87,180 research outputs found
Artificial intelligence-based tools to control healthcare associated infections: A systematic review of the literature
No full textBackground: Healthcare-associated infections (HAIs) are the most frequent adverse events in healthcare and a global public health concern. Surveillance is the foundation for effective HAIs prevention and control. Manual surveillance is labor intensive, costly and lacks standardization. Artificial Intelligence (AI) and machine learning (ML) might support the development of HAI surveillance algorithms aimed at understanding HAIs risk factors, improve patient risk stratification, identification of transmission pathways, timely or real-time detection. Scant evidence is available on AI and ML implementation in the field of HAIs and no clear patterns emerges on its impact. Methods: We conducted a systematic review following the PRISMA guidelines to systematically retrieve, quantitatively pool and critically appraise the available evidence on the development, implementation, performance and impact of ML-based HAIs detection models. Results: Of 3445 identified citations, 27 studies were included in the review, the majority published in the US (n = 15, 55.6%) and on surgical site infections (SSI, n = 8, 29.6%). Only 1 randomized controlled trial was included. Within included studies, 17 (63%) ML approaches were classified as predictive and 10 (37%) as retrospective. Most of the studies compared ML algorithms’ performance with non-ML logistic regression statistical algorithms, 18.5% compared different ML models’ performance, 11.1% assessed ML algorithms’ performance in comparison with clinical diagnosis scores, 11.1% with standard or automated surveillance models. Overall, there is moderate evidence that ML-based models perform equal or better as compared to non-ML approaches and that they reach relatively high-performance standards. However, heterogeneity amongst the studies is very high and did not dissipate significantly in subgroup analyses, by type of infection or type of outcome. Discussion: Available evidence mainly focuses on the development and testing of HAIs detection and prediction models, while their adoption and impact for research, healthcare quality improvement, or national surveillance purposes is still far from being explored
Artificial intelligence-based tools to control healthcare associated infections: A systematic review of the literature
No full textPrevalence of huntington disease in Italy: A systematic review and meta-analysis
No full textWorldwide prevalence of Huntington’s disease (HD) is quite heterogenous. As Italy is characterized by significant genetic heterogeneity, with presumptive differences between Italian regions, this review was undertaken to define available data of HD prevalence in Italy, to assess geographic heterogeneity, and reconcile possible variation in HD prevalence rates with the availability of genetic testing. Methods. In total, 14 relevant studies were identified from Medline/Embase, and analysis of available Italian regional reports on rare diseases. Results. A cumulative prevalence of 3.9/100,000 inhabitants (95% Confidence Interval 3.0 - 5.0) was identified, with apparently higher rates in the last decades (4.1/100,000 vs. 3.0/100,000). The lowest rates were among the resident of the Oristano province in Sardinia, while the highest were reported in three mountainous and rather isolated areas (i.e. Molise, San Marino, Varese; all well over 10 cases/100,000 inhabitants). These differences cannot be not fully explained by varying approaches to case-ascertainment or diagnosis, and a possible “founder effect” may therefore be extensively advocated. Discussion. The prevalence of HD in retrieved Italian reports varied up to almost tenfold between different geographical regions. Even though such variation can in part be attributed to differences in case-ascertainment and/or diagnostic criteria, there is consistent evidence of significant founder effects in certain areas such as the provinces of Varese, the Republic of San Marino, and the region od Molise - all of them with estimates > 10/100,000 cases. As our estimates suggest that up to half of Italian HD cases may be still waiting, Public Health approach should improve diagnostic rates in order to guaranteeing palliative and symptomatic interventions (antidepressants, antipsychotics, anti-choreiform medications) to all individuals and their families
Hantaviruses in agricultural and forestry workers: Knowledge, attitudes and practices in Italian physicians
No full textHantaviruses are viral pathogens usually endemic in rodent populations. Human exposure follows inhalation of dusts contaminated with rodent excreta, and most individuals have been in-fected in occupational settings heavily contaminated with rodent droppings, such as agricultural and forestry. To date, knowledge, attitudes and practices of medical professionals, especially occupational physicians (OP), regarding hantavirus disease in at-risk workers have been scarcely investigated. We investigated these topics through a structured questionnaire administered through an online survey of 223 medical professionals (42.2% of them working as OP). Adequate general knowledge of hantavirus disease was found in 48.9% of respondents, with OP exhibiting a better understanding of clinical features of human hantavirus infections. OP aware of the endemic status of hantavirus in North-Eastern Italy exhibited higher risk perception for agricultural workers (odds ratio 21,193, 95% confidence interval 3.666–122.505). On the contrary, a better knowledge of hantaviruses was association with acknowledging an increased risk of hantavirus infection in forestry workers (odds ratio 5.880, 95% confidence interval 1.620–21.343). Hantavirus in Italy represent an often-overlooked biological risk in occupational settings. The lack of preventive immunization, the inappropriate risk perception and the unsatisfying awareness of hantavirus issues collectively stress the importance of appropriate information campaigns among health care providers
Use of contrast-enhanced intraoperative ultrasonography during liver surgery for colorectal liver metastases - Its impact on operative outcome. Analysis of a prospective cohort study
No full textReduced brachial flow-mediated vasodilation in young adult ex extremely low birth weight preterm: a condition predictive of increased cardiovascular risk?
