Scoliosis Management through Apps and Software Tools.

Background: Scoliosis is curvature of the spine, often found in adolescents, which can impact on quality of life. Generally, scoliosis is diagnosed by measuring the Cobb angle, which represents the gold standard for scoliosis grade quantification. Commonly, scoliosis evaluation is conducted in person by medical professionals using traditional methods (i.e., involving a scoliometer and/or X-ray radiographs). In recent years, as has happened in various medicine disciplines, it is possible also in orthopedics to observe the spread of Information and Communications Technology (ICT) solutions (i.e., software-based approaches). As an example, smartphone applications (apps) and web-based applications may help the doctors in screening and monitoring scoliosis, thereby reducing the number of in-person visits. Objectives: This paper aims to provide an overview of the main features of the most popular scoliosis ICT tools, i.e., apps and web-based applications for scoliosis diagnosis, screening, and monitoring. Several apps are assessed and compared with the aim of providing a valid starting point for doctors and patients in their choice of software-based tools. Benefits for the patients may be: reducing the number of visits to the doctor, self-monitoring of scoliosis. Benefits for the doctors may be: monitoring the scoliosis progression over time, managing several patients in a remote way, mining the data of several patients for evaluating different therapeutic or exercise prescriptions. Materials and Methods: We first propose a methodology for the evaluation of scoliosis apps in which five macro-categories are considered: (i) technological aspects (e.g., available sensors, how angles are measured); (ii) the type of measurements (e.g., Cobb angle, angle of trunk rotation, axial vertebral rotation); (iii) availability (e.g., app store and eventual fee to pay); (iv) the functions offered to the user (e.g., posture monitoring, exercise prescription); (v) overall evaluation (e.g., pros and cons, usability). Then, six apps and one web-based application are described and evaluated using this methodology. Results: The results for assessment of scoliosis apps are shown in a tabular format for ease of understanding and intuitive comparison, which can help the doctors, specialists, and families in their choice of scoliosis apps. Conclusions: The use of ICT solutions for spinal curvature assessment and monitoring brings several advantages to both patients and orthopedics specialists. Six scoliosis apps and one web-based application are evaluated, and a guideline for their selection is provided.

Bioinformatics and High-Performance Computing Methods for Deciphering and Fighting COVID-19-Editorial.

The COVID-19 disease (Coronavirus Disease 19), caused by the SARS-CoV-2 virus (Severe Acute Respiratory Syndrome Coronavirus 2), has posed many challenges worldwide at various levels, with special focus to the biological, medical, and epidemiological ones [...].

Investigating Topic Modeling Techniques to Extract Meaningful Insights in Italian Long COVID Narration.

Through an adequate survey of the history of the disease, Narrative Medicine (NM) aims to allow the definition and implementation of an effective, appropriate, and shared treatment path. In the present study different topic modeling techniques are compared, as Latent Dirichlet Allocation (LDA) and topic modeling based on BERT transformer, to extract meaningful insights in the Italian narration of COVID-19 pandemic. In particular, the main focus was the characterization of Post-acute Sequelae of COVID-19, (i.e., PASC) writings as opposed to writings by health professionals and general reflections on COVID-19, (i.e., non-PASC) writings, modeled as a semi-supervised task. The results show that the BERTopic-based approach outperforms the LDA-base approach by grouping in the same cluster the 97.26% of analyzed documents, and reaching an overall accuracy of 91.97%.

Application of CCTV Methodology to Analyze COVID-19 Evolution in Italy.

Italy was one of the European countries most afflicted by the COVID-19 pandemic. From 2020 to 2022, Italy adopted strong containment measures against the COVID-19 epidemic and then started an important vaccination campaign. Here, we extended previous work by applying the COVID-19 Community Temporal Visualizer (CCTV) methodology to Italian COVID-19 data related to 2020, 2021, and five months of 2022. The aim of this work was to evaluate how Italy reacted to the pandemic in the first two waves of COVID-19, in which only containment measures such as the lockdown had been adopted, in the months following the start of the vaccination campaign, the months with the mildest weather, and the months affected by the new COVID-19 variants. This assessment was conducted by observing the behavior of single regions. CCTV methodology allows us to map the similarities in the behavior of Italian regions on a graph and use a community detection algorithm to visualize and analyze the spatio-temporal evolution of data. The results depict that the communities formed by Italian regions change with respect to the ten data measures and time.

