Applications of metrological techniques for clinical implementation of dosimetry and radiobiology in molecular radiotherapy

Molecular radiotherapy (MRT) is a fast developing and promising treatment for metastasised neuroendocrine tumours. Efficacy of MRT is based on the capability to selectively "deliver" radiation to tumour cells, minimizing administered dose to normal tissues. Outcome of MRT depends on the individual patient characteristics. For that reason, personalized treatment planning is important to improve outcomes of therapy. Dosimetry plays a key role in this setting, as it is the main physical quantity related to radiation effects on cells. Dosimetry in MRT consists in a complex series of procedures ranging from imaging quantification to dose calculation. This doctoral thesis focused on several aspects concerning the clinical implementation of absorbed dose calculations in MRT. Accuracy of SPECT/CT quantification was assessed in order to determine the optimal reconstruction parameters. A model of PVE correction was developed in order to improve the activity quantification in small volume, such us lesions in clinical patterns. Advanced dosimetric methods were compared with the aim of defining the most accurate modality, applicable in clinical routine. Also, for the first time on a large number of clinical cases, the overall uncertainty of tumour dose calculation was assessed. As part of the MRTDosimetry project, protocols for calibration of SPECT/CT systems and implementation of dosimetry were drawn up in order to provide standard guidelines to the clinics offering MRT. To estimate the risk of experiencing radio-toxicity side effects and the chance of inducing damage on neoplastic cells is crucial for patient selection and treatment planning. In this thesis, the NTCP and TCP models were derived based on clinical data as help to clinicians to decide the pharmaceutical dosage in relation to the therapy control and the limitation of damage to healthy tissues. Moreover, a model for tumour response prediction based on Machine Learning analysis was developed.

The transformative potential of community engagement in higher education: an analysis of service-learning effects on students, communities, and institutions.

Service-learning in higher education is gaining attention as a reliable tool to support students’ learning and fulfil the mission of higher education institutions (HEIs). This dissertation addresses existing gaps in the literature by examining the effects and perspectives of service-learning in HEIs through three studies. The first study compares the effects of a voluntary semester-long service-learning course with traditional courses. A survey completed by 110 students before and after the lectures found no significant group differences in the psychosocial variables under inspection. Nevertheless, service-learning students showed higher scores concerning the quality of participation. Factors such as students’ perception of competence, duration of service-learning, and self-reported measures may have influenced the results. The second study explores the under-researched perspective of community partners in higher education and European settings. Twelve semi-structured interviews were conducted with community partners from various community organisations across Europe. The results highlight positive effects on community members and organisations, intrinsic motivations, organisational empowerment, different forms of reciprocity, the co-educational role of community partners, and the significant role of a sense of community and belonging. The third study focuses on faculty perspectives on service-learning in the European context. Twenty-two semi-structured interviews were conducted in 14 European countries. The findings confirm the transformative impact of service-learning on the community, students, teachers, and HEIs, emphasising the importance of motivation and institutionalisation processes in sustaining engaged scholarship. The study also identifies the relevance of the community experience, sense of community, and community responsibility with the service-learning experience; relatedness is proposed as the fifth pillar of service-learning. Overall, this dissertation provides new insights into the effects and perspectives of service-learning in higher education. It integrates the 4Rs model with the addition of relatedness, guiding the theoretical and practical implications of the findings. The dissertation also suggests limitations and areas for further research.

Network analysis and machine learning assist drug repurposing and safety assessment in neurological diseases

In recent decades, two prominent trends have influenced the data modeling field, namely network analysis and machine learning. This thesis explores the practical applications of these techniques within the domain of drug research, unveiling their multifaceted potential for advancing our comprehension of complex biological systems. The research undertaken during this PhD program is situated at the intersection of network theory, computational methods, and drug research. Across six projects presented herein, there is a gradual increase in model complexity. These projects traverse a diverse range of topics, with a specific emphasis on drug repurposing and safety in the context of neurological diseases. The aim of these projects is to leverage existing biomedical knowledge to develop innovative approaches that bolster drug research. The investigations have produced practical solutions, not only providing insights into the intricacies of biological systems, but also allowing the creation of valuable tools for their analysis. In short, the achievements are: • A novel computational algorithm to identify adverse events specific to fixed-dose drug combinations. • A web application that tracks the clinical drug research response to SARS-CoV-2. • A Python package for differential gene expression analysis and the identification of key regulatory "switch genes". • The identification of pivotal events causing drug-induced impulse control disorders linked to specific medications. • An automated pipeline for discovering potential drug repurposing opportunities. • The creation of a comprehensive knowledge graph and development of a graph machine learning model for predictions. Collectively, these projects illustrate diverse applications of data science and network-based methodologies, highlighting the profound impact they can have in supporting drug research activities.

