MATHEMATICAL MODELING IN PATHOPHYSIOLOGY (FISIOMAT)

Dating back from 1969, the CNR research group in biomathematics (both at the Institute’s main location in downtown Rome and at the Gemelli UCSC Medical School location) has studied statistical and mathematical models of the immune response, peristaltic motion, pathophysiologic processes in cardiocirculatory shock, sepsis and metabolism.

 The historical origin of these activities traces both the inheritance from the famous group of Systems analysis headed by Prof. Antonio Ruberti at Rome 1 University, and from the need for  concrete clinical applications of multiparametric, cardiorespiratory and metabolic monitoring in surgical critically ill patients, in days when the pioneering use of computers for such purposes needed a cable connection between the Istituto di Clinica Chirurgica of Policlinico Gemelli in Rome and a central computer facility in Cleveland, Ohio.

 Today, the group is most active in mathematical modelling and attendant control techniques in glucose metabolism and diabetes; ventilatory and circulatory mechanics; cardiorespiratory response to sepsis, septic shock and hemorrhagic shock; tumor growth and treatment; population dynamics; epidemic models; biomaterials; immunomodulation.


Research topics
METABOLISM IN CRITICAL ILLNESS

  • Improving the early recognition and treatment of the major pathophysiologic derangements, which often occur after major surgery or trauma (sepsis - systemic infections, severe inflammatory response states:  criteria for appropriate monitoring of such patients based on the study of hemodynamic, respiratory and metabolic changes; acquisition of selected parameters useful to assess clinical severity, especially those obtainable in a simplified way, and suitable for use also in minor hospital and less organized settings of care.
  • Study of alterations of energy and protein/amino acid metabolism; optimization of artificial nutrition in critically ill patients.
  • Clinical applications of original mathematical models for the quantification of abnormalities of carbon dioxide transport and exchange, and of acid-base balance, in vivo.
  • Study of metabolism in patients undergoing major hepatic resections, who are particularly prone to develop septic complications and severe liver failure. The studies on oncologic hepatobiliary surgery patients with various types of tumors have further been extended to early and long-term results associated with specific risk factors, operative techniques and combined treatments.

CELL POPULATIONS

structured models for cell populations; models for cell populations with kinetic heterogeneity; methods for the analysis of flow cytometry data.


CELL REPLICATION AND EPIDEMICS
  • PDE models of the spatial tumor evolution in healthy tissues including neoangiogenesis and cooption of host-tissue vessels.
  • Age-structured population models of epidermis growth. Mechanisms of control of the cell proliferation in the epidermis basal layer.
  • “Nested” epidemic models, i.e. structured population models in which the epidemic evolution is linked to the intra-host dynamics of the pathogen.
  • Models of the HIV epidemic in Italy in relation to antiretroviral treatment and drug resistance.
  • Protocol optimization in radiotherapy

ENERGY METABOLISM AND ARTIFICIAL PANCREAS
  • Design of model-based closed-loop algorithm, aiming at plasma glucose regulation. The control law is synthesized by properly exploiting glucose measurements, and respects major constraints provided by the available Continuous Glucose Sensors and insulin pumps.
  • Dynamical models of the many hormones related to metabolism. The aim is to build up a multi-scale model able to predict the evolution of long-term diseases caused by metabolic dysfunctions and obesity.
  • Models of glucose-insulin system with applications to the analysis of clinical data (e.g., from IVGTT and OGTT) with attention to the effects of bariatric surgery in obese and diabetic patients.

EXPOSURE MODELS IN EPIDEMIOLOGY

mathematical modelling of exposure to environmental and occupational agents; estimation of dose for chemical and physical agents; health impact analysis.


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