Organisational models supported by technology for the management of diabetic disease and its complications in a diabetic clinic setting: study protocol for a randomised controlled trial targeting type 2 diabetes individuals with non-ideal glycaemic values (Telemechron study).

Introduction: Type 2 diabetes mellitus (T2DM) is a non-communicable disease representing one of the most serious public health challenges of the twenty-first century. Its incidence continues to rise in both developed and developing countries, causing the death of 1.5 million people every year.

Supporting patients and clinicians during the breast cancer care path with AI: The Arianna solution.

The onset of cancer disease is a traumatic experience for both patients and their families that suddenly change the patient's life and is accompanied by important physical, emotional, and psycho-social problems. The complexity of this scenario has been exacerbated by the COVID-19 pandemic which dramatically affected the continuity of the provision of optimal care to chronic patients. Telemedicine can support the management of oncology care paths by furnishing a suite of effective and efficient tools to monitor the therapies of cancer patients.

Digital Health Service for Identification of Frailty Risk Factors in Community-Dwelling Older Adults: The SUNFRAIL+ Study Protocol.

This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults.

Food Frequency Questionnaire Personalisation Using Multi-Target Regression.

Fondazione Bruno Kessler is developing a mobile app prototype for empowering citizens to improve their health conditions through different lifestyle interventions that will be incorporated into a mobile application for lifestyle promotion of the Province of Trento in the context of the Trentino Salute 4.0 Competence Center. The envisioned interventions are based on promoting behaviour change in various domains such as physical activity, mental health and nutrition.

Use of the ONCO-TreC electronic diary compared with a standard paper diary to improve adherence to oral cancer therapy in patients with solid and haematological tumours: protocol for a randomised controlled trial.

Introduction: ONCO-TreC platform consists of a mobile application delivered to patients as electronic diary and a web-based dashboard managed by healthcare professionals. We aim to compare the effectiveness of ONCO-TreC electronic diary with a standard paper diary, in improving adherence to oral cancer therapy in patients with solid and haematological tumours.

Methods And Analysis: This is an open label, superiority, randomised controlled trial conducted in two Italian oncology units.

Explainable AI meets persuasiveness: Translating reasoning results into behavioral change advice.

Explainable AI aims at building intelligent systems that are able to provide a clear, and human understandable, justification of their decisions. This holds for both rule-based and data-driven methods. In management of chronic diseases, the users of such systems are patients that follow strict dietary rules to manage such diseases.

TreC platform. An integrated and evolving care model for patients' empowerment and data repository.

Introduction: Health care has been deeply revolutionized by the new wave of information and communication technology (ICT) development, particularly related to the electronic/personal health record (PHR). The present paper describes the original design and implementation approach followed in the Trentino Province (Italy) to promote an Integrated Care Model for patients' empowerment and data repository, by means of an evolving Personal Health Record - PHR platform, named TreC (Trentino Citizens Clinical Record).

Materials And Methods: The TreC Platform is conceived as a communication hub among different stakeholders.

Over Expressed TKTL1, CIP-2A, and B-MYB Proteins in Uterine Cervix Epithelium Scrapings as Potential Risk Predictive Biomarkers in HR-HPV-Infected LSIL/ASCUS Patients.

High oncogenic risk human papillomaviruses (HR-HPVs) promote cervical carcinoma development, the fourth most common feminine cancer. A slow oncodevelopmental phase-defined histopathologically as Cervical Intraepithelial Neoplasia (CIN) grades 1-3, or cytologically as Low- or High-grade Squamous Intraepithelial Lesions (LSIL or HSIL)-precedes the malignancy. Cervical carcinoma screenings through HR-HPV genotyping and Pap smears are regularly performed in Western countries.

PerKApp: A general purpose persuasion architecture for healthy lifestyles.

