Supervised machine learning in psychiatry:towards application in clinical practice

In recent years, the field of machine learning (often named with the more general term artificial intelligence) has literally exploded and its application has been proposed in basically all fields, including psychiatry and mental health. This has been motivated by the promise of using machine learning to develop new clinical tools that could help perform personalized predictions and recommendations, ultimately improving the results achievable in the psychiatric clinical practice that still faces only a limited success in the fight against mental diseases. However, despite this huge interest, there is still a substantial lack of tools in psychiatry that are based on machine learning algorithms. Massimiliano Grassi, in his Ph.D. thesis, investigates the challenges of translating machine learning algorithms into clinical practice and proposes innovative solutions to these challenges. The thesis presents the development and validation of new algorithms for the prediction of the onset of Alzheimer’s disease, the remission of obsessive-compulsive disorder, and the automatization of sleep staging in polysomnography, a method to diagnose sleep disorders. The results from these studies demonstrate that the use of machine learning in psychiatric clinical practice is not just a promise, and it is possible to develop machine learning algorithms that achieve clinically relevant performance even if based solely on information that can be easily accessible in the daily clinical routine

Will the Kaplan Fiber Complex Be the ''New Anterolateral Ligament''? Insights from Direct Surgical Exploration in the Context of ACL Injury and Reconstruction

According to the most popular scientific literature database in 2022, nearly 20 papers mentioning the "Kaplan Fiber" complex have been published in the last 2 years, highlighting the role of this anatomical structure in the context of anterior cruciate ligament tear [...]

The Use of 3D-Printed Custom-Made Implants as an Attractive Potential Alternative to the Treatment of Segmental Bone Loss in Foot and Ankle

The treatment of segmental tibial and ankle bone loss after radical surgery for chronic osteomyelitis is one of the most challenging problems encountered by orthopaedic surgeons [...]

A functionalized enol lactone containing a protected α-amino acid

The crystal structure of N-(3,9-dimethyl-4-phenyl-2,5-dioxo-3,4-dihydro-2H,5H-pyrano[3,2-c]chromen-3-yl)-N-methylbenzamide methanol monosolvate, C28H23NO5·CH3OH, has been determined at room temperature by X-ray diffraction. Structural parameters are discussed with reference to ab initio calculations

Multimodal treatment for local recurrent malignant gliomas: resurgery and/or reirradiation followed by chemotherapy

The therapeutic management of recurrent malignant gliomas (MGs) is not determined. Therefore, the efficacy of a multimodal approach and a combination systemic therapy was investigated. A retrospective analysis of 26 MGs patients at first relapse treated with multimodal therapy (chemotherapy plus surgery and/or reirradiation) or chemotherapy alone was performed. Second-line chemotherapy consisted of fotemustine (FTM) in combination with bevacizumab (BEV) (cFTM/BEV) or followed by third-line BEV (sFTM/BEV). Subgroup analyses were performed. Multimodal therapy provided a higher overall response rate (ORR) (73 vs. 47%), disease control rate (DCR) (82 vs. 67%), median progression-free survival (mPFS) (11 vs. 7 months; P=0.08) and median overall survival (mOS) (13 vs. 8 months; P=0.04) compared with chemotherapy. Concomitant FTM/BEV resulted in higher ORR (84 vs. 36%), DCR (92 vs. 57%), mPFS (10 vs. 5 months; P=0.22) and mOS (11 vs. 5.2 months; P=0.15) compared with sFTM/BEV. Methylated patients did not experience additional survival benefits with multimodality treatment but had higher mPFS (10 vs 7.1 months; P=0.33) and mOS (11 vs. 8 months; P=0.33) with cFTM/BEV. Unmethylated patients experienced the greatest survival benefit with the multimodal approach (mPFS: 10 vs. 5 months; mOS 11 vs 6 months; both P=0.02) and cFTM/BEV (mPFS: 5 vs. 2 months; mOS 6 vs. 3.2 months; both P=0.01). In conclusion, in recurrent MGs, multimodal therapy and cFTM/BEV provide survival and response benefits. Methylated patients benefit from a cFTM/BEV but not from a multimodal approach. Notably, unmethylated patients had the highest survival benefit with the two strategies

On the accuracy of UAV photogrammetric survey for the evaluation of historic masonry structural damages

