After a brief review of the most recent findings in the study of human evolution, an extensive comparison of the complete genomes of our nearest relative, the chimpanzee (Pan troglodytes), of extant Homo sapiens, archaic Homo neanderthalensis and the Denisova specimen were made. The focus was on non-synonymous mutations, which consequently had an impact on protein levels and these changes were classified according to degree of effect. A total of 10,447 non-synonymous substitutions were found in which the derived allele is fixed or nearly fixed in humans as compared to chimpanzee. Their most frequent location was on chromosome 21. Their presence was then searched in the two archaic genomes. Mutations in 381 genes would imply radical amino acid changes, with a fraction of these related to olfaction and other important physiological processes. Eight new alleles were identified in the Neanderthal and/or Denisova genetic pools. Four others, possibly affecting cognition, occured both in the sapiens and two other archaic genomes. The selective sweep that gave rise to Homo sapiens could, therefore, have initiated before the modern/archaic human divergence.
Funding Acknowledgements Type of funding sources: None. Background Predicting worsening heart failure (WHF) events in chronic heart failure (HF) patients is important to avoid hospitalizations. In patients implanted with cardiac implantable electronic devices (CIEDs) remote monitoring may help to identify patients at risk of WHF thanks to the ability to monitor physiological parameters that may change before WHF. However, clinicians need to know patient HF-related signs, symptoms and therapy non-compliance to determine type and time of necessary interventions. A patient Smartphone Application (App) may be an ideal option to remotely collect this information from patients and help clinicians in the decision-making process. Purpose to assess the penetration of App technology in a large real-world HF population and to evaluate patient willingness and compliance to use a HF-dedicated App to weekly send a diary on HF signs, symptoms and therapy compliance to the cardiologist. Methods From January 2021 to July 2022, 10 Italian hospitals in the framework of the One Hospital ClinicalService project designed a questionnaire on the use of App technology and submitted it to their HF patients with CIED during scheduled in-hospital follow-up. If the patient or his caregiver was able and willing to use Apps, the HF-dedicated App was activated on his smartphone. Compliance in using the App (= percentage of weeks in a year with at list an App diary received by all patients) was evaluated for patients who have received it for at least one year. Results 495 HF patients with CIED (age 67±13 years, 79% males, 26% NYHA III-IV, LVEF 35±11%, 60% with 3-chamber CIED, 43% with high school qualification) completed the questionnaire. Out of them, 80% have access to App technology, directly or through a caregiver; ≥62% can do all high-level activities (APP installation, email, web browsing) and 21% has already used Health Apps; 73% is willing to weekly send a diary using the App. 311 patients (63% of respondents) downloaded the HF-dedicated App on their or caregiver’s smartphone. They were younger and with higher school qualification than those not receiving the App. No other difference in baseline characteristics was seen. 138 patients have received the App for at least 1 year. Their compliance decreased during time, from 60% (weeks 1-13) to 42% (weeks 40-52; p <.001). Patients aging ≥ 60 years had a higher mean yearly compliance (53%) than younger patients (42%; p <.001; Fig. 1). Hospitals with dedicated staff to remote monitoring achieved a higher mean yearly patient compliance (64%) than other sites (33%, p <.001). Conclusion In a large real-world HF population with CIED patients, the penetration of Smartphone technology was high and > 60-year-old patients had higher compliance to the use of a new HF-dedicated App compared to younger patients. The use of Smartphone App technology to collect WHF sign/symptoms is feasible and may improve remote management of HF patients.
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