Publications by authors named "Giannotti F"

Background: Bacteremia is a common complication in allogeneic hematopoietic cell transplant recipients (alloHCTr), especially during the pre-engraftment period. International guidelines recommend antibacterial prophylaxis (ABP), despite potential selection for multidrug-resistant organisms (MDRO). Limited contemporary data exist on the epidemiology of pre-engraftment bacteremia in alloHCTr, who do not receive ABP.

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This paper focuses on the use of local Explainable Artificial Intelligence (XAI) methods, particularly the Local Rule-Based Explanations (LORE) technique, within healthcare and medical settings. It emphasizes the critical role of interpretability and transparency in AI systems for diagnosing diseases, predicting patient outcomes, and creating personalized treatment plans. While acknowledging the complexities and inherent trade-offs between interpretability and model performance, our work underscores the significance of local XAI methods in enhancing decision-making processes in healthcare.

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A crucial challenge in critical settings like medical diagnosis is making deep learning models used in decision-making systems interpretable. Efforts in Explainable Artificial Intelligence (XAI) are underway to address this challenge. Yet, many XAI methods are evaluated on broad classifiers and fail to address complex, real-world issues, such as medical diagnosis.

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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment option for patients with highly chemorefractory Hodgkin lymphoma (HL). The CD30-targeting antibody-drug conjugate Brentuximab-Vedotin (BV) and programmed cell death protein-1 (PD-1) blocking agents have demonstrated clinical activity with durable responses in relapsed/refractory (r/r) HL. However, patients with a history of allo-HSCT were frequently excluded from clinical trials due to concerns about the risk of graft-versus-host disease (GVHD).

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Among 292 recipients of allogeneic hematopoietic cell transplant (2018-2022), 64 (21.9%) tested positive for anti-hepatitis E virus (HEV) immunoglobulin G. Among 208 recipients tested by plasma/serum HEV polymerase chain reaction (2012-2022), 3 (1.

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Background: A transplant infectious disease (TID) assessment is essential to select recipients for an allogeneic hematopoietic cell transplant (HCT) and tailor prophylactic and empirical treatment recommendations.

Methods: We performed a retrospective single-center study to describe our model of care based on a routine TID consultation prior to an allogeneic HCT between 2018 and 2022 in 292 adult (≥18-year-old) consecutive patients. We describe the performance of a TID consultation, arbitrarily defined as major (HCT postponement, procedure, cytomegalovirus [CMV] recipient serology reinterpretation) and minor interventions.

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Background: Allogeneic hematopoietic cell transplant recipients (allo-HCTRs) with positive cytomegalovirus (CMV) serology may have false-positive results due to blood product transfusion-associated passive immunity.

Methods: This single-center cohort study included allo-HCTRs with negative baseline (at malignancy diagnosis) CMV serology and indeterminate/low-positive (CMV IgG titer, ≥0.6-<50 U/mL) pretransplant CMV serology with negative pretransplant plasma CMV DNAemia.

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In this single-center study of 61 allogeneic hematopoietic cell transplant (HCT) recipients receiving letermovir primary cytomegalovirus (CMV) prophylaxis for the first 100 days, we report 23% incidence of clinically significant CMV infection during the first 100 days after letermovir discontinuation, predominately in haploidentical HCT recipients, without any associations with CMV-DNAemia under letermovir.

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Article Synopsis
  • Sorafenib improves survival rates for FLT3-ITD mutated acute myeloid leukemia (AML) patients following allogeneic hematopoietic stem cell transplantation (HSCT), with low toxicity discontinuation rates reported in clinical trials.
  • In a study of 30 patients treated with sorafenib maintenance therapy, 87% experienced toxicities that led to dose reductions or treatment interruptions.
  • Despite high interruption rates, the overall survival median was not reached after 12 months, indicating that sorafenib maintenance may still have a positive impact, and re-challenging patients or switching to alternative treatments is feasible.
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  • Peripheral allogeneic hematopoietic stem cell transplant recipients are highly susceptible to severe respiratory infections from viruses like RSV and influenza, which can lead to serious conditions such as bronchiolitis obliterans (BO).
  • This study presents a case where a patient developed BO following a SARS-CoV-2 infection ten months after their stem cell transplant, with a resurgence of graft-versus-host disease symptoms.
  • The findings emphasize the importance of monitoring lung function in these patients post-COVID-19 infection and suggest that further research is needed to understand the relationship between SARS-CoV-2 and BO.
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We present two allogeneic hematopoietic cell transplantation recipients (HCTr) treated with pritelivir for acyclovir-resistant/refractory (r/r) HSV infection based on the expanded access program of the pritelivir manufacturer. Outpatient treatment with pritelivir was administered, with partial response by week 1 of treatment and complete response by week 4 of treatment in both patients. No adverse events were noted.