Forecasting COVID-19 Epidemic Trends by Combining a Neural Network with Rt Estimation

On 31 December 2019, a cluster of pneumonia cases of unknown etiology was reported in Wuhan (China). The cases were declared to be Coronavirus Disease 2019 (COVID-19) by the World Health Organization (WHO). COVID-19 has been defined as SARS Coronavirus 2 (SARS-CoV-2). Some countries, e.g., Italy, France, and the United Kingdom (UK), have been subjected to frequent restrictions for preventing the spread of infection, contrary to other ones, e.g., the United States of America (USA) and Sweden. The restrictions afflicted the evolution of trends with several perturbations that destabilized its normal evolution. Globally

Forecasting COVID-19 Epidemic Trends by Combining a Neural Network with Rt Estimation.

On 31 December 2019, a cluster of pneumonia cases of unknown etiology was reported in Wuhan (China). The cases were declared to be Coronavirus Disease 2019 (COVID-19) by the World Health Organization (WHO). COVID-19 has been defined as SARS Coronavirus 2 (SARS-CoV-2). Some countries, e.g., Italy, France, and the United Kingdom (UK), have been subjected to frequent restrictions for preventing the spread of infection, contrary to other ones, e.g., the United States of America (USA) and Sweden. The restrictions afflicted the evolution of trends with several perturbations that destabilized its normal evolution. Globally, Rt has been used to estimate time-varying reproduction numbers during epidemics. Methods: This paper presents a solution based on Deep Learning (DL) for the analysis and forecasting of epidemic trends in new positive cases of SARS-CoV-2 (COVID-19). It combined a neural network (NN) and an Rt estimation by adjusting the data produced by the output layer of the NN on the related Rt estimation. Results: Tests were performed on datasets related to the following countries: Italy, the USA, France, the UK, and Sweden. Positive case registration was retrieved between 24 February 2020 and 11 January 2022. Tests performed on the Italian dataset showed that our solution reduced the Mean Absolute Percentage Error (MAPE) by 28.44%, 39.36%, 22.96%, 17.93%, 28.10%, and 24.50% compared to other ones with the same configuration but that were based on the LSTM, GRU, RNN, ARIMA (1,0,3), and ARIMA (7,2,4) models, or an NN without applying the Rt as a corrective index. It also reduced MAPE by 17.93%, the Mean Absolute Error (MAE) by 34.37%, and the Root Mean Square Error (RMSE) by 43.76% compared to the same model without the adjustment performed by the Rt. Furthermore, it allowed an average MAPE reduction of 5.37%, 63.10%, 17.84%, and 14.91% on the datasets related to the USA, France, the UK, and Sweden, respectively.

International comparisons of laboratory values from the 4CE collaborative to predict COVID-19 mortality.

Given the growing number of prediction algorithms developed to predict COVID-19 mortality, we evaluated the transportability of a mortality prediction algorithm using a multi-national network of healthcare systems. We predicted COVID-19 mortality using baseline commonly measured laboratory values and standard demographic and clinical covariates across healthcare systems, countries, and continents. Specifically, we trained a Cox regression model with nine measured laboratory test values, standard demographics at admission, and comorbidity burden pre-admission. These models were compared at site, country, and continent level. Of the 39,969 hospitalized patients with COVID-19 (68.6% male), 5717 (14.3%) died. In the Cox model, age, albumin, AST, creatine, CRP, and white blood cell count are most predictive of mortality. The baseline covariates are more predictive of mortality during the early days of COVID-19 hospitalization. Models trained at healthcare systems with larger cohort size largely retain good transportability performance when porting to different sites. The combination of routine laboratory test values at admission along with basic demographic features can predict mortality in patients hospitalized with COVID-19. Importantly, this potentially deployable model differs from prior work by demonstrating not only consistent performance but also reliable transportability across healthcare systems in the US and Europe, highlighting the generalizability of this model and the overall approach.

COVID-19 Community Temporal Visualizer: a new methodology for the network-based analysis and visualization of COVID-19 data.