Abstract Photogrammetric surveys via Unmanned Aerial Vehicles are nowadays a valuable tool for historic masonry structures inspection, surveillance, mapping and 3D modeling issues. When structural damage mapping and structural assessment are of interest obtaining accurate and reliable geometric models is a crucial issue. Therefore, the flight plan, the georeferencing and the data processing steps need to be properly designed. In this paper, a procedure for the photogrammetric survey via Unmanned Aerial Vehicles of a masonry structures is used in order to obtain effective visual inspections and a 3D model of a historic masonry arch bridge located along the ancient Via Amerina (Todi, Perugia, Italy). The photogrammetric survey provides a detailed representation of the actual geometry, including lack of volumes and significant cracks along the vault and the spandrel walls, outlining a severe damage state affecting all the structure. Finally, a Total Station and a Laser Scanner were used to compare the results obtained by photogrammetry, highlighting the advantages, the limits and the weaknesses offered by their use

Hyaluronan delivery by polymer demixing in polysaccharide-based hydrogels and membranes for biomedical applications

Alginate-based membranes containing hyaluronic acid (HA) were manufactured by freeze-drying calcium-reticulated hydrogels. The study of the distribution of the two macromolecules within the hydrogel enabled to highlight a polymer demixing mechanism that tends to segregate HA in the external parts of the constructs. Resistance and pliability of the membranes were tuned, while release and degradation studies enabled to quantify the diffusion of both polysaccharides in physiological solution and to measure the viable lifetime of the membranes. Biological studies in vitro proved that the liquid extracts from the HA-containing membranes stimulate wound healing and that fibroblasts are able to colonize the membranes. Overall, such novel alginate-HA membranes represent a promising solution for several medical needs, in particular for wound treatment, giving the possibility to provide an in situ administration of HA from a resorbable device

Correction to: Management of early ankle osteoarthritis through anterior joint-preserving surgery: a retrospective evaluation at mid- to long-term follow-up

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Gait Monitoring and Analysis: A Mathematical Approach

Gait abnormalities are common in the elderly and individuals diagnosed with Parkinson’s, often leading to reduced mobility and increased fall risk. Monitoring and assessing gait patterns in these populations play a crucial role in understanding disease progression, early detection of motor impairments, and developing personalized rehabilitation strategies. In particular, by identifying gait irregularities at an early stage, healthcare professionals can implement timely interventions and personalized therapeutic approaches, potentially delaying the onset of severe motor symptoms and improving overall patient outcomes. In this paper, we studied older adults affected by chronic diseases and/or Parkinson’s disease by monitoring their gait due to wearable devices that can accurately detect a person’s movements. In our study, about 50 people were involved in the trial (20 with Parkinson’s disease and 30 people with chronic diseases) who have worn our device for at least 6 months. During the experimentation, each device collected 25 samples from the accelerometer sensor for each second. By analyzing those data, we propose a metric for the “gait quality” based on the measure of entropy obtained by applying the Fourier transform

Interpreting permeability as a function of free drug fraction: The case studies of cyclodextrins and liposomes

: In order to solubilize poorly soluble active pharmaceutical ingredients, various strategies have been implemented over the years, including the use of nanocarriers, such as cyclodextrins and liposomes. However, improving a drug's apparent solubility does not always translate to enhanced bioavailability. This work aimed to investigate to which extent complexation with cyclodextrins and incorporation into liposomes influence drug in vitro permeability and to find a mechanistic description of the permeation process. For this purpose, we investigated hydroxypropyl-β-cyclodextrin (HP-β-CD) and phosphatidylcholine liposomes formulations of three chemically diverse compounds (atenolol, ketoprofen and hydrocortisone). We studied drug diffusion of the formulations by UV-localized spectroscopy and advanced data fitting to extract parameters such as diffusivity and bound-/free drug fractions. We then correlated this information with in vitro drug permeability obtained with the novel PermeaPadR barrier. The results showed that increased concentration of HP-β-CD leads to increased solubilization of the poorly soluble unionized ketoprofen, as well as hydrocortisone. However, this net increment of apparent solubility was not proportional to the increased flux measured. On the other hand, normalising the flux over the empirical free drug concentration, i.e., the free fraction, gave a meaningful absolute permeability coefficient. The results achieved for the liposomal formulation were consistent with the finding on cyclodextrins. In conclusion, we proved the adequacy and usefulness of our method for calculating free drug fractions in the examined enabling formulations, supporting the validity of the established drug diffusion/permeation theory that the unbounded drug fraction is the main driver for drug permeation across a membrane