Species identification, distributioin and reproductive interactions of common smoot-hound and blackspotted smooth-hound shark (Genus mustelus) in the Adriatic Sea

Longstanding taxonomic ambiguity and uncertainty exist in the identification of the common (M. mustelus) and blackspotted (M. punctulatus) smooth-hound in the Adriatic Sea. The lack of a clear and accurate method of morphological identification, leading to frequent misidentification, prevents the collation of species-specific landings and survey data for these fishes and hampers the delineation of the distribution ranges and stock boundaries of the species. In this context, adequate species-specific conservation and management strategies can not be applied without risks of population declining and local extinction. In this thesis work I investigated the molecular ecology of the two smooth-hound sharks which are abundant in the demersal trawl surveys carried out in the NC Adriatic Sea to monitor and assess the fishery resources. Ecological and evolutionary relationships were assessed by two molecular tests: a DNA barcoding analysis to improve species identification (and consequently the knowledge of their spatial ecology and taxonomy) and a hybridization assay based on the nuclear codominant marker ITS2 to evaluate reproductive interactions (hybridization or gene introgression). The smooth-hound sharks (N=208) were collected during the MEDITS 2008 and 2010 campaigns along the Italian and Croatian coasts of the Adriatic Sea, in the Sicilian Channel and in the Algerian fisheries. Since the identification based on morphological characters is not strongly reliable, I performed a molecular identification of the specimens producing for each one the cytochrome oxidase subunit 1 (COI) gene sequence (ca. 640 bp long) and compared them with reference sequences from different databases (GenBank and BOLD). From these molecular ID data I inferred the distribution of the two target species in the NC Adriatic Sea. In almost the totality of the MEDITS hauls I found no evidence of species sympatry. The data collected during the MEDITS survey showed an almost different distribution of M. mustelus (confined along the Italian coasts) and M. punctulatus (confined along the Croatian coasts); just one sample (Gulf of Venice, where probably the ranges of the species overlap) was found to have catches of both the species. Despite these data results suggested no interaction occurred between my two target species at least during the summertime (the period in which MEDITS survey is carried out), I still wanted to know if there were inter-species reproductive interactions so I developed a simple molecular genetic method to detect hybridization. This method is based on DNA sequence polymorphism among species in the nuclear ribosomal Internal Transcribed Spacer 2 locus (ITS2). Its application to the 208 specimens collected raised important questions regarding the ecology of this two species in the Adriatic Sea. In fact results showed signs of hybridization and/or gene introgression in two sharks collected during the trawl survey of 2008 and one collected during the 2010 one along the Italian and Croatian coasts. In the case that it will be confirmed the hybrid nature of these individuals, a spatiotemporal overlapping of the mating behaviour and ecology must occur. At the spatial level, the northern part of the Adriatic Sea (an area where the two species occur with high frequency of immature individuals) could likely play the role of a common nursery area for both species.

Analyse von Middleware-Technologien bzgl. Performanz und ihrer Eignung für lose und eng gekoppelte verteilte Anwendungen

