StochKit-FF: Efficient Systems Biology on Multicore Architectures

The stochastic modelling of biological systems is an informative, and in some cases, very adequate technique, which may however result in being more expensive than other modelling approaches, such as differential equations. We present StochKit-FF, a parallel version of StochKit, a reference toolkit for stochastic simulations. StochKit-FF is based on the FastFlow programming toolkit for multicores and exploits the novel concept of selective memory. We experiment StochKit-FF on a model of HIV infection dynamics, with the aim of extracting information from efficiently run experiments, here in terms of average and variance and, on a longer term, of more structured data.Comment: 14 pages + cover pag

Assessment of malnutrition risk in post-stroke patients: a systematic literature review

Stroke is one of the main causes of death, especially when associated with malnutrition. Assessment of nutritional status in all stages of the disease is therefore mandatory to improve clinical outcome

An integrated modelling approach for R5-X4 mutation and HAART therapy assessment

We have modelled the within-patient evolutionary process during HIV infection using different methodologies. New viral strains arise during the course of HIV infection. These multiple strains of the virus are able to use different coreceptors, in particular the CCR5 and the CXCR4 (R5 and X4 phenotypes, respectively)influence the progression of the disease to the AIDS phase. We present a model of HIV early infection and CTLs response which describes the dynamics of R5 quasispecies, specifying the R5 to X4 switch and effects of immune response. We illustrate dynamics of HIV multiple strains in the presence of multidrug HAART therapy. The HAART combined with X4 strain blocker drugs might help to reduce infectivity and lead to slower progression of disease. On the methodology side, our model represents a paradigm of integrating formal methods and mathematical models as a general framework to study HIV multiple strains during disease progression, and will inch towards providing help in selecting among vaccines and drug therapies. The results presented here are one of the rare cases of methodological cross comparison (stochastic and deterministic) and a novel implementation of model checking in therapy validation

La valutazione del Rischio Clinico percepito in un Blocco Operatorio:analisi sperimentale e progetto di intervento

Razionale. La finalit\ue0 dello studio consiste nell\u2019analisi delle attivit\ue0 infermieristiche in ambito operatorio e nella creazione di una mappatura delle criticit\ue0 organizzative e di processo tramite strumenti testati e validati in altre realt\ue0. Si proporr\ue0 un nuovo strumento di prevenzione del \u201crischio clinico\u201d ed un progetto didattico di aggiornamento professionale rivolto al personale infermieristico. Obiettivo. La gestione dei processi di rischio all\u2019interno di una struttura complessa quale un Blocco operatorio di chirurgia generale, rappresenta un difficile compito per infermieri e personale sanitario che vi lavora quotidianamente. obiettivo di questo lavoro \ue8 fornire informazioni relative e proporre un metodo integrato di formazione del personale e di controllo dei fattori di rischio utilizzando nuovi strumenti. Metodologia. utilizzo di metodiche di approccio al problema, come la SafetyWalkAround e l\u2019analisi FMEcA adattandole al contesto operativo. A livello di formazione si sono utilizzati strumenti di indagine conoscitiva come l\u2019intervista con questionario e il Focus group per la valutazione delle competenze e del livello culturale degli infermieri in materia. Risultati. Vengono descritti gli strumenti di indagine; si \ue8 creata una scheda di prevenzione del possibile \u201cevento avverso\u201d applicabile al contesto lavorativo. Si propone un corso di formazione al personale delineandone contenuti, modalit\ue0 e verifica. Conclusioni. gli strumenti proposti forniscono un validissimo aiuto nell\u2019identificazione delle criticit\ue0 strutturali e assistenziali. il loro utilizzo ha permesso di evidenziare punti critici e la relativa ricerca di soluzioni concrete. La proposta di un corso di formazione \ue8 stata pienamente accettata dal personale infermieristico, propenso a migliorarsi per fornire livelli assistenziali pi\uf9 alti

