Multidisciplinary Interaction Research Articles

Циркадианный стресс Homo sapiens: новые нейрофизиологические, нейроэндокринные и психонейроиммунные механизмы

Circadian stress causes dysregulation of brain Homo sapiens software followed by impairment of the cognitive and visceral brains. The body’s circadian rhythms are programmed with a system of circadian genes. Circadian clock and circadian system — are the biophysical and biochemical regulators of immune protection. Circadian synchronization system is an evolutionary software product of biocomputer for survival and preparation of the organism for expected cyclic challenges, different epigenetic orientation. Understanding the temporal relationship between stressors and stress reactions is critical to understanding the molecular foundations of the physiology and pathogenesis of the disease. Chronic stress and circadian mismatch trigger a cascade of failures in the functioning of neurophysiological, neuroendocrine, and psychoneuroimmune mechanisms. Epigenetic loading and allostatic overload reduce both the body’s overall workability and its physical, occupational, and cognitive components. Circadian stress has a pathological effect on a person, in all his age periods of life. The level of disease exposure depends on the stability of the body’s protective systems. In the works of N. P. Romanchuk, it is established that modern solution to the problem of rehabilitation of cognitive brain H. sapiens with the use, on the one hand, tools and technologies of artificial intelligence, and on the other — multidisciplinary interaction of neurophysiologist with clinical universal specialist in the field of neurology, psychiatry, psychotherapy, psychoanalysis, and geriatrics. Modern artificial intelligence technologies are capable of much, including predicting cognitive disorders and cognitive disorders, through combined and hybrid neuroimaging, next-generation sequencing, etc., with the aim of initiating timely and effective rehabilitation of brain H. sapiens. Chronotherapy and psychochronobiological strategies to protect various groups and categories of the population from the effects of circadian stress allow blocking the transition of cognitive disorders to cognitive disorders. The skin is a unique synchronized near interface of the skin-circadian system, and the condition of the skin of the face and hands is an individual indicator (biomarker) of the effect of chronic circadian stress on accelerated (premature) aging of the human body.

Senile asthenia: clinical aspects of the perioperative period and anesthesia

The objective : to summarize data from publications devoted to the problems faced by clinicians when managing patients with senile asthenia. Results : the growing number of surgical patients of elderly and senile ages aggravates the negative statistics of complications and treatment results, thus it is necessary to search for a comprehensive effective solution to this problem. Understanding the pathophysiological models causing senile asthenia allows not only focusing on early diagnosis and management of potential complications but also preventing their development. Risk stratification, comprehensive diagnosis of functional status and geriatric syndromes in the light of a possible adverse postoperative period make it possible to choose the optimal analgesia and perioperative management of a patient with senile asthenia. The clinical organization of the treatment process and rehabilitation treatment based on multidisciplinary interaction in such patients improves postoperative results.

Multi-model management for time-dependent multidisciplinary design optimization problems

In previous work, we presented a relative adequacy framework (RAF) for multi-model management in single- and multi-disciplinary design optimization to select the most efficient model in different areas of the design space as the latter is being explored during the optimization process. In this work, we extend our framework to allow the consideration of time-dependent multidisciplinary design optimization (MDO) problems with particular emphasis on strongly coupled transient fluid-structure interaction (FSI). The computational models used for analysis in the problems under consideration are typically not amenable to reliable and cost-effective approximation of gradients. Therefore, we use the mesh adaptive direct search optimization algorithm in conjunction with a trust-region approach for multi-model management. The algorithm is modified to automate the search for adequate modeling parameters during the time-dependent multidisciplinary analysis. We show that multidisciplinary temporal interactions may have a significant impact on multi-model management; models that could have been selected in a time-invariant MDO environment may be inadequate in certain areas of the design space in a time-dependent MDO context. At the same time, the relative adequacy framework may improve multidisciplinary temporal analysis convergence and/or MDO coordination. We demonstrate the proposed RAF for multi-model management in time-dependent MDO using a flexible plate FSI example.

