Marco Marigliano1,11*† , Roberto Franceschi2†, Enza Mozzillo3†, Valentina Tiberi4†, Monica Marino4 , Giada Boccolini4 , Malgorzata Wasniewska5 , Maria Elizabeth Street6 , Maria Rosaria Licenziati7 , Riccardo Bonfanti8 , Felice Citriniti9 , Giuseppe D’Annunzio10, Maria Carolina Salerno3 , Valentino Cherubini4 and the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED)
† Marco Marigliano, Roberto Franceschi, Enza Mozzillo and Valentina Tiberi contributed equally to this work.
Abstract
Backgrounds The incidence of Type 1 Diabetes (T1D) in children and adolescents is increasing by 3–4% per year. Children and adolescents with T1D (CwD) should receive person-centered, specialized treatment from a multidisciplinary team to ensure appropriate care. Italy is the first to implement a countrywide T1D screening program, which will raise the need for funding for specialized pediatric care. The study aims to update the organization of the Italian Centers for pediatric diabetes care.
Methods In 2022, members of the 59 Italian Centers following CwD were invited to complete an email survey regarding the Centers’ organization, characteristics, and activities. The questionnaire included information on responders, department organization, team composition, activities, and the organizational structures: department, ambulatory care services (AC), simple operational units (UOS), simple departmental operational units (UOSd), and complex operational units (UOC).
Results The data collected referred to the year 2022. According to the results, 21,318 people with diabetes were treated. Of these, 19,643 subjects (92.1%) have T1D (16,672 were CwD), 387 (1,8%) have Type 2 Diabetes, and 1,288 (6,1%) have other forms of diabetes. Compared to the 2012 survey, a 13% decrease (from 68 to 59 Centers) in the number of pediatric Centers caring for CwD was observed with a parallel increase of total (+6.6%) and average (+22%) number of CwD per Center. The estimated prevalence of T1D has increased (1.4 vs. 1.7 per 1,000 CwD—2012 vs. 2022). A reduction in numbers for AC (-22%) and UOS (-35%) was observed, whereas UOSd/UOC increased by 50%. Almost 35% of the dietitians and 40% of the psychologists were not permanent members of the multidisciplinary diabetes team.
Conclusions The observed decrease in the overall number of pediatric diabetes Centers, the reduction in specialized and dedicated HCPs, and the concurrent increase in the number of treated CwD in the last ten years indicate an alarming situation for pediatric diabetes treatment in Italy. Furthermore, the projected rise in CwD due to the National T1D screening program emphasizes the need for increased resources for specialized pediatric care of CwD at all stages.
Keywords Type 1 diabetes, Care, Children, Adolescents, Benchmarking, Team, Screening, Technology
Loϊc Binan,1,2 Aiping Jiang,3,4,5 Serwah A. Danquah,1,6,12 Vera Valakh,1,6,13 Brooke Simonton,2,14 Jon Bezney,2,15 Robert T. Manguso,3,4,5 Kathleen B. Yates,3,4,5 Ralda Nehme,6 Brian Cleary,7,8,9,10,11,* and Samouil L. Farhi1,16,*
1 Spatial Technology Platform, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
2 Klarman Cell Observatory, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
3 Cancer Program, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
4 Krantz Family Center for Cancer Research, Massachusetts General Hospital, Boston, MA 02144, USA
5 Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
6 Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
7 Faculty of Computing and Data Sciences, Boston University, Boston, MA 02215, USA
8 Department of Biology, Boston University, Boston, MA 02215, USA
9 Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
10 Program in Bioinformatics, Boston University, Boston, MA 02215, USA
11 Biological Design Center, Boston University, Boston, MA 02215, USA
12 Present address: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
13 Present address: Stoke Therapeutics, Bedford, MA, USA
14 Present address: The Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
15 Present address: Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
16 Lead contact
*Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (B.C.), 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (S.L.F.)
https://doi.org/10.1016/j.cell.2025.02.012
SUMMARY
Pooled optical screens have enabled the study of cellular interactions, morphology, or dynamics at massive scale, but they have not yet leveraged the power of highly plexed single-cell resolved transcriptomic readouts to inform molecular pathways. Here, we present a combination of imaging spatial transcriptomics with parallel optical detection of in situ amplified guide RNAs (Perturb-FISH). Perturb-FISH recovers intracellular effects that are consistent with single-cell RNA-sequencing-based readouts of perturbation effects (Perturb-seq) in a screen of lipopolysaccharide response in cultured monocytes, and it uncovers intercellular and density-dependent regulation of the innate immune response. Similarly, in three-dimensional xenograft models, Perturb-FISH identifies tumor-immune interactions altered by genetic knockout. When paired with a functional readout in a separate screen of autism spectrum disorder risk genes in human-induced pluripotent stem cell (hIPSC) astrocytes, Perturb-FISH shows common calcium activity phenotypes and their associated genetic interactions and dysregulated molecular pathways. Perturb-FISH is thus a general method for studying the genetic and molecular associations of spatial and functional biology at single-cell resolution.
南方医科大学第三附属医院副主任医师 硕士导师 医学博士
采用无痛非手术疗法诊治各种原因导致的皮肤溃烂，如糖尿病足溃疡、压疮、下肢血管性溃疡、外伤后伤口不愈、手术后切口不愈、痛风、骨髓炎等。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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