Declarative process modeling in BPMN

Traditional business process modeling notations, including the standard Business Process Model and Notation (BPMN), rely on an imperative paradigm wherein the process model captures all allowed activity flows. In other words, every flow that is not specified is implicitly disallowed. In the past decade, several researchers have exposed the limitations of this paradigm in the context of business processes with high variability. As an alternative, declarative process modeling notations have been proposed (e.g., Declare). These notations allow modelers to capture constraints on the allowed activity flows, meaning that all flows are allowed provided that they do not violate the specified constraints. Recently, it has been recognized that the boundary between imperative and declarative process modeling is not crisp. Instead, mixtures of declarative and imperative process modeling styles are sometimes preferable, leading to proposals for hybrid process modeling notations. These developments raise the question of whether completely new notations are needed to support hybrid process modeling. This paper answers this question negatively. The paper presents a conservative extension of BPMN for declarative process modeling, namely BPMN-D, and shows that Declare models can be transformed into readable BPMN-D models. © Springer International Publishing Switzerland 2015

LTLf and LDLf Monitoring: A Technical Report

Runtime monitoring is one of the central tasks to provide operational decision support to running business processes, and check on-the-fly whether they comply with constraints and rules. We study runtime monitoring of properties expressed in LTL on finite traces (LTLf) and in its extension LDLf. LDLf is a powerful logic that captures all monadic second order logic on finite traces, which is obtained by combining regular expressions and LTLf, adopting the syntax of propositional dynamic logic (PDL). Interestingly, in spite of its greater expressivity, LDLf has exactly the same computational complexity of LTLf. We show that LDLf is able to capture, in the logic itself, not only the constraints to be monitored, but also the de-facto standard RV-LTL monitors. This makes it possible to declaratively capture monitoring metaconstraints, and check them by relying on usual logical services instead of ad-hoc algorithms. This, in turn, enables to flexibly monitor constraints depending on the monitoring state of other constraints, e.g., "compensation" constraints that are only checked when others are detected to be violated. In addition, we devise a direct translation of LDLf formulas into nondeterministic automata, avoiding to detour to Buechi automata or alternating automata, and we use it to implement a monitoring plug-in for the PROM suite

Physical activity scale for the elderly: translation, cultural adaptation, and validation of the Italian version

Objective. The aim of the study was to translate and culturally adapt the Physical Activity Scale for the Elderly into Italian (PASE-I) and to evaluate its psychometric properties in the Italian older adults healthy population. Methods. For translation and cultural adaptation, the "Translation and Cultural Adaptation of Patient-Reported Outcomes Measures" guidelines have been followed. Participants included healthy individuals between 55 and 75 years old. The reliability and validity were assessed following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. To evaluate internal consistency and test-retest reliability, Cronbach's α and Intraclass Correlation Coefficient (ICC) were, respectively, calculated. The Berg Balance Score (BBS) and the PASE-I were administered together, and Pearson's correlation coefficient was calculated for validity. Results. All the PASE-I items were identical or similar to the original version. The scale was administered twice within a week to 94 Italian healthy older people. The mean PASE-I score in this study was 159±77.88. Cronbach's α was 0.815 (p < 0.01) and ICC was 0.977 (p < 0.01). The correlation with the BBS was 0.817 (p < 0.01). Conclusions. The PASE-I showed positive results for reliability and validity. This scale will be of great use to clinicians and researchers in evaluating and managing physical activities in the Italian older adults population

Practical application of contrast-enhanced magnetic resonance mammography [CE-MRM] by an algorithm combining morphological and enhancement patterns

The purpose of this article is to report our practical utilization of dynamic contrast-enhanced magnetic resonance mammography [DCE-MRM] in the diagnosis of breast lesions. In many European centers, was preferred a high-temporal acquisition of both breasts simultaneously in a large FOV. We preferred to scan single breasts, with the aim to combine the analysis of the contrast intake and washout with the morphological evaluation of breast lesions. We followed an interpretation model, based upon a diagnostic algorithm, which combined contrast enhancement with morphological evaluation, in order to increase our confidence in diagnosis. DCE-MRM with our diagnostic algorithm has identified 179 malignant and 41 benign lesions; final outcome has identified 178 malignant and 42 benign lesions, 3 false positives and 2 false negatives. Sensitivity of CE-MRM was 98.3%; specificity, 95.1%; positive predictive value 98.9%; negative predictive,. value, 92.8% and accuracy, 97.7%. (C) 2008 Elsevier Ltd. All rights reserve

A Robust and Self-Paced BCI System Based on a Four Class SSVEP Paradigm: Algorithms and Protocols for a High-Transfer-Rate Direct Brain Communication

In this paper, we present, with particular focus on the adopted processing and identification chain and protocol-related solutions, a whole self-paced brain-computer interface system based on a 4-class steady-state visual evoked potentials (SSVEPs) paradigm. The proposed system incorporates an automated spatial filtering technique centred on the common spatial patterns (CSPs) method, an autoscaled and effective signal features extraction which is used for providing an unsupervised biofeedback, and a robust self-paced classifier based on the discriminant analysis theory. The adopted operating protocol is structured in a screening, training, and testing phase aimed at collecting user-specific information regarding best stimulation frequencies, optimal sources identification, and overall system processing chain calibration in only a few minutes. The system, validated on 11 healthy/pathologic subjects, has proven to be reliable in terms of achievable communication speed (up to 70 bit/min) and very robust to false positive identifications