No full textBackground.Sporadic data present in literature report how preterm birth and low birth weight constitute the risk factors for the development of cardiovascular diseases in later life. Aim.To assess the presence of potential alterations to endothelial function in young adults born preterm at extremely low birth weight (<1000g; ex ELBW). Method.Thirty-two ex-ELBW subjects (10 males [M] and 22 females [F], aged 17-28 years, mean [±DS] 20.1±2.5 years) were compared with 32 healthy, age-matched subjects born at term (C, 9 M and 23 F). Exclusion criteria: 1) pathological conditions known to affect endothelial function; 2) administration of drugs known to affect endothelial function. Endothelial function was assessed by non-invasive finger plethysmography, previously validated by the US Food and Drug Administration (Endopath; Itamar Medical Ltd., Cesarea, Israel). Results.Endothelial function was significantly reduced in ex-ELBW subjects compared to C (1.94±0.37 vs 2.68±0.41, p<0.0001). Moreover, this function correlated significantly with gestational age (r=0.56, p<0.0009) and birth weight (r=0.63, p<0.0001). Conclusions.The results obtained reveal a significant decrease in endothelial function of ex-ELBW subjects compared to controls, underlining a probable correlation with preterm birth and low birth weight. Taken together, these results suggest that an ELBW may underlie the onset of early circulatory dysfunction predictive of increased cardiovascular risk
Use of contrast-enhanced intraoperative ultrasonography during liver surgery for colorectal cancer liver metastases - Its impact on operative outcome. Analysis of a prospective cohort study
No full textMandate or not mandate: Knowledge, attitudes, and practices of italian occupational physicians towards SARS-CoV-2 immunization at the beginning of vaccination campaign
No full textVaccinations used to prevent coronavirus disease (COVID-19)—the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)—are critical in order to contain the ongoing pandemic. However, SARS-CoV-2/COVID-19 vaccination rates have only slowly increased since the beginning of the vaccination campaign, even with at-risk workers (e.g., HCWs), presump-tively because of vaccine hesitancy. Vaccination mandates are considered instrumental in order to rapidly improve immunization rates (but they minimize the impact of vaccination campaigns). In this study, we investigated the acceptance (i.e., knowledge, attitudes, and practices) from occupational physicians (OPs)) in regard to SARS-CoV-2/COVID-19 vaccination mandates. A total of 166 OPs participated in an internet-based survey by completing structured questionnaires. Adequate, general knowledge of SARS-CoV-2/COVID-19 was found in the majority of OPs. High perception of SARS-CoV-2 risk was found in around 80% of participants (79.5% regarding its occurrence, 81.9% regarding its potential severity). SARS-CoV-2/COVID-19 vaccination was endorsed by 90.4% of respondents, acceptance for SARS-CoV-2 vaccine was quite larger for mRNA formulates (89.8%) over adenoviral ones (59.8%). Endorsement of vaccination mandates was reported by 60.2% of respondents, and was more likely endorsed by OPs who exhibited higher concern for SARS-CoV-2 infection occurrence (odds ratio 3.462, 95% confidence intervals 1.060–11.310), who were likely to accept some sort of payment/copayment for SARS-CoV-2/COVID-19 vaccination (3.896; 1.607; 9.449), or who were more likely to believe HCWs not vaccinates against SARS-CoV-2 as unfit for work (4.562; 1.935; 10.753). In conclusion, OPs exhibited wide acceptance of SARS-CoV-2/COVID-19 vaccinations, and the majority endorsed vaccination mandates for HCWs, which may help improve vaccination rates in occupational settings
Air temperatures and occupational injuries in the construction industries: A report from northern Italy (2000–2013)
No full textAir temperatures and occupational injuries in the construction industries: A report from northern Italy (2000–2013)
No full textThe aim of this study was to assess the relationship between environmental temperatures and occupational injuries (OIs) in construction workers (CWs) from a subalpine region of North-Eastern Italy. Data about OIs from 2000 to 2013, and daily weather for the specific site of the events were retrieved. Risk for daily OIs was calculate through a Poisson regression model. Estimated daily incidence for OIs was 5.7 (95%CI 5.5–5.8), or 2.8 OIs/10,000 workers/d (95%CI 2.7–2.9), with higher rates for time periods characterized by high temperatures (daily maximum ≥35°C), both in first 2 d (3.57, 95%CI 3.05–4.11) and from the third day onwards (i.e. during Heat Waves: 3.43, 95%CI 3.08–3.77). Higher risk for OIs was reported in days characterized temperatures ≥95th per-centile (OR 1.145, 95%CI 1.062–1.235), summer days (daily maximum ≥25°C, OR 1.093, 95%CI 1.042–1.146). On the contrary, no significant increased risk was found for OIs having a more severe prognosis (≥40 d or more; death). In conclusion, presented findings recommend policymakers to develop appropriate procedures and guidelines, in particular aimed to improve the compliance of younger CWs towards severe-hot daily temperatures
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