Approximate Inference in Probabilistic Answer Set Programming for Statistical Probabilities

Type 1 statements were introduced by Halpern in 1990 with the goal to represent statistical information about a domain of interest. These are of the form ''x of the elements share the same property''. The recently proposed language PASTA (Probabilistic Answer set programming for STAtistical probabilities) extends Probabilistic Logic Programs under the Distribution Semantics and allows the definition of this type of statements. To perform exact inference, PASTA programs are converted into probabilistic answer set programs under the Credal Semantics. However, this algorithm is infeasible for scenarios when more than a few random variables are involved. Here, we propose several algorithms to perform both conditional and unconditional approximate inference in PASTA programs and test them on different benchmarks. The results show that approximate algorithms scale to hundreds of variables and thus can manage real world domains

MAP Inference in Probabilistic Answer Set Programs

Reasoning with uncertain data is a central task in artificial intelligence. In some cases, the goal is to find the most likely assignment to a subset of random variables, named query variables, while some other variables are observed. This task is called Maximum a Posteriori (MAP). When the set of query variables is the complement of the observed variables, the task goes under the name of Most Probable Explanation (MPE). In this paper, we introduce the definitions of cautious and brave MAP and MPE tasks in the context of Probabilistic Answer Set Programming under the credal semantics and provide an algorithm to solve them. Empirical results show that the brave version of both tasks is usually faster to compute. On the brave MPE task, the adoption of a state-of-the-art ASP solver makes the computation much faster than a naive approach based on the enumeration of all the worlds

Moving a step forward to promote patient safety and quality of care in Europe

Improving safety and quality of care has always been at the heart of national, European and international policies. The premises of such concern have their roots in the times of the Greek physician Hippocrates of Cos, about the 4th century BC, with the directive primum non nocere (“first do no harm”). [...

Italian contribution to University Autonomy in Kazakhstan: the Erasmus+ project “Transition to University Autonomy in Kazakhstan” (TRUNAK)

University autonomy is the capacity of universities to be self-governin

Healthcare organizational performance: why changing the culture really matters

An organization may be considered as having three components: a structure, systems and culture. Culture is the most difficult part of the organization to affect. After all, culture has the key role in impacting and improving rganizational performance. The leadership of an organization and its key operations are paramount in shaping the culture. Leadership and organizational culture are inextricably intertwined. They are two sides of the same coin. Culture is a medium through which leadership travels and impacts organizational erformance. If leaders are to fulfil the challenges of the 21st century, they must first understand the dynamics of culture and their role as sculptors through behavioural and cognitive ways

Eating episode frequency and fruit and vegetable consumption among Italian university students

Objective: To analyze breakfast consumption, regularity of meals, fruit and vegetable consumption in the Italian University Student population on a national level.Design: Descriptive analysis evaluating data taken from the “Sportello Salute Giovani” questionnaire.Participants: 12.000 university students who self-administered a confidential survey. 8292 questionnaires were analyzed.Variables measured: Age; sex; self-reported economic status; BMI; number of breakfast and portions of vegetables and portions of fruit usually consumed per week; number of eating episodes per day; intended weight loss.Analysis: Descriptive and logistic regression analyses were conducted. Gender and age differences were tested by Chi2 and Mann-Whitney tests.Results: 15.8% of males and 26.3% of females declared to consume at least one portion of fruit every day. Similar results were found for vegetable consumption. Age does not influence fruit or vegetables consumption, frequency of eating episodes or breakfast habit. Both a regular breakfast and a higher number of eating episodes are significantly associated both with a higher frequency of fruit and vegetables intake.Conclusions and implications: This study underlines the need to promote nutritional education campaigns to increase adherence to nutritional guidelines

Are undocumented migrants’ entitlements and barriers to healthcare a public health challenge for the European Union?

