Towards a European health research and innovation cloud (HRIC).

The European Union (EU) initiative on the Digital Transformation of Health and Care (Digicare) aims to provide the conditions necessary for building a secure, flexible, and decentralized digital health infrastructure. Creating a European Health Research and Innovation Cloud (HRIC) within this environment should enable data sharing and analysis for health research across the EU, in compliance with data protection legislation while preserving the full trust of the participants. Such a HRIC should learn from and build on existing data infrastructures, integrate best practices, and focus on the concrete needs of the community in terms of technologies, governance, management, regulation, and ethics requirements. Here, we describe the vision and expected benefits of digital data sharing in health research activities and present a roadmap that fosters the opportunities while answering the challenges of implementing a HRIC. For this, we put forward five specific recommendations and action points to ensure that a European HRIC: i) is built on established standards and guidelines, providing cloud technologies through an open and decentralized infrastructure; ii) is developed and certified to the highest standards of interoperability and data security that can be trusted by all stakeholders; iii) is supported by a robust ethical and legal framework that is compliant with the EU General Data Protection Regulation (GDPR); iv) establishes a proper environment for the training of new generations of data and medical scientists; and v) stimulates research and innovation in transnational collaborations through public and private initiatives and partnerships funded by the EU through Horizon 2020 and Horizon Europe.

The influence of the entry region on the instability of a coflowing injector device.

The occurrence of dripping and jetting regimes in a microfluidic coflowing injector device has been related recently to the spatio-temporal stability properties of the developed velocity profile. Dripping corresponds to an absolutely unstable flow while jetting is observed when the Rayleigh-Plateau instability of the core-annular jet is convective. In this work we take into account the effect of the entry region on the dripping to jetting transition by carrying out a global stability analysis of the steady two-phase base flow. We show that, depending on the flow parameters, the entry region can affect significantly the transition between the two regimes.

[The role of neuromodulators (substance P and calcitonin gene-related peptide) in the development of neurogenic inflammation in the oral mucosa]. / Ruolo dei neuromodulatori (sostanza P e calcitonin gene-related peptide) nella flogosi neurogena della mucosa orale.

Vatous observations carried out in the course of the years have shown that certain neuropeptides have a possible role to play as inflammation mediators. The substances on which attention has been principally focused are: substance P, calcitonin gene-related peptide, capsaicin an histamine. Knowledge acquired in this field, however, does not yet permit us to sufficiently clarify the role, not to speak of the possible action mechanism, on the basis of which these neuropeptides act, although it is confirmed that these substances have been found first in laboratory animals and later also in human tissues in the course of experimentally induced neurogenic inflammation. The need to know more and more about inflammatory mechanisms and the increasingly complex possibilities offered by the application of technology in the field of medical research have led to many small advance in our knowledge of what is involved in inflammation. In fact it has been understood that behind the typical signs of inflammation (the famous four cardinal signs of Celsus: pain, redness, swelling, heat) no abstract entities or strange alchemies are concealed, but a series of well-known, classified substance, the so-called "inflammation mediators", namely a variety of substances of cellular or plasmatic origin united by the fact that exist, in stationary state conditions, in the form of inactive precursors, or sequestered in intracellular sites where they are unable to carry out their action. Following an inflammatory stimulus, they are activated, or their synthesis can be induced, or their release from intracellular sequestration sites in favoured; in any case they are stored in the disturbance district in concentrations that are such as to act on their respective targets, triggering event s that characterise the various stages of the inflammatory process.

Loss of autonomy of hospitalized elderly patients: does hospitalization increase disability?

AIM: The study of the determinants of loss of autonomy during hospitalization may be valuable in the identification of the most effective interventions and to achieve better outcomes. The aim of this study was to describe changes in the level of autonomy of the elderly admitted to the hospital at the entrance and at discharge in relation to a rehabilitation program. METHODS: Prospective observational study conducted at the INRCA Geriatric Hospital of Ancona. The study included patients aged 65 years and over, daily admitted to INRCA Hospital of Ancona between September and December 2010. Criteria for inclusion were age ≥ 65 years, length of stay > 24 hours and signed informed consent. Patients admitted for less than 24 hours or in day hospital or day surgery were excluded from the beginning. A total of 1266 elderly patients were recruited in the period. From this sample, 74 people who died during hospitalization were excluded. At the time of hospitalization (within 24 hours) and at discharge, patients were evaluated with the Barthel Index (BI), the Rankin scale, and a short assessment of cognitive status derived from the Mini Mental State Examination (MMSE). RESULTS: Referring to 1192 subjects who participated to the study, the mean age was 82.13 years ±7.39, age range between 65 and 100 years. The average BI was 56.6±36.16 (SD) (median value =60) at admission and 63.84±34.7 (SD) (median value=70) at discharge. The average Rankin score at admission was 2.63±1.5 (SD) (median value=3). CONCLUSION: Patients presented better score of the BI at discharge and this figure was associated to the implementation of a rehabilitation treatment. Hospitalization of the elderly patient in a suitable environment, such as a geriatric hospital, contrary to some theories highlighting only the negative aspects of removal from the living environment, can be a measure of benefit for the reduction of disability and the recovery of compromised activities along and after the acute event. The collection of data on the level of autonomy of the subjects before and after hospitalization can be a useful element for clinical evaluation in a geriatric hospital.