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Article ; Online: Human-like problem-solving abilities in large language models using ChatGPT.

Orrù, Graziella / Piarulli, Andrea / Conversano, Ciro / Gemignani, Angelo

Frontiers in artificial intelligence

2023 Volume 6, Page(s) 1199350

Abstract: Backgrounds: The field of Artificial Intelligence (AI) has seen a major shift in recent years due to the development of new Machine Learning (ML) models such as Generative Pre-trained Transformer (GPT). GPT has achieved previously unheard-of levels of ... ...

Abstract	Backgrounds: The field of Artificial Intelligence (AI) has seen a major shift in recent years due to the development of new Machine Learning (ML) models such as Generative Pre-trained Transformer (GPT). GPT has achieved previously unheard-of levels of accuracy in most computerized language processing tasks and their chat-based variations. Aim: The aim of this study was to investigate the problem-solving abilities of ChatGPT using two sets of verbal insight problems, with a known performance level established by a sample of human participants. Materials and methods: A total of 30 problems labeled as " Results: The study highlighted that ChatGPT can be trained in out-of-the-box thinking and demonstrated potential in solving verbal insight problems. The global performance of ChatGPT equalled the most probable outcome for the human sample in both Conclusions: The use of transformer architecture and self-attention in ChatGPT may have helped to prioritize inputs while predicting, contributing to its potential in verbal insight problem-solving. ChatGPT has shown potential in solving insight problems, thus highlighting the importance of incorporating AI into psychological research. However, it is acknowledged that there are still open challenges. Indeed, further research is required to fully understand AI's capabilities and limitations in verbal problem-solving.
Language	English
Publishing date	2023-05-24
Publishing country	Switzerland
Document type	Journal Article
ISSN	2624-8212
ISSN (online)	2624-8212
DOI	10.3389/frai.2023.1199350
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Article ; Online: Cost utility analysis of Remdesivir and Dexamethasone treatment for hospitalised COVID-19 patients - a hypothetical study.

Carta, Andrea / Conversano, Claudio

BMC health services research

2021 Volume 21, Issue 1, Page(s) 986

Abstract: Background: Sars-Cov-2 is a novel corona virus associated with significant morbidity and mortality. Remdesivir and Dexamethasone are two treatments that have shown to be effective against the Sars-Cov-2 associated disease. However, a cost-effectiveness ... ...

Abstract	Background: Sars-Cov-2 is a novel corona virus associated with significant morbidity and mortality. Remdesivir and Dexamethasone are two treatments that have shown to be effective against the Sars-Cov-2 associated disease. However, a cost-effectiveness analysis of the two treatments is still lacking. Objective: The cost-utility of Remdesivir, Dexamethasone and a simultaneous use of the two drugs with respect to standard of care for treatment Covid-19 hospitalized patients is evaluated, together with the effect of Remdesivir compared to the base model but based on alernative assumptions. Methods: A decision tree for an hypothetical cohort of Covid-19 hospitalized patients, from an health care perspective and a one year horizon is specified. Efficacy data are retrieved from a literature review of clinical trials, whilst costs and utility are obtained from other published studies. Results: Remdesivir, if health care costs are related to the days of hospitalization, is a cost saving strategy. Dexamethasone is cost effective with an ICER of <DOLLAR/>5208/QALY, and the concurrent use of Remdesivir and Dexamethasone is the most favorable strategy for higher level of willingness to pay thresholds. Moreover, if Remdesivir has a positive effect on mortality the utility is three times higher respect to base case. Whereas, if health care costs are not related to the length of patient hospitalization Remdesivir has an ICER respect to standard of care of <DOLLAR/>384412.8/QALY gained, which is not cost effective. We also find that Dexaamethasone is cost effective respect to standard care if we compute the cost for live saved with an ICER of <DOLLAR/>313.79 for life saved. The uncertainty of the model parameters is also tested through both a one-way deterministic sensitivity analysis and a probabilistic sensitivity analysis. Conclusion: We find that the use of Remdesivir and/or Dexamethasone is effective from an economic standpoint.
MeSH term(s)	Adenosine Monophosphate/analogs & derivatives ; Alanine/analogs & derivatives ; COVID-19/drug therapy ; Cost-Benefit Analysis ; Dexamethasone ; Humans ; SARS-CoV-2
Chemical Substances	remdesivir (3QKI37EEHE) ; Adenosine Monophosphate (415SHH325A) ; Dexamethasone (7S5I7G3JQL) ; Alanine (OF5P57N2ZX)
Language	English
Publishing date	2021-09-18
Publishing country	England
Document type	Journal Article
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-021-06998-w
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Article ; Online: An Unusual Cause of Stroke: A "Forgotten" Intracardiac Catheter Discovered After 48 Years.

