University of Udine
Archivio istituzionale della ricerca - Università degli Studi di UdineNot a member yet
91472 research outputs found
Sort by
Multi-neighborhood simulated annealing for the integrated patient-to-room and nurse-to-patient assignment problem
No full textWe consider a recently proposed integrated healthcare problem that deals with the assignment of patients to suitable rooms in wards (Patient-to-Room) and the assign- ment of nurses to patients to balance their workload and reduce patient disturbance (Nurse-to-Patient), in one single stage. For this problem, we designed an integrated local search method that uses four distinct neighborhoods and is guided by a Sim- ulated Annealing metaheuristic. We configured and tuned our search method, ran it on the available datasets with different running times, and validated it using the available solution checker. Finally, we compared the results with the ones available in the literature and with a sequential version of our method. The outcome is that our search method outperforms the previous ones, in particular for large and real-world instances. Finally, we observe that the integrated approach is particularly effective when the planning horizon is short
Prognostic role of genetic variants in recurrent pericarditis
Get PDFBackground: Recent interest in the genetic basis of pericarditis has prompted investigation into the prognostic relevance of disease-associated genetic variants (DAVs), particularly in recurrent pericarditis (RP). Autoinflammatory mechanisms have been implicated in RP, suggesting that genetic predisposition may influence disease severity, treatment response, and long-term outcomes. This study aimed to evaluate the prognostic impact of DAVs in adults with RP. Methods: A prospective observational cohort study was conducted at a tertiary referral centre for pericardial diseases, enrolling all consecutive adult patients with at least three RP episodes between October 2017 and December 2021. Whole exome sequencing was used to identify DAVs. Results: Of the 131 patients included, 30 (22.9 %) were found to carry a DAV. Compared with those without DAVs, these patients more frequently exhibited systemic inflammatory features, including elevated C-reactive protein (>10 mg/L in 93.3 % vs 77.7 %, p = 0.049) and fever (76.7 % vs 49.5 %, p = 0.008). After a median follow-up of 47 months (IQR 34–75), long-term remission was achieved in only 33.3 % of DAV carriers, compared to 67.3 % in the control group (log-rank p = 0.03). In multivariable Cox regression analysis, the presence of a DAV remained independently associated with a reduced likelihood of achieving sustained remission (HR 0.468, 95 % CI 0.240–0.984; p = 0.045). Conclusions: This is the first study to assess outcomes in RP patients with DAVs. Approximately one in four patients showed a genetic predisposition, which was linked to a larger inflammatory burden and a significantly lower probability of long-term remission, highlighting the prognostic value of genetic testing in RP
Prognostic implications of risk definitions from the monarchE and NATALEE trials
Get PDFBackground The monarchE and NATALEE trials employed different high-risk inclusion criteria. The main objective is to assess prognostic differences based on their inclusion criteria. Methods Patients with hormone receptor-positive/HER2-negative early breast cancer enrolled in the phase III Mammella InterGruppo (MIG) 1, Gruppo Italiano Mammella (GIM) 2, and GIM3 trials were categorized as high-risk cohort (HRC) and low-risk cohort (LRC) according to the inclusion criteria of monarchE and NATALEE trials. Subsequently, they were further classified in 3 different cohorts: concordant LRC (low risk for both trials), discordant risk cohort (high risk for only one trial), and concordant HRC (high risk for both trials). Main outcomes were disease-free survival (DFS) and overall survival (OS). Results Among 4795 patients, 1343 (28.0%) and 2689 (56.1%) were classified as HRC according to the monarchE and NATALEE, respectively. At a median follow-up of 7.0 years (y), 7-y DFS was 87% and 89% in the LRC and 69% and 76% in the HRC according to monarchE and NATALEE, respectively. The 7-y DFS was 89%, 84%, and 69% in concordant LRC, discordant cohort, and concordant HRC, respectively (discordant cohort vs concordant LRC: hazard ratio [HR] = 1.45, 95% CI = 1.22 to 1.73; concordant HRC vs concordant LRC: HR = 2.97, 95% CI = 2.53 to 3.48; P <. 001). The 7-y OS was 96% in concordant LRC, 95% in discordant cohort, and 84% in concordant HRC (discordant cohort vs concordant LRC: HR = 1.52, 95% CI = 1.16 to 1.98; concordant HRC vs concordant LRC: HR = 3.38, 95% CI = 2.66 to 4.29; P <. 001). Conclusions Patients in the concordant HRC showed statistically and clinically significant poorer prognoses compared with patients in the discordant risk and concordant LRC
Anthropic and natural variations effects on basin hydrodynamics and settling time in multi-inlet systems: Insights from Marano and Grado lagoon
Get PDFMulti-inlet lagoons are complex environments with a generally high socio-economic value, which often require interventions aimed at stabilizing the inlets or improving navigability. The effects that arise from anthropogenic or natural changes localized in a single basin can concern the entire system since the basins are interconnected.