Multidisciplinary Nature of the Psycholinguistic Discourse Neuroeconomics

Introduction. The article is devoted to the issues of multidisciplinary interaction in new scientific fields, which involve a wide variety of convergences, no matter how strange at first glance they may seem. One of these phenomena is the interaction of psycholinguistics and neuroeconomics.
 The goal. The article examines the transition of modern science to multidisciplinary discourse, which makes it necessary to conceptualize and possibly operationalize methods of psycholinguistics. The conceptualization of new areas of neuroeconomics, in a psycholinguistic context, presupposes a certain mental experience that includes, in addition to the processes of creating new concepts and contextual economic knowledge, also defining the role of interests, intentions, emotions in human economic activity.
 Methods. Multivariate analysis, comparative analysis, extrapolation.
 Results. It is proved that in recent decades the development of new areas of economic science, namely those related to the development of neuroeconomics, has significantly expanded the field of psycholinguistics. The production of new paradigms of economic theory, the formation of the corresponding definitions, objects requires the design and definition of them both in form and in content. It considers the need for a theoretical and orderly definition of the functional meaning of the psycholinguistic context of new definitions, the result of which can be a conceptual system for communication between specialists in various fields of science at the level of their professional understanding. It seems that the central issues in the psycholinguistic discourse of neuroeconomics have become the relationship between economics, psychology, linguistics and psycholinguistics. Such connection is undoubtedly of a multidisciplinary nature, which contributes to the deepening of the relationship between scientific thought, culture and language and became the impetus for understanding the nature of human cognition at a higher, multidisciplinary level of development of science. This is a necessary component for understanding the meanings and structure of concepts, terms and definitions, as well as communications at a higher scientific level.
 Conclusions. It is concluded that new areas of neuroeconomics such as behavioral economics, behavioral finance, emotional economics, psychological economics, have become areas of economic theory that, explicitly or implicitly, take into account the psychological characteristics of human perception and behavior in the process of economic activity. These definitions catalyze the theoretical integration of various scientific fields, and, above all, psycholinguistic science.

I still miss human contact, but this is more flexible—Paradoxes in virtual learning interaction and multidisciplinary collaboration

AbstractTeaching and learning in universities have shifted towards online education, and there is not enough scientific knowledge about suitable pedagogical design principles to guide the construction of hybrid learning spaces for today’s university students. In this design‐based research, we studied the benefits and challenges in reaching the expected learning outcomes of an e‐course, “Collaboration and Professional Interaction Skills.” The practical purpose was developing the pedagogical design of this e‐course. The scientific objective was to build on the research about design principles that guide teachers in constructing e‐courses, enabling in‐depth learning in hybrid learning spaces. The pedagogical design was guided by six design principles. Empirical data (21 students’ assignments and reflections, teacher’s observations, data from the digital learning management system) were collected in two research cycles. Students were from different degree programmes of educational sciences. Thematic analysis of students’ individually and collaboratively authored assignments was carried out in both research cycles. The most emphasised benefits and challenges concerned the combination of working and creating knowledge together, virtually, in a multidisciplinary group. Based on the results, practical recommendations were made for university‐level pedagogical designs that facilitate effective and active collaboration and interaction, and learning of such competence. Practitioner NotesWhat is already known about this topic: In higher education, more emphasis needs to be placed on learning skills such as multidisciplinary teamwork and collaborative knowledge creation. There is a need for more personalised learning opportunities that offer flexibility in one’s studies and take learners’ diverse situations into account. Advanced understanding of suitable pedagogical design principles and knowledge from empirical cases is needed. What this paper adds: What to consider when technology is used to mediate the learning processes. How to tackle the demands of personalised study opportunities and demanding interaction skills by online collaboration. Implications for practice and/or policy: Pedagogical design exemplifying how students build shared knowledge objects iteratively. Students need guidelines and support for multidisciplinary collaboration and interaction online. Learning management systems are not fully tailored for iterative multidisciplinary collaboration; thus, the designer of the course must be aware of the limitations and develop ways of overcoming the discrepancies between the learning management system and learning objectives.