Die vorliegende Dissertation analysiert die Middleware- Technologien CORBA (Common Object Request Broker Architecture), COM/DCOM (Component Object Model/Distributed Component Object Model), J2EE (Java-2-Enterprise Edition) und Web Services (inklusive .NET) auf ihre Eignung bzgl. eng und lose gekoppelten verteilten Anwendungen. Zusätzlich werden primär für CORBA die dynamischen CORBA-Komponenten DII (Dynamic Invocation Interface), IFR (Interface Repository) und die generischen Datentypen Any und DynAny (dynamisches Any) im Detail untersucht. Ziel ist es, a. konkrete Aussagen über diese Komponenten zu erzielen, und festzustellen, in welchem Umfeld diese generischen Ansätze ihre Berechtigung finden. b. das zeitliche Verhalten der dynamischen Komponenten bzgl. der Informationsgewinnung über die unbekannten Objekte zu analysieren. c. das zeitliche Verhalten der dynamischen Komponenten bzgl. ihrer Kommunikation zu messen. d. das zeitliche Verhalten bzgl. der Erzeugung von generischen Datentypen und das Einstellen von Daten zu messen und zu analysieren. e. das zeitliche Verhalten bzgl. des Erstellens von unbekannten, d. h. nicht in IDL beschriebenen Datentypen zur Laufzeit zu messen und zu analysieren. f. die Vorzüge/Nachteile der dynamischen Komponenten aufzuzeigen, ihre Einsatzgebiete zu definieren und mit anderen Technologien wie COM/DCOM, J2EE und den Web Services bzgl. ihrer Möglichkeiten zu vergleichen. g. Aussagen bzgl. enger und loser Koppelung zu tätigen. CORBA wird als standardisierte und vollständige Verteilungsplattform ausgewählt, um die o. a. Problemstellungen zu untersuchen. Bzgl. seines dynamischen Verhaltens, das zum Zeitpunkt dieser Ausarbeitung noch nicht oder nur unzureichend untersucht wurde, sind CORBA und die Web Services richtungsweisend bzgl. a. Arbeiten mit unbekannten Objekten. Dies kann durchaus Implikationen bzgl. der Entwicklung intelligenter Softwareagenten haben. b. der Integration von Legacy-Applikationen. c. der Möglichkeiten im Zusammenhang mit B2B (Business-to-Business). Diese Problemstellungen beinhalten auch allgemeine Fragen zum Marshalling/Unmarshalling von Daten und welche Aufwände hierfür notwendig sind, ebenso wie allgemeine Aussagen bzgl. der Echtzeitfähigkeit von CORBA-basierten, verteilten Anwendungen. Die Ergebnisse werden anschließend auf andere Technologien wie COM/DCOM, J2EE und den Web Services, soweit es zulässig ist, übertragen. Die Vergleiche CORBA mit DCOM, CORBA mit J2EE und CORBA mit Web Services zeigen im Detail die Eignung dieser Technologien bzgl. loser und enger Koppelung. Desweiteren werden aus den erzielten Resultaten allgemeine Konzepte bzgl. der Architektur und der Optimierung der Kommunikation abgeleitet. Diese Empfehlungen gelten uneingeschränkt für alle untersuchten Technologien im Zusammenhang mit verteilter Verarbeitung.

Probabilistic tomography of atmospheric parameters from GNSS data

The objective of the work is the evaluation of the potential capabilities of navigation satellite signals to retrieve basic atmospheric parameters. A capillary study have been performed on the assumptions more or less explicitly contained in the common processing steps of navigation signals. A probabilistic procedure has been designed for measuring vertical discretised profiles of pressure, temperature and water vapour and their associated errors. Numerical experiments on a synthetic dataset have been performed with the main objective of quantifying the information that could be gained from such approach, using entropy and relative entropy as testing parameters. A simulator of phase delay and bending of a GNSS signal travelling across the atmosphere has been developed to this aim.

The atmospheric stable boundary layer: Data analysis and comparison with similarity theories

The objective of this dissertation is to study the structure and behavior of the Atmospheric Boundary Layer (ABL) in stable conditions. This type of boundary layer is not completely well understood yet, although it is very important for many practical uses, from forecast modeling to atmospheric dispersion of pollutants. We analyzed data from the SABLES98 experiment (Stable Atmospheric Boundary Layer Experiment in Spain, 1998), and compared the behaviour of this data using Monin-Obukhov's similarity functions for wind speed and potential temperature. Analyzing the vertical profiles of various variables, in particular the thermal and momentum fluxes, we identified two main contrasting structures describing two different states of the SBL, a traditional and an upside-down boundary layer. We were able to determine the main features of these two states of the boundary layer in terms of vertical profiles of potential temperature and wind speed, turbulent kinetic energy and fluxes, studying the time series and vertical structure of the atmosphere for two separate nights in the dataset, taken as case studies. We also developed an original classification of the SBL, in order to separate the influence of mesoscale phenomena from turbulent behavior, using as parameters the wind speed and the gradient Richardson number. We then compared these two formulations, using the SABLES98 dataset, verifying their validity for different variables (wind speed and potential temperature, and their difference, at different heights) and with different stability parameters (zita or Rg). Despite these two classifications having completely different physical origins, we were able to find some common behavior, in particular under weak stability conditions.