This study analyses the changes occurring in the Marano and Grado lagoon over the last 52 years, with a 2DH numerical approach and the correlation between different hydrodynamic variables. In particular, tidal prisms, water levels, residual currents, asymmetries between tidal flood and ebb are analysed and discussed in the light of a new parameter called settling time. It suggests the time required by each basin to drain the volume of water stored during the rising tidal phase. The construction of the jetties to protect the Porto Buso inlet and the narrowing of the Lignano cross-section inlet have increased the settling time of the respective basins, while the loss of salt marshes in the Grado basin has reduced it. The results obtained show that any modification of the settling time of a basin in a tidal multi-inlet system lengthens or shortens the response of the basin itself to the tidal forcing. This also determines level gradients, and transverse flows that modify the hydrodynamic pattern of the neighbouring basins
Annotation Practices in Computational Pathology: A European Society of Digital and Integrative Pathology (ESDIP) Survey Study
Get PDFIntegrating digital pathology and artificial intelligence (AI) algorithms can potentially improve diagnostic practice and precision medicine. Developing reliable, generalizable, and comparable AI algorithms depends on access to meticulously annotated data. However, achieving this requires robust collaboration among pathologists, computer scientists, and other researchers to ensure data quality and consistency. The lack of standardization and scalability is a significant challenge when generating annotations and annotated data sets. Recognizing these limitations, the Scientific Committee of the European Society of Digital and Integrative Pathology (ESDIP) performed a comprehensive international survey to understand the current state of annotation practices and identify actionable areas to address critical needs in the annotation process. The analysis and summary of the survey results provide several insights for all stakeholders involved in data preparation and ground truthing, ultimately contributing to the advancement of AI in computational pathology
Management Strategies for Generalised Granuloma Annulare: A Systematic Review of Current and Emerging Therapies
Get PDFGeneralised Granuloma Annulare (GGA) is a chronic inflammatory skin disorder with no standard treatment. Since the last review in 2013, new treatments and varied responses have highlighted the need for an updated synthesis to guide clinical decisions. This systematic review aimed to evaluate the epidemiology, comorbidities and treatment outcomes in patients with GGA, synthesising evidence from published studies to provide insights into both conventional and emerging therapeutic strategies. A systematic literature search was conducted in CENTRAL, Embase and PubMed, following PRISMA guidelines. Studies published in English, French or Spanish up to January 15, 2024, were included. Data extraction focused on patient demographics, comorbidities, treatment regimens and therapeutic outcomes. A total of 689 patients were included. The mean age of patients was 52.8 years, with a female predominance (72.6%). Based on this systematic review, we propose a stepwise approach: first-line treatment includes hydroxychloroquine and phototherapy (PUVA > UVA1 > nb-UVB). Oral corticosteroids along with high-potency topical steroids or calcineurin inhibitors may be used in extensive or rapidly progressive disease or as bridging therapy pending slower-acting agents. Sulfones are second-line, with oral retinoids (e.g., isotretinoin) as alternatives if contraindicated. For refractory cases, off-label anti-TNF-α agents or JAK inhibitors are recommended, with methotrexate or cyclosporine as valid alternatives. This largest systematic review of GGA treatments offers an evidence-based clinical framework. While steroids and phototherapy remain standard, emerging options like JAK inhibitors and biologics show promise for refractory cases. Tailored, multimodal strategies may improve outcomes, though further trials are needed to standardise guidelines
