Data-Aware Declarative Process Mining with SAT

Process Mining is a family of techniques for analyzing business process execution data recorded in event logs. Process models can be obtained as output of automated process discovery techniques or can be used as input of techniques for conformance checking or model enhancement. In Declarative Process Mining, process models are represented as sets of temporal constraints (instead of procedural descriptions where all control-flow details are explicitly modeled). An open research direction in Declarative Process Mining is whether multi-perspective specifications can be supported, i.e., specifications that not only describe the process behavior from the control-flow point of view, but also from other perspectives like data or time. In this paper, we address this question by considering SAT (Propositional Satisfiability Problem) as a solving technology for a number of classical problems in Declarative Process Mining, namely log generation, conformance checking and temporal query checking. To do so, we first express each problem as a suitable FO (First-Order) theory whose bounded models represent solutions to the problem, and then find a bounded model of such theory by compilation into SAT

Process mining meets model learning: Discovering deterministic finite state automata from event logs for business process analysis

Within the process mining field, Deterministic Finite State Automata (DFAs) are largely employed as foundation mechanisms to perform formal reasoning tasks over the information contained in the event logs, such as conformance checking, compliance monitoring and cross-organization process analysis, just to name a few. To support the above use cases, in this paper, we investigate how to leverage Model Learning (ML) algorithms for the automated discovery of DFAs from event logs. DFAs can be used as a fundamental building block to support not only the development of process analysis techniques, but also the implementation of instruments to support other phases of the Business Process Management (BPM) lifecycle such as business process design and enactment. The quality of the discovered DFAs is assessed wrt customized definitions of fitness, precision, generalization, and a standard notion of DFA simplicity. Finally, we use these metrics to benchmark ML algorithms against real-life and synthetically generated datasets, with the aim of studying their performance and investigate their suitability to be used for the development of BPM tools

Lymphogranuloma venereum proctitis mimicking inflammatory bowel diseases in 11 patients: a 4-year single-center experience

ABSTRACT Lymphogranuloma venereum (LGV) is a sexually transmitted disease caused by Chlamydia trachomatis (CT) serovars L1–L3. Our study wants to underline the similarities between rectal LGV and idiopathic inflammatory bowel diseases (IBD), which can share clinical, endoscopic and histopathological findings

Localized cold urticaria after vaccination in a child: A case and literature review

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Minimalinvasive Versorgung von Erosionen zur Wiederherstellung von Gesundheit, Funktion und Ästhetik mit indirekten Restaurationen

This article discusses the treatment of tooth structure loss due to erosion using indirect lithium disilicate ceramic restorations. Minimally invasive approaches, in which the eroded teeth are conservatively prepared and restored with minimally invasive restorations, are recommended. Lithium disilicate ceramics are currently the material of choice for this type of treatment as they can withstand maximum occlusal forces in the posterior region. The restorative process should be guided by diagnostic procedures that define the clinical therapeutic goal at the beginning of treatment. Adhesive cementation with the correct protocol is crucial for full mechanical strength of the restoration. At the end of the treatment, in addition to preventive measures, an overnight protective splint is recommended to ensure long-term clinical stability

In hepatocellular carcinoma miR-221 modulates sorafenib resistance through inhibition of caspase-3\u2013mediated apoptosis

Purpose: The aberrant expression of miR-221 is a hallmark of human cancers, including hepatocellular carcinoma (HCC), and its involvement in drug resistance, together with a proved in vivo efficacy of anti-miR-221 molecules, strengthen its role as an attractive target candidate in the oncologic field. The discovery of biomarkers predicting the response to treatments represents a clinical challenge in the personalized treatment era. This study aimed to investigate the possible role of miR-221 as a circulating biomarker in HCC patients undergoing sorafenib treatment as well as to evaluate its contribution to sorafenib resistance in advanced HCC. Experimental Design: A chemically induced HCC rat model and a xenograft mouse model, together with HCC-derived cell lines were employed to analyze miR-221 modulation by Sorafenib treatment. Data from the functional analysis were validated in tissue samples from surgically resected HCCs. The variation of circulating miR-221 levels in relation to Sorafenib treatment were assayed in the animal models and in two independent cohorts of patients with advanced HCC. Results: MiR-221 over-expression was associated with Sorafenib resistance in two HCC animal models and caspase-3 was identified as its target gene, driving miR-221 anti-apoptotic activity following Sorafenib administration. Lower pre-treatment miR-221 serum levels were found in patients subsequently experiencing response to Sorafenib and an increase of circulating miR-221 at the two months assessment was observed in responder patients. Conclusions: MiR-221 might represent a candidate biomarker of likelihood of response to Sorafenib in HCC patients to be tested in future studies. Caspase-3 modulation by miR-221 participates to Sorafenib resistance

Italian Guidelines in diagnosis and treatment of alopecia areata

Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations

High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19

Background. This study’s primary aim was to evaluate the impact of thrombotic complications on the development of secondary infections. The secondary aim was to compare the etiology of secondary infections in patients with and without thrombotic complications. Methods. This was a cohort study (NCT04318366) of coronavirus disease 2019 (COVID-19) patients hospitalized at IRCCS San Raffaele Hospital between February 25 and June 30, 2020. Incidence rates (IRs) were calculated by univariable Poisson regression as the number of cases per 1000 person-days of follow-up (PDFU) with 95% confidence intervals. The cumulative incidence functions of secondary infections according to thrombotic complications were compared with Gray’s method accounting for competing risk of death. A multivariable Fine-Gray model was applied to assess factors associated with risk of secondary infections. Results. Overall, 109/904 patients had 176 secondary infections (IR, 10.0; 95% CI, 8.8–11.5; per 1000-PDFU). The IRs of secondary infections among patients with or without thrombotic complications were 15.0 (95% CI, 10.7–21.0) and 9.3 (95% CI, 7.9–11.0) per 1000-PDFU, respectively (P = .017). At multivariable analysis, thrombotic complications were associated with the development of secondary infections (subdistribution hazard ratio, 1.788; 95% CI, 1.018–3.140; P = .043). The etiology of secondary infections was similar in patients with and without thrombotic complications. Conclusions. In patients with COVID-19, thrombotic complications were associated with a high risk of secondary infections

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI