Stefania De Simone

Dr. Stefania De Simone

University of Foggia, Italy

Research Focus & Metrics

Academic Career Length

6Years (2021-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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24 July 2025 in Frontiers in Medicine
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Journal Article
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FOFrancesco Orsini
Francesco Orsini
ACAndrea Cioffi
Andrea Cioffi
LCLuigi Cipolloni
Luigi Cipolloni
RBRoberta Bibbò
Roberta Bibbò
AMAngelo Montana
Angelo Montana
CCCamilla Cecannecchia
Camilla Cecannecchia
Introduction: Recent advancements in Artificial Intelligence have shown immense potential across various domains of healthcare, including forensic pathology. This systematic review aims to evaluate the latest innovations brought by Artificial Intelligence in forensic pathology and provide insights into future directions in this evolving field.Methods: A systematic literature search was conducted using databases for papers published from 1990 to 2025. The search strategy combined terms related to artificial intelligence, forensic odontology, forensic psychiatry and forensic medicine/pathology. Following PRISMA guidelines, 65 articles were initially identified, of which 18 met the inclusion criteria after applying exclusion criteria.Results: Artificial Intelligence applications demonstrated significant success across multiple forensic domains. In post-mortem analysis, deep learning achieved 70–94% accuracy in neurological forensics. Wound analysis systems showed high accuracy rates (87.99–98%) in gunshot wound classification. Artificial Intelligence-enhanced diatom testing for drowning cases achieved precision scores of 0.9 and recall scores of 0.95. Microbiome analysis applications reached accuracy rates up to 90% for individual identification and geographical origin determination. AI shows promise in forensic age estimation, psychiatric risk assessment, and insanity evaluations.Discussion: While Artificial Intelligence shows promise as a supportive tool in forensic pathology, several limitations persist, including small sample sizes and variable performance across different applications. Artificial Intelligence serves best as an enhancement rather than a replacement for human expertise. Future development should focus on larger datasets, specialized systems for different forensic applications, and improved interpretability of Artificial Intelligence decisions for legal contexts. The integration of Artificial Intelligence in forensic pathology represents a significant advancement, requiring careful balance between technological innovation and human expertise for optimal implementation.

27 December 2022 in Healthcare
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Journal Article
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SSStefania De Simone
Stefania De Simone
MBMaria Antonella Bosco
Maria Antonella Bosco
Raffaele La RussaRaffaele La Russa
Raffaele La Russa
SVSimona Vittorio
Simona Vittorio
NFNicola Di Fazio
Nicola Di Fazio
BBBenedetta Baldari
Benedetta Baldari
According to WHO data, suicide is a public health priority. In particular, suicide is the fourth-leading cause of death in young people. Many risk factors of suicide are described, including individual-, relationship-, community-, and societal-linked ones. The leading factor is the diagnosis of mental illness. Nevertheless, not all people who attempt suicide are psychiatric patients; these characteristics help define high-risk populations. There are currently no useful biomarkers to indicate the risk of suicide. In recent years, neurotrophic factors have increasingly become of scientific interest. This review aims to summarize the current scientific knowledge on the correlation between BDNF and GDNF and suicide, to theorize whether neurotrophins could be a reliable marker for an early diagnosis of suicidal risk. The authors conducted a systematic review following PRISMA criteria. They found eight research papers in agreement with the inclusion criteria. According to the results of these studies, there may be a connection between BDNF brain levels and complete suicide, although there are discrepancies. A lack of interest in GDNF may suggest less involvement in the suicidal dynamic. Further studies may provide helpful information to researchers.

20 June 2021 in Medicina
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Journal Article
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GBGiuseppe Bertozzi
Giuseppe Bertozzi
Aniello MaieseAniello Maiese
Aniello Maiese
GPGiovanna Passaro
Giovanna Passaro
ATAlberto Tosoni
Alberto Tosoni
Antonio MirijelloAntonio Mirijello
Antonio Mirijello
Raffaele La RussaRaffaele La Russa
Raffaele La Russa
Background: Neutropenic enterocolitis (NE), which in the past was also known as typhlitis or ileocecal syndrome for the segment of the gastrointestinal tract most affected, is a nosological entity that is difficult to diagnose and whose pathogenesis is not fully known to date. Initially described in pediatric patients with leukemic diseases, it has been gradually reported in adults with hematological malignancies and non-hematological conditions, such as leukemia, lymphoma, multiple myeloma, aplastic anemia, and also myelodysplastic syndromes, as well as being associated with other immunosuppressive causes such as AIDS treatment, therapy for solid tumors, and organ transplantation. Therefore, it is associated with high mortality due to the rapid evolution in worse clinical pictures: rapid progression to ischemia, necrosis, hemorrhage, perforation, multisystem organ failure, and sepsis. Case report: A case report is included to exemplify the clinical profile of patients with NE who develop sepsis. Literature Review: To identify a specific profile of subjects affected by neutropenic enterocolitis and the entity of the clinical condition most frequently associated with septic evolution, a systematic review of the literature was conducted. The inclusion criteria were as follows: English language, full-text availability, human subjects, and adult subjects. Finally, the papers were selected after the evaluation of the title and abstract to evaluate their congruity with the subject of this manuscript. Following these procedures, 19 eligible empirical studies were included in the present review. Conclusions: Despite the recent interest and the growing number of publications targeting sepsis and intending to identify biomarkers useful for its diagnosis, prognosis, and for the understanding of its pathogenesis, and especially for multi-organ dysfunction, and despite the extensive research period of the literature review, the number of publications on the topic “neutropenic enterocolitis and sepsis” appears to be very small. In any case, the extrapolated data allowed us to conclude that the integration of medical history, clinical and laboratory data, radiological imaging, and macroscopic and histological investigations can allow us to identify a specific pathological profile.

23 April 2022 in Diagnostics
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Andrea BernettiAndrea Bernetti
Andrea Bernetti
Raffaele La RussaRaffaele La Russa
Raffaele La Russa
Alessandro de SireAlessandro de Sire
Alessandro de Sire
FAFrancesco Agostini
Francesco Agostini
SSStefania De Simone
Stefania De Simone
PFPietro Fiore
Pietro Fiore
Background: Cervical spine manipulations (CSM) have been performed for centuries and are a widely practiced intervention to manage cervical spine musculoskeletal disorders. We aimed to perform an overview of the literature concerning the effects and the adverse events of CSM in the Physical and Rehabilitation Medicine (PRM) field with a forensic medicine perspective. Methods: A search in the scientific literature (PubMed, Google Scholar, PEDro and Cochrane) was carried out from inception until October 2020. Results: Fourteen articles were included in this narrative summary. The possible development of side effects requires a careful mandatory balance of benefits and risks even when there is an indication for this approach. Moreover, a qualified professional is essential to perform CSM–a non-invasive therapeutic procedure that can be potentially harmful. Conclusions: In conclusion, it is essential to perform the diagnosis, to treat, and to manage complications within the PRM field, both for the reduction of malpractice claims and, most importantly, for the safety of the patient.

11 January 2025 in Healthcare
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Journal Article
Open access
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FOFrancesco Orsini
Francesco Orsini
ACAndrea Cioffi
Andrea Cioffi
LCLuigi Cipolloni
Luigi Cipolloni
MBMaria Antonella Bosco
Maria Antonella Bosco
CFChiara Fabrello
Chiara Fabrello
SSStefania De Simone
Stefania De Simone
Background/Objectives: Biomedical progress has extended the lifespan of patients with incurable diseases, sparking debates about their desire to live under certain conditions. This study examines the ethical and legal challenges surrounding end-of-life issues in Europe, including informed consent, the refusal of treatment, the right to health, self-determination, advance directives, assisted suicide, and euthanasia. European countries exhibit different interpretations and regulations of these practices, leading to patient “migrations” seeking favorable legal environments. Methods: This study analyzes end-of-life legislation across European countries in a comparative and qualitative way, highlighting differences, commonalities, and the potential for uniform regulation. The data were collected from the literature published between 2000 and 2024, focusing on the EU member states, Switzerland, and the United Kingdom. Results: The examination of the norms governing end-of-life practices in various European countries revealed significant differences in legislative frameworks, reflecting diverse cultural, ethical, and legal perspectives. These variations have led to patient migrations in search of suitable legal environments to end their lives with dignity. Conclusions: This study highlights the need for a harmonized approach to end-of-life legislation in Europe to ensure equitable access to end-of-life care and to uphold human dignity. Continuous legal updates and comparative studies are essential to balance medical advancements with ethical considerations. The findings emphasize the importance of autonomy and self-determination, which are fundamental human rights that should be respected in the context of end-of-life decisions.

15 October 2022 in Medicina
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Journal Article
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PFPaolo Frisoni
Paolo Frisoni
LDLuca Diani
Luca Diani
SSStefania De Simone
Stefania De Simone
MBMaria Antonella Bosco
Maria Antonella Bosco
LCLuigi Cipolloni
Luigi Cipolloni
Margherita NeriMargherita Neri
Margherita Neri
Background and Objectives: Aquaporins are a family of water channel proteins. In this study, the renal and intrapulmonary expression of aquaporin-5 (AQP5) was examined in forensic autopsy cases to evaluate it as a drowning marker and to differentiate between freshwater drowning and saltwater drowning. Materials and Methods: Cases were classified into three groups: freshwater drowning (FWD), saltwater drowning (SWD), and controls (CTR). Samples were obtained from forensic autopsies at less than 72 h postmortem (15 FWD cases, 15 SWD cases, and 17 other cases) and were subjected to histological and immunohistochemical investigations. Results: In FWD group, intrapulmonary AQP5 expression was significantly suppressed compared with SWD and CTR; there was no significant difference in AQP5 expression among the other two groups. The same differences in expression were also observed in the kidney. Conclusions: These observations suggest that AQP5 expression in alveolar cells was suppressed by hypotonic water to prevent hemodilution. Moreover, it is possible to hypothesize that in the kidney, with the appearance of hypo-osmotic plasma, AQP5 is hypo-expressed, as a vital reaction, to regulate the renal reabsorption of water. In conclusion, the analysis of renal and intrapulmonary AQP5 expression would be forensically useful for differentiation between FWD and SWD, or between FWD and death due to other causes.