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Article Synopsis
  • - The article defines and discusses three key complications after hematopoietic cell transplantation (HCT): graft failure, poor graft function, and erythroblastopenia, highlighting the associated risk factors and treatment guidelines.
  • - Graft failure is a severe but rare complication, while poor graft function occurs more frequently; new research is anticipated to validate current treatment recommendations for these issues.
  • - Erythroblastopenia is another rare complication post-HCT, and even with improved donor-recipient compatibility, some patients still experience this problem.
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Sinusoidal obstruction syndrome (SOS), also known as hepatic veno-occlusive disease (VOD), is a well-known complication of allogeneic hematopoietic stem cell transplantation (HSCT) associated with a mortality rate of up to 85%.  Defibrotide has shown efficacy in treatment of SOS/VOD. Moreover, evidence exists supporting the efficacy of defibrotide as SOS/VOD prophylaxis.

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Background: Limited data exist to describe end-of-treatment (EOT) parameters of antifungal therapy for invasive mould infections (IMI).

Methods: In a 10-year cohort of consecutive adult allogeneic haematopoietic cell transplant recipients with proven/probable IMI, we describe treatment duration and patient profile at EOT.

Results: There were 61 patients with 66 proven/probable IMI identified: 47/66 (71%) invasive aspergillosis (IA), 11/66 (17%) mucormycosis, and 8/66 (12%) other-IMI.

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Unlabelled: Peace is a principal dimension of well-being and is the way out of inequity and violence. Thus, its measurement has drawn the attention of researchers, policymakers, and peacekeepers. During the last years, novel digital data streams have drastically changed the research in this field.

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Background: Despite progress in diagnostic, prevention, and treatment strategies, invasive mold infections (IMIs) remain the leading cause of mortality in allogeneic hematopoietic cell transplant (allo-HCT) recipients.

Methods: We describe the incidence, risk factors, and mortality of allo-HCT recipients with proven/probable IMI in a retrospective single-center 10-year (01/01/2010-01/01/2020) cohort study.

Results: Among 515 allo-HCT recipients, 48 (9.

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Background: The COVID-19 pandemic caused by SARS-CoV-2 has greatly modified outpatient follow-ups. The aim of this retrospective study was to evaluate the organizational modalities and clinical effects of rearrangements of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) outpatient visits performed in our centers at Ravenna and Lugo Hospitals, Italy, during the pandemic outbreak in 2020.

Methods: All scheduled in-person device follow-up visits in March-December 2020 have been considered.

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Background: Antifungal treatment duration and changes for invasive mould infections (IMI) have been poorly described.

Methods: We performed a 10-year cohort study of adult (≥18-year-old) allogeneic haematopoietic cell transplant recipients with proven/probable IMI to describe the duration and changes of antifungal treatment. All-cause-12-week mortality was described.

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Article Synopsis
  • The study analyzed antifungal combination therapy used for invasive mold infections (IMIs) in patients who underwent allogeneic hematopoietic cell transplantation (HCT) over a 10-year period.
  • Out of 515 patients, 9.1% experienced 48 IMI episodes, primarily invasive aspergillosis and non-IA IMIs, with almost half receiving some form of combination antifungal treatment.
  • Significant mortality was observed, with a 30% death rate at 12 weeks, and patients treated mainly with combination therapy had an increased risk of mortality, especially those with non-IA IMIs.
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Increased availability of epidemiological data, novel digital data streams, and the rise of powerful machine learning approaches have generated a surge of research activity on real-time epidemic forecast systems. In this paper, we propose the use of a novel data source, namely retail market data to improve seasonal influenza forecasting. Specifically, we consider supermarket retail data as a proxy signal for influenza, through the identification of sentinel baskets, i.

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