Predicting the safety of medicines in pregnancy: A workshop report

The framework for developmental toxicity testing has remained largely unchanged for over 50 years and although it remains invaluable in assessing potential risks in pregnancy, knowledge gaps exist, and some outcomes do not necessarily correlate with clinical experience. Advances in omics, in silico approaches and alternative assays are providing opportunities to enhance our understanding of embryo-fetal development and the prediction of potential risks associated with the use of medicines in pregnancy. A workshop organised by the Medicines and Healthcare products Regulatory Agency (MHRA), “Predicting the Safety of Medicines in Pregnancy – a New Era?”, was attended by delegates representing regulatory authorities, academia, industry, patients, funding bodies and software developers to consider how to improve the quality of and access to nonclinical developmental toxicity data and how to use this data to better predict the safety of medicines in human pregnancy. The workshop delegates concluded that based on comparative data to date alternative methodologies are currently no more predictive than conventional methods and not qualified for use in regulatory submissions. To advance the development and qualification of alternative methodologies, there is a requirement for better coordinated multidisciplinary cross-sector interactions coupled with data sharing. Furthermore, a better understanding of human developmental biology and the incorporation of this knowledge into the development of alternative methodologies is essential to enhance the prediction of adverse outcomes for human development. The output of the workshop was a series of recommendations aimed at supporting multidisciplinary efforts to develop and validate these alternative methodologies.

Abstract P6-12-11: Implementation of a digital platform to improve patient care through better multidisciplinary team communication: Experience of a Brazilian breast oncology practice

Abstract Background: The possibility of prompt interaction with the involved professionals in a health system has a great positive impact and represents one of the determining factors for the quality of care provided to cancer patients. Breast cancer treatment involves the use of long-term therapies, most of them oral, with constant possibility of side effects which are frequently not reported during medical visits. Trials using digital platforms for patient electronic monitoring have showed increased survival and patient satisfaction, favoring to the adoption of this strategy. In Brazil, to our knowledge, no such trials have been conducted. CLION / CAM Group is a large multidisciplinary private oncology practice located in the northeast part of Brazil, mostly dedicated to the care of breast cancer patients. Here we describe our experience in developing and implementing a digital platform to improve patient care and further developments focused on treatment side effects and patients reported outcomes. Methods: The project started in May 2017 with the development of a mobile platform (versions web, iOS and Android-based) and internal tests. In January 2018 the platform was lunched with a chat center specifically designed for the patient and multidisciplinary team (doctors and nurses initially). To improve user experience, some implementations were idealized: 1) groups for multidisciplinary case discussion on a safe digital environment; 2) fast and friendly view of the medical agendas and scheduling of each patient through the application; 3) integration with the electronic health record; 4) sending questionnaires to specific groups, allowing monitoring of therapeutic adherence to oral medications and more complex adverse reactions. Results: until July 7th 2019, 601 users downloaded the mobile platform. There were 31 doctors, 32 non-medical professionals (nursing staff, pharmacy, nutrition, psychology, physical therapist and dentistry) and 538 patients, of whom, 425 with breast cancer diagnosis including 121 taking oral therapy. A total of 1537 chats were initiated, with 27886 messages, 1618 images and 160 documents exchanged. Conclusion: Implementing a digital mobile platform for cancer patient care is feasible in a private oncology practice in Brazil and resulted in an intense and productive multidisciplinary team interaction. Systems of this nature should be encouraged in order to keep the communication channel open to patients and families, improving the care to be rendered. Simple measures, inexpensive to the health care system and, demonstrably, highly effective. A prospective clinical trial comparing patient reported outcome with conventional care vs using the mobile platform is been developed with breast cancer patients using oral oncologic drugs at our institution. Citation Format: Jorge HS Leal, Carlos Augusto Malbouisson, Ricardo Gomes, Ivana Lebre, Adriano Magno, Ana Carla Rocha, Janyce Cassiolato, Livia Lopes, Daniel FST Argolo. Implementation of a digital platform to improve patient care through better multidisciplinary team communication: Experience of a Brazilian breast oncology practice [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-12-11.