Automatically monitoring and supporting healthy lifestyle is a recent research trend, fostered by the availability of low-cost monitoring devices, and it can significantly contribute to the prevention of chronic diseases deriving from incorrect diet and lack of physical activity. In this paper, we present a general purpose architecture for persuasion scenarios and behavioral change. The architecture is designed to be easily portable across languages and domains and has been implemented and evaluated in a specific system for Workplace Health Promotion (WHP) called PerKApp.

Optimisation and validation of a remote monitoring system (Onco-TreC) for home-based management of oral anticancer therapies: an Italian multicentre feasibility study.

Introduction: Despite the growing number of oral agents available for cancer treatment, their efficacy may be reduced due to the lack of adherence, inappropriate adverse event self-management and arbitrary dose adjustment. The management of anticancer therapies could exponentially benefit from the introduction of mobile health technologies in a highly integrated electronic oncology system.

Methods And Analysis: We plan to customise and fine-tune an existing monitoring TreC platform used in different chronic diseases in the oncology setting.

Integrating mHealth in Oncology: Experience in the Province of Trento.

Background: The potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system.

Objective: Here we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home.

Methods: The STM system is fully integrated with the electronic oncological patient record.

A mobile logbook to diagnose masked hypertension: a pilot application.

In the last years, there has been a growing interest in health mobile applications. Great benefits could be gained by seemingly "simple" solutions if these were designed to build a bridge between doctors and patients. In this paper, we describe a mobile health solution for patients allowing them to measure and record accurately their blood pressure at home, helping doctors to diagnose hypertension.

Implementation and evaluation of an Asbru-based decision support system for adjuvant treatment in breast cancer.

The domain of cancer treatment is a promising field for the implementation and evaluation of a protocol-based clinical decision support system, because of the algorithmic nature of treatment recommendations. However, many factors can limit such systems' potential to support the decision of clinicians: technical challenges related to the interoperability with existing electronic patient records and clinical challenges related to the inherent complexity of the decisions, often collectively taken by panels of different specialists. In this paper, we evaluate the performances of an Asbru-based decision support system implementing treatment protocols for breast cancer, which accesses data from an oncological electronic patient record.

PI3KCA mutation status is of limited prognostic relevance in ER-positive breast cancer patients treated with hormone therapy.

PI3K/AKT/mTOR pathway alterations are frequent in patients with infiltrating breast cancer (IBC). Their clinical and pathological relevance has been insufficiently documented. We evaluated PI3KCA for mutations and the expression of PTEN, AKT, mTOR and p70S6K by immunohistochemistry in 246 IBC patients treated with hormone therapy (median follow-up, 97 months).

An ontology of cancer therapies supporting interoperability and data consistency in EPRs.

Ontologies can formally describe the semantics of the medical domain in an unambiguous and machine processable form, acting as a conceptual interface between different applications that must interoperate. In this paper we present an ontology of cancer therapies originally developed to bridge the gap between an oncologic Electronic Patient Record (EPR) and a guideline-based decision support system. We show an application of the ontology complemented by rules to classify therapies recorded in the EPR.

PI3KCA mutations and/or PTEN loss in Her2-positive breast carcinomas treated with trastuzumab are not related to resistance to anti-Her2 therapy.

The purpose of this study is to evaluate whether activating mutations of the p110α catalytic subunit of class A phosphoinositide 3-kinases (PI3KCA) or complete loss of phosphatase and tensin homolog (PTEN) is associated with response to anti-human epidermal growth factor receptor 2 (Her2) treatment in breast cancer (BC). We analysed PI3KCA hot-spot mutations and PTEN immunohistochemical expression in 129 Her2-positive infiltrating BC treated with trastuzumab, including 26 cases treated with neoadjuvant therapy, 48 metastatic infiltrating breast cancer (IBC; MBC) and 55 early-stage IBC, with complete clinical information (mean follow-up 37, 66 and 32 months, respectively). PI3KCA hot-spot mutations were observed in 25 cases (19 %): 12 (9 %) in exon 9 and 13 (10 %) in exon 20.

