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BACKGROUND: Worldwide healthcare systems face challenges in assessing and monitoring chronic care pathways and, even more, the value generated for patients. Patient-reported outcomes measures (PROMs) represent a valid Real-World Evidence (RWE) source to fully assess health systems' performance in managing chronic care pathways. METHODS: The originality of the study consists in the chance of adopting PROMs, as a longitudinal assessment tool for continuous monitoring of patients' adherence to therapies and self-care behavior recommendations in clinical practice and as a chance to provide policy makers insights to improve chronic pathways adopting a patient perspective. The focus was on PROMs of patients with chronic heart failure (CHF) collected in the Gabriele Monasterio Tuscan Foundation (FTGM), a tertiary referral CHF centre in Pisa, Italy. During the hospital stay, CHF patients were enrolled and received a link (via SMS or email) to access to the first questionnaire. Follow-up questionnaires were sent 1, 7 and 12 months after the index hospitalisation. Professionals invited 200 patients to participate to PROMs surveys. 174 answers were digitally collected at baseline from 2018 to 2020 and analysed. Quantitative and qualitative analyses were conducted, using Chi2, t-tests and regression models together with narrative evidence from free text responses. RESULTS: Both quantitative and qualitative results showed FTGM patients declared to strongly adhere to the pharmacological therapy across the entire pathway, while seemed less careful to adhere to self-care behavior recommendations (e.g., physical activity). CHF patients that performed adequate Self-Care Maintenance registered outcome improvements. Respondents declared to be supported by family members in managing their adherence. CONCLUSIONS: The features of such PROMs collection model are relevant for researchers, policymakers and for managers to implement interventions aimed at improving pathway adherence dimensions. Among those, behavioral economics interventions could be implemented to increase physical activity among CHF patients since proven successful in Tuscany. Strategies to increase territorial care and support patients' caregivers in their daily support to patients' adherence should be further explored. Systematic PROMs collection would allow to monitor changes in the whole pathway organization. This study brings opportunities for extending such monitoring systems to other organizations to allow for reliable benchmarking opportunities.

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COVID-19 vaccine hesitancy is still widespread. During the pandemic, the internet has been the preferred channel for health-related information, especially for less-educated citizens who tend to be the most hesitant about vaccination. A well-structured web communication strategy could help both to overcome vaccine hesitancy and to ensure equity in healthcare service access. This study investigated how the various regional and local health authorities in Italy used their institutional websites to inform users about COVID-19 vaccinations between March and April 2021. We browsed 129 institutional websites, checking the availability, quality and quantity, actionability and readability of information using a literature-based common grid. Descriptive statistics and statistical tests were performed. The online public dissemination of COVID-19 vaccination information in Italy was fragmented, both across and within regions. The side effects of vaccinations, were often not reported on the websites, thus missing an opportunity to enhance vaccination uptake. More focus should also be placed on readability, since readability indexes showed that they were difficult to understand. Our research revealed that several actions could be implemented to enhance online communication on COVID-19 vaccination. For instance, simplifying texts can make them more understandable and the information reported actionable.

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We describe a simple and efficient one-step method to make cDNA libraries using homologous recombination in yeast. cDNA from any source, together with a linear vector, is used to transform yeast. Through homologous recombination and gap repair, the cDNA is unidirectionally incorporated into the yeast expression vector in vivo. The cDNA-encoded proteins can then be screened for potential protein-protein interactions with a bait already present in the yeast. This method allows rapid construction and screening of cDNA libraries, even from extremely small amounts of mRNA, and can replace the use of conventional cDNA libraries.

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A model of computerized clinical history is presented for physicians and anyone else interested in automatic information processing. The questionnaire should be compiled by the patient, controlled and examined by paramedical and medical staff, processed and managed by computer and organized into an output report. In addition to historiddition to historical data, this report includes the results of fun ctional and laboratory findings. In such a context, the purpose of anamnesis is to provide a complete clinical history in the interests of the better "classification" of the patient. Its logic and structure, however, also lends itself well to clinical and statistical uses and to a standardization of the clinical card.

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