Loss of Renal Function After Retrograde Ureteral Placement of an Allium Stent for Severe Ureteral Stricture

Background: Ureteral strictures are a recurrent chronic condition that leads to severe side effects and poor quality of life. Management of ureteral stricture is a great challenge for urologists and no specific guidelines exist. Retrograde Allium®ureteral stent (AUS) is a newly developed ureteral stent to treat either bulbar urethral or ureteral stenosis. Case Presentation: We describe a case of a 74-year-old Caucasian adult male presenting with a severe ureteral stricture secondary to an ureteroscopy for stone disease. Treatment with retrograde AUS placement produced a complete loss of renal function after 36 months, probably because of the development of a long achalasic stretch of the ureter. Conclusions: AUS is a new and promising device for the treatment of ureteral stenosis. However, a lack of standardization of the technique recommends a close instrumental follow-up after the procedure to decide the optimal time for stent removal

Contralateral prophylactic mastectomies. Correlations between primary tumor and histological findings of controlateral breast

Backgound: In Italy in 2015 48,000 new cases of breast carcinomas were diagnosed. Women who are diagnosed with breast cancer have a significant risk of developing contralateral breast cancer during the rest of their lives and this risk is closely associated to the family history, to the onset of breast cancer at a young age and is expressed at about 0.5 to 1% of metachronous tumors per year. The purpose of this work was to evaluate which and how many neoplastic lesions were seen in the contralateral breast that underwent prophylactic mastectomy and to understand what factors predict the appearance of such lesions. Methods: 168 bilateral mastectomies were analyzed in patients with an average age of 47 years, carried out from July 2008 to April 2016, at the Breast Unit of the Sant’Andrea Hospital. We considered women of any age suffering from unilateral breast cancer without either clinical or radiological evidence of a malignant lesion in the contralateral breast and negative for mutations of the BRCA1-BRCA2 genes test. Of the 168 bilateral mastectomies 35 patients were excluded from the study because they underwent neoadjuvant chemotherapy, another 35 patients because they were suffering from a bilateral neoplasia and 7 cases because they had mutated BRCA1 or BRCA2 genes. Therefore the remaining 91 patients were included in the study. Results: Both the histological features of the primary tumor and any lesions found in the contralateral prophylactic breast were analyzed. Histological examination of the main breast showed 59 cases of Invasive Ductal Carcinoma (IDC), 17 cases of Invasive Lobular Carcinoma (ILC), 9 cases of In Situ Ductal Carcinoma (ISDC), 3 microinvasive ductal, 1 invasive tubular carcinoma, 1 in situ lobular and 1 widespread in situ. In the contralateral breast, the definitive histological examination revealed that 47 patients had an occult lesion in the prophylactic contralateral breast; in particular 2 cases of LIN 1, 7 cases of LIN2, 6 cases of lobular carcinoma in situ, 26 between DIN1A/DIN1A-B/DIN1B, 4 cases of carcinoma in situ and 2 cases of Invasive Ductal Carcinoma. The correlation obtained from the observation of the main tumor has shown that in a total of 59 invasive ductal carcinoma 32 have a controlateral occult lesions and in a total of 17 cases of invasive lobular carcinoma 9 have an occult lesion in the prophylactic breast. Of these lesions, the multicentric relationship is that 50% of invasive ductal and invasive lobular carcinoma of the main breast have a contralateral lesion. Conclusion: In conclusion we would like to remind, as demonstrated by our follow-up data and as the literature reiterates, that this surgery does not improve patient survival. Certainly patients with unilateral breast cancer have many surgical therapies to be able to deal with not only having a bilateral mastectomy. The end point of this work is try to understand the risk factors of having a contralateral breast lesion to reduce the probability of a metachronous cance

Importance of perforating vessels in nipple-sparing mastectomy. an anatomical description

BACKGROUND: Nipple-sparing mastectomy (NSM), understood as an oncologically valid procedure, is relatively new, and is an evolution of traditional mastectomy, particularly in relation to breast-conserving surgery. The anterior perforating branches are responsible for the cutaneous vascularization of the breast skin, and their preservation is a fundamental step to avoid possible postoperative necrosis. Therefore, evaluating the potential complications of cancer-related reconstructive surgical procedures such as NSM, both the distance of the tumoral lesion from the skin and the surgical incision site should be carefully considered. The preferred site of incision corresponds to the inframammary fold or possibly the periareolar area. METHODS: We retrospectively reviewed 113 patients who underwent NSM from January 2005 to October 2012 to evaluate skin complications. The anatomical study was performed by magnetic resonance imaging of the breast. RESULTS: Only one of the 113 women who had undergone a NSM procedure had total necrosis (0.9%) and six patients had partial necrosis (5.8%) of the nipple-areola complex