Journey Map Guidelines

The Journey Map tool provides a graphic and structured visualization about all the factors that can influence the User Experience, directly constructed from the user's perspective. Basically it is a schematization of the user path, crossing different service touchpoints1, as the user starts to use a service until some goals are achieved. Into the user journey also the emotional aspects that affect the quality of the user experience and its level of satisfaction are considered. Graphically the Journey Map is a matrix composed by columns and rows. The columns, from left to right, show all the steps that form the user journey, a timeline that provides a sequential and chronological disposition of each stage for further details. In horizontal are displayed several rows, representing the research areas of interests (eg. Where the action takes place, the touchpoints involved in the context considered, the unexpressed needs of the user, his/her level of confidence to technology, etc…). All these elements together usually have different impacts along the journey steps; in this way the Journey Map can better track them and represent and identify these changes that interact with the user experience. In this specific occasion, the Journey Map will be used with the purpose to extrapolate qualitative and quantitative data about the User Experience of children with T1DM aged 8-10 in using the first prototype of the MyPAL app , as a graphical facilitator for an interactive discussion. In order to obtain reliable proofs of children’s experience, the Journey Map activity will be exploited with a co-creation methodological approach, where interactivity is essential and represents a great tool to collect insights in a playful and stimulating environment. In fact, this activity will involve directly our users (children) by mapping his/her experience and telling indirectly to us his/her feedbacks and expectations. This tool allows both individual and choral sessions and participatory techniques between deductive and analytical thinking. In this context, the Journey Map will be used as an individual explorative tool of investigation (one child per time)

Sharing is caring: Designing a value-sensitive mhealth platform for sharing type 1 diabetes management within families

Within a mobile-technology enhanced educational framework, this study investigates needs and expectations of children (aged 8-14) with type 1 diabetes, and their parents, to define the functionalities of PAL Inform, a web-based monitoring module. The aim is to design it as a tool for parents to be informed on the educational progresses, as well on diabetes-related data, of their children without violating their values (privacy, trust, autonomy). Through a set of co-design activities, carried out with 39 children and 45 parents, it was possible to define which kind of information parents would monitor and children (especially pre-adolescents), in turn, would share, without compromising family dynamics: i.e. glycaemic values and trends, insulin doses, carbohydrates intake, generic emotional status, educational progresses on diabetes-related knowledge. Leveraging on these insights, a set of functional requirements was elicited for the future monitoring module implementation

Prevalence of Anisakis spp. and Hysterothylacium spp. larvae in teleosts and cephalopods sampled from waters off Sardinia.

A study was carried out on the presence of Anisakis and Hysterothylacium larvae in fish and cephalopods caught in Sardinian waters. A total of 369 specimens of 24 different species of teleosts and 5 species of cephalopods were collected from different fishing areas of Sardinia. Larvae were detected and isolated by both visual inspection and enzymatic digestion. These methods allowed Anisakis type I and type II third-stage larvae and Hysterothylacium third-and fourth-stage larvae to be detected. The prevalence, mean intensity, and mean abundance were calculated. The results obtained showed the highest prevalence of Anisakidae in Zeus faber (100%) and of Anisakis in Micromesistius poutassou (87.5%). The highest prevalence of Anisakis type I larvae was in M. poutassou (81.2%), and that of Anisakis type II larvae was in Todarodes sagittatus (20%). The highest values for prevalence, mean intensity, and mean abundance for Hysterothylacium were found in Z. faber. These prevalences and the mean intensity and abundance were higher than those reported by different authors in other Mediterranean areas. This may be because the enzymatic digestive method used in this research resulted in higher recovery levels. The data suggest that Sardinia may be a high-risk area for zoonotic diseases and that measures such as information campaigns, aimed at both sanitary service personnel and consumers, should be employed to limit the spread of such zoonosis. Copyright © International Association for Food Protection

Raising awareness of alcohol as a modifiable risk factor for breast cancer: A randomized controlled trial comparing the efficacy of accessing an interactive website with a non-interactive website