Fiore, Giorgio / Stella, Stefano / Conversano, Andrea / Agricola, Eustachio

JACC. Case reports

2022 Volume 6, Page(s) 101668

Abstract: A 48-year-old man with recurrent cerebral ischemic events underwent transesophageal echocardiography to investigate cardioembolic sources because transthoracic echocardiography had spotted a dubious filamentous mass on the mitral valve. A venous ... ...

Abstract	A 48-year-old man with recurrent cerebral ischemic events underwent transesophageal echocardiography to investigate cardioembolic sources because transthoracic echocardiography had spotted a dubious filamentous mass on the mitral valve. A venous umbilical catheter, lost during the hospital stay after his birth, was surprisingly identified in his cardiac chambers. (
Language	English
Publishing date	2022-11-03
Publishing country	Netherlands
Document type	Case Reports
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2022.10.006
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Article: On the Use of Markov Models in Pharmacoeconomics: Pros and Cons and Implications for Policy Makers.

Carta, Andrea / Conversano, Claudio

Frontiers in public health

2020 Volume 8, Page(s) 569500

Abstract: We present an overview of the main methodological features and the goals of pharmacoeconomic models that are classified in three major categories: regression models, decision trees, and Markov models. In particular, we focus on Markov models and define a ...

Abstract	We present an overview of the main methodological features and the goals of pharmacoeconomic models that are classified in three major categories: regression models, decision trees, and Markov models. In particular, we focus on Markov models and define a semi-Markov model on the cost utility of a vaccine for Dengue fever discussing the key components of the model and the interpretation of its results. Next, we identify some criticalities of the decision rule arising from a possible incorrect interpretation of the model outcomes. Specifically, we focus on the difference between median and mean ICER and on handling the willingness-to-pay thresholds. We also show that the life span of the model and an incorrect hypothesis specification can lead to very different outcomes. Finally, we analyse the limit of Markov model when a large number of states is considered and focus on the implementation of tools that can bypass the lack of memory condition of Markov models. We conclude that decision makers should interpret the results of these models with extreme caution before deciding to fund any health care policy and give some recommendations about the appropriate use of these models.
MeSH term(s)	Administrative Personnel ; Cost-Benefit Analysis ; Economics, Pharmaceutical ; Humans
Language	English
Publishing date	2020-10-30
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2020.569500
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Article ; Online: Cost utility analysis of Remdesivir and Dexamethasone treatment for hospitalised COVID-19 patients - a hypothetical study

Andrea Carta / Claudio Conversano

BMC Health Services Research, Vol 21, Iss 1, Pp 1-

2021 Volume 12

Abstract: Abstract Background Sars-Cov-2 is a novel corona virus associated with significant morbidity and mortality. Remdesivir and Dexamethasone are two treatments that have shown to be effective against the Sars-Cov-2 associated disease. However, a cost- ... ...

