CASE-BASED REASONING FOR MANAGING NONCOMPLIANCE WITH CLINICAL GUIDELINES

Despite the recognized advantages that can be obtained in clinical practice when following clinical guidelines (GL), situations of noncompliance with them may emerge. Keeping track of such deviations from the default GL execution, and documenting the physician's motivations, would clearly be an added value. Moreover, repeated alterations of GL actions (or flow) may highlight the need for an adaptation of the GL itself to the local reality, or may even indicate an improper or weak initial GL definition.
In this article, we propose an approach for managing noncompliance with GL, based on the case-based reasoning methodology. In front of a new noncompliance case, our tool allows the physician to retrieve past situations similar to the current one, and to decide whether to reapply the same GL modifications adopted in them. Moreover, the tool is able to learn indications from the ground noncompliance cases that can be deployed for local adaptation, and possibly, for suggesting more formal GL revisions to be carried out by a committee of expert physicians.     

Enhancing augmented reality with cognitive and knowledge perspectives: a case study in museum exhibitions

ABSTRACT

In this paper, we present our results related to the definition of a methodology that combines augmented reality (AR) with semantic techniques for the creation of digital stories associated with museum exhibitions. In contrast to traditional AR approaches, we augment real-world elements by supplementing contents of a museum exhibition with additional inputs that provide new and different meanings. In this way we augment a cultural resource with respect to both its presentation and meaning. The methodology is framed in the cultural re-mediation theory and is grounded on a set of ontologies aimed at modelling a cultural resource and correlating it with external multimedia objects and resources. To provide an easy tool for the creation of museum narratives, the methodology makes use of a set of recognised practices widely adopted by museum curators that have been formalised through inference rules. The defined methodology has been experimented in a scenario related to Flemish paintings to validate the augmentation of cultural objects with two different approaches, the first basing on similarities and the second on dissimilarities.     

Hyper-arc consistency of polynomial constraints over finite domains using the modified Bernstein form

This paper describes an algorithm to enforce hyper-arc consistency of polynomial constraints defined over finite domains. First, the paper describes the language of so called polynomial constraints over finite domains, and it introduces a canonical form for such constraints. Then, the canonical form is used to transform the problem of testing the satisfiability of a constraint in a box into the problem of studying the sign of a related polynomial function in the same box, a problem which is effectively solved by using the modified Bernstein form of polynomials. The modified Bernstein form of polynomials is briefly discussed, and the proposed hyper-arc consistency algorithm is finally detailed. The proposed algorithm is a subdivision procedure which, starting from an initial approximation of the domains of variables, removes values from domains to enforce hyper-arc consistency.     

IRS-III: A broker-based approach to semantic Web services

A factor limiting the take up of Web services is that all tasks associated with the creation of an application, for example, finding, composing, and resolving mismatches between Web services have to be carried out by a software developer. Semantic Web services is a combination of semantic Web and Web service technologies that promise to alleviate these problems. In this paper we describe IRS-III, a framework for creating and executing semantic Web services, which takes a semantic broker-based approach to mediating between service requesters and service providers. We describe the overall approach and the components of IRS-III from an ontological and architectural viewpoint. We then illustrate our approach through an application in the eGovernment domain.     

Morphological patterns of angiogenesis in ovarian follicle capillary networks. A scanning electron microscopy study of corrosion cast

To describe the morphological characteristics of the ovarian follicle (F) capillary neoformation and regression, the angiogenic figures were studied by means of scanning electron microscopy of corrosion casts in developing and mature F of rabbit, pig, and cow. Developing F showed gradual neoformation of thecal capillaries characterized by budding and then sprouting, likely from preexisting interstitial vessels. Postcapillary venules frequently showed vasoconstriction rings (sphincters). Vasodilation followed capillary elongation. Mature F, in addition to vessel elongation and dilation, also presented infolding of dilated capillary walls, followed by capillary duplication and sinusoidalization. Periovulatory F mainly showed functional changes, such as capillary dilation, signs of iperpermeabilization, and ischemia, the latter being limited to the apical follicular area. Vessel regression was characterized by thinning of capillaries and presence of avascular areas within the atretic F wall at any stage. This study showed two main types of angiogenic patterns. (a) longitudinal elongation (in series, sprouting angiogenesis) characterizing the initial phase of F development and (b) parallel duplication (in parallel, infolding or intussusceptive angiogenesis), ending in capillary lateral replication or splitting, secondary to functional microvascular changes. Indirect evidence of the establishment of postcapillary resistances contributing to capillary remodeling, was also shown. It is concluded that the sequence of capillary neoformation in mammalian ovarian F occurs in six steps: (1) budding, (2) sprouting (and elongation), (3) dilation, (4) infolding (intussusception), (5) duplication (splitting and elongation), and (6) sinusoidalization. Capillary regression hits F at any stage and characterizes F atresia.     