Background – Alcohol consumption is a potentially modifiable risk factor for breast cancer (BC). Reducing alcohol consumption within the daily amount at low-risk for alcohol-related consequences (daily alcohol threshold) may contribute to preventing BC new cases. However, most women are unaware of risk factors for BC, the daily alcohol threshold, and how to measure alcohol use. We aimed at investigating the efficacy of accessing an interactive website in increasing the knowledge that alcohol is a BC risk factor. Methods – We conducted a randomized controlled trial among women waiting for mammography. Women completed a questionnaire to investigate their knowledge before and after accessing an interactive (intervention group) and non-interactive (control group) website. Results – We recruited 671 women, randomized 329 (49.0%) and 342 (51.0%) to the intervention and control groups, respectively. At baseline, most women were not aware of most modifiable BC risk factors. Accessing either website significantly increased the percentage of women who acquired the knowledge on BC risk factors, with the interactive website achieving better results: 82% and 69% of women acquired the knowledge that alcohol is a risk factor for BC in the intervention and control groups, respectively (p<0.001). Among women with lower levels of education, the probability of acquiring this knowledge was higher in the intervention group than control group. Conclusion – Our results show that accessing an interactive website may increase the percentage of women who acquire the knowledge that alcohol is a BC risk factor especially among women of lower levels of education

Metformin therapy effects on the expression of sodium-glucose cotransporter 2, leptin, and sirt6 levels in pericoronary fat excised from pre-diabetic patients with acute myocardial infarction

Background and purpose: pericoronary fat over-inflammation might lead to the development and destabilization of coronary plaque in patients with pre-diabetes (PDM). Notably, pericoronary fat could over-express the sodium-glucose cotransporter 2 (SGLT2) and leptin, along with decreased sirtuin 6 (SIRT6) expression in PDM vs. normoglycemic (NG) patients undergoing coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). However, in the current study, we evaluated inflammatory markers, SGLT2, SIRT6, and leptin levels in pericoronary fat and, subsequently, 12-month prognosis comparing PDM to NG subjected to CABG for AMI. In addition, we evaluated in PDM patients the effects of metformin therapy on SIRT6 expression, leptin, and SGLT2 levels, and assessed its beneficial effect on nitrotyrosine and inflammatory cytokine levels. Methods: we studied AMI patients referred for CABG, divided into PDM and NG-patients. PDM patients were divided into never-metformin users and metformin users. Finally, we evaluated major adverse cardiac events (MACE) at a 12-month follow-up. Results: the MACE was 9.1% in all PDM and 3% in NG patients (p < 0.05). Metformin users presented a significantly lower MACE rate in PDM than never-metformin users (p < 0.05). PDM showed higher inflammatory cytokines, 3-nitrotyrosine levels, SGLT2, and leptin content, and decreased SIRT6 protein levels in pericoronary fat compared to NG-patients (p < 0.05). PDM never-metformin-users showed higher SGLT2 and leptin levels in pericoronary fat than current-metformin-users (p < 0.05). Conclusions: metformin therapy might ameliorate cardiovascular outcomes by reducing inflammatory parameters, SGLT2, and leptin levels, and finally improving SIRT6 levels in AMI-PDM patients treated with CABG

Metabolic syndrome is associated with a poor outcome in patients affected by outflow tract premature ventricular contractions treated by catheter ablation

The purpose of this study was to investigate the impact of metabolic syndrome (MS) on outcome of catheter ablation (CA) for treatment of frequent premature ventricular contraction beats (PVCs) originating from right ventricular outflow tract (RVOT), left ventricular outflow tract (LVOT) or coronary cusps (CUSPs), in patients with normal ventricular systolic function and absence of cardiac structural disease. In this multicentre prospective study we evaluated 90 patients with frequent PVCs originating from RVOT (n = 68), LVOT (n = 19) or CUSPs (n = 3), treated with CA. According to baseline diagnosis they were divided in patients with MS (n = 24) or without MS (n = 66). The study endpoint was a composite of recurrence of acute or delayed outflow tract ventricular arrhythmia: acute spontaneous or inducible outflow tract ventricular arrhythmia recurrence or recurrence of outflow tract PVCs in holter monitoring at follow up. Patients with MS compared to patients without MS showed a higher acute post-procedural recurrence of outflow tract PVCs (n = 8, 66.6%, vs. n = 6, 9.0%, p = 0.005). At a mean follow up of 35 (17-43) months survival free of recurrence of outflow tract PVCs was lower in patients with baseline MS compared to patients without MS diagnosis (log-rank test, p < 0.001). In cox regression analysis, only MS was independently associated with study endpoint (HR = 9.655 , 95% CI 3.000-31.0.68 , p < 0.001). MS is associated with a higher recurrence rate of outflow tract PVCs after CA in patients without structural heart disease

