Archivio Istituzionale della Ricerca- Università del Piemonte Orientale
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Checking Medical Process Conformance by Exploiting LLMs
Get PDFClinical guidelines, which represent the normative process models for healthcare organizations, are typically available in a textual, unstructured form. This issue hampers the application of classical conformance-checking algorithms to the medical domain, which take in input of a formalized and computer-interpretable description of the process. In this paper, (i) we propose overcoming this problem by taking advantage of a Large Language Model (LLM), in order to extract normative rules from textual guidelines; (ii) we then check and quantify the conformance of the patient event log with respect to such rules. Additionally, (iii) we adopt the approach as a means for evaluating the quality of the models mined by different process discovery algorithms from the event log, by comparing their conformance to the rules. We have tested our work in the domain of stroke. As regards conformance checking, we have proved the compliance of four Northern Italy hospitals to a general rule for diagnosis timing and to two rules that refer to thrombolysis treatment, and have identified some issues related to other rules, which involve the availability of magnetic resonance instruments. As regards process model discovery evaluation, we have assessed the superiority of Heuristic Miner with respect to other mining algorithms on our dataset. It is worth noting that the easy extraction of rules in our LLM-assisted approach would make it quickly applicable to other fields as well
Rete multi-attore nelle politiche per persone anziane e con disabilità: il caso di Novara
No full textFemtoscopic study of the proton-proton and proton-deuteron systems in heavy-ion collisions at the LHC
Get PDFThis work reports femtoscopic correlations of p-−p(p ̅-−p ̅) and p−−d(p ̅-−d ̅) pairs measured in Pb–Pb collisions at center-of-mass energy per nucleon sNN = 5.02 TeV in the ALICE Collaboration. A fit to the measured proton-proton correlation functions allows one to extract the dependence of the nucleon femtoscopic radius of the particle-emitting source on the pair transverse mass (mT) and on the average charge particle multiplicity 〈dNch/dη〉1/3 for three centrality intervals (0–10%,10−−30%,30−−50%). In both cases, the expected power-law and linear scalings are observed, respectively. The measured p–d correlations can be described by both two- and three-body calculations, indicating that the femtoscopy observable is not sensitive to the short-distance features of the dynamics of the p-(p-n) system, due to the large inter-particle distances in Pb–Pb collisions at the LHC. Indeed, in this study, the minimum measured femtoscopic source sizes for protons and deuterons have a minimum value at 2.73−0.05+0.05 and 3.10−0.86+1.04 fm, respectively, for the 30–50% centrality collisions. Moreover, the m T-scaling obtained for the p–p and p–d systems is compatible within 1 σ of the uncertainties. These findings provide new input for fundamental studies on the production of light (anti)nuclei under extreme conditions
Assessment of preload dependance in critical care: new insights and techniques
No full textFluid administration is a cornerstone in the management of hemodynamic instability, aimed at increasing cardiac output (CO) and improving tissue perfusion. However, only half of critically ill patients experience a meaningful rise in CO after fluid loading, underscoring the importance of identifying preload responsiveness to avoid unnecessary or harmful volume expansion. Traditional fluid challenges (350–500 ml) represent treatments rather than diagnostic tools, prompting the investigation of smaller-volume tests, such as mini-fluid challenges. These, however, require accurate CO monitoring to ensure reliability.This thesis explores two clinical studies developed during a PhD program, each targeting a different approach to preload responsiveness assessment. The first study demonstrates that calibrated pulse contour analysis reliably detects changes in CO following a 50 ml fluid bolus (micro-fluid challenge), supporting its use as a minimally invasive test of fluid responsiveness. The second study evaluates bioreactance, a non-invasive CO monitoring technique, in the same context. Results indicate that the current commercial version of the device lacks the sensitivity to detect hemodynamic changes following a micro-bolus, although previous work by our group suggests that optimized settings may enhance its performance. In an era of precision medicine, these studies collectively aim to expand the toolkit for hemodynamic monitoring in critical care, highlighting the need for tailored, responsive, and minimally invasive strategies to guide fluid management in high-risk patients