Determination of bone mineral volume fraction using impedance analysis and Bruggeman model

Measurements by impedance spectroscopy and Bruggeman effective medium approximation model were employed in order to determine the mineral volume fraction of dry bone. This approach assumes that two or more phases are present into the composite: the matrix (environment) and the other ones are inclusion phases. A fragment of femur diaphysis dense bone from a young pig was investigated in its dehydrated state. Measuring the dielectric properties of bone and its main components (hydroxyapatite and collagen) and using the Bruggeman approach, the mineral volume filling factor was determined. The computed volume fraction of the mineral volume fraction was confirmed by a histogram test analysis based on the SEM microstructures. In spite of its simplicity, the method provides a good approximation for the bone mineral volume fraction. The method which uses impedance spectroscopy and EMA modeling can be further developed by considering the conductive components of the bone tissue as a non-invasive in situ impedance technique for bone composition evaluation and monitoring.     

Commiphora myrrha (Nees) Engl. extracts: evaluation of antioxidant and antiproliferative activity and their ability to reduce microbial growth on fresh‐cut salad

With the aim to develop natural preservatives displaying also chemopreventive activity, different Commiphora myrrha (Nees) Engl. extracts were studied. Myrrh essential oils, obtained by steam distillation and microwave‐assisted hydrodistillation, and several other extracts, obtained by sequential procedures with petroleum ether (PE), ethanol, ethyl acetate and butanol, have been screened for their antioxidant (DPPH· scavenging assay) and antiproliferative activity (on both nontumour and colon cancer cell lines) without previous purification. Considering that the colon cancer cell lines were more sensitive to PE and ethanol extracts, the latter of which showed the highest antioxidant activity (EC50 = 0.160 ± 0.008 mg mL^?1), both have been selected for further antibacterial/antifungal activity tests using an antimicrobial diffusion test and a growth inhibition test on salads. Results showed that the ethanol extract possessed the higher antibacterial and antifungal activity. Compared to untreated product, fresh‐cut salads treated with these two myrrh extracts displayed a significant lower bacterial growth. Although further investigation is required, these promising results offer hints as how to improve the shelf life of fresh‐cut salad.     

Intrinsic Fluorescence of the Active and the Inactive Functional Forms of Human Thymidylate Synthase

The observables associated with protein intrinsic fluorescence – spectra, time decays, anisotropies – offer opportunities to monitor in real time and non-invasively a protein‘s functional form and its interchange with other forms with different functions. We employed these observables to sketch the fluorometric profiles of two functional forms of human thymidylate synthase (hTS), a homodimeric enzyme crucial for cell proliferation and thus targeted by anticancer drugs. The protein takes an active and an inactive form. Stabilization of the latter by peptides that, unlike classical hTS inhibitors, bind it at the monomer/monomer interface offers an alternative inhibition mechanism that promises to avoid the onset of drug resistance in anticancer therapy. The fluorescence features depicted herein can be used as tools to identify and quantify each of the two protein forms in solution, thus making it possible to investigate the kinetic and thermodynamic aspects of the active/inactive conformational interchange. Two examples of fluorometrically monitored interconversion kinetics are provided.     

Use of cryogenic machining to improve the adhesion of sphene bioceramic coatings on titanium substrates for dental and orthopaedic applications

Rods of commercially pure titanium were machined using standard oil-based emulsion and cryogenic cooling, and were then coated with sphene (CaTiSiO₅) bioceramic by spray coating using an automatic airbrush. The sphene bioceramic was synthesized in-situ starting from a suspension of polysiloxane that used as SiO₂ precursor, CaCO₃ and TiO₂ nanoparticles. The suspension was deposited on the machined substrates, which were heat treated up to 950?°C in order to promote the formation of sphene ceramic. The produced coated prototypes were characterized to evaluate the effect of the machining conditions on surface roughness and microstructure of the substrate, and thereby their effect on coating adhesion. Nanoindentation tests were employed to determine the hardness and elastic modulus of the coating through its thickness. Results showed that the reduced amount of defects on the surface of the cryo-machined substrates, contributed to increase the hardness, elastic modulus and adhesion strength of the coating-substrate interfaces compared to standard machined samples, therefore improving adhesion of the coating to the underlying substrate.     

A Comparative Study of Mechanical Properties,Thermal Conductivity,Residual Stresses,and Wear Resistance of Aluminum-Alumina Composites Obtained by Squeeze Casting and Powder Metallurgy

Squeeze casting and powder metallurgy techniques were employed to fabricate AlSi12/Al₂O₃ composites, which are lightweight structural materials with potential applications in the automotive industry. The impact of the processing route on the material properties was studied. Comparative analyses were conducted for the Vickers hardness, flexural strength, fracture toughness, thermal conductivity, thermal residual stresses, and frictional wear. Our results show that the squeeze cast composite exhibits superior properties to those obtained using powder metallurgy.