Application Platforms for the Internet of Things: Theory, Architecture, Protocols, Data Formats, and Privacy

The Internet of Things (IoT) is the next industrial revolution: we will interact naturally with real and virtual devices as a key part of our daily life. This technology shift is expected to be greater than the Web and Mobile combined. As extremely different technologies are needed to build connected devices, the Internet of Things field is a junction between electronics, telecommunications and software engineering. Internet of Things application development happens in silos, often using proprietary and closed communication protocols. There is the common belief that only if we can solve the interoperability problem we can have a real Internet of Things. After a deep analysis of the IoT protocols, we identified a set of primitives for IoT applications. We argue that each IoT protocol can be expressed in term of those primitives, thus solving the interoperability problem at the application protocol level. Moreover, the primitives are network and transport independent and make no assumption in that regard. This dissertation presents our implementation of an IoT platform: the Ponte project. Privacy issues follows the rise of the Internet of Things: it is clear that the IoT must ensure resilience to attacks, data authentication, access control and client privacy. We argue that it is not possible to solve the privacy issue without solving the interoperability problem: enforcing privacy rules implies the need to limit and filter the data delivery process. However, filtering data require knowledge of how the format and the semantics of the data: after an analysis of the possible data formats and representations for the IoT, we identify JSON-LD and the Semantic Web as the best solution for IoT applications. Then, this dissertation present our approach to increase the throughput of filtering semantic data by a factor of ten.

Differential expression analysis for sequence count data via mixtures of negative binomials

The recent advent of Next-generation sequencing technologies has revolutionized the way of analyzing the genome. This innovation allows to get deeper information at a lower cost and in less time, and provides data that are discrete measurements. One of the most important applications with these data is the differential analysis, that is investigating if one gene exhibit a different expression level in correspondence of two (or more) biological conditions (such as disease states, treatments received and so on). As for the statistical analysis, the final aim will be statistical testing and for modeling these data the Negative Binomial distribution is considered the most adequate one especially because it allows for "over dispersion". However, the estimation of the dispersion parameter is a very delicate issue because few information are usually available for estimating it. Many strategies have been proposed, but they often result in procedures based on plug-in estimates, and in this thesis we show that this discrepancy between the estimation and the testing framework can lead to uncontrolled first-type errors. We propose a mixture model that allows each gene to share information with other genes that exhibit similar variability. Afterwards, three consistent statistical tests are developed for differential expression analysis. We show that the proposed method improves the sensitivity of detecting differentially expressed genes with respect to the common procedures, since it is the best one in reaching the nominal value for the first-type error, while keeping elevate power. The method is finally illustrated on prostate cancer RNA-seq data.

Data management and data analysis in the large European projects GEHA (GEnetics of Healthy Aging) and NU-AGE (NUtrition and AGEing): a bioinformatic approach

The aging process is characterized by the progressive fitness decline experienced at all the levels of physiological organization, from single molecules up to the whole organism. Studies confirmed inflammaging, a chronic low-level inflammation, as a deeply intertwined partner of the aging process, which may provide the “common soil” upon which age-related diseases develop and flourish. Thus, albeit inflammation per se represents a physiological process, it can rapidly become detrimental if it goes out of control causing an excess of local and systemic inflammatory response, a striking risk factor for the elderly population. Developing interventions to counteract the establishment of this state is thus a top priority. Diet, among other factors, represents a good candidate to regulate inflammation. Building on top of this consideration, the EU project NU-AGE is now trying to assess if a Mediterranean diet, fortified for the elderly population needs, may help in modulating inflammaging. To do so, NU-AGE enrolled a total of 1250 subjects, half of which followed a 1-year long diet, and characterized them by mean of the most advanced –omics and non –omics analyses. The aim of this thesis was the development of a solid data management pipeline able to efficiently cope with the results of these assays, which are now flowing inside a centralized database, ready to be used to test the most disparate scientific hypotheses. At the same time, the work hereby described encompasses the data analysis of the GEHA project, which was focused on identifying the genetic determinants of longevity, with a particular focus on developing and applying a method for detecting epistatic interactions in human mtDNA. Eventually, in an effort to propel the adoption of NGS technologies in everyday pipeline, we developed a NGS variant calling pipeline devoted to solve all the sequencing-related issues of the mtDNA.