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR &lt; 60 mL/min/1.73 m2) or eGFR reduction &gt; 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR &lt; 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR &gt; 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

A case study on the labeling of bottarga produced in Sardinia from ovaries of grey mullets (Mugil cephalus and Mugil capurrii) caught in Eastern Central Atlantic coasts

The aim of this case study is to show how traditional and molecular methods can be employed to identify the Mugilidae species currently used in Sardinia (Italy) to produce the traditional bottarga for the processing of their ovaries. A total of six specimens of Mugil cephalus (n=3) and Mugil capurrii (n=3) were subjected to external morphology and meristic measurements. Subsequently, tissue samples of white muscle and ovaries from three individuals per species were underwent PCR-sequencing assay of mitochondrial DNA cytochrome oxidase subunit I (COI). The external morphology and meristic characters showed a sufficient level of reliability in the identification between the two species. At the same time, the molecular techniques showed the discriminatory power and confirmed the correct species identification in all the sampling units. DNA barcoding may be an effective aid to traditional taxonomy and can facilitate accurate species identification among the Mugilidae

Effect of Hyperglycemia on COVID-19 Outcomes: Vaccination Efficacy, Disease Severity, and Molecular Mechanisms

Background/aims: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-stranded single-stranded RNA virus, a member of the subgenus Sarbecovirus (beta-CoV lineage B) and responsible for the coronavirus disease 2019 (COVID-19). COVID-19 encompasses a large range of disease severity, from mild symptoms to severe forms with Intensive Care Unit admission and eventually death. The severe forms of COVID-19 are usually observed in high-risk patients, such as those with type two diabetes mellitus. Here, we review the available evidence linking acute and chronic hyperglycemia to COVID-19 outcomes, describing also the putative mediators of such interactions. Findings/conclusions: Acute hyperglycemia at hospital admission represents a risk factor for poor COVID-19 prognosis in patients with and without diabetes. Acute and chronic glycemic control are both emerging as major determinants of vaccination efficacy, disease severity and mortality rate in COVID-19 patients. Mechanistically, it has been proposed that hyperglycemia might be a disease-modifier for COVID-19 through multiple mechanisms: (a) induction of glycation and oligomerization of ACE2, the main receptor of SARS-CoV-2; (b) increased expression of the serine protease TMPRSS2, responsible for S protein priming; (c) impairment of the function of innate and adaptive immunity despite the induction of higher pro-inflammatory responses, both local and systemic. Consistently, managing acute hyperglycemia through insulin infusion has been suggested to improve clinical outcomes, while implementing chronic glycemic control positively affects immune response following vaccination. Although more research is warranted to better disentangle the relationship between hyperglycemia and COVID-19, it might be worth considering glycemic control as a potential route to optimize disease prevention and management

Effect of Hyperglycemia on COVID-19 Outcomes: Vaccination Efficacy, Disease Severity, and Molecular Mechanisms

Background/Aims: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-stranded single-stranded RNA virus, a member of the subgenus Sarbecovirus (beta-CoV lineage B) and responsible for the coronavirus disease 2019 (COVID-19). COVID-19 encompasses a large range of disease severity, from mild symptoms to severe forms with Intensive Care Unit admission and eventually death. The severe forms of COVID-19 are usually observed in high-risk patients, such as those with type two diabetes mellitus. Here, we review the available evidence linking acute and chronic hyperglycemia to COVID-19 outcomes, describing also the putative mediators of such interactions. Findings/Conclusions: Acute hyperglycemia at hospital admission represents a risk factor for poor COVID-19 prognosis in patients with and without diabetes. Acute and chronic glycemic control are both emerging as major determinants of vaccination efficacy, disease severity and mortality rate in COVID-19 patients. Mechanistically, it has been proposed that hyperglycemia might be a disease-modifier for COVID-19 through multiple mechanisms: (a) induction of glycation and oligomerization of ACE2, the main receptor of SARS-CoV-2; (b) increased expression of the serine protease TMPRSS2, responsible for S protein priming; (c) impairment of the function of innate and adaptive immunity despite the induction of higher pro-inflammatory responses, both local and systemic. Consistently, managing acute hyperglycemia through insulin infusion has been suggested to improve clinical outcomes, while implementing chronic glycemic control positively affects immune response following vaccination. Although more research is warranted to better disentangle the relationship between hyperglycemia and COVID-19, it might be worth considering glycemic control as a potential route to optimize disease prevention and management.</jats:p