Plume risk in videolaparoscopy and in endoscopic surgery

Approximately 90% of endoscopic and open surgical procedures generate some level of surgical smoke. (Ulmer B, 1998). Lasers and electrosurgery devices commonly used to cut, coagulate, vaporize, and ablate tissue are the \u201chot\u201d tools that cause targeted cells to heat to the point of rupturing the cellular membrane and spewing cellular contents into the air as surgical smoke. Through continuous exposure, the inhalation of surgical smoke can become harmful to the surgical team members. Plume can also be hazardous to patients during laparoscopy or other endoscopy procedures when the contaminants of surgical smoke are absorbed into the patient\u2019s vascular system. Research studies have repeatedly highlighted the hazards of surgical smoke during laser use so smoke evacuation has been accepted as a common practice. Unfortunately evacuation of smoke generated during electrosurgery has not been as widely accepted even though research has been definitive in proving inhalation hazards. One of the most interesting paper, by Tomita, demonstrated that using an electrosurgery device on one gram of tissue, inhaling the plume was equivalent to smoking 6 unfiltered cigarettes. This study demonstrated that plume generated during electrosurgical procedures has the potential to be twice as harmful as the smoke produced during laser surgeries. (Tomita et al., 1989) The bottom line is that all surgical smoke should be considered as harmful if not evacuated appropriately. Unfortunately many healthcare professionals are indifferent and do not feel the need to evacuate plume since they have been breathing it for years. The following toxic chemical byproducts have been identified in surgical smoke resulting from tissue pyrolysis: (Hoglan, 1995 and Ott, 1993) acrolein, acetonitrile acrylonitrile, methane phenol polycyclic aromatic hydrocarbons propene propylene pyridene pyrrole styrene toluene xylene, acetylene alkyl benzenes, benzene, butadiene, butane, carbon monoxide creosols, ethane, ethylene, formaldehyde, free radicals hydrogen, cyanide isobutene. Complete evacuation of surgical smoke is necessary because of these unwanted hazards and potential complications. Research has conclusively shown that surgical smoke is hazardous to the surgical team members who are exposed to it on a continual basis and hazardous to endoscopic patients when the plume is not evacuated. Also during endoscopic procedures the usage of electric tools to cut and coagulate is frequent, and this could represent a real problems for operators may be more than for the patients. At the present time it is not possible to find in literature papers about hazards of surgical smoke during endoscopic procedures even if they have to be considered definitely as surgical procedures. This implies the necessity of a deeper consciousness to the smokes risk and consequently a more care in operators and patients protection

Construction and validation of a low-cost laparoscopic simulator

INTRODUCTION. To present the University of Genoa Advanced Simulation Center (ASC) and the design a trainer (eLap4D) that would achieve the equivalent goals of the fundamentals of laparoscopic surgery trainer at an economical cost. The validation process is going to be shown too. METHODS. The laparoscopic trainer is a physical low-cost laparoscopic training platform that reproduces the tactile feedback (eLaparo4d) integrated with a software for virtual anatomical realistic scenarios (Unity3D V 4.1). A sample of 20 students was selected, divided into 2 homogeneous groups with respect to the level of confidence with the use of video games, consolles, smartphones (this has been possible thanks to the use of a questionnaire, administered before the practical phase of training). The groups participated in a training program based on 5 basic laparoscopic skills (laparoscopic focusing and navigation, hand - eye - coordination and grasp coordination). So, a second and third study sample was chosen, consisting of 20 post graduate students (intermediate group) and 20 experienced surgeons; for theese groups was provided a training program identical to the previous group as well as their subdivision into 2 group. The face validity was used for an ergonomic analysis of the simulator, the construct to test the system's ability to differentiate potential expert users (experienced surgeons) from non-experts (student without experience in laparoscopic surgery). RESULTS. We analyzed the results of the three samples obtained by comparing variables such as: score % of fullfillment panality time At the same time, the students' improvements have been monitored, developing a customized learning curve for each user. To evaluate the structural characteristics of the simulator a specific questionnaire has been used. The results encouraged us. The simulator is ergonomically satisfactory and its structural features are adapted to the training. The system was able to differentiate the level of experience and also has therefore met the requirements of "construct validity". CONCLUSION. Valid laparoscopic simulators can be constructed at an economical cost

New teaching models for the medical school of medicine: comparison between oral and online classes. The experience of the Genoa school of medicine

The authors have created and tested a tool for performing online classes (AulaWeb, online e-learning of the Genoa school of Medicine). Described here are the results obtained from the pilot project that was performed. Two groups of 50 students each were created among the students who voluntarily signed up for the ADE on the theme of laparoscopic surgery. Each group was further divided into 2 smaller groups of 25 students, which followed respectively classic oral classes or on line classes. The experiment was divided into 2 parts. While the oral classes were the same for the 2 parts of the experiment, the online classes were characterized by the delivering of videos in the 1st part and videos and interactive web teaching in the 2nd part. Standardized questionnaires were distributed to the students, at the beginning and at the end to evaluate the efficacy of the system used to deliver the information. Both groups of students greatly improved their scores answering the questionnaires, but the on line groups expressed greater satisfaction in particular because of the fruition of free didactic contents. In conclusion we can confirm that, when used properly, the web is a fantastic learning tool for students because, not only it delivers information in a stronger way, but it also provides a faster and more enthusiastic way of learning

Laparoscopic Skills Simulator: Laparoscopic skills simulator: A gradual structured training program for acquiring laparoscopic abilities

The aim of this study is to investigate the importance of acquiring basic and advanced laparoscopic skills using a virtual reality low cost simulator in laparoscopic surgery. The authors have considered six basic and five advanced skills. The training exercises are related to the acquisition of tasks which allow students to reach basic gestures competences. In the second phase the students will perform complex drills to acquire a correct gesture. The authors have developed a standardized, graduated and evidence-based training course. A software able to handle the training task has been created through a virtual interface based on the concept \u201cstudent - exercise \u2013 evaluation\u201d. The results are expected because data analysis will be possible only after a period of simulator testing on different samples of students. Referring to the experience reported by other authors, they expect significant results in terms of: reduction of learning time, better dexterity, ability to recognize and correct procedural errors, positive economic impact in term of better patients outcome, analyzed by codified clinical indicators