Implementation of a VLSI amplifier interfaced with biomedical sensors for ultra wide band data transmission

This thesis presents a CMOS Amplifier with High Common Mode rejection designed in UMC 130nm technology. The goal is to achieve a high amplification factor for a wide range of biological signals (with frequencies in the range of 10Hz-1KHz) and to reject the common-mode noise signal. It is here presented a Data Acquisition System, composed of a Delta-Sigma-like Modulator and an antenna, that is the core of a portable low-complexity radio system; the amplifier is designed in order to interface the data acquisition system with a sensor that acquires the electrical signal. The Modulator asynchronously acquires and samples human muscle activity, by sending a Quasi-Digital pattern that encodes the acquired signal. There is only a minor loss of information translating the muscle activity using this pattern, compared to an encoding technique which uses astandard digital signal via Impulse-Radio Ultra-Wide Band (IR-UWB). The biological signals, needed for Electromyographic analysis, have an amplitude of 10-100μV and need to be highly amplified and separated from the overwhelming 50mV common mode noise signal. Various tests of the firmness of the concept are presented, as well the proof that the design works even with different sensors, such as Radiation measurement for Dosimetry studies.

Impact of anthropogenic stressors on the population genetics of the common bioindicator Dreissena polymorpha (Pallas, 1771)

Toxicant inputs from agriculture, industry and human settlements have been shown to severely affect freshwater ecosystems. Pollution can lead to changes in population genetic patterns through various genetic and stochastic processes. In my thesis, I investigated the impact of anthropogenic stressors on the population genetics of the zebra mussel Dreissena polymorpha. In order to analyze the genetics of zebra mussel populations, I isolated five new highly polymorphic microsatellite loci. Out of those and other already existing microsatellite markers for this species, I established a robust marker set of six microsatellite loci for D. polymorpha. rnMonitoring the biogeographical background is an important requirement when integrating population genetic measures into ecotoxicological studies. I analyzed the biogeographical background of eleven populations in a section of the River Danube (in Hungary and Croatia) and some of its tributaries, and another population in the River Rhine as genetic outgroup. Moreover, I measured abiotic water parameters at the sampling sites and analyzed if they were correlated with the genetic parameters of the populations. The genetic differentiation was basically consistent with the overall biogeographical history of the populations in the study region. However, the genetic diversity of the populations was not influenced by the geographical distance between the populations, but by the environmental factors oxygen and temperature and also by other unidentified factors. I found strong evidence that genetic adaptation of zebra mussel populations to local habitat conditions had influenced the genetic constitution of the populations. Moreover, by establishing the biogeographical baseline of molecular variance in the study area, I laid the foundation for interpreting population genetic results in ecotoxicological experiments in this region.rnIn a cooperation project with the Department of Zoology of the University of Zagreb, I elaborated an integrated approach in biomonitoring with D. polymorpha by combining the analysis techniques of microsatellite analysis, Comet assay and micronucleus test (MNT). This approach was applied in a case study on freshwater contamination by an effluent of a wastewater treatment plant (WWTP) in the River Drava (Croatia) and a complementary laboratory experiment. I assessed and compared the genetic status of two zebra mussel populations from a contaminated and a reference site. Microsatellite analysis suggested that the contaminated population had undergone a genetic bottleneck, caused by random genetic drift and selection, whereas a bottleneck was not detected in the reference population. The Comet assay did not indicate any difference in DNA damage between the two populations, but MNT revealed that the contaminated population had an increased percentage of micronuclei in hemocytes in comparison to the reference population. The laboratory experiment with mussels exposed to municipal wastewater revealed that mussels from the contaminated site had a lower percentage of tail DNA and a higher percentage of micronuclei than the reference population. These differences between populations were probably caused by an overall decreased fitness of mussels from the contaminated site due to genetic drift and by an enhanced DNA repair mechanism due to adaptation to pollution in the source habitat. Overall, the combination of the three biomarkers provided sufficient information on the impact of both treated and non-treated municipal wastewater on the genetics of zebra mussels at different levels of biological organization.rnIn my thesis, I could show that the newly established marker set of six microsatellite loci provided reliable and informative data for population genetic analyses of D. polymorpha. The adaptation of the analyzed zebra mussel populations to the local conditions of their habitat had a strong influence on their genetic constitution. We found evidence that the different genetic constitutions of two populations had influenced the outcome of our ecotoxicological experiment. Overall, the integrated approach in biomonitoring gave comprehensive information about the impact of both treated and non-treated municipal wastewater on the genetics of zebra mussels at different levels of biological organization and was well practicable in a first case study.

