Circadian rhythms, sleep and autonomic function in progressive supranuclear palsy: characteristic features and reciprocal interactions

Background: Progressive supranuclear palsy (PSP) is a rare neurodegenerative condition. The aims of this study were to evaluate the association between sleep, the circadian system and autonomic function in a cohort of PSP patients. Methods: Patients with PSP diagnosed according to consensus criteria were recruited prospectively and retrospectively and performed the following tests: body core temperature (BcT), sleep-wake cycle, systolic and diastolic blood pressure (SBP, DBP) continuous monitoring for 48 h under controlled environmental conditions; cardiovascular reflex tests (CRTs). The analysis of circadian rhythmicity was performed with the single cosinor method. For state-dependent analysis, the mean value of variables in each sleep stage was calculated as well as the difference to the value in wake. Results: PSP patients presented a reduced total duration of night sleep, with frequent and prolonged awakenings. During daytime, patients had very short naps, suggesting a state of profound sleep deprivation across the 24-h. REM sleep behaviour disorder was found in 15%, restless legs syndrome in 46%, periodic limb movements in 52% and obstructive sleep apnea in 54%. BcT presented the expected fall during night-time, however, compared to controls, mean values during day and night were higher. However BcT state-dependent modulation was maintained. Increased BcT could be attributed to an inability to properly reduce sympathetic activity favoured by the sleep deprivation. At CRTs, PSP presented mild cardiovascular adrenergic impairment and preserved cardiovagal function. 14% had non-neurogenic orthostatic hypotension. Only 2 PSP presented the expected BP dipping pattern, possibly as a consequence of sleep disruption. State-dependent analysis showed a partial loss of the state-dependent modulation for SBP. Discussion: This study showed that PSP presented abnormalities of sleep, circadian rhythms and cardiovascular autonomic function that are likely to be closely linked one to another.

Sustainability and environmental impact of the Italian ceramic tile industry

The increasing consumption rates among citizens and the uncontrolled exploitation of natural resources have made environmental pollution and management of waste the main problems facing humanity in its upcoming future. Together with generation of energy and transport, industrial production certainly plays a key role in the genesis of these problems. It is for this reason that the concepts of environmental, social and economic sustainability have emerged over the years as the cornerstones for future development. In light of this, the most forward-looking industries have begun to study their impact on environment and society in order to improve their performances and, at the same time, to anticipate the increasingly rigorous environmental regulations. In this work, various performance indicators related to the Italian ceramic tile sector will be presented and discussed. In particular, the emission factor of characteristic pollutants will be reported on a period of up to fifteen years while data regarding waste management, concentration of pollutants and emission legal limits for the last decade will be here disclosed as a result of a vast analysis on recorded data. The collected information describes the present level of performance of the ceramic tile manufacturing industries in Italy and shows how recycling is now a consolidated reality and how some pollutants, such as particulate matter, fluorine and lead are actually disappearing from production processes and how others, such as volatile organic compounds, are increasing instead. Moreover, the adoption of alternative raw materials for the production of ceramic tiles is discussed and the implementation of the recycling of various waste is addressed at experimental or industrial scale. Finally, the development of a new ceramic engobe with high content of waste glass (20%) is presented as an experimental example of reutilization of resources in the ceramic tile industry.