Pattern of psychiatric morbidity among referred inpatients in a tertiary care hospital of Bangladesh

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity.
 Bang J Psychiatry December 2017; 31(2): 38-42

MRI impacts endometriosis management in the setting of image-based multidisciplinary conference: a retrospective analysis.

The aim of the study was to quantify the value of pre-operative magnetic resonance imaging (MRI) in guiding surgical management of women with endometriosis. Pre-operative discussion of patient management and review of imaging occurred for 136 patients with endometriosis in an MRI-based multidisciplinary conference co-directed by an abdominal radiologist and gynecologic surgeon. A tri-compartmental report template guided the systematic imaging review. Management changes made as a result of the conference were identified via retrospective chart review and classified as major, directly influencing the surgical procedure or approach, or minor, impacting the patient's medical management, therapies, or diagnostic evaluation. Of the 136 patients discussed in conference, a management change was identified in 18.4% (25 patients). Major changes occurred in 8.1% (11 patients) and minor changes in 13.2% (18 patients). The sum of major and minor management changes exceeded the total, as both major and minor management changes were made for 4 patients. Our findings demonstrate the ability of an MRI-based multidisciplinary conference to result in pre-operative management changes in approximately 1 of 5 pre-operatively reviewed women with endometriosis. Importantly, systematic review of the MRI facilitated management changes beyond that of the dictated report alone, which was available to clinicians prior to the conference. The study reflects the value of multidisciplinary interaction, with radiologists serving more directly as clinical consultants to surgical services, and suggests an opportunity to optimize the role of MRI in endometriosis management with standardized reports emphasizing surgically pertinent findings.

Современные инструменты и методики эпигенетической защиты здорового старения и долголетия Homo sapiens

The human brain is the main tool and the most valuable resource on our planet. New epigenetics Homo sapiens and H. sapiens brain manage the interaction of genetic and epigenetic programs of aging and healthy longevity. Epigenetic clocks are mathematical models and artificial intelligence that predict the biological age of a person using DNA methylation data and are the most accurate biomarkers of the aging process. Genetic and epigenetic factors that limit a person’s life expectancy are relevant in biogerontological, biophysical and neurophysiological studies, especially from the point of view of the medical economy. Cerebrovascular aging can be considered from several points of view, including changes in vascular density (number of capillaries and arterioles), vascular plasticity (dynamic regulation of vascular density or structure) and vascular reactivity (adaptation of vessels to acute metabolic changes in tissues). The main control mechanisms in the cerebral circulation are unique in comparison with other vascular channels and include, but are not limited to such features as the blood-brain barrier, perivascular innervation, intracellular communication between neurons, perivascular glial cells and smooth muscle cells, high tissue metabolism, lack of anoxic tolerance and the presence of collateral arteries. Multidisciplinary and multimodal interaction in the triad brain-eyes-vessels makes it possible to identify early biomarkers of both general accelerated and pathological aging, and to diagnose neurodegeneration in a timely manner, and to carry out effective neurorehabilitation of cognitive impairment. Biochipping, neural and brain chips, the next (new) generation sequencing technology will allow the study of the expression of thousands of genes that will be used as biomarkers. Combined and hybrid methods of neuroimaging in collaboration with artificial intelligence technologies are modern tools for the diagnosis and prevention of cognitive impairment and healthy aging of the H. sapiens brain.