Data dissemination over complex networks through gossip

This thesis offers a practical and theoretical evaluations about gossip-epidemic algorithms, comparing those most common in the literature with new proposed algorithms and analyzing their behavior. Tests have been executed using one hundred graphs that has been randomly generated by Large Unstructured NEtwork Simulator (LUNES), a simulation software provided by Parallel and Distributed Simulation Research Group (PADS), of the Department of Computer Science, Università di Bologna and simulated using Advanced RTI System (ARTÌS), based on the High Level Architecture standard. Literatures algorithms have been analyzed and taken as base for new algorithms.

A river runs through it - ancient DNA data on the neolithic populations of the Great Hungarian Plain

This thesis was part of a multidisciplinary research project funded by the German Research Foundation (“Bevölkerungsgeschichte des Karpatenbeckens in der Jungsteinzeit und ihr Einfluss auf die Besiedlung Mitteleuropas”, grant no. Al 287/10-1) aimed at elucidating the population history of the Carpathian Basin during the Neolithic. The Carpathian Basin was an important waypoint on the spread of the Neolithic from southeastern to central Europe. On the Great Hungarian Plain (Alföld), the first farming communities appeared around 6000 cal BC. They belonged to the Körös culture, which derived from the Starčevo-Körös-Criş complex in the northern Balkans. Around 5600 cal BC the Alföld-Linearbandkeramik (ALBK), so called due to its stylistic similarities with the Transdanubian and central European LBK, emerged in the northwestern Alföld. Following a short “classical phase”, the ALBK split into several regional subgroups during its later stages, but did not expand beyond the Great Hungarian Plain. Marking the beginning of the late Neolithic period, the Tisza culture first appeared in the southern Alföld around 5000 cal BC and subsequently spread into the central and northern Alföld. Together with the Herpály and Csőszhalom groups it was an integral part of the late Neolithic cultural landscape of the Alföld. Up until now, the Neolithic cultural succession on the Alföld has been almost exclusively studied from an archaeological point of view, while very little is known about the population genetic processes during this time period. The aim of this thesis was to perform ancient DNA (aDNA) analyses on human samples from the Alföld Neolithic and analyse the resulting mitochondrial population data to address the following questions: is there population continuity between the Central European Mesolithic hunter-gatherer metapopulation and the first farming communities on the Alföld? Is there genetic continuity from the early to the late Neolithic? Are there genetic as well as cultural differences between the regional groups of the ALBK? Additionally, the relationships between the Alföld and the neighbouring Transdanubian Neolithic as well as other European early farming communities were evaluated to gain insights into the genetic affinities of the Alföld Neolithic in a larger geographic context. 320 individuals were analysed for this study; reproducible mitochondrial haplogroup information (HVS-I and/or SNP data) could be obtained from 242 Neolithic individuals. According to the analyses, population continuity between hunter-gatherers and the Neolithic cultures of the Alföld can be excluded at any stage of the Neolithic. In contrast, there is strong evidence for population continuity from the early to the late Neolithic. All cultural groups on the Alföld were heavily shaped by the genetic substrate introduced into the Carpathian Basin during the early Neolithic by the Körös and Starčevo cultures. Accordingly, genetic differentiation between regional groups of the ALBK is not very pronounced. The Alföld cultures are furthermore genetically highly similar to the Transdanubian Neolithic cultures, probably due to common ancestry. In the wider European context, the Alföld Neolithic cultures also highly similar to the central European LBK, while they differ markedly from contemporaneous populations of the Iberian Peninsula and the Ukraine. Thus, the Körös culture, the ALBK and the Tisza culture can be regarded as part of a “genetic continuum” that links the Neolithic Carpathian Basin to central Europe and likely has its roots in the Starčevo -Körös-Criş complex of the northern Balkans.