Evaluation of Polycyclic Aromatic Hydrocarbons (PAHs) in Pork Meat Cooked with Two Different Methods
Get PDFDuring domestic grilling, polycyclic aromatic hydrocarbons (PAHs), which include genotoxic and carcinogenic compounds, can be produced as a result of fat pyrolysis, leakage of cellular juices onto the heat source, and incomplete combustion of fuel. This study aimed to assess the formation of PAHs in pork neck cooked using two different grilling methods (traditional flat grill with beech charcoal and asado grill with beech wood flame) under controlled conditions, with cooking stopping at a core temperature of 72 °C. The impact of marinating and cooking speed (fast or slow) was also evaluated over three cooking sessions. After grilling, the meat samples underwent microwave-assisted extraction, purification through solid-phase extraction (SPE), and analysis using ultra-high-performance liquid chromatography (UHPLC) with spectrofluorometric detection. Statistical analysis was performed using ANOVA (R software, version 4.3.0). None of the samples exceeded the legal limits for benzo[a]pyrene (BaP) and PAH4 (sum of chrysene, benzo[a]anthracene, BaP, and benzo[b]fluoranthene). However, the asado grill showed a significantly higher average PAH contamination (1.21 μg/kg of BaP and 3.92 μg/kg of PAH4) compared with the traditional grill (0.22 μg/kg of BaP and 1.71 μg/kg of PAH4). Marinating and cooking speed did not have a significant impact on PAH levels
Sibilla Aleramo e Piero Gigli: un carteggio
No full textII futurista modenese Piero Gigli e la matura Sibilla Aleramo s'incontrano sullo sfondo della Milano del 1917, negli ambienti artistici e letterari (la Casa Rossa di Corso Venezia, la dimora di Margherita Sarfatti), in cui il ventenne Gigli, reduce dal fronte, è stato introdotto da Marinetti, conosciuto all’ospedale militare di Udine. La corrispondenza superstite, assieme a pagine di memorie di Gigli, attesta le aspettative di chi, attratto dalla spregiudicatezza dei comportamenti dell'affermata scrittrice, aspirava, anche per suo tramite, alla consacrazione artistica; dall’altro, un incapricciamento iniziale, presto raffreddato dall'estraneità dell'alessandrina ad ogni sperimentalismo e, di più, dal turbinio di tentazioni che la rendevano decisamente volubile nelle relazioni
Developing a nationwide registry of UK veterans seeking help from sector charities-a machine learning approach to stratification
Get PDFThe assistance to veterans in the UK is provided by the National Health Service and over 1800 military charities. These charities count services using different definitions and reporting systems, so to date a national registry of service usage does not exist. The aim of the Map Of Need Aggregation ResearCH study is to build a standardized registry of service usage data for the military charity sector. Data are completely anonymized by adopting a Secure Hashing Algorithm. A unique anonymous identifier is generated allowing both privacy protection and avoiding double counts. Data are standardized and linked with an automated process to create an aggregated dataset. The dataset describes the population, using both a priori and machine learning approaches. To date a total of 42 509 veterans with 128 423 needs are included. The mean age was 60.1 years, and 90% were male. 65% were receiving other benefits, 5% were homeless and 1% were in prison. 65% of the needs recorded concerned social wellbeing. 40% of veterans received assistance in at least two different years. The k-means clustering approach returned 4 subgroups of use that were identical to those created using a priori knowledge. The dataset is the most comprehensive source of veteran charity usage data in the UK to date. Service usage is generally homogenous among subgroups, but some differences were highlighted indicating that younger, non-officer veterans may be more at risk of presenting with more complex needs. These first useful insights can help allocate resources to build an effective preventive strategy for more complex cases