Abstract	Abstract Background Sars-Cov-2 is a novel corona virus associated with significant morbidity and mortality. Remdesivir and Dexamethasone are two treatments that have shown to be effective against the Sars-Cov-2 associated disease. However, a cost-effectiveness analysis of the two treatments is still lacking. Objective The cost-utility of Remdesivir, Dexamethasone and a simultaneous use of the two drugs with respect to standard of care for treatment Covid-19 hospitalized patients is evaluated, together with the effect of Remdesivir compared to the base model but based on alernative assumptions. Methods A decision tree for an hypothetical cohort of Covid-19 hospitalized patients, from an health care perspective and a one year horizon is specified. Efficacy data are retrieved from a literature review of clinical trials, whilst costs and utility are obtained from other published studies. Results Remdesivir, if health care costs are related to the days of hospitalization, is a cost saving strategy. Dexamethasone is cost effective with an ICER of <DOLLAR/>5208/QALY, and the concurrent use of Remdesivir and Dexamethasone is the most favorable strategy for higher level of willingness to pay thresholds. Moreover, if Remdesivir has a positive effect on mortality the utility is three times higher respect to base case. Whereas, if health care costs are not related to the length of patient hospitalization Remdesivir has an ICER respect to standard of care of <DOLLAR/>384412.8/QALY gained, which is not cost effective. We also find that Dexaamethasone is cost effective respect to standard care if we compute the cost for live saved with an ICER of <DOLLAR/>313.79 for life saved. The uncertainty of the model parameters is also tested through both a one-way deterministic sensitivity analysis and a probabilistic sensitivity analysis. Conclusion We find that the use of Remdesivir and/or Dexamethasone is effective from an economic standpoint.
Keywords	Sars-Cov-2 ; Covid-19 ; Remdesivir ; Dexamethasone ; Cost Utility ; Cost Effectiveness ; Public aspects of medicine ; RA1-1270
Subject code	310
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: HPV Vaccination during the COVID-19 Pandemic in Italy: Opportunity Loss or Incremental Cost.

Mennini, Francesco Saverio / Silenzi, Andrea / Marcellusi, Andrea / Conversano, Michele / Siddu, Andrea / Rezza, Giovanni

Vaccines

2022 Volume 10, Issue 7

Abstract: Objectives: Italy was the first European country to introduce universal vaccination of adolescents, for both males and females, against Human Papilloma Virus (HPV) starting in 2017 with the NIP 2017-2019's release. However, vaccine coverage rates (VCRs) ...

Abstract	Objectives: Italy was the first European country to introduce universal vaccination of adolescents, for both males and females, against Human Papilloma Virus (HPV) starting in 2017 with the NIP 2017-2019's release. However, vaccine coverage rates (VCRs) among adolescents have shown a precarious take-off since the NIP's release, and this situation worsened due to the impact of the COVID-19 pandemic in 2020. The aim of this work is to estimate the epidemiological and economic impact of drops in VCRs due to the pandemic on those generations that missed the vaccination appointment and to discuss alternative scenarios in light of the national data. Methods: Through an analysis of the official ministerial HPV vaccination reports, a model was developed to estimate the number of 12-year-old males and females who were not vaccinated against HPV during the period 2017-2021. Based on previously published models that estimate the incidence and the economic impact of HPV-related diseases in Italy, a new model was developed to estimate the impact of the aggregated HPV VCRs achieved in Italy between 2017 and 2021. Results: Overall, in 2021, 723,375 girls and 1,011,906 boys born between 2005 and 2009 were not vaccinated against HPV in Italy (42% and 52% of these cohorts, respectively). As compared with the 95% target provided by the Italian NIP, between 505,000 and 634,000 girls will not be protected against a large number of HPV-related diseases. For boys, the number of the unvaccinated population compared to the applicable target is over 615,000 in the 'best case scenario' and over 749,000 in the 'worst case scenario'. Overall, between 1.1 and 1.3 million young adolescents born between 2005 and 2009 will not be protected against HPV-related diseases over their lifetime with expected lifetime costs of non-vaccination that will be over EUR 905 million. If the 95% optimal VCRs were achieved, the model estimates a cost reduction equal to EUR 529 million, the net of the costs incurred to implement the vaccination program. Conclusion: Suboptimal vaccination coverage represents a missed opportunity, not only because of the increased burden of HPV-related diseases, but also in terms of economic loss. Thus, reaching national HPV immunization goals is a public health priority.
Language	English
Publishing date	2022-07-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10071133
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Article ; Online: The Psychological Impact of Sars-Cov-2 Quarantine: Observations Through the Lens of the Polyvagal Theory.