Ricostruzione di un data-set ad alta risoluzione (30 secondi d'arco) di temperature massime e minime giornaliere per un'area ad orografia complessa (Trentino Alto-Adige)

Dati climatici ad alta risoluzione sono attualmente molto richiesti essendo indispensabili per la valutazione degli impatti dei cambiamenti climatici alla scala locale in svariati campi d'applicazione. Per aumentare l'offerta di tali dati per il territorio italiano viene presentata in questo studio la realizzazione di un data-set con risoluzione di trenta secondi d'arco, per le temperature massime e minime giornaliere per il Trentino Alto Adige, per il periodo che va dal 1951 al 2014. La metodologia utilizzata per proiettare i dati meteorologici di un set di stazioni su di un grigliato ad alta risoluzione si basa sull'assunzione che la struttura spazio-temporale del campo di una variabile meteorologica su una determinata area possa essere descritta dalla sovrapposizione di due campi:i valori normali relativi e un periodo standard, ovvero la climatologia,e le deviazioni da questi, ovvero le anomalie. La climatologia mensile verrà interpolata sull'intero dominio tramite una regressione lineare pesata della temperatura rispetto alla quota,stimata separatamente per ogni nodo del grigliato,con pesi legati alla topografia del territorio,in modo da attribuire di volta in volta la massima importanza alle stazioni con caratteristiche più simili a quella del punto di griglia considerato. Da questa sarà possibile tramite la sovrapposizione con le anomalie mensili ricostruite sul medesimo grigliato, ottenute mediante un'interpolazione basata su una media pesata,ottenere un grigliato a 30 secondi d'arco, di serie temporali mensili in valori assoluti. Combinando poi l'interpolazione dei rapporti delle anomalie giornaliere relative alla media mensile per un set di stazioni con i campi mensili precedentemente stimati,sarà possibile costruire il data-set a risoluzione giornaliera. Prima di quest'ultima fase sarà necessario effettuare un'operazione di sincronizzazione dei dati giornalieri per assicurarsi che non vi siano sfasamenti nelle serie utilizzate. I risultati confermano l'efficacia nell'utilizzo di tale metodo su regioni orograficamente complesse, sia nel confronto diretto con i casi di studio,nei quali si nota bene la discriminazione spaziale effettuata dal modello, che nella valutazione dell'accuratezza e della precisione dei risultati. I dati ottenuti non sono affetti da errori sistematici,mentre l'errore medio assoluto risulta pari od inferiore ai $2^{\circ}$C, in linea con precedenti studi realizzati su altre aree alpine. Il metodo e i risultati risultano soddisfacenti ma ulteriormente migliorabili, sia tramite un ulteriore ottimizzazione del modello usato, che con un aumento nella qualità dei dati sui quali è stato svolto lo studio.

Realizzazione di un data-set ad alta risoluzione (30 secondi d'arco) di precipitazioni mensili su un'area ad orografia complessa (Trentino Alto-Adige)

