Applied Mathematics Tools in Digital Transformation

Digital transformation is a process that companies start with different purposes. Once an enterprise embarks on a digital transformation process it translates all its business processes (or, at least, part of them) into a digital replica. Such a digital replica, the so-called digital twin, can be described by Mathematical Science tools allowing cost reduction on industrial processes, faster time-to-market of new products and, in general, an increase of competitive advantage for the company. Digital twin is a descriptive or predictive model of a given industrial process or product that is a valuable tool for business management, both in planning—because it can give different scenario analysis—and in managing the daily operations; moreover, it permits optimization of product and process operations. We present widespread applied mathematics tools that can help this modeling process, along with some successful cases

The use of electronical devices and relative levels of Nomophobia within a group of Italian nurses: an Observational Study

Background: In healthcare, the use of smartphones and other electronical devices are becoming important tools among health professionals. Thanks to these devices, there are new methods of assistance. However, if used incorrectly, they may cause distraction during clinical practice. The excessive use of such devices has generated a new form of addiction in the workplace named nomophobia, a phobia still little explored in literature. We reported an analysis of the frequency and method of use of these electronical devices. The primary aim of the research was to investigate the level of dependence on electronic devices (nomophobia) and the digital habits of nurses. Secondary aim of the study was to evaluate the possible association between nomophobia and distraction in the workplace. Methods: A transversal multicenter study was conducted on a sample of Italian nurses, using the Nurses’ Use of Personal Communication Devices Questionnaire and the Nomophobia Questionnaire (NMP-Q). Results: 34.1% of the sample (n=184) declared that they used smartphones and other electronical devices a moderately during working hours. 20.2 % (n=109) used them frequently and 8.9% (n=48) uses devices during working hours constantly. However, 44.0% (n=222) never uses health apps for patient medical assistance, the 32.9% (n=166) never uses learning apps or apps for professional development. 16.6% (n=87) admit that the use of these devices negatively affected their working performance (mean 80.5; SD 40.1). Study participants showed moderated levels of nomophobia (media=50.34; SD=29.0). Conclusion: The results of the study demonstrate the scares use of such electronical tools to implement adequate care among Italian nurses. Nomophobia can have significant impact on the risk of making mistakes. Future studies should examine not only nurses but also other help professionals and support staff, to bring out an underestimated dimension

Attitudes, knowledge and Practices of Nurses towards HIV/AIDS Patients. An Observational, Cross Sectional, Multicenter study

Background. Attitudes, knowledge and practices of nurses towards HIV/AIDS patients are of continuous interest, especially in developing countries. However, in Italy, this topic is still scarcely debated. Materials and methods. An observational, cross sectional, multicentre study was conducted on a sample of 144 nurses in two Italian Hospitals of the Puglia Region ("Vito Fazzi" Hospital in Lecce and "San Giuseppe da Copertino" Hospital in Copertino (Le)). Results. A large part of the sample (97.2%, n=140) stated that they never refused to take care of a patient with AIDS. Only 22.9%, (n=33), of the sample had attended a training course and almost half (63.2%, n=91) used the gloves regularly when performing blood samples or when administering therapy to patients. With regard to the assessment of HIV knowledge, the percentage of nurses who know the meaning of the terms " seropositive" (83.3%, n=120), "HIV-positive person" (91.7%, n=132) and "window period" (47.9%, n=69) decreased. Conclusions. The results of the study show that a non-negligible percentage of nurses could be considered at risk of infection due to non-routine use of gloves, incorrect handling of the patient's biological samples and not knowing how to decontaminate a surface with potentially infected blood

The Economic and Fiscal Impact of Influenza Vaccination for Health Care Workers in Italy

Influenza has a significant impact on the health care system and also on production and economic systems. Vaccinated health care workers (HCWs) are more likely to have improved productivity compared to unvaccinated workers. The study aim was to estimate the economic and fiscal impact of an influenza vaccination program for HCWs in Italy. We performed a cost analysis aimed to estimate the indirect costs (productivity losses due to working days lost) and the increase in tax revenues derived from the increase in vaccination coverage among HCWs. Assuming an incremental increase in vaccination coverage of 10% per year over a period of 5 years, total savings could be obtained in terms of a reduction in productivity losses equal to -(sic)4,475,497.16 and an increase in tax revenues of (sic)327,158.84. This revenue could be used to finance other health interventions. Our results are fundamental in view of the sustainability of health systems and of a value-based allocation of health resources. Therefore, a complete social perspective, including the fiscal impact of flu vaccination, should be adopted to assess the economic value of influenza vaccines. Currently, health policies based on the whole value of flu vaccination are needed

Attitudes, perceptions, and knowledge of the population on End-of-Life and Advance Treatment Declaration: an observational study in Southern Italy

