Crescenzio Gallo

Characterization of obstructive sleep apnea–hypopnea syndrome (OSA) population by means of cluster analysis

Obstructive sleep apnea–hypopnea syndrome (OSA) is being identified increasingly as an important health issue. It is typified by repeated episodes of upper airway collapse during sleep leading to occasional hypoxaemia, sleep fragmentation and poor sleep quality. OSA is also being considered as an independent risk factor for hypertension, diabetes and cardiovascular diseases, leading to increased multi‐morbidity and mortality. Cluster analysis, a powerful statistical set of techniques, may help in investigating and classifying homogeneous groups of patients with similar OSA characteristics. This study aims to investigate the (possible) different groups of patients in an OSA population, and to analyse the relationships among the main clinical variables in each group to better understand the impact of OSA on patients. Starting from a well‐characterized OSA population of 198 subjects afferent to our sleep centre, we identified three different communities of OSA patients. The first has a very severe disease [apnea–hypopnea index (AHI) = 65.91 ± 22.47] and sleep disorder has a strong impact on daily life: a low level of diurnal partial pressure of oxygen (PaO2) (77.39 ± 11.64 mmHg) and a high prevalence of hypertension (64%); the second, with less severe disease (AHI = 28.88 ± 17.13), in which sleep disorders seem to be less important for diurnal PaO2 and have a minimum impact on comorbidity; and the last with very severe OSA (AHI = 57.26 ± 15.09) but with a low risk of nocturnal hypoxaemia (T90 = 11.58 ± 8.54) and less sleepy (Epworth Sleepiness Scale 10.00 ± 4.77).

Vibrational Characterization of Synthetic Eumelanin by Means of Raman and Surface Enhanced Raman Scattering

Eumelanin biopolymer synthetized from L-DOPA has been characterized by Raman and Surface Enhanced Raman Spectroscopy (SERS). Although Raman spectra of eumelanin were scarcely resolved, SERS measurements of this biopolymer on nanostructured gold substrate, provided a large enhancement of vibrational peaks related to functional groups adherent to the substrate, so that well resolved vibrational spectra were obtained. The SERS peaks correspond to vibrational modes related to the monomeric units of eumelanin. So, SERS spectra can be used to identify the monomeric content of eumelanin and resolve the presence of vibrational modes which have been calculated and predicted according to different theoretical models and previously observed in vibrational spectra of single monomeric units.

Discrimination of different degrees of oral squamous cell carcinoma by means of Raman microspectroscopy and atomic force microscopy

Oral squamous cell carcinoma is a widespread cancer disease whose survival rate is strongly dependent on early diagnosis and on the degree of malignancy. The conventional histopathology methods, which are currently the standard ones for diagnosis, are very invasive so that they can be hardly proposed as screening methods for an early and accurate detection of disease. Raman microspectroscopy and atomic force microscopy can be potentially considered as useful tools for cancer diagnosis and detection of the malignancy degree because they provide information about the biochemical cellular content and nanomechanical properties, respectively, which would be modified by the onset and progression of pathology. The present work shows that both techniques can successfully discriminate the two cellular types of cells characterized by different degrees of oral squamous cell carcinoma. The discrimination by Raman microspectroscopy occurs according to a larger content of nucleic acids and a minor content of protein components in cells characterized by a larger degree of disease, whereas the discrimination by atomic force microscopy is achieved because of a decrease of stiffness as the degree of disease increases. Overall, both techniques could provide useful diagnostic information related to the degree of malignancy of the oral squamous cell carcinoma disease.