TreC - a REST-based regional PHR.

The Personal Health Record (PHR) is progressively becoming a fundamental tool to allow people to control their health. User needs, however, impose to design a PHR solution that must offer a great flexibility in terms of managing heterogeneous health data, composing data in higher level concepts and interfacing the PHR with different devices to collect and visualize data. We propose to adopt REST as core of a regional PHR architecture and present a PHR based on this architecture implemented and tested in our Province.

Diagnostic value of automated Her2 evaluation in breast cancer: a study on 272 equivocal (score 2+) Her2 immunoreactive cases using an FDA approved system.

Goal of this study was to asses the performance of Aperio computer-assisted analysis for HER2 immunohistochemical measurement in 292 equivocally (score2+) HercepTest immunoreactive breast cancer cases, evaluated by an experienced pathologist and analyzed with fluorescent in situ hybridization (FISH). The automatic Aperio categorization and the percentage of immunoreactive cells as evaluated by the computer and by the pathologist were recorded. Computer-assisted analysis classified 7 (2.

Embedding oncologic protocols into the provision of care: the Oncocure project.

A computerized Decision Support System (CDSS) can improve the adherence of the clinicians to clinical guidelines and protocols. Integrating it within the clinical workflow can reduce the workload of the physicians, and improve the acceptance of the system. The building of a prescriptive CDSS and its integration with a legacy cancer patient management system is the aim of the Oncocure project, which implements the existing protocol for the medical treatment of breast cancer in the Asbru language, and interfaces the Asbru interpreter with the Electronic Patient Record (EPR) in use in an oncologic unit.

An ontological approach to support clinical governance: the case of breast cancer guidelines.

Guidelines are an essential tool to ensure an optimal clinical governance in oncology. The Province of Trento started a research project whose aim is to develop a system for supporting and controlling the best evidence-based oncological care process based on guidelines. The significant role of ontologies for the semantic interoperability of such a system is pointed out.

[Synchronous gastric and oesophageal cancer: a case report].

We describe the case of a male patient, aged 50, affected by an undifferentiated cancer of the gastric stump of a Billroth II gastric resection associated with a well-differentiated squamous-cell cancer of the oesophagus. The patient was submitted to gastrectomy and removal of the oesophagus together with reconstruction trough colon interposition. The association of the two synchronous neoplasms of the stomach and oesophagus is a very uncommon event, as the evidence in the medical literature demonstrates.

Design and implementation of a tool for translating SBML into the biochemical stochastic pi-calculus.

Motivation: SBML is becoming a standard 'de-facto' to represent and store biological models. Although SBML is very useful in defining ways of exchanging and storing biological information, it is not formal enough to allow direct translation into non ambiguous formal representation languages to perform analysis and simulation of models. We here suggest to map SBML models into process calculi representations.

Full-dose intraoperative radiotherapy with electrons in breast cancer. First report on late toxicity and cosmetic results from a single-institution experience.

Purpose: To investigate the feasibility of applying exclusive intraoperative radiation therapy (IORT) after conservative surgery in limited-stage breast carcinoma and to evaluate late effects and cosmetic results after this new conservative treatment.

Patients And Methods: From October 2000 to November 2002, 47 consecutive patients with unifocal breast carcinoma up to a diameter of 2 cm received conservative surgery followed by IORT with electrons as the sole adjuvant local therapy. Three different dose levels were used: 20 Gy (seven patients), 22 Gy (20 patients), and 24 Gy (20 patients).

A real time Teleconsultation System for Sharing an Oncologic Web-based Electronic Medical Record.

This poster presents an innovative real-time Teleconsultation System for synchronized navigation of the pages of a web-based Oncological Electronic Medical Record, designed to provide clinicians a cooperative work tool supporting the oncologic patient management between different hospitals. The system embeds additional tools supporting the discussion: digital whiteboard, chat and a digital audio channel.