Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
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Do Outpatient Services Impact Length of Stay? A Preliminary Analysis through Deep Learning Classification
Get PDFTimely discharge of hospitalized patients can prevent complications and reduce costs. In this paper, we have investigated whether outpatient services, i.e., diagnostic exams or specialist consultations provided by external wards, have a clear impact on Length of Stay (LOS). In particular, we have worked on an event log of more than 7000 real patient traces, logging the sequence of outpatient services provided during hospitalization, and we have classified the traces into long (more or equal than 20 days) versus short (less than 20 days) LOS, resorting to a deep learning approach that adopts a Long Short-Term Memory (LSTM) network. The very high quality of the classification results suggests that outpatient services play a significant role in determining LOS, and hospitals should work on optimizing their organization
Extracellular Vesicles and Circulating Nucleic Acids
Get PDFThe GISM Annual Meeting 2025 convened experts in regenerative medicine and nanomedicine to discuss recent advances in mesenchymal stromal/stem cell (MSC) research and extracellular vesicle (EV) technologies. The meeting emphasized novel strategies to enhance the therapeutic potential of MSCs and EVs, addressing both basic biological insights and translational challenges. Discussions highlighted the importance of standardizing production and characterization methods to improve scalability and reproducibility for clinical applications. Emerging therapeutic approaches, including cell engineering and targeted drug delivery, were showcased alongside preclinical and clinical studies. The conference provided a platform for interdisciplinary exchange, fostering collaboration and paving the way toward the clinical integration of EV and cell-based nanomedicine
Mild acute biliary pancreatitis: still a surgical disease. A post-hoc analysis of the MANCTRA-1 international study
No full textMisure di adattamento ai cambiamenti climatici per le imprese agricole e le comunità rurali
No full textIl settore agroalimentare è attualmente avversato da fenomeni estremi causati dai cambiamenti climatici come l’aumento delle temperature, periodi di siccità sempre più prolungati, seguiti da frequenti eventi di precipitazione intensa, ma anche da incendi sempre più estesi e ricorrenti.
Questa situazione pone le imprese agricole dinanzi a sfide sempre più difficili. Oltre agli eventi catastrofali citati in precedenza bisogna tenere in considerazione che l’aumento delle temperature provoca una variazione delle coltivazioni in relazione alle condizioni climatiche delle diverse latitudini. Si impongono urgenti azioni di mitigazione e adattamento. Questo lavoro fa riferimento a queste ultime – data l’ampiezza della tematica – con attenzione particolare a quelle più urgenti o significative. Tra queste occupano un posto di rilievo le c.d. “Nature-based Solutions”, ovvero metodologie di adattamento basate su effetti naturali e compatibili con la preservazione degli ecosistemi e della biodiversità. Un esempio particolarmente significativo si rinviene nell’agroforestazione che costituisce un approccio agronomico in grado di combinare alberi e/o arbusti con colture agrarie nello stesso appezzamento di terreno. Esaminando alcuni casi paradigmatici, il presente contributo intende evidenziare il ruolo delle imprese agricole nel realizzare pratiche sostenibili per adattarsi al cambiamento climatico. A tal fine è necessaria una gestione equa delle risorse, che faccia anche tesoro delle esperienze delle comunità rurali
Evaluating High Intraocular Pressure Criteria for Failure in Glaucoma Surgery: Impact on Estimated Success and Visual Field Rates
Get PDFPurpose: Review high intraocular pressure (IOP) thresholds used as failure criteria in glaucoma surgical outcome studies, evaluate their impact on success rates, and examine the relationship between surgical success criteria and visual field (VF) progression rates. Design: Systematic literature review and application of high IOP failure criteria to 2 retrospective cohorts. Participants: Two cohorts of 934 and 1765 eyes underwent trabeculectomy and deep sclerectomy (DS), respectively, with a median follow-up of 41.4 months for trabeculectomy and 45.4 months for DS. Visual field analysis was conducted on patients in the trabeculectomy cohort with ≥4 VFs in ≥2 years post-surgery. Methods: We applied literature-based high IOP failure criteria to the patient cohorts, defining failure as exceeding these IOP thresholds, loss of light perception, hypotony revision surgery, or need for additional IOP-lowering surgery. Success rates were estimated with Kaplan–Meier statistics, and Cohen's kappa statistic assessed the agreement among criteria in defining failure at 5 years. Linear mixed models estimated VF mean deviation (MD) progression rates based on success or failure status. Main Outcome Measures: Kaplan–Meier success rates, Cohen's kappa, and MD progression rates. Results: From 2503 initial studies, 277 were included, identifying 144 high IOP failure criteria. The 21-mmHg criterion variations showed success rates at 5 years ranging from 8.7% to 74.0% for trabeculectomy and 22.1% to 89.9% for DS. The median Cohen's kappa for 21-mmHg criteria indicated fair agreement (0.39 for trabeculectomy, 0.42 for DS). A subset of 339 trabeculectomy eyes were eligible for the VF analysis. Overall, the median (interquartile range) postoperative progression rate was −0.36 (−0.09 to −0.74) dB/year. Distributions of progression rates greatly overlapped between failure and success groups as defined by the various criteria. Conclusions: The criteria for defining high IOP failure in glaucoma surgery are highly heterogeneous in the current literature. Varying high IOP criteria has a large impact on glaucoma surgery success rates, highlighting the need for standardized failure criteria to enable consistent interpretation and comparison across studies. IOP-based classifications are poor surrogates for postoperative VF progression rates. Long-term visual field rates provide a more consistent primary outcome measure and may be incorporated into composite success criteria
Practical recommendations for the management of radiodermatitis: on behalf of the ESTRO RTT committee