In an advanced scientific and technological context, where it is now tangible the possibility of interfering indefinitely in the process of dying, it becomes necessary to disseminate knowledge about end of life that, for the great variety of areas that it invests, presents many controversial aspects. With the Law no. 219/2017, the right of self-determination and freedom of treatment of the patient is enshrined, aspects that to date still remain too little discussed. An online survey was conducted from December 2019 to February 2020, among the population residing in the provinces of Lecce and Brindisi, spread thanks to the collaboration of local authorities. A large part of the sample (82.4%, N=333) claims the right to self-determination, stating that therapeutic decisions are up to the patient who has signed his advance treatment dispositions, declared absolutely binding for 50% (N=205) of the sample. However, there is still a lack of information about how to draw up advance treatment agreements (AADs). 12.6% (N=51) of those interviewed stated that they knew nothing about it and only 32.9% (N=133) felt ready and adequately informed to make their own declarations. Another peculiar aspect is that topics such as euthanasia and assisted suicide seem to be considered at the margins of acceptability among End-of-Life instances. The results of the study show that knowledge on the subject has definitely improved over the years and that in most of the issues addressed, the population has an adequate degree of preparedness even though there is still some skepticism in dealing with issues such as assisted suicide and euthanasia. Future research could explore the possibility of identifying effective training tools and communication strategies that can be used by the widest possible segment of the population

Telerehabilitation for Stroke: A Personalized Multi-Domain Approach in a Pilot Study

: Stroke, a leading cause of long-term disability worldwide, manifests as motor, speech language, and cognitive impairments, necessitating customized rehabilitation strategies. In this context, telerehabilitation (TR) strategies have emerged as promising solutions. In a multi-center longitudinal pilot study, we explored the effects of a multi-domain TR program, comprising physiotherapy, speech therapy, and neuropsychological treatments. In total, 84 stroke survivors (74 analyzed) received 20 tailored sessions per domain, addressing individual impairments and customized to their specific needs. Positive correlations were found between initial motor function, cognitive status, independence in activities of daily living (ADLs), and motor function improvement after TR. A lower initial health-related quality of life (HRQoL) perception hindered progress, but improved ADL independence and overall health status, and reduced depression correlated with a better QoL. Furthermore, post-treatment improvements were observed in the entire sample in terms of fine motor skills, upper-limb functionality, balance, independence, and cognitive impairment. This multi-modal approach shows promise in enhancing stroke rehabilitation and highlights the potential of TR in addressing the complex needs of stroke survivors through a comprehensive support and interdisciplinary collaboration, personalized for each individual's needs

Cardiac surgery in 260 octogenarians: a case series

Background: The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery interventions performed in patients ≥80 years old over a six years' period. Methods: A retrospective observational study performed in a university hospital. 260 patients were included in the study (3.5% of the patients undergoing cardiac surgery in the study period). Results: Mean age was 82 ± 1.8 years. Eighty-five percent of patients underwent elective surgery, 15% unplanned surgery and 4.2% redo surgery. Intervention for aortic valve pathology and coronary artery bypass grafting were performed in 51% and 46% of the patients, respectively. Interventions involving the mitral valve were the 26% of the total, those on the tricuspid valve were 13% and those on the ascending aortic arch the 9.6%. Postoperative low output syndrome was identified in 44 patients (17%). Mortality was 3.9% and most of the patients (91%) were discharged from hospital in good clinical conditions. Hospital mortality was lower in planned vs unplanned surgery: 3.8% vs 14% respectively. Chronic obstructive pulmonary disease (OR 9.106, CI 2.275 - 36.450) was the unique independent predictor of mortality. Conclusions: Clinicians should be aware that cardiac surgery can be safely performed at all ages, that risk stratification is mandatory and that hemodynamic treatment to avoid complications is expected

The Eye-tracking technology in the healthcare settings: an observational, cross sectional, multicenter study

Successful communication is considered an essential component of the quality of care and safety of the patient with Amyotrophic Lateral Sclerosis (ALS). Recent technology has provided alternative communication systems, including the Eye-tracking technology, which enables interaction with others in the more advanced stages of the disease. The aim of the study is to investigate patients' difficulties in using the eye tracker, their problem in obtaining the device and the clinical complications resulting from it. A "snowball sampling" method study was conducted from April to September 2020 until sample saturation. The results of the study demonstrate the countless difficulties in obtaining the eye- tracker, with long waiting times, which are not followed by adequate training in its correct use. Among the consequences linked to the use of this device, the most frequent were nystagmus (8.8%), onset of eyelid ptosis (16.2%) and the appearance of increased fatigue. 56.1% of the sample used the eye tracker to surf the Internet whereas 9.1% used it to write e-mails. Overall, the use of the eye tracker led to an improvement in overall quality of life (24%). In Conclusions, the Eye-tracking technology is a valuable device for Alternative Augmentative Communication (AAC) in ALS patients and can be used with good performance, therefore the need for information, training and improvement on this topic is essentia

Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases

Background: People with chronic neurological diseases, such as Parkinson’s Disease (PD) and Multiple Sclerosis (MS), often present postural disorders and a high risk of falling. When difficulties in achieving outpatient rehabilitation services occur, a solution to guarantee the continuity of care may be telerehabilitation. This study intends to expand the scope of our previously published research on the impact of telerehabilitation on quality of life in an MS sample, testing the impact of this type of intervention in a larger sample of neurological patients also including PD individuals on postural balance. Methods: We included 60 participants with MS and 72 with PD. All enrolled subjects were randomized into two groups: 65 in the intervention group and 67 in the control group. Both treatments lasted 30–40 sessions (5 days/week, 6–8 weeks). Motor, cognitive, and participation outcomes were registered before and after the treatments. Results: All participants improved the outcomes at the end of the treatments. The study’s primary outcome (Mini-BESTest) registered a greater significant improvement in the telerehabilitation group than in the control group. Conclusions: Our results demonstrated that non-immersive virtual reality telerehabilitation is well tolerated and positively affects static and dynamic balance and gait in people with PD and MS