Motivated by the aging trend, much effort is being invested into implementing ICT (Information and Communications Technology)-enabled systems to provide a better quality of life and support the independent living of older people. As a result, many systems, often labeled as eHealth or AAL (Ambient/Active Assisted Living), were developed over the years. In creating such systems, which very often serve various needs, different architectures have emerged. This work focuses on analyzing and comparing the work and architectures from seven (six of which are in progress) EU-funded healthcare projects, with a total budget of 126MEUR in which we participate. After establishing the theoretical foundation by defining core concepts, we give a brief background on architectures in eHealth and AAL. We elaborate on the chosen analysis method based on three established healthcare and AAL taxonomies we identified by performing a literature survey and the selected Reference Architecture Model (RAM). Since there is no standard way of describing architectures in the eHealth and AAL domain, we conducted the online survey during August and September 2020 and identified CREATE-IoT 3D RAM as the most appropriate option. We present a classification of selected projects based on established taxonomies and map projects’ architectures to CREATE-IoT 3D RAM, which we also propose as standard RAM for future digital healthcare and AAL projects. During our analysis, we identify the most common types of assistance: communication support, reminders, monitoring, and guidance to address health and communication issues. We conclude that proper ecosystems are critical for lowering entry barriers and facilitating sustainable solutions for smart and healthy living.

Due to population ageing and medical advances, people with advanced chronic diseases (ACD) live longer. Such patients are even more likely to face either temporary or permanent reduced functional reserve, which typically further increases their healthcare resource use and the burden of care on their caregiver(s). Accordingly, these patients and their caregiver(s) may benefit from integrated supportive care provided via digitally supported interventions. This approach may either maintain or improve their quality of life, increase their independence, and optimize the healthcare resource use from early stages. ADLIFE is an EU-funded project, aiming to improve the quality of life of older people with ACD by providing integrated personalized care via a digitally enabled toolbox. Indeed, the ADLIFE toolbox is a digital solution which provides patients, caregivers, and health professionals with digitally enabled, integrated, and personalized care, supporting clinical decisions, and encouraging independence and self-management. Here we present the protocol of the ADLIFE study, which is designed to provide robust scientific evidence on the assessment of the effectiveness, socio-economic, implementation, and technology acceptance aspects of the ADLIFE intervention compared to the current standard of care (SoC) when applied in real-life settings of seven different pilot sites across six countries. A quasi-experimental trial following a multicenter, non-randomized, non-concurrent, unblinded, and controlled design will be implemented. Patients in the intervention group will receive the ADLIFE intervention, while patients in the control group will receive SoC. The assessment of the ADLIFE intervention will be conducted using a mixed-methods approach.

Hollow organs such as the lungs pose a considerable challenge for post-mortem imaging in preclinical research owing to their extremely low contrast and high structural complexity. The aim of our study was to enhance the contrast of tuberculosis lesions for their stratification by 3D x-ray–based virtual slicing. Organ samples were taken from five control and five tuberculosis-infected mice. Micro-Computed Tomography (CT) scans of the subjects were acquired in vivo (without contrast agent) and post-mortem (with contrast agent). The proposed contrast-enhancing technique consists of x-ray contrast agent uptake (silver nitrate and iodine) by immersion. To create the histology ground-truth, the CT scan of the paraffin block guided the sectioning towards specific planes of interest. The digitalized histological slides reveal the presence, extent, and appearance of the contrast agents in lung structures and organized aggregates of immune cells. These findings correlate with the contrast-enhanced micro-CT slice. The abnormal densities in the lungs due to tuberculosis disease are concentrated in the right tail of the lung intensity histograms. The increase in the width of the right tail (~376%) indicates a contrast enhancement of the details of the abnormal densities. Postmortem contrast agents enhance the x-ray attenuation in tuberculosis lesions to allow 3D visualization by polychromatic x-ray CT, providing an advantageous tool for virtual slicing of whole lungs. The proposed contrast-enhancing technique combined with computational methods and the diverse micro-CT modalities will open the doors to the stratification of lesion types associated with infectious diseases.

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