Reconstruction of a Chronic Quadriceps Tendon Rupture in an Elderly Polio Patient
Get PDFQuadriceps tendon tears are uncommon lesions and their diagnosis can be missed in up to 50% of cases. We report a case of a 83-year-old man with polio who has a chronic quadriceps tendon tear in a healthy limb. A modified Codivilla technique augmented with an ipsilateral semitendinosus tendon was performed. Partial weight bearing was allowed immediately after surgery, and at 3 months the patient was able to walk with full weight bearing on the involved limb. The 5-year follow-up MRI showed good quadriceps tendon healing with the full integration of the tendon graft. Tendon repair with autograft augmentation represents a potential and effective solution in elderly patients with a chronic quadriceps tendon tear
Diagnostic Challenges in a Young Man with a Suspected Mast Cell Disorder, Dysplastic Bone Marrow Morphology, and a ZRSR2 Mutation
No full textCounterhegemonic food networks for a just food transition. Reflections from Latin America
Get PDFThe emergence of food movements has stressed the need of readdressing food
systems, starting from daily practices, towards a just transition. Nonetheless, most of theoretical debate about Alternative Food Networks (AFN) developed in the Global North and scarcely adapts to the Global South. This contribution aims to challenge the mainstream conceptualization of AFN in the international debate, highlighting the need of decolonizing and counter-hegemonic theories, best fitting the social, economic and geographical context of food systems in the Global South. After a review on the literature, we reflect on Counter-Hegemonic Food Networks (CHFN), focusing on a Latin American perspective and discussing some evidences from Brazil and Mexico
A Novel Closo-Ortho-Carborane-Based Glucosamine Derivative as a Promising Agent for Boron Neutron Capture Therapy
Get PDFBackground: Boron Neutron Capture Therapy (BNCT) is a promising cancer treatment that combines tumor-selective boron delivery agents with thermal neutrons to kill cancer cells while sparing normal tissue. BNCT requires boron-containing compounds that exhibit high tumor selectivity and achieve therapeutic boron concentrations within tumor cells. This work focuses on the early development of a novel boron cluster carbohydrate derivative based on the glucosamine structure. Our results indicate that this derivative may have advantages over the typical boron delivery agent used in clinical applications and may significantly improve boron delivery capacity at the cellular level. Methods: The performance of the compound in terms of boron uptake was tested in the U87-MG glioblastoma cell line employing neutron autoradiography imaging and quantification. Results: The compound was non-toxic for cells, and it showed a remarkable capacity to enrich cells with boron. The ratio between boron concentration provided in the culture medium and boron concentration achieved in cells was compared to that obtained with boronophenylalanine (BPA), the gold standard in BNCT. The result demonstrated a significantly better performance compared with BPA, showing that the novel agent can concentrate boron in cells more than in culture medium. Conclusions: The encouraging preliminary results provide a starting point for its potential application in in vivo tests
Verso una teo-logica dei "doppi pensieri": Italo Mancini
No full textLa filosofia della religione costituisce il nucleo centrale del pensiero di Italo Mancini (1925-1993), che in modo istruttivo la articola – come il presente contributo intende mostrare – in riferimento alla dimensione metafisica, alla prospettiva ermeneutica e all’istanza pratica. A una fase iniziale caratterizzata da indagini esclusivamente ontologiche e metafisiche, tese a dimostrare l’esistenza del Dio dei filosofi, un Dio che non parla e che salva dalla contraddittorietà dell’esperienza solo in termini razionali, segue infatti – proprio perché una tale “Dio muto” a Mancini non può bastare – una fase successiva in cui la religione è posta al centro della riflessione e in cui la mediazione metafisica si rapporta, secondo una impostazione di tipo “fondativo”, con il tema della rivelazione storica (costituente per Mancini l’essenza della religione) e con la questione della sua comprensione ermeneutica. In seguito la rivelazione è interpretata soprattutto in rapporto alla sua dimensione di liberazione dei processi storici dai fenomeni di violenza e di oppressione loro perennemente sottesi. La riflessione manciniana approda infine a una teo-logica dei “doppi pensieri” che intende articolare organicamente il rapporto tra le richiamate istanze della teoria e della prassi e che, riferendosi all’interpretazione dei simboli religiosi e della struttura ossimorica da cui essi sono abitati, tende a concepire la filosofia della religione per più versi come una ermeneutica del cristianesimo