L'associazione Tipifarnib-Bortezomib nel trattamento delle leucemie acute mieloidi: risultati di uno studio multicentrico di fase I/II e validazione di un profilo genico predittivo di risposta

Background. Outcome of elderly acute myeloid leukemia (AML) patients is dismal. Targeted-therapies might improve current results by overcoming drug-resistance and reducing toxicity. Aim. We conduced a phase II study aiming to assess efficacy and toxicity of Tipifarnib (Zarnestra®) and Bortezomib (Velcade®) association in AML patients >18 years, unfit for conventional therapy, or >60 years, in relapse. Furthermore, we aimed to evaluated the predictive value of the RASGRP1/APTX ratio, which was previously found to be associated to treatment sensitivity in patients receiving Zarnestra alone. Methods. Velcade (1.0 mg/m2) was administered as weekly infusion for 3 weeks (days 1, 8, 15). Zarnestra was administered at dose of 300-600 mg BID for 21 consecutive days. Real-time quantitative-PCR (q-PCR) was used for RASGRP1/APTX quantification. Results. 50 patients were enrolled. Median age was 71 years (56-89). 3 patients achieved complete remission (CR) and 1 partial response (PR). 2 patients obtained an hematological improvement (HI), and 3 died during marrow aplasia. 10 had progressive disease (PD) and the remaining showed stable disease (SD). RASGRP1/APTX was evaluated before treatment initiation on bone marrow (BM) and/or peripheral blood (PB). The median RASGRP/APTX value on BM was higher in responder (R) patients than in non responders (NR) ones, respectively (p=0.006). Interestingly, no marrow responses were recorded in patients with BM RASGRP1/APTX ratio <12, while the response rate was 50% in patients with ratio >12. Toxicity was overall mild, the most common being febrile neutropenia. Conclusion. We conclude that the clinical efficacy of the combination Zarnestra-Velcade was similar to what reported for Zarnestra alone. However we could confirm that the RASGPR1/APTX level is an effective predictor of response. Though higher RASGRP1/APTX is relatively rare (~10% of cases), Zarnestra (±Velcade) may represent an important option in a subset of high risk/frail AML patients.

Finite element models of coseismic deformation due to the 2009 L'Aquila (Italy) and 2008 Wenchuan(China) earthquakes

The topic of my Ph.D. thesis is the finite element modeling of coseismic deformation imaged by DInSAR and GPS data. I developed a method to calculate synthetic Green functions with finite element models (FEMs) and then use linear inversion methods to determine the slip distribution on the fault plane. The method is applied to the 2009 L’Aquila Earthquake (Italy) and to the 2008 Wenchuan earthquake (China). I focus on the influence of rheological features of the earth's crust by implementing seismic tomographic data and the influence of topography by implementing Digital Elevation Models (DEM) layers on the FEMs. Results for the L’Aquila earthquake highlight the non-negligible influence of the medium structure: homogeneous and heterogeneous models show discrepancies up to 20% in the fault slip distribution values. Furthermore, in the heterogeneous models a new area of slip appears above the hypocenter. Regarding the 2008 Wenchuan earthquake, the very steep topographic relief of Longmen Shan Range is implemented in my FE model. A large number of DEM layers corresponding to East China is used to achieve the complete coverage of the FE model. My objective was to explore the influence of the topography on the retrieved coseismic slip distribution. The inversion results reveals significant differences between the flat and topographic model. Thus, the flat models frequently adopted are inappropriate to represent the earth surface topographic features and especially in the case of the 2008 Wenchuan earthquake.

Sviluppo di un'applicazione bioinformatica per la gestione dei dati di antibiotico sensibilità di isolati clinici

Il problema dell'antibiotico-resistenza è un problema di sanità pubblica per affrontare il quale è necessario un sistema di sorveglianza basato sulla raccolta e l'analisi dei dati epidemiologici di laboratorio. Il progetto di dottorato è consistito nello sviluppo di una applicazione web per la gestione di tali dati di antibiotico sensibilità di isolati clinici utilizzabile a livello di ospedale. Si è creata una piattaforma web associata a un database relazionale per avere un’applicazione dinamica che potesse essere aggiornata facilmente inserendo nuovi dati senza dover manualmente modificare le pagine HTML che compongono l’applicazione stessa. E’ stato utilizzato il database open-source MySQL in quanto presenta numerosi vantaggi: estremamente stabile, elevate prestazioni, supportato da una grande comunità online ed inoltre gratuito. Il contenuto dinamico dell’applicazione web deve essere generato da un linguaggio di programmazione tipo “scripting” che automatizzi operazioni di inserimento, modifica, cancellazione, visualizzazione di larghe quantità di dati. E’ stato scelto il PHP, linguaggio open-source sviluppato appositamente per la realizzazione di pagine web dinamiche, perfettamente utilizzabile con il database MySQL. E’ stata definita l’architettura del database creando le tabelle contenenti i dati e le relazioni tra di esse: le anagrafiche, i dati relativi ai campioni, microrganismi isolati e agli antibiogrammi con le categorie interpretative relative al dato antibiotico. Definite tabelle e relazioni del database è stato scritto il codice associato alle funzioni principali: inserimento manuale di antibiogrammi, importazione di antibiogrammi multipli provenienti da file esportati da strumenti automatizzati, modifica/eliminazione degli antibiogrammi precedenti inseriti nel sistema, analisi dei dati presenti nel database con tendenze e andamenti relativi alla prevalenza di specie microbiche e alla chemioresistenza degli stessi, corredate da grafici. Lo sviluppo ha incluso continui test delle funzioni via via implementate usando reali dati clinici e sono stati introdotti appositi controlli e l’introduzione di una semplice e pulita veste grafica.