In questa tesi si presenta la realizzazione di un data-set ad alta risoluzione (30 secondi d'arco) di precipitazioni mensili (per il periodo 1921-2014), per la regione del Trentino-Alto Adige. Esso è basato su una densa rete di stazioni con osservazioni di lunga durata, sottoposte ai necessari controlli di qualità. La tecnica di interpolazione si basa sull'assunzione che la configurazione spazio-temporale del campo di una variabile meteorologica su una certa area possa essere descritta con la sovrapposizione di due campi: i valori normali relativi a un periodo standard (1961-1990), ossia le climatologie, e le deviazioni da questi, ossia le anomalie. Le due componenti possono venire ricostruite tramite metodologie diverse e si possono basare su data-set indipendenti. Per le climatologie bisogna avere un elevato numero di stazioni (anche se disponibili per un lasso temporale limitato); per le anomalie viceversa la densità spaziale ha un rilievo minore a causa della buona coerenza spaziale della variabilità temporale, mentre è importante la qualità dei dati e la loro estensione temporale. L'approccio utilizzato per le climatologie mensili è la regressione lineare pesata locale. Per ciascuna cella della griglia si stima una regressione lineare pesata della precipitazione in funzione dell'altitudine; si pesano di più le stazioni aventi caratteristiche simili a quelle della cella stessa. Invece le anomalie mensili si ricavano, per ogni cella di griglia, grazie a una media pesata delle anomalie delle vicine stazioni. Infine la sovrapposizione delle componenti spaziale (climatologie) e temporale (anomalie) consente di ottenere per ogni nodo del grigliato una serie temporale di precipitazioni mensili in valori assoluti. La bontà dei risultati viene poi valutata con gli errori quadratici medi (RMSE) e i coefficienti di correlazione di Pearson delle singole componenti ricostruite. Per mostrare le potenziali applicazioni del prodotto si esaminano alcuni casi studio.

Prognosis of Atrial Fibrillation in Patients with Symptomatic Peripheral Arterial Disease: Data from the REduction of Atherothrombosis for Continued Health (REACH) Registry

BACKGROUND: Atrial fibrillation (AF) is a significant risk factor for cardiovascular (CV) mortality. This study aims to evaluate the prognostic implication of AF in patients with peripheral arterial disease (PAD). METHODS: The International Reduction of Atherothrombosis for Continued Health (REACH) Registry included 23,542 outpatients in Europe with established coronary artery disease, cerebrovascular disease (CVD), PAD and/or >/=3 risk factors. Of these, 3753 patients had symptomatic PAD. CV risk factors were determined at baseline. Study end point was a combination of cardiac death, non-fatal myocardial infarction (MI) and stroke (CV events) during 2 years of follow-up. Cox regression analysis adjusted for age, gender and other risk factors (i.e., congestive heart failure, coronary artery re-vascularisation, coronary artery bypass grafting (CABG), MI, hypertension, stroke, current smoking and diabetes) was used. RESULTS: Of 3753 PAD patients, 392 (10%) were known to have AF. Patients with AF were older and had a higher prevalence of CVD, diabetes and hypertension. Long-term CV mortality occurred in 5.6% of patients with AF and in 1.6% of those without AF (p<0.001). Multivariable analyses showed that AF was an independent predictor of late CV events (hazard ratio (HR): 1.5; 95% confidence interval (CI): 1.09-2.0). CONCLUSION: AF is common in European patients with symptomatic PAD and is independently associated with a worse 2-year CV outcome.

Oral mucosal findings related to tobacco use and alcohol consumption: a study on Swiss army recruits involving self-reported and clinical data

PURPOSE: The aim of the present study was to assess the oral mucosal health status of young male adults (aged 18 to 24 years) in Switzerland and to correlate their clinical findings with self-reported risk factors such as tobacco use and alcohol consumption. MATERIALS AND METHODS: Data on the oral health status of 615 Swiss Army recruits were collected using a standardised self-reported questionnaire, followed by an intraoral examination. Positive clinical findings were classified as (1) common conditions and anatomical variants, (2) reactive lesions, (3) benign tumour lesions and (4) premalignant lesions. The main locations of the oral mucosal findings were recorded on a topographical classification chart. Using correlational statistics, the findings were further associated with the known risk factors such as tobacco use and alcohol consumption. RESULTS: A total of 468 findings were diagnosed in 327 (53.17%) of the 615 subjects. In total, 445 findings (95.09%) were classified as common conditions, anatomical variants and reactive soft-tissue lesions. In the group of reactive soft-tissue lesions, there was a significantly higher percentage of smokers (P < 0.001) and subjects with a combination of smoking and alcohol consumption (P < 0.001). Eight lesions were clinically diagnosed as oral leukoplakias associated with smokeless tobacco. The prevalence of precursor lesions in the population examined was over 1%. CONCLUSIONS: Among young male adults in Switzerland, a significant number of oral mucosal lesions can be identified, which strongly correlate with tobacco use. To improve primary and secondary prevention, young adults should therefore be informed more extensively about the negative effects of tobacco use on oral health.