John Cabot University ScholarShip

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    Advancing Toward P6 Medicine: Recommendations for Integrating Artificial Intelligence in Internal Medicine
    (2025) Said-Criado, Ismael; Pietrantonio, Filomena; Montagna, Marco; Rosiello, Francesco; Missikoff, Oleg; Drago, Carlo; Leung, Tiffany I.; Vinci, Antonio; Signorini, Alessandro; Gómez-Huelgas, Ricardo
    Background: Internists formulate diagnostic hypotheses and personalized treatment plans by integrating data from a comprehensive clinical interview, reviewing a patient’s medical history, physical examination and findings from complementary tests. The patient treatment life cycle generates a significant volume of data points that can offer valuable insights to improve patient care by guiding clinical decision-making. Artificial Intelligence (AI) and, in particular, Generative AI (GAI), are promising tools in this regard, particularly after the introduction of Large Language Models. The European Federation of Internal Medicine (EFIM) recognizes the transformative impact of AI in leveraging clinical data and advancing the field of internal medicine. This position paper from the EFIM explores how AI can be applied to achieve the goals of P6 Medicine principles in internal medicine. P6 Medicine is an advanced healthcare model that extends the concept of Personalized Medicine toward a holistic, predictive, patient-centered approach that also integrates psycho-cognitive and socially responsible dimensions. An additional concept introduced is that of Digital Therapies (DTx), software applications designed to prevent and manage diseases and disorders through AI, which are used in the clinical setting if validated by rigorous research studies. Methods: The literature examining the relationship between AI and Internal Medicine was investigated through a bibliometric analysis. The themes identified in the literature review were further examined through the Delphi method. Thirty international AI and Internal Medicine experts constituted the Delphi panel. Results: Delphi results were summarized in a SWOT Analysis. The evidence is that through extensive data analysis, diagnostic capacity, drug development and patient tracking are increased. Conclusions: The panel unanimously considered AI in Internal Medicine as an opportunity, achieving a complete consensus on the matter. AI-driven solutions, including clinical applications of GAI and DTx, hold the potential to strongly change internal medicine by streamlining workflows, enhancing patient care and generating valuable data.
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    Age diversity management in healthcare: leveraging generational differences with an inclusive approach
    (2025) Pietrantonio, Filomena; Brunelli, Giulia; Vassallo, Gabriele Angelo; Moriconi, Luca; Signorini, Alessandro; Moriconi, Andrea
    This paper examines the growing generational diversity within the healthcare workforce and highlights the importance of leveraging these differences through an inclusive approach. As Baby Boomers, Generation X, and Millennials coexist in the healthcare workforce, organizations face new challenges and opportunities. Each generation brings its own distinct values, expectations, and work attitudes that significantly impact team dynamics, stress management, job retention, and leadership preferences. Through a comprehensive literature review, the study suggests effective strategies to address generational differences to promote collaboration and team cohesion. Particular attention is paid to the role of coordinators in identifying and applying tailored interventions, such as mentoring, reverse mentoring, shared leadership models, and tailored communication styles, that cater to the specific needs of each generation. The paper emphasizes the relevance of recognizing age-related diversity as an asset to create resilient, adaptable, and high-performing teams. By adopting age diversity management practices, healthcare organizations can better appreciate individual contributions and encourage an environment of mutual respect and learning. Ultimately, the study states that inclusive and flexible leadership can improve staff satisfaction and the quality of patient care in a rapidly evolving healthcare landscape.
