Some DLV Applications for Knowledge Management

Abstract. Even if the industrial exploitation of the DLV system has started very recently, DLV already has a history of applications on the industrial level. The most valuable applications from a commercial viewpoint are those in the area of Knowledge Management. They have been realized by the company EXEURA s.r.l. -a spin-off company of the University of Calabria having a branch also in Chicago -with the support of the DLVSYSTEM s.r.l.. DLV applications in this area have not been realized directly, but through some specializations of DLV into Knowledge Management (KM) products for Text Classification, Information Extraction, and Ontology Representation and Reasoning. After briefly describing these KM products, we report on their recently-released successful applications

Listeria monocytogenes infection in pregnancy and neonatal sepsis

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Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Polyoma BK virus infection in renal transplant recipients

Several studies reported a correlation between the human Polyomavirus BK (BKV) and interstitial nephritis (PVN: Polyoma Virus Nephropaty) in renal transplant recipients in whom immunosuppressive treatment is thought to facilitate or induce reactivation of the virus. In the present study we monthly evaluated the presence of BKV-DNA in plasma and urine of 29 kidney transplant recipients. We used a nested PCR for BKV-DNA screening in plasma and urine and a quantitative assay Real Time PCR in case of a positive screening result. The viral DNA has been detected in 48% of the patients samples: only in urine of six patients; in plasma of four and in both of two. Immunosuppressive therapy has been decreased in positive patients. The kidney loss occurred just in the two patients with high viral load in plasma and urine. The definitive diagnosis of BKV Nephropaty requires allograft biopsy though biomolecular test for BKV-DNA in urine (viruria) and in plasma (viremia) could be very important non-invasive method for the early diagnosis of PVN

Staphylococci with markers of antibiotic resistance collected from blood cultures

Introduction: Blood culture is still the gold standard for the detection of the causative agent of sepsis. Especially in intensive care patients and those with vascular catheters, the most common organisms isolated are coagulase-negative staphylococci (CoNS) and Staphylococcus aureus, both characterized by multidrug resistance. Purposes of our work are the study of the incidence of markers of resistance in staphylococci and evaluation of potential changes over the years. Materials and methods: In the period January 2008-June 2011 5239 blood cultures were analyzed.They were mainly obtained from the departments of Intensive Care, Cardiology, Hematology, General Medicine, Emergency Medicine, Infectious Diseases, Oncology, Pulmonology and Pediatric Hematoncology. The vials containing the blood were incubated in the BACTEC 9120 automated tool of Becton Dickinson and susceptibility testing performed with the Phoenix instrument of the same company. Results:Within a total of 5239 blood cultures, 3967 (75.7%) were negative and 1272 (24.3%) positive. Fungi were isolated in 6.2% (79) of the positive ones, Gram-negative bacteria in 24.6% (313) and Gram-positive bacteria in 69.2% (880). Within the latter, 187 (21.2%) were not staphylococcal isolates, 693 (78.8%) were stafiloccocci mainly represented by S. epidermidis, S. aureus, S. hominis, S. haemolyticus and S. saprophyticus. Of the 693 staphylococcal isolates, 436 (62.9%) were b lactamase producers, and between them 336 (77.1%) were methicillin resistant, while only 3 of 436 (0.69%) were S. aureus resistant to vancomycin as well.The incidence of markers of resistance was very high, especially in patients in intensive care and cardiac surgery, who are usually subjected to combined antibiotic therapy. In the three years studied there were no statistically significant differences in the resistance of staphylococci. Conclusions: The data show an alarming high number of multi-resistant staphylococci, which is often a real therapeutic challenge for the clinician. The interpretation of the meaning of the isolation of CoNS entails a thorough evaluation because they are commonly isolated from contaminated blood cultures

Endotoxin dosage in sepsis

Introduction. Endotoxin, a component of the cell wall of Gram-negative bacteria is a major contributor to the pathogenesis of septic shock and multiple organ failure (MOF). Its entry into the bloodstream stimulates monocytes/macrophages which once activated produce and release cytokines, nitric oxide and other mediators that induce systemic inflammation, endothelial damage, organ dysfunction, hypotension (shock) and MOF.The aim of this study is to evaluate the usefulness of a quantitative test for the dosage of endotoxin to determine the risk of severe Gram-negative sepsis. Materials and methods. In the period January 2009 - June 2011 we performed 897 tests for 765 patients, mostly coming from the emergency room and intensive care, of which 328 (43%) women (mean age 53) and 437 (57%) male (mean age 49). Fifty-nine patients, no statistically significant difference in sex, were monitored by an average of two determinations of EA.All patients had procalcitonin values significantly altered.The kit used was EAA (Endotoxin Activity Assay) Estor Company, Milan, which has three ranges of endotoxin activity (EA): low risk of sepsis if <0.40 units, medium if between 0.40 and 0.59; high if 0.60. Results. 78 out of 765 patients (10%) had a low risk, 447 (58%) a medium risk and 240 (32%) a high risk.The dosage of EA, combined with that of procalcitonin, has allowed a more targeted antibiotic therapy. Six patients in serious clinical conditions were treated by direct hemoperfusion with Toraymyxin, a device comprising a housing containing a fiber polypropylene and polystyrene with surface-bound polymyxin B, an antibiotic that removes bacterial endotoxins from the blood. Conclusions.The test is useful in risk stratification as well as Gram negative sepsis, to set and monitor targeted therapies, also based on the neutralization of endotoxin

Listeria monocytogenes infection in pregnancy and neonatal sepsis

Authors report a fatal neonatal sepsis caused by Listeria monocytogenes. While the diagnostic procedure aimed to identify the microrganism is described, it is emphasized the importance to recover Streptococcus agalactiae (GBS) and L. monocytogenes by means of vaginal-rectal swab culture. The intrapartum screening for L. monocytogenes, by Polymerase Chain Reaction (PCR) providing results in 75 minutes is also evaluated