocks, which may be reduced with appropriate device programming. Severe ICD complications were common, and risks vs benefits of ICDs need to be considered.

项与 Istituto Auxologico Italiano 相关的新闻（医药）

2024-04-11

·mobihealthnews

oVRcome announces pilot program with NHS for autistic individuals

New Zealand-based virtual reality and cognitive behavioral therapy company oVRcome announced it signed an international contract with the U.K.'s National Health Service (NHS) to help autistic individuals navigate hospital environments and social interactions. oVRcome, launched in 2021, utilizes a smartphone and a headset to deliver exposure therapy to adults and children with numerous conditions, including phobias, social anxiety, panic disorder and other ailments. Exposure therapy is a type of cognitive behavioral therapy that helps patients build up their tolerance to their specific phobias through short bursts of exposure. The U.K.-based pilot program aims to reduce the appointment cancellation rate among individuals on the autism spectrum by helping them navigate hospital and social settings via oVRcome's exposure therapy platform. The program will immerse autistic individuals in virtual environments, complete with scripted videos showing ways of behaving in social settings so that they can practice navigating these environments and feel more comfortable. Up to a hundred individuals will participate in the pilot program, scheduled to begin in August. "What we know firsthand is that members of the autistic community experience anxiety around accessing medical services and environments. Often, this anxiety leads to the cancellation of appointments, with many of these being essential to the individual's health and wellbeing," Adam Hutchinson, founder of oVRcome, told MobiHealthNews. "Our goal is to reduce this anxiety through customized virtual reality exposure therapy co-designed with members of the community. This is accessed via the oVRcome smartphone app, with a clinician being able to connect to the VR session remotely via our clinician portal." THE LARGER TREND In 2022, oVRcome released the results of a randomized, controlled trial performed in the Department of Psychological Medicine at the University of Otago. The study aimed to reduce the symptoms of common phobias, including a fear of flying, heights, needles, spiders and dogs. Based on findings, which were published in the Australian and New Zealand Journal of Psychiatry, the app-based CBT program alleviated symptoms of phobias by 75% among participants after six weeks of treatment. Barbara Rothbaum of Emory University is credited as being the inventor of virtual reality exposure therapy, which is now used by numerous researchers globally, including at Stanford University's Virtual Reality and Immersive Technology (VR-IT) lab, the Applied Technology for Neuro-Psychology Laboratory (ATN-P Lab) at Istituto Auxologico Italiano, in Italy, and the University of Barcelona. Another company using VR to teach neurodiverse individuals behavioral, social and life skills is Floreo. It recently received a strategic investment from Cleveland Clinic and acquired Autism EyesTM, an autism-focused diagnostics and assessment company developed by Cleveland Clinic Innovations.