Evaluation of Genome-Wide Expression Profiles of Blood and Sputum Neutrophils in Cystic Fibrosis Patients Before and After Antibiotic Therapy

In seeking more specific biomarkers of the cystic fibrosis (CF) lung inflammatory disease that would be sensitive to antibiotic therapy, we sought to evaluate the gene expression profiles of neutrophils in CF patients before treatment in comparison with non-CF healthy individuals and after antibiotic treatment. Genes involved in neutrophil-mediated inflammation, i.e. chemotaxis, respiratory burst, apoptosis, and granule exocytosis, were the targets of this study. Microarray analysis was carried out in blood and airway neutrophils from CF patients and in control subjects. A fold change (log) threshold of 1.4 and a cut-off of p<0.05 were utilized to identify significant genes. Community networks and principal component analysis were used to distinguish the groups of controls, pre- and post-therapy patients. Control subjects and CF patients before therapy were readily separated, whereas a clear distinction between patients before and after antibiotic therapy was not possible. Blood neutrophils before therapy presented 269 genes down-regulated and 56 up-regulated as compared with control subjects. Comparison between the same patients before and after therapy showed instead 44 genes down-regulated and 72 up-regulated. Three genes appeared to be sensitive to therapy and returned to “healthy” condition: phorbol-12-myristate-13-acetate-induced protein 1 (PMAIP1), hydrogen voltage-gated channel 1 (HVCN1), and β-arrestin 1 (ARRB1). The up-regulation of these genes after therapy were confirmed by real time PCR. In airway neutrophils, 1029 genes were differentially expressed post- vs pre-therapy. Of these, 30 genes were up-regulated and 75 down-regulated following antibiotic treatment. However, biological plausibility determined that only down-regulated genes belonged to the gene classes studied for blood neutrophils. Finally, it was observed that commonly expressed genes showed a greater variability in airway neutrophils than that found in blood neutrophils, both before and after therapy. These results indicate more specific targets for future interventions in CF patients involving respiratory burst, apoptosis, and granule exocytosis.

Periodontal clinical and microbiological data in desquamative gingivitis patients

ObjectivesA series of patients affected by desquamative gingivitis (DG) was investigated in order to evaluate relation patterns among clinical parameters relevant to plaque-induced periodontitis, periodontal microbiological data and the presence of DG lesions.Patients and methodsEight oral lichen planus (OLP) and four mucous membrane pemphigoid (MMP) patients were examined. Periodontal measurements (performed at six sites per tooth on all teeth) included probing depth (PD), gingival recession (REC), clinical attachment loss (CAL) and full-mouth plaque (FMPS) and bleeding (FMBS) scores; the presence and the exact location (site by site) of DG lesions were carefully recorded. Sub-gingival plaque samples were collected and examined by means of real-time PCR for the quantitative determination of the six most important marker organisms of periodontitis. Statistically significant differences and correlation of studied variables between DG-positive and DG-negative sites were investigated in MMP and OLP cases using Mann–Whitney test (p < 0.05) and the Spearman rank correlation coefficient, respectively.ResultsOLP gingival lesions do not significantly affect CAL, although the presence of such lesions may reduce REC and increase PD and FMPS. MMP gingival lesions significantly worsened CAL and increased REC and FMPS. In both OLP and MMP cases, no significant difference was found between DG-positive and DG-negative sites as regards the relative percentage of the investigated species on the total bacterial load. Correlations between the presence of DG lesions and clinical parameters (CAL, PD, REC) were not significant (p < 0.05). Significant correlations were found for the presence of gingival OLP lesions and Aggregatibacter actinomycetemcomitans (AA) and for the absence of gingival MMP lesions and AA.ConclusionsThese findings are not definitive, but highlight the need for further investigations of periodontal clinical and microbiological aspects of disorders causing DG in order to clarify their potential interference with plaque-related periodontitis.

CFTR‐dependent chloride efflux in cystic fibrosis mononuclear cells is increased by ivacaftor therapy

The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) potentiator ivacaftor (Kalydeco®) improves clinical outcome in G551D cystic fibrosis (CF) patients. Here, we have investigated whether ivacaftor has a clinical impact on non‐G551D gating mutations and function of circulating leukocytes as well.