Get PDFBackground: There is a substantial body of literature addressing the prevention, acute management, and follow-up care of radiation induced dermatitis (RID). The quality and application of this evidence, however, is inconsistent and its interpretation varies widely. While several national guidelines have been developed to standardise practices locally, many of these resources are not publicly available. On behalf of the European Society for Radiotherapy and Oncology (ESTRO) Radiation Therapist (RTT) Committee, an international writing group consisting of 12 experts from radiotherapy and two patient representatives composed a recommendation document for the management of RID. Main body: The consensus for these recommendations was generated based on available international guidelines, and supplemented with evidence-based review articles on the topic. These recommendations focus on the prevention and practical management of early stage RID by avoiding skin trauma and maintaining hygiene. Addressing pain and inflammation in higher grades is also covered. The current literature refutes some of the traditional recommendations, especially restricting washing as well as the use of deodorant or the potential dose build-up of lotions which has been included and rectified in recent guidelines. In addition, the importance of grading the severity, including a baseline assessment is presented. The benefit of clear, and non-contradictory communication within the multidisciplinary team as well as patient involvement (e.g. PROMs or similar) is highlighted. Furthermore, the importance of recognising different skin types and skin tones, and the impact on how RID changes these in their appearance is stressed. Conclusion: This document provides practical, actionable recommendations for the clinical management of RID, referencing the supporting literature. These recommendations have, however, identified a lack of high-level evidence, especially for agent-specific recommendations
La Guía espiritual de Miguel de Molinos: primera aproximación desde la filología de autor
No full textRichter transformation in diffuse large B-cell lymphoma in patients with chronic lymphocytic leukemia receiving ibrutinib: risk factors and outcomes
No full textThis study aimed to define the incidence and risk factors for diffuse large B cell lymphoma variant of RT (DLBCL-RT) in 976 patients with CLL who received ibrutinib therapy. DLBCL-RT was recorded in 83 (8.5%) patients, with a 7-year 15.6% rate. Most patients exhibited clinical signs of aggressive lymphoma, enlarged lymph nodes in 83%, cytopenia in 60%, and Suvmax values ≥ 5 at CT/PET in 98%. Among patients for whom the data was available, 83% had unmutated IGHV, 60% TP53 disruption, 26% mutated NOTCH1, 10% were categorized in subset #8 and 82% had a clonally-related lymphoma. Response to chemoimmunotherapy was achieved by 32% of patients. Median OS was 4.7 months, with cytopenia at DLBCL-RT diagnosis being the only significant factor for inferior survival (HR, 1.68). In multivariable analysis, factors predictive for increased risk of DLBCL-RT were age <70 years (HR: 1.98, p = 0.019), TP53 disruption (HR: 1.72, p = 0.044), with a trend to significance for prior treatment (HR: 1.91, p = 0.065). According to the number of these risk factors, DLBCL-RT rate varied from 4% to 22.6% (p < 0.0001). In conclusion, patients with CLL receiving ibrutinib with age <70 years, TP53 disruption and previously treated are at increased risk for developing DLBCL-RT and deserve close monitoring
Changing Food in a Changing World: Assessing Compliance to Insects, Cultivated Meat, and Soil-Less Products Among Italian Undergraduates
Get PDF: Background/Objectives: In recent decades, the need for sustainable alternatives to traditional foods for the global population has become urgent. To this aim, edible insects, cultivated meat, and vegetables produced through soil-less farming have been proposed. This cross-sectional study was aimed at exploring willingness to eat these novel foods and its possible correlates in young Italian adults. Methods: An electronic questionnaire was administered to the student populations of 13 universities throughout the Italian territory. Results: The results show that insects and cultivated meat were widely acknowledged as possible food, while soil-free cultivation seems to be less known. Indeed, the percentage of participants who have heard of insects, cultivated meat, and soil-free cultivation was respectively equal to 91.5%, 84.7%, and 32.9%. However, the majority of respondents were uncertain about the sustainability of all the proposed products (52.6% for insects, 39.5% for cultivated meat, and 58.0% for soil-free cultivation, respectively), and the propensity to try and eat insects (9.5%) was lower than that declared for synthetic meat (22.8%) and products from soil-free cultivation (19.2%). However, the regression analysis showed that the propensity to eat these foods regularly is positively related to the confidence in their sustainability (p < 0.001). Willingness to try each of the proposed foods positively correlated with that declared for the others (p < 0.001). Conclusions: These findings highlight the need to implement interventions aimed at increasing awareness about the use of these products as alternatives to less sustainable foods and the importance of identifying consumer groups to which these interventions should be addressed
Tutela dei creditori e obblighi inderogabili di solidarietà economica e sociale: prime riflessioni sulla necessità di un bilanciamento (Trib. Avellino, 25 maggio 2025)
No full textUna rilettura costituzionalmente orientata delle norme che governano
l’esercizio dell’azione revocatoria appare necessaria per attualizzare
l’istituto all’aumento dei casi in cui il debitore è chiamato ad adempiere
ad un obbligo para o sovraordinato a quello di soddisfacimento del
creditore consentendogli un’adeguata pianificazione patrimoniale e
gestione delle risorse.
The author’s view
A new interpretation of the “azione revocatoria” ruled by the Italian Civile
Code appears necessary in order to up to date it with the increase in cases
in which the debtor is required to fulfil an obligation that is equal to or
superior to that of satisfying the creditor, allowing the debtor to plan his
assests manage his resources appropriately