Understanding the evolution of the spread of the COVID-19 pandemic requires the analysis of several data at the spatial and temporal levels. Here, we present a new network-based methodology to analyze COVID-19 data measures containing spatial and temporal features and its application on a real dataset. The goal of the methodology is to analyze sets of homogeneous datasets (i.e. COVID-19 data taken in different periods and in several regions) using a statistical test to find similar/dissimilar datasets, mapping such similarity information on a graph and then using a community detection algorithm to visualize and analyze the spatio-temporal evolution of data. We evaluated diverse Italian COVID-19 data made publicly available by the Italian Protezione Civile Department at https://github.com/pcm-dpc/COVID-19/. Furthermore, we considered the climate data related to two periods and we integrated them with COVID-19 data measures to detect new communities related to climate changes. In conclusion, the application of the proposed methodology provides a network-based representation of the COVID-19 measures by highlighting the different behaviour of regions with respect to pandemics data released by Protezione Civile and climate data. The methodology and its implementation as R function are publicly available at https://github.com/mmilano87/analyzeC19D.

What Every Reader Should Know About Studies Using Electronic Health Record Data but May Be Afraid to Ask.

Coincident with the tsunami of COVID-19-related publications, there has been a surge of studies using real-world data, including those obtained from the electronic health record (EHR). Unfortunately, several of these high-profile publications were retracted because of concerns regarding the soundness and quality of the studies and the EHR data they purported to analyze. These retractions highlight that although a small community of EHR informatics experts can readily identify strengths and flaws in EHR-derived studies, many medical editorial teams and otherwise sophisticated medical readers lack the framework to fully critically appraise these studies. In addition, conventional statistical analyses cannot overcome the need for an understanding of the opportunities and limitations of EHR-derived studies. We distill here from the broader informatics literature six key considerations that are crucial for appraising studies utilizing EHR data: data completeness, data collection and handling (eg, transformation), data type (ie, codified, textual), robustness of methods against EHR variability (within and across institutions, countries, and time), transparency of data and analytic code, and the multidisciplinary approach. These considerations will inform researchers, clinicians, and other stakeholders as to the recommended best practices in reviewing manuscripts, grants, and other outputs from EHR-data derived studies, and thereby promote and foster rigor, quality, and reliability of this rapidly growing field.

COVID-WAREHOUSE: A Data Warehouse of Italian COVID-19, Pollution, and Climate Data.

The management of the COVID-19 pandemic presents several unprecedented challenges in different fields, from medicine to biology, from public health to social science, that may benefit from computing methods able to integrate the increasing available COVID-19 and related data (e.g., pollution, demographics, climate, etc.). With the aim to face the COVID-19 data collection, harmonization and integration problems, we present the design and development of COVID-WAREHOUSE, a data warehouse that models, integrates and stores the COVID-19 data made available daily by the Italian Protezione Civile Department and several pollution and climate data made available by the Italian Regions. After an automatic ETL (Extraction, Transformation and Loading) step, COVID-19 cases, pollution measures and climate data, are integrated and organized using the Dimensional Fact Model, using two main dimensions: time and geographical location. COVID-WAREHOUSE supports OLAP (On-Line Analytical Processing) analysis, provides a heatmap visualizer, and allows easy extraction of selected data for further analysis. The proposed tool can be used in the context of Public Health to underline how the pandemic is spreading, with respect to time and geographical location, and to correlate the pandemic to pollution and climate data in a specific region. Moreover, public decision-makers could use the tool to discover combinations of pollution and climate conditions correlated to an increase of the pandemic, and thus, they could act in a consequent manner. Case studies based on data cubes built on data from Lombardia and Puglia regions are discussed. Our preliminary findings indicate that COVID-19 pandemic is significantly spread in regions characterized by high concentration of particulate in the air and the absence of rain and wind, as even stated in other works available in literature.

Statistical and Network-Based Analysis of Italian COVID-19 Data: Communities Detection and Temporal Evolution.

The coronavirus disease (COVID-19) outbreak started in Wuhan, China, and it has rapidly spread across the world. Italy is one of the European countries most affected by COVID-19, and it has registered high COVID-19 death rates and the death toll. In this article, we analyzed different Italian COVID-19 data at the regional level for the period 24 February to 29 March 2020. The analysis pipeline includes the following steps. After individuating groups of similar or dissimilar regions with respect to the ten types of available COVID-19 data using statistical test, we built several similarity matrices. Then, we mapped those similarity matrices into networks where nodes represent Italian regions and edges represent similarity relationships (edge length is inversely proportional to similarity). Then, network-based analysis was performed mainly discovering communities of regions that show similar behavior. In particular, network-based analysis was performed by running several community detection algorithms on those networks and by underlying communities of regions that show similar behavior. The network-based analysis of Italian COVID-19 data is able to elegantly show how regions form communities, i.e., how they join and leave them, along time and how community consistency changes along time and with respect to the different available data.