Tinjauan Historis dan Proliferasi dalam Kajian Komunikasi Pembangunan Kontemporer

<p><em>Research on the use of ICTs for international development, or information and communication technology for development (ICT4D) research, has a history going back some 30 years. The purpose of this paper is to take stock of the ICT4D research field at this important juncture in time, when ICTs are increasingly pervasive and many different disciplines are involved in researching the area. The paper first provides some reflections on the history of the field broken down into three phases from the mid-1980s to the present day. This is followed by a detailed discussion of future research agenda, including topic selection, and the role of theory. ICT4D research started largely in the academic field of information systems but it is concluded that the future lies in a multidisciplinary interaction between researchers, practitioners, and policy-makers.</em></p>

Liver transplantation for hepatoblastoma in children

To improve the outcomes in children with hepatoblastoma. There were 160 children with focal liver lesions who underwent surgery at the department of liver transplantation in 2008-2019. Patients with malignant tumors made up 77% (n=123). Hepatoblastoma (HB) prevailed (86%, n=106). Liver transplantation was performed in 19 (18%) patients with HB. Median follow-up after transplantation was 24.3 months by December 2019. Follow-up period did not exceed 4 years in more than 2/3 of patients. Overall and disease-free 10-year survival was 87.1% and 82.7%, respectively. Similar values were observed after resections (91.1% and 86.6%). At the same time, actuarial 4-year survival after liver transplantation for HB was 68%. Improvement of treatment outcomes may be achieved through multidisciplinary interaction ensuring timely drug therapy and liver transplantation.

Мозг, глаза, свет: биоэлектромагнитизм света и нейрореабилитация когнитивных нарушений

Biological electrical magnetism of light and neural networks of the brain is the adaptation and optimization of external and internal lighting conditions (type, nature, duration) to improve the cognitive brain. Homo sapiens brain operates in a 24-hour biological electrical magnetic environment. Light is the strongest synchronizing signal for the circadian system, and therefore keeps most biological and psychological rhythms internally synchronized, which is important for the optimal functioning of H. sapiens brain. Circadian Sleep–Wake disorders and chronic circadian misalignment, often seen in psychiatric and neurodegenerative diseases, may be effective in neurorehabilitation of cognitive impairment. Beneficial effects on circadian synchronization, sleep quality, mood and cognitive performance-depend on the time, intensity and spectral composition of light exposure. Multidisciplinary and multimodal interaction in the triad “brain–eyes–vessels” allows to identify early biomarkers of both General accelerated and pathological aging, and timely diagnose neurodegeneration, and conduct effective neurorehabilitation of cognitive disorders. Control and treatment of vascular risk factors and endocrine disorders can reduce the prevalence of long-term disability among the elderly population. Combined and hybrid methods of neuroimaging in conjunction with artificial intelligence technologies, allow to understand and diagnose neurological disorders and find new methods of neurorehabilitation and medical and social support that will lead to improved mental health. To restore circadian neuroplasticity of the brain, a multimodal scheme is proposed: circadian glasses, functional nutrition and physical activity. A combined and hybrid cluster in the diagnosis, treatment, prevention and rehabilitation of cognitive disorders and cognitive disorders has been developed and implemented.

Control Co‐Design: An engineering game changer

AbstractOver the last few decades, control engineers have focused on developing innovative control theories and algorithms to regulate systems. These control efforts are usually at the last stage of a sequential strategy that allows engineering departments to work independently and consecutively toward the design of new products and systems. Control algorithms are usually developed at the end of that sequential process, once the mechanical, electrical, and other subsystems are completely defined. This paper discusses a different approach, named Control Co‐Design (CCD). Following a concurrent engineering strategy that considers multidisciplinary subsystem interactions from the beginning of the design process, CCD applies control concepts to design the entire system and reach optimal solutions that are not achievable otherwise. This approach is a game changer for the control engineer, who will be not only the designer of advanced control algorithms but also the natural leader of the design of new products and systems. This paper describes some historic engineering breakthroughs achieved by applying CCD and explores some relevant application areas. It also presents three complementary CCD methodologies that include control‐inspired paradigms, formal mathematical co‐optimization techniques, and co‐simulation campaigns to enhance engineering creativity and achieve radically new optimal designs.