Modelling the stable, nocturnal boundary layer: different approaches to turbulence closure problem

Il lavoro è dedicato all'analisi fisica e alla modellizzazione dello strato limite atmosferico in condizioni stabili. L'obiettivo principale è quello di migliorare i modelli di parametrizzazione della turbulenza attualmente utilizzati dai modelli meteorologici a grande scala. Questi modelli di parametrizzazione della turbolenza consistono nell' esprimere gli stress di Reynolds come funzioni dei campi medi (componenti orizzontali della velocità e temperatura potenziale) usando delle chiusure. La maggior parte delle chiusure sono state sviluppate per i casi quasi-neutrali, e la difficoltà è trattare l'effetto della stabilità in modo rigoroso. Studieremo in dettaglio due differenti modelli di chiusura della turbolenza per lo strato limite stabile basati su assunzioni diverse: uno schema TKE-l (Mellor-Yamada,1982), che è usato nel modello di previsione BOLAM (Bologna Limited Area Model), e uno schema sviluppato recentemente da Mauritsen et al. (2007). Le assunzioni delle chiusure dei due schemi sono analizzate con dati sperimentali provenienti dalla torre di Cabauw in Olanda e dal sito CIBA in Spagna. Questi schemi di parametrizzazione della turbolenza sono quindi inseriti all'interno di un modello colonnare dello strato limite atmosferico, per testare le loro predizioni senza influenze esterne. Il confronto tra i differenti schemi è effettuato su un caso ben documentato in letteratura, il "GABLS1". Per confermare la validità delle predizioni, un dataset tridimensionale è creato simulando lo stesso caso GABLS1 con una Large Eddy Simulation. ARPS (Advanced Regional Prediction System) è stato usato per questo scopo. La stratificazione stabile vincola il passo di griglia, poichè la LES deve essere ad una risoluzione abbastanza elevata affinchè le tipiche scale verticali di moto siano correttamente risolte. Il confronto di questo dataset tridimensionale con le predizioni degli schemi turbolenti permettono di proporre un insieme di nuove chiusure atte a migliorare il modello di turbolenza di BOLAM. Il lavoro è stato compiuto all' ISAC-CNR di Bologna e al LEGI di Grenoble.

Sviluppo di un approccio congiunto fuzzy-Bayesiano per l'analisi e la modellizzazione degli ecosistemi: applicazione ad ecosistemi marini costieri.

Nell’attuale contesto di aumento degli impatti antropici e di “Global Climate Change” emerge la necessità di comprenderne i possibili effetti di questi sugli ecosistemi inquadrati come fruitori di servizi e funzioni imprescindibili sui quali si basano intere tessiture economiche e sociali. Lo studio previsionale degli ecosistemi si scontra con l’elevata complessità di questi ultimi in luogo di una altrettanto elevata scarsità di osservazioni integrate. L’approccio modellistico appare il più adatto all’analisi delle dinamiche complesse degli ecosistemi ed alla contestualizzazione complessa di risultati sperimentali ed osservazioni empiriche. L’approccio riduzionista-deterministico solitamente utilizzato nell’implementazione di modelli non si è però sin qui dimostrato in grado di raggiungere i livelli di complessità più elevati all’interno della struttura eco sistemica. La componente che meglio descrive la complessità ecosistemica è quella biotica in virtù dell’elevata dipendenza dalle altre componenti e dalle loro interazioni. In questo lavoro di tesi viene proposto un approccio modellistico stocastico basato sull’utilizzo di un compilatore naive Bayes operante in ambiente fuzzy. L’utilizzo congiunto di logica fuzzy e approccio naive Bayes è utile al processa mento del livello di complessità e conseguentemente incertezza insito negli ecosistemi. I modelli generativi ottenuti, chiamati Fuzzy Bayesian Ecological Model(FBEM) appaiono in grado di modellizare gli stati eco sistemici in funzione dell’ elevato numero di interazioni che entrano in gioco nella determinazione degli stati degli ecosistemi. Modelli FBEM sono stati utilizzati per comprendere il rischio ambientale per habitat intertidale di spiagge sabbiose in caso di eventi di flooding costiero previsti nell’arco di tempo 2010-2100. L’applicazione è stata effettuata all’interno del progetto EU “Theseus” per il quale i modelli FBEM sono stati utilizzati anche per una simulazione a lungo termine e per il calcolo dei tipping point specifici dell’habitat secondo eventi di flooding di diversa intensità.

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.

3D-ultrastructure, functions and stress responses of rhogocytes from the freshwater gastropods Biomphalaria glabrata and