Undocumented migrants (UMs) are at higher risk for health problems because of their irregular status and the consequences of economic and social marginalization. Moreover, the emergent reality of undocumented migration in Europe calls for action in the field of management of UM's health demands as their access to health services has become a sensitive political and social issue. In this light, this paper aims to address UMs' entitlement and barriers to healthcare and related policies citing evidence from peer-reviewed and grey literature concerning people living in a country within the European Union without the legal right to be/remain in the destination country. A systematic review was performed using several databases and websites, and a total of 54 publications in English, with full text available, were taken into consideration. Between 2000 and 2015, Europe hosted the second largest number of international migrants (20 million, 1.3 million per year) after Asia. Even though there is limited evidence specifically focused on UMs' health, it is possible to state that infectious diseases, chronic illnesses, mental disorders, maternal-child conditions, dental issues, acute illnesses and injuries are the most common pathologies. In most cases across Europe, UMs have access only to emergency care. Even in countries where they are fully entitled to healthcare, formal and informal barriers hinder them from being or feeling entitled to this right. Socio-cultural barriers, such as language and communication problems, lack of formal and informal social and healthcare networks and lack of knowledge about the healthcare system and about informal networks of healthcare professionals are all common impediments. From the healthcare providers' perspective, there can be difficulties in providing appropriate care and in dealing with cultural and language barriers and false identification. Communication strategies play a central role in addressing the inequalities in access to healthcare services, and the definition and provision of specific training, focused on UMs' health needs, would be desirable. Improving access to healthcare for UMs is an urgent priority since the lack of access is proven to have serious consequences for UMs' health and wellbeing. Notwithstanding, few available examples of policies and best practices aimed at overcoming barriers in the delivery of healthcare to UMs are available

Quality improvement of medical records through internal auditing: a comparative analysis

Introduction The systematic evaluation of the quality of medical records is crucial. Nevertheless, even if the improvement of medical records quality represents a priority for every health organization, it might be difficult to realize. This is the first study to assess the efficacy of internal audit as a tool to improve the quality of medical records in hospital setting.    Methods The program was carried out in a third level teaching hospital. Trained ad hoc evaluation teams carried out two retrospective assessments of quality of medical records using a random sampling strategy. The quality assessment was performed using a 48-items evaluation grid divided into 9 domains: General; Patient Medical History and Physical Examination; Daily Clinical Progress Notes; Daily Nursing Progress Notes; Drug Therapy Chart; Pain Chart; Discharge Summary; Surgery Register; Informed Consent. After the first evaluation of 1.460 medical records, an audit departmental program was set up. The second evaluation was carried out after the internal auditing for 1.402 medical records.   Results Compared to the first analysis, a significant quality amelioration in all the sections of the medical chart was shown with the second analysis, with an increase of all the scores above 50%. The differences found for each section of medical records between the first and second analysis are all significant (p<0.01).   Conclusions Internal audits are not just measurement activities but a necessary activity to support the organization in achieving its objectives and assessing the quality of clinical care and maintaining high quality professional performance

In-Hospital Glucose Monitoring: Adequacy and Resource Management

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Dose-Dependent Impairment of the Immune Response to the Moderna-1273 mRNA Vaccine by Mycophenolate Mofetil in Patients with Rheumatic and Autoimmune Liver Diseases

The purpose of this study was to evaluate the efficacy and safety of the Moderna-1273 mRNA vaccine for SARS-CoV-2 in patients with immune-mediated diseases under different treatments. Anti-trimeric spike protein antibodies were tested in 287 patients with rheumatic or autoimmune diseases (10% receiving mycophenolate mofetil, 15% low-dose glucocorticoids, 21% methotrexate, and 58% biologic/targeted synthetic drugs) at baseline and in 219 (76%) 4 weeks after the second Moderna-1273 mRNA vaccine dose. Family members or caretakers were enrolled as the controls. The neutralizing serum activity against SARS-CoV-2-G614, alpha, and beta variants in vitro and the cytotoxic T cell response to SARS-CoV-2 peptides were determined in a subgroup of patients and controls. Anti-SARS-CoV-2 antibody development, i.e., seroconversion, was observed in 69% of the mycophenolate-treated patients compared to 100% of both the patients taking other treatments and the controls (p < 0.0001). A dose-dependent impairment of the humoral response was observed in the mycophenolate-treated patients. A daily dose of >1 g at vaccination was a significant risk factor for non-seroconversion (ROC AUC 0.89, 95% CI 0.80-98, p < 0.0001). Moreover, in the seroconverted patients, a daily dose of >1 g of mycophenolate was associated with significantly lower anti-SARS-CoV-2 antibody titers, showing slightly reduced neutralizing serum activity but a comparable cytotoxic response compared to other immunosuppressants. In non-seroconverted patients treated with mycophenolate at a daily dose of >1 g, the cytotoxic activity elicited by viral peptides was also impaired. Mycophenolate treatment affects the Moderna-1273 mRNA vaccine immunogenicity in a dose-dependent manner, independent of rheumatological disease