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Maggioni A.P.,Research Center | Calabria S.,Collaborative Outcome Research | Rossi E.,Interuniversity Consortium | Martini N.,Drug and Health
International Journal of Cardiology | Year: 2017

Aim: To assess clinical characteristics, use of resources and costs of patients at very high risk (VHR) of cardiovascular (CV) events. Further, to assess how VHR patients are treated with statins (rate of prescription, dosages, adherence). Methods and results: A record linkage analysis was carried out of patient demographics, drug prescriptions, hospital discharge, specialty procedures from the ARNO Observatory, including 2,989,512 subjects of Local Health Units well representing the whole Italian country. Accrual lasted from January 1 to December 31, 2011.Among these subjects, 17,126 (0.56%) experienced a CV event, representing the cohort at VHR. Between VHR patients, 4810 (28.1%) individuals represent the diabetic cohort. Mean age of VHR patients was 77. ±. 13, females were 43.8%.Statins and/or ezetimibe were prescribed in 59.9% and 68.5% during the first year of follow respectively in VHR and VHR-diabetics. Prescription continuity at 1. year was 64.7% in patients at VHR, and 63.4% in VHR diabetics. At 1. year, at least one re-hospitalization occurred in 55.0% of patients for a total of 17,631 re-hospitalizations. In VHR diabetics, at least one readmission occurred in 59.6% of patients. Average annual cost for a single VHR patient was €11,644 (drugs: €1007; hospitalizations: €10,097; specialty procedures: €540); the corresponding cost for diabetics was €13,199 (drugs: €1394; hospitalizations: €11,032, specialty procedures €773). Conclusions: Atherothrombotic events are a relevant cause of hospitalization in the community setting. Prescription rate and continuity of treatment with statins seem to be at least suboptimal. NHS costs are high, with re-hospitalizations being the main cost-driver. © 2017 Elsevier B.V.

Guarnieri T.,University of Bologna | Guarnieri T.,S. Orsola Malpighi University Hospital | Guarnieri T.,Interuniversity Consortium
Current Cancer Drug Targets | Year: 2016

Epidemiological data suggest that Non Steroidal Anti Inflammatory Drugs (NSAIDs) and Cyclooxygenase 2 (COX2) inhibitors (COXibs) can exert chemopreventive and antitumour effects in many human neoplasia. This is particularly true in colon cancer (CC), where the regular assumption of these molecules has been shown to exert chemopreventive and chemotherapeutic effects. Since the late ‘90s, there has been a progressive increase in experimental evidence, indicating that in CC the antiproliferative effects of NSAIDs and COXibs could be both dependent on and independent of COXs inhibition, and that these effects do not necessarily exclude each other. This review will examine some of these COX-independent cellular pathways, with a focus on those involved in the inhibition of CC cells proliferation through transcription factors crosstalk. © 2016 Bentham Science Publishers.

Guidazzoli A.,Interuniversity Consortium | Liguori M.C.,Interuniversity Consortium | Felicori M.,Bologna City Council
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2013

ICT projects dedicated to Cultural Heritage, in order to both democratise knowledge and act as an additional attraction towards audiences, should not neglect the communicative aspects. This approach can led towards two different perspectives: the creation of emotional and engaging events, and the creation of applications aiming at a more active participation of users in the development of the final product. The candidacy of the porticoes of Bologna as a UNESCO World Heritage Site will exploit the second solution to best involve citizens in the effort, offering, at the same time, training opportunities to students and young professionals. © 2013 Springer-Verlag.

Morbiducci U.,Polytechnic University of Turin | Gallo D.,Polytechnic University of Turin | Massai D.,Polytechnic University of Turin | Ponzini R.,Interuniversity Consortium | And 4 more authors.
Journal of Biomechanics | Year: 2011

Here we present a study on the impact of assumptions on image-based hemodynamic simulations of healthy carotid bifurcations. In particular, we evaluate to which extent assumptions on blood rheology influence bulk flow features, driven by the fact that few studies have provided adequate insights into the influence of assumptions to confidently model the 4D hemodynamics within the bifurcation. The final goal is to complement, integrate and extend with a quantitative characterization of the bulk flow the description currently adopted to classify altered hemodynamics, which is based on wall shear stress (WSS).Hemodynamic simulations of two image-based carotid bifurcation geometries were carried out assuming a reference Newtonian viscosity, two non-Newtonian rheology models and Newtonian viscosities based on characteristic shear rates. WSS-based and Lagrangian-based metrics for helical flow quantification and for vorticity dynamics quantification were calculated. Our findings suggest that the assumption of Newtonian rheology: (1) could be reasonable for bulk flow metrics (differences from non-Newtonian behavior are lower than 10%); (2) influences at different levels the WSS-based indicators, depending on the bifurcation model, even if in our study it is lower than the major source of uncertainty as recognized by the literature (i.e., uncertainty on geometry reconstruction). © 2011 Elsevier Ltd.