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    Women’s Leadership in the Healthcare Landscape. Original Evidence from an Innovative Narrative Review of the Literature: The Female-Led Study
    (2025) Pietrantonio, Filomena; Mochi, Giorgia; Ricci, Lidia; Simonelli, Maria Sofia; Boschero, Lucilla; D'Alessandro, Biagio; Buno, Francesca; Pieragostini, Luisa; Migliano, Emilia; Russo, Giovanna; Vassallo, Gabriele Angelo; Materazzo, Marco; Granvillano, Giuseppa; Vinci, Antonio; Signorini, Alessandro; Rosiello, Francesco
    The “great man” theory inherently excludes women as it traditionally focuses on leadership features associated with men. In recent years, the healthcare sector has experienced a growing presence of women in leadership roles; however, although female health workers significantly outnumber men, the number of women leaders remains lower than that of men. This article seeks to investigate potential differences between male and female leadership, identify the winning characteristics of female leadership, and examine the barriers and obstacles that may preclude women’s access to leadership positions. A review of existing reviews available on PubMed was conducted using specific search queries. The authors analyzed the selected articles according to specific inclusion and exclusion criteria, using the PICO methodology. Out of 967 articles, 18 met the inclusion criteria. The most frequently identified characteristics of female leadership included a democratic and non-individualistic style, strong communication skills, and empathy. The most common obstacles to the advancement of female leadership included lower compensation, persistent stereotypes and prejudices, and insufficient support from institutions in addressing the gender gap. Academic studies confirm that women tend to adopt a transformational leadership style, in contrast to the more autocratic and assertive male leadership. Further research on female leadership is essential for monitoring progress and fostering actions that allow women to thrive in top leadership positions.
  • Publication
    Evaluating Wireless Vital Parameter Continuous Monitoring for Critically Ill Patients Hospitalized in Internal Medicine Units: A Pilot Randomized Controlled Trial
    (2025) Pietrantonio, Filomena; Signorini, Alessandro; Bussi, Anna Rosa; Rosiello, Francesco; Vinci, Fabio; Delli Castelli, Michela; Pascucci, Matteo; Alessi, Elena; Moriconi, Luca; Vinci, Antonio; Moriconi, Andrea; D'Amico, Roberto
    Background: Wireless Vital Parameter Continuous Monitoring (WVPCM) allows the continuous tracking of patient physiological parameters, facilitating the earlier detection of clinical deterioration, especially in low-intensity care settings. The aim of this study is to evaluate the effectiveness of using WVPCM compared to the usual monitoring of critically ill patients hospitalized in Internal Medicine wards. An investigation of the attitude of health professionals towards the use of new technologies in daily practice to improve patient management was also carried out. Methods: The LIght Monitor Study (LIMS) is a prospective, open-label, randomized, multi-center pilot trial comparing WVPCM and conventional nurse monitoring during the first 72 h of hospitalization. A central randomization unit used computer-generated tables to allocate patients to two different types of monitoring. The main outcome was the occurrence of major complications. The study planned to enroll 296 critically ill patients with a Modified Early Warning Score (MEWS) ≥ 3 and/or National Early Warning Score (NEWS) ≥ 5 across two Internal Medicine (IM) Units in Italy. The investigation of the attitude of nurses towards the use of WVPCM was carried out by using a questionnaire and a qualitative survey. Results: Due to the COVID-19 outbreak, the study was interrupted early and only 135 patients (WVPCM = 68; standard care = 67) were randomized. One patient in the control group was excluded from analysis because of drop-out, leaving 134 patients for intention to treat analysis. No statistically significant differences between standard care and WVPCM were observed in terms of major complications (37.5%, vs. 31.2% p = 0.475), in-hospital mortality (17.5% vs. 11.1%, p = 0.309), and median hospital length of stay (9 vs. 10 days, p = 0.463). WVPCM decreased nursing workload compared to the control, as the average time spent by nurses on the detection of vital signs per patient was 0 min per patient per day compared to 24.4 min (p < 0.001) observed in the control group. Twenty-two percent of patients in the WVPCM group (15/68) experienced discomfort with the device, resulting in its removal. The investigation of nurses involved 16 out of 18 people participating in the study. Opinions on the wireless device for patient monitoring were particularly favorable; most of them considered remote monitoring clearly superior to traditional in-person visits and easy to use after a brief practice period. All participants recognized the safety benefits of the system. Conclusions: The reduced sample size of this pilot study does not allow us to draw any conclusions on the superiority of WVPCM compared to standard care in terms of clinical outcomes. However, we observed a positive trend in the reduction of major complications.

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