The novel complex allele [A238V;F508del] of the CFTR gene: clinical phenotype and possible implications for cystic fibrosis etiological therapies.

Few mutations in cis have been annotated for F508del homozygous patients. Southern Italy patients who at a first analysis appeared homozygous for the F508del mutation (n=63) or compound heterozygous for the F508del and another mutation in the cystic fibrosis transmembrane conductance regulator gene (n=155) were searched for the A238V mutation in exon 6. The allelic frequency of the complex allele [A238V;F508del] was 0.04. When the whole data set was used (comprised also of 56 F508del/F508del and 34 F508del/other mutation controls), no differences reached the statistical significance in the clinical parameters, except chloride concentrations which were lower in [A238V;F508del]/other mutation compared with F508del/other mutation (P=0.03). The two study groups presented less complications than the control groups. Within the minimal data set (34 F508del/F508del, 27 F508del/other mutation, 4 [A238V;F508del]/F508del cases and 5 [A238V;F508del]/other mutation cases); that is, presenting all the variables in each patient, forced expiratory volume in 1 s and forced vital capacity presented a trend to lower levels in the study groups in comparison with the F508del/F508del group, and C-reactive protein approximated statistically significant higher levels in the [A238V;F508del]/other mutation as compared with F508del/F508del patients (P=0.09). The analysis of statistical dependence among the variables showed a significant anticorrelation between chloride and body mass index in the [A238V;F508del]/other mutation group. In conclusion, the complex allele [A238V;F508del] seems to be associated with less general complications than in the control groups, on the other hand possibly giving a worse pulmonary phenotype and higher systemic/local inflammatory response. These findings have implications for the correct recruitment and clinical response of F508del patients in the clinical trials testing the new etiological drugs for cystic fibrosis.

Web Information System Platforms for Publishing Spatial Data

The best tools to manage the exchange of information and services between heterogeneous subjects through new technological tools with particular reference to information systems are certainly the Web-based information systems. Leveraging the infrastructure of the Web, these systems may be able to handle multimedia data, to perform distributed and cooperative applications based on service, in addition to customizing applications and related data. This paper provides an overview on Web Information Systems with particular reference to GIS, presenting a description of the usage scenarios and a comparison between two significant platform for publishing spatial data.

BI4IPM: A Business Intelligence System for the Analysis of Olive Tree's Integrated Pest Management

TheAgri-Foodsectorisfacingglobalchallenges.Thefirstchallengeisfeedingaworldpopulation thatwill reach9.3billionpeople in2050,according toUNprojections.Thesecondchallenge is thedemandfromconsumersforhigh-qualityproductsobtainedthroughmoresustainable,safeand clear agri-food chains. Integratedpestmanagement (IPM) couldbe an important instrument for helpingfarmersfacethesechallenges.IPMrequiresthesimultaneoususeofdifferentcropprotection techniquestocontrolpeststhroughanecologicalandeconomicapproach.Thisworkexploresthe possibilityofdevelopingaframeworkthatcombinesbusinessintelligence(BI)technologieswith IPMprinciplestosupportfarmersinthedecisionalprocess,therebydecreasingenvironmentalcost andimprovingproductionperformance.TheproposedBIsystemiscalledBI4IPM,anditcombines on-linetransactionprocessing(OLTP)withon-lineanalyticalprocessing(OLAP)toverifyadherence totheIPMtechnicalspecifications. KEywORdS Business Intelligence, Data Models, Integrated Pest Management, OLAP, Olive Tree, OLTP

Prevalence of comorbidities in patients with obstructive sleep apnea syndrome, overlap syndrome and obesity hypoventilation syndrome

Sleep‐disordered breathing causes a burden to the sufferer, the health care system and the society. Most studies have focused on obstructive sleep apnea (OSA); however, the prevalence of comorbidities in patients affected by overlap syndrome (OS) and obesity hypoventilation syndrome (OHS) has not been carefully evaluated.