Morbiducci U.,Polytechnic University of Turin | Ponzini R.,Interuniversity Consortium | Rizzo G.,CNR Institute of Molecular Bioimaging and Physiology | Cadioli M.,Philips | And 3 more authors.
Biomechanics and Modeling in Mechanobiology | Year: 2011

The hemodynamics within the aorta of five healthy humans were investigated to gain insight into the complex helical flow patterns that arise from the existence of asymmetries in the aortic region. The adopted approach is aimed at (1) overcoming the relative paucity of quantitative data regarding helical blood flow dynamics in the human aorta and (2) identifying common characteristics in physiological aortic flow topology, in terms of its helical content. Four-dimensional phase-contrast magnetic resonance imaging (4D PC MRI) was combined with algorithms for the calculation of advanced fluid dynamics in this study. These algorithms allowed us to obtain a 4D representation of intra-aortic flow fields and to quantify the aortic helical flow. For our purposes, helicity was used as a measure of the alignment of the velocity and the vorticity. There were two key findings of our study: (1) intra-individual analysis revealed a statistically significant difference in the helical content at different phases of systole and (2) group analysis suggested that aortic helical blood flow dynamics is an emerging behavior that is common to normal individuals. Our results also suggest that helical flow might be caused by natural optimization of fluid transport processes in the cardiovascular system, aimed at obtaining efficient perfusion. The approach here applied to assess in vivo helical blood flow could be the starting point to elucidate the role played by helicity in the generation and decay of rotating flows in the thoracic aorta. © 2010 Springer-Verlag.

Guarrasi M.,University of Palermo | Guarrasi M.,Interuniversity Consortium | Reale F.,University of Palermo | Reale F.,National institute for astrophysics | And 3 more authors.
Astronomy and Astrophysics | Year: 2014

Context. The expansion of coronal loops in the transition region may considerably influence the diagnostics of the plasma emission measure. The cross-sectional area of the loops is expected to depend on the temperature and pressure, and might be sensitive to the heating rate. Aims. The approach here is to study the area response to slow changes in the coronal heating rate, and check the current interpretation in terms of steady heating models. Methods. We study the area response with a time-dependent 2D magnetohydrodynamic (MHD) loop model, including the description of the expanding magnetic field, coronal heating and losses by thermal conduction, and radiation from optically thin plasma. We run a simulation for a loop 50 Mm long and quasi-statically heated to about 4 MK. Results. We find that the area can change substantially with the quasi-steady heating rate, e.g., by ~40% at 0.5 MK as the loop temperature varies between 1 MK and 4 MK, and, therefore, affects the interpretation of the differential emission measure vs. temperature (DEM(T)) curves. © 2014 ESO.

Maggioni A.P.,Research Center | Orso F.,Research Center | Calabria S.,Collaborative Outcome Research | Rossi E.,Interuniversity Consortium | And 3 more authors.
European Journal of Heart Failure | Year: 2016

Aims Patients with heart failure (HF) randomized in controlled trials are generally selected and do not fully represent the 'real world'. The purpose of this study is to better describe the characteristics of HF by analysing administrative data of a population of nearly 2 500 000 subjects. Methods and results Data came from the ARNO Observatory including inhabitants of five Local Health Units of the Italian National Health Service (INHS). Patients were selected when discharged for HF (1 January 2008-31 December 2012) and prescribed at least one HF treatment. Clinical characteristics, pharmacological treatments, rehospitalization, and direct costs for the INHS were described during 1-year follow-up (FU). Of the 2 456 739 subjects included in the database, 54 059 (2.2%) were hospitalized for HF: 41 413 were discharged alive and prescribed HF treatments. Mean age was 78 ± 11 years and 51.4% were females. Just 26.6% were managed in a cardiology setting. The most frequent co-morbidities were diabetes (30.7%), COPD (30.5%), and depression (21%). ACE inhibitors/ARBs, beta-blockers, and mineralocorticoid antagonists were prescribed in 65.8, 49.7, and 42.1% of patients, respectively. During 1-year FU, at least one rehospitalization occurred in 56.6% of patients, 49% of them due to non-cardiovascular causes. The direct cost per patient per year to the INHS was €11 867, of which 76% was related to hospitalizations. Conclusions Real-world evidence provides a description of patient characteristics and treatment patterns that are different from those reported by randomized clinical trials. Costs for the INHS are mainly driven by hospitalizations, which are often due to non-cardiovascular reasons. © 2016 European Society of Cardiology.