Poli, Andrea / Gemignani, Angelo / Conversano, Ciro

Clinical neuropsychiatry

2021 Volume 17, Issue 2, Page(s) 112–114

Abstract: According to the polyvagal theory, quarantine and social distancing following COVID-19 pandemic may dampen nucleus ambiguuus (NA) activity in the brainstem and hinder homeostatic cardiorespiratory functioning, emotional self-regulation and health. In ... ...

Abstract	According to the polyvagal theory, quarantine and social distancing following COVID-19 pandemic may dampen nucleus ambiguuus (NA) activity in the brainstem and hinder homeostatic cardiorespiratory functioning, emotional self-regulation and health. In addition, enduring quarantine may foster heightened implicit vigilance for social threat, emotional dysregulation, poor sleep and immune response, potentially increasing the chance of infections. Promoting activities aimed at increasing NA functioning, like self-compassion, may support emotional self-regulation, adequate immune response and health.
Language	English
Publishing date	2021-11-24
Publishing country	Italy
Document type	Journal Article
ISSN	2385-0787
ISSN (online)	2385-0787
DOI	10.36131/CN20200216
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Article ; Online: On the Use of Markov Models in Pharmacoeconomics

Andrea Carta / Claudio Conversano

Frontiers in Public Health, Vol

Pros and Cons and Implications for Policy Makers

2020 Volume 8

Abstract	We present an overview of the main methodological features and the goals of pharmacoeconomic models that are classified in three major categories: regression models, decision trees, and Markov models. In particular, we focus on Markov models and define a semi-Markov model on the cost utility of a vaccine for Dengue fever discussing the key components of the model and the interpretation of its results. Next, we identify some criticalities of the decision rule arising from a possible incorrect interpretation of the model outcomes. Specifically, we focus on the difference between median and mean ICER and on handling the willingness-to-pay thresholds. We also show that the life span of the model and an incorrect hypothesis specification can lead to very different outcomes. Finally, we analyse the limit of Markov model when a large number of states is considered and focus on the implementation of tools that can bypass the lack of memory condition of Markov models. We conclude that decision makers should interpret the results of these models with extreme caution before deciding to fund any health care policy and give some recommendations about the appropriate use of these models.
Keywords	pharmacoeconomics ; cost-utility analysis ; Markov models ; Dengue fever ; incremental cost-effectiveness ratio ; willingness to pay ; Public aspects of medicine ; RA1-1270
Subject code	519
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: HPV Vaccination during the COVID-19 Pandemic in Italy

Francesco Saverio Mennini / Andrea Silenzi / Andrea Marcellusi / Michele Conversano / Andrea Siddu / Giovanni Rezza

Vaccines, Vol 10, Iss 7, p

Opportunity Loss or Incremental Cost

2022 Volume 1133

Abstract: Objectives: Italy was the first European country to introduce universal vaccination of adolescents, for both males and females, against Human Papilloma Virus (HPV) starting in 2017 with the NIP 2017–2019′s release. However, vaccine coverage rates (VCRs) ... ...