Temporomandibular Joint Bioengineering Conference: Working Together Toward Improving Clinical Outcomes.

The sixth temporomandibular joint (TMJ) Bioengineering Conference (TMJBC) was held on June 14-15 2018, in Redondo Beach, California, 12 years after the first TMJBC. Speakers gave 30 presentations and came from the United States, Europe, Asia, and Australia. The goal of the conference has remained to foster a continuing forum for bioengineers, scientists, and surgeons and veterinarians to advance technology related to TMJ disorders. These collective multidisciplinary interactions over the past decade have made large strides in moving the field of TMJ research forward. Over the past 12 years, in vivo approaches for tissue engineering have emerged, along with a wide variety of degeneration models, as well as with models occurring in nature. Furthermore, biomechanical tools have become more sensitive and new biologic interventions for disease are being developed. Clinical directives have evolved for specific diagnoses, along with patient-specific biological and immunological responses to TMJ replacement devices alloplastic and/or bioengineered devices. The sixth TMJBC heralded many opportunities for funding agencies to advance the field: (1) initiatives on TMJ that go beyond pain research, (2) more training grants focused on graduate students and fellows, (3) partnership funding with government agencies to translate TMJ solutions, and (4) the recruitment of a critical mass of TMJ experts to participate on grant review panels. The TMJ research community continues to grow and has become a pillar of dental and craniofacial research, and together we share the unified vision to ultimately improve diagnoses and treatment outcomes in patients affected by TMJ disorders.

Workplace-Based Assessment in Cross-Border Health Professional Education

Construct: The globalization of healthcare has been accentuated by the export of health professional curricula overseas. Yet intact translation of pedagogies and practices devised in one cultural setting may not be possible or necessarily appropriate for alternate environments. Purposeful examination of workplace learning is necessary to understand how the source or “home” program may need adapting in the distributed or “host” setting. Background: Strategies to optimize cross-border medical education partnerships have been largely focused on elements of campus-based learning. Determining how host clinical supervisors approach assessment in experiential settings within a different culture and uphold the standards of home programs is relevant given the influence of context on trainees’ demonstrated competencies. In this mixed-methods study, we sought to explore assessor judgments of student workplace-based performance made by preceptors sharing a pharmacy curriculum in Canada and Qatar. Approach: Using modified Delphi consensus technique, we asked clinical supervisors in Canada (n = 18) and in Qatar (n = 14) to categorize trainee performance as described in 16 student vignettes. The proportion of ratings for three levels of expectation (exceeds, meets, or below) was calculated and within-country group consensus achieved if the level of agreement reached 80%. Between-country group comparisons were measured using a chi-square statistic. We then conducted follow-up semi-structured interviews to gain further perspectives and clarify assessor rationale. Transcripts were analyzed using thematic content analysis. Results: The threshold for between-country group differences in assessor impressions was met for only two of the 16 student vignettes. Compared to Canadian clinical supervisors, relatively more preceptors in Qatar judged one described student as meets rather than exceeds expectations and one as meets rather than falls below expectations. Analysis of follow-up interviews exploring how culture may inform variations in assessor judgments identified themes associated with the profession, organization, learner, and supervisor performance theories but not their particular geographic context. Clinical supervisors in both countries were largely aligned in expectations of student knowledge, skills, and behaviors demonstrated in patient care and multidisciplinary team interactions. Conclusions: Our study demonstrated that variation in student assessment was more frequent among clinical supervisors within the same national context than any differences identified between the two countries. In these program settings, national sociocultural norms did not predict global assessor impressions or competency-specific judgments; instead, professional and organizational cultures were more likely to inform student characterizations of performance in workplace-based settings. Further study situated within the specific experiential learning contexts of cross-border health professional curricula is assuredly warranted.