Roda A.,University of Bologna | Roda A.,Interuniversity Consortium | Mirasoli M.,University of Bologna | Mirasoli M.,Interuniversity Consortium | And 4 more authors.
Microchimica Acta | Year: 2012

Foodborne illnesses caused by pathogenic bacteria represent a widespread and growing problem to public health, and there is an obvious need for rapid detection of food pathogens. Traditional culture-based techniques require tedious sample workup and are time-consuming. It is expected that new and more rapid methods can replace current techniques. To enable large scale screening procedures, new multiplex analytical formats are being developed, and these allow the detection and/or identification of more than one pathogen in a single analytical run, thus cutting assay times and costs. We review here recent advancements in the field of rapid multiplex analytical methods for foodborne pathogenic bacteria. A variety of strategies, such as multiplex polymerase chain reaction assays, microarray- or multichannel-based immunoassays, biosensors, and fingerprint-based approaches (such as mass spectrometry, electronic nose, or vibrational spectroscopic analysis of whole bacterial cells), have been explored. In addition, various technological solutions have been adopted to improve detectability and to eliminate interferences, although in most cases a brief pre-enrichment step is still required. This review also covers the progress, limitations and future challenges of these approaches and emphasizes the advantages of new separative techniques to selectively fractionate bacteria, thus increasing multiplexing capabilities and simplifying sample preparation procedures. © 2012 Springer-Verlag.

Marchesini G.,University of Bologna | Forlani G.,University of Bologna | Rossi E.,Interuniversity Consortium | Berti A.,Interuniversity Consortium | De Rosa M.,Interuniversity Consortium
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2011

Aims/hypothesis: To estimate the prevalence and the direct cost of pharmacologically-treated diabetes in Italy. Methods: The ARNO observatory database, containing the 20-year medical prescriptions of over 10 million Italian people, was used. Ten-year longitudinal data were available in 22 Local Health Districts (LHD). Subjects were classified as having diabetes when prescribed glucose-lowering drugs (oral agents or insulin) (311,979 individuals in 2006). The direct cost was calculated as the sum of drug use, financial compensation by LHD for the inpatient (hospital DRG) and outpatient activities (consultations, laboratory tests, radiology, etc.), all regulated by government contracts. Individuals with diabetes were compared with pharmacologically-treated subjects without diabetes, pair-matched for age, sex and general practitioner. Results: In the 10-year period, the prevalence of pharmacologically-treated diabetes increased from 3.08% to 4.45% (P for trend, <0.001). The average pro capita cost totaled €2,589 in 2006 (95% confidence interval (CI), 2,584-2,594), corresponding to a rate ratio vs. no-diabetes of 1.54 (95% CI, 1.50-1.56). The cost of drugs was € 827 (rate ratio, 1.80 vs. no-diabetes; 95% CI, 1.79-1.82), that of service use, € 488 (rate ratio, 1.07 (0.93-1.25). Only 20% of the pharmaceutical cost was due to glucose-lowering drugs, a percentage stable through the years. The cost of any hospital admission, as defined by DRGs, was independent of diabetes, but the overall cost was much higher in diabetes due to much higher admission rates. Cardiovascular complications and renal failure accounted for the large majority of excess hospital cost. Conclusion: The direct economic burden of pharmacologically-treated diabetes on the National Health System is very high, due to the growing prevalence of disease and the cost of complications. © 2009 Elsevier B.V.

Bertazzo M.,InterUniversity Consortium | Di Iorio A.,University of Rome La Sapienza
Journal of Digital Information | Year: 2012

The article describes the integrated adoption of Fedora Commons and MediaMosa for managing a digital repository. The integration was experimented along with the development of a cooperative project, Sapienza Digital Library (SDL). The functionalities of the two applications were exploited to built a weaving factory, useful for archiving, preserving and disseminating of multi-format and multi-protocol audio video contents, in different fruition contexts. The integration was unleashed by means of both repository-to-repository interaction, and mapping of video Content Model's disseminators to MediaMosa's Restful services. The outcomes of this integration will lead to a more flexible management of the dissemination services, as well as to economize the overproduction of different dissemination formats.

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