Abstract	Objectives: Italy was the first European country to introduce universal vaccination of adolescents, for both males and females, against Human Papilloma Virus (HPV) starting in 2017 with the NIP 2017–2019′s release. However, vaccine coverage rates (VCRs) among adolescents have shown a precarious take-off since the NIP’s release, and this situation worsened due to the impact of the COVID-19 pandemic in 2020. The aim of this work is to estimate the epidemiological and economic impact of drops in VCRs due to the pandemic on those generations that missed the vaccination appointment and to discuss alternative scenarios in light of the national data. Methods: Through an analysis of the official ministerial HPV vaccination reports, a model was developed to estimate the number of 12-year-old males and females who were not vaccinated against HPV during the period 2017–2021. Based on previously published models that estimate the incidence and the economic impact of HPV-related diseases in Italy, a new model was developed to estimate the impact of the aggregated HPV VCRs achieved in Italy between 2017 and 2021. Results: Overall, in 2021, 723,375 girls and 1,011,906 boys born between 2005 and 2009 were not vaccinated against HPV in Italy (42% and 52% of these cohorts, respectively). As compared with the 95% target provided by the Italian NIP, between 505,000 and 634,000 girls will not be protected against a large number of HPV-related diseases. For boys, the number of the unvaccinated population compared to the applicable target is over 615,000 in the ‘best case scenario’ and over 749,000 in the ‘worst case scenario’. Overall, between 1.1 and 1.3 million young adolescents born between 2005 and 2009 will not be protected against HPV-related diseases over their lifetime with expected lifetime costs of non-vaccination that will be over EUR 905 million. If the 95% optimal VCRs were achieved, the model estimates a cost reduction equal to EUR 529 million, the net of the costs incurred to implement the vaccination program. ...
Keywords	HPV ; HTA ; incremental cost ; RWD ; COVID-19 ; vaccination strategies ; Medicine ; R
Subject code	306
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Women4Health cohort: a unique cohort to study women-specific mechanisms of cardio-metabolic regulation.

Busonero, Fabio / Lenarduzzi, Stefania / Crobu, Francesca / Gentile, Roberta Marie / Carta, Andrea / Cracco, Francesco / Maschio, Andrea / Camarda, Silvia / Marongiu, Michele / Zanetti, Daniela / Conversano, Claudio / Di Lorenzo, Giovanni / Mazzà, Daniela / De Seta, Francesco / Girotto, Giorgia / Sanna, Serena

European heart journal open

2024 Volume 4, Issue 2, Page(s) oeae012

Abstract: Aims: Epidemiological research has shown relevant differences between sexes in clinical manifestations, severity, and progression of cardiovascular and metabolic disorders. To date, the mechanisms underlying these differences remain unknown. Given the ... ...

Abstract	Aims: Epidemiological research has shown relevant differences between sexes in clinical manifestations, severity, and progression of cardiovascular and metabolic disorders. To date, the mechanisms underlying these differences remain unknown. Given the rising incidence of such diseases, gender-specific research on established and emerging risk factors, such as dysfunction of glycaemic and/or lipid metabolism, of sex hormones and of gut microbiome, is of paramount importance. The relationships between sex hormones, gut microbiome, and host glycaemic and/or lipid metabolism are largely unknown even in the homoeostasis status. Yet this knowledge gap would be pivotal to pinpoint to key mechanisms that are likely to be disrupted in disease context. Methods and results: Here we present the Women4Health (W4H) cohort, a unique cohort comprising up to 300 healthy women followed up during a natural menstrual cycle, set up with the primary goal to investigate the combined role of sex hormones and gut microbiota variations in regulating host lipid and glucose metabolism during homoeostasis, using a multi-omics strategy. Additionally, the W4H cohort will take into consideration another ecosystem that is unique to women, the vaginal microbiome, investigating its interaction with gut microbiome and exploring-for the first time-its role in cardiometabolic disorders. Conclusion: The W4H cohort study lays a foundation for improving current knowledge of women-specific mechanisms in cardiometabolic regulation. It aspires to transform insights on host-microbiota interactions into prevention and therapeutic approaches for personalized health care.
Language	English
Publishing date	2024-02-27
Publishing country	England
Document type	Journal Article
ISSN	2752-4191
ISSN (online)	2752-4191
DOI	10.1093/ehjopen/oeae012
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