Formazione, apprendimento e nuove prospettive e-learning. Lo sviluppo delle nuove tecnologie didattiche e la creazione di sistemi di apprendimento lungo l’intero arco della vita

The thesis of this paper is based on the assumption that the socio-economic system in which we are living is characterised by three great trends: growing attention to the promotion of human capital; extremely rapid technological progress, based above all on the information and communication technologies (ICT); the establishment of new production and organizational set-ups. These transformation processes pose a concrete challenge to the training sector, which is called to satisfy the demand for new skills that need to be developed and disseminated. Hence the growing interest that the various training sub-systems devote to the issues of lifelong learning and distance learning. In such a context, the so-called e-learning acquires a central role. The first chapter proposes a reference theoretical framework for the transformations that are shaping post-industrial society. It analyzes some key issues such as: how work is changing, the evolution of organizational set-ups and the introduction of learning organization, the advent of the knowledge society and of knowledge companies, the innovation of training processes, and the key role of ICT in the new training and learning systems. The second chapter focuses on the topic of e-learning as an effective training model in response to the need for constant learning that is emerging in the knowledge society. This chapter starts with a reflection on the importance of lifelong learning and introduces the key arguments of this thesis, i.e. distance learning (DL) and the didactic methodology called e-learning. It goes on with an analysis of the various theoretic and technical aspects of e-learning. In particular, it delves into the theme of e-learning as an integrated and constant training environment, characterized by customized programmes and collaborative learning, didactic assistance and constant monitoring of the results. Thus, all the aspects of e-learning are taken into exam: the actors and the new professionals, the virtual communities as learning subjects, the organization of contents in learning objects, the conformity to international standards, the integrated platforms and so on. The third chapter, which concludes the theoretic-interpretative part, starts with a short presentation of the state-of-the-art e-learning international market that aims to understand its peculiarities and its current trends. Finally, we focus on some important regulation aspects related to the strong impulse given by the European Commission first, and by the Italian governments secondly, to the development and diffusion of e-learning. The second part of the thesis (chapters 4, 5 and 6) focus on field research, which aims to define the Italian scenario for e-learning. In particular, we have examined some key topics such as: the challenges of training and the instruments to face such challenges; the new didactic methods and technologies for lifelong learning; the level of diffusion of e-learning in Italy; the relation between classroom training and online training; the main factors of success as well as the most critical aspects of the introduction of e-learning in the various learning environments. As far as the methodological aspects are concerned, we have favoured a qualitative and quantitative analysis. A background analysis has been done to collect the statistical data available on this topic, as well as the research previously carried out in this area. The main source of data is constituted by the results of the Observatory on e-learning of Aitech-Assinform, which covers the 2000s and four areas of implementation (firms, public administration, universities, school): the thesis has reviewed the results of the last three available surveys, offering a comparative interpretation of them. We have then carried out an in-depth empirical examination of two case studies, which have been selected by virtue of the excellence they have achieved and can therefore be considered advanced and emblematic experiences (a large firm and a Graduate School).

Statistical methods for biomedical signal analysis and processing

Statistical modelling and statistical learning theory are two powerful analytical frameworks for analyzing signals and developing efficient processing and classification algorithms. In this thesis, these frameworks are applied for modelling and processing biomedical signals in two different contexts: ultrasound medical imaging systems and primate neural activity analysis and modelling. In the context of ultrasound medical imaging, two main applications are explored: deconvolution of signals measured from a ultrasonic transducer and automatic image segmentation and classification of prostate ultrasound scans. In the former application a stochastic model of the radio frequency signal measured from a ultrasonic transducer is derived. This model is then employed for developing in a statistical framework a regularized deconvolution procedure, for enhancing signal resolution. In the latter application, different statistical models are used to characterize images of prostate tissues, extracting different features. These features are then uses to segment the images in region of interests by means of an automatic procedure based on a statistical model of the extracted features. Finally, machine learning techniques are used for automatic classification of the different region of interests. In the context of neural activity signals, an example of bio-inspired dynamical network was developed to help in studies of motor-related processes in the brain of primate monkeys. The presented model aims to mimic the abstract functionality of a cell population in 7a parietal region of primate monkeys, during the execution of learned behavioural tasks.