Extraorgan retroperitoneal mature teratoma in a 12-year-old child

Teratomas are germ cell tumors consisting of derivatives of 3 germ layers and havingvarious malignant potential – from benign mature forms to immature embryonic and forms with somatic type of malignancy.This article describes the clinical caseof rare localization of mature teratoma – retroperitoneal space, aswell asan example of multidisciplinary interaction of clinicians, radiation diagnosticians and pathomorphologists in correct preoperative diagnosis using computed tomography, successful surgical treatment and histological verification of extraorgan teratoma of the retroperitoneal space.

PATIENT ORGANIZATIONS AN IMPORTANT UNIT IN DIABETES CARE

A new moment in the health promotion is the participation of different specialists and institutions in the system and outside the healthcare system. A good example of implementing multidisciplinary cooperation, coordination and interaction of state, municipal and local structures with non-profit organizations with a view to prevention, health education and adequate treatment for patients with diabetes mellitus is the inclusion of patient organizations and associations in an integrative model of care. Based on a sociological survey of 3168 patients with diabetes mellitus, we present the benefits of patients' organizations and the membership of patients with diabetes mellitus.. The need for patient organizations to be included in a new integrative model of healthcare provision for patients with diabetes mellitus results from the proposed approach. of them psychosocial support, motivation, training and awareness of patients.

URBESS – nature based assessment tool for smart and sustainable urban planning

The focus of the URBESS Pathfinder Project is to investigate the feasibility of a service based on the integration of a suite of existing software tools that simulate the adoption of nature based solutions NDASH specifically green infrastructure - in urban areas and estimate the multiple impacts and multidisciplinary interactions, with the aim at setting priorities for a more effective urban planning. The innovative aspect is the contemporaneous application of the three software packages to be integrated for a systemic approach with the aim at supporting and strengthening the confidence of urban planners and construction enterprises in making new sustainable interventions in the urban texture. The main goals of the project were: 1) to conduct a market scan to study and analyze in detail, opportunities, barriers, risks, competitors that the proposed approach/product can face on the market. Desk research, 1-to-1 meeting and a survey will be arranged in order to engage potential clients and stakeholders (i.e., city decision makers, urban planners, architects, water engineers) and collect feedback and directions to take into account in the development of the service according to the market needs. The study will be focused on Italy but also European city decision makers and urban planners will be engaged exploiting the Climate-KIC connections of the Urban Transition Theme network; 2) to make a strategic analysis by adopting the PEST&SWOT tool for understanding and reviewing the perceptions and crucial aspects obtained as outputs from all the aforementioned activities and by, finally, drawing a preliminary business model prior to making further decisions about the development and implementation of the service.

A Multidisciplinary Approach for the Development of Smart Distribution Networks

Electric power systems are experiencing relevant changes involving the growing penetration of distributed generation and energy storage systems, the introduction of electric vehicles, the management of responsive loads, the proposals for new energy markets and so on. Such an evolution is pushing a paradigm shift that is one of the most important challenges in power network design: the management must move from traditional planning and manual intervention to full “smartization” of medium and low voltage networks. Peculiarities and criticalities of future power distribution networks originate from the complexity of the system which includes both the physical aspects of electric networks and the cyber aspects, like data elaboration, feature extraction, communication, supervision and control; only fully integrated advanced monitoring systems can foster this transition towards network automation. The design and development of such future networks require distinct kinds of expertise in the industrial and information engineering fields. In this context, this paper provides a comprehensive review of current challenges and multidisciplinary interactions in the development of smart distribution networks. The aim of this paper is to discuss, in an integrated and organized manner, the state of the art while focusing on the need for interaction between different disciplines and highlighting how innovative and future-proof outcomes of both research and practice can only emerge from a coordinated design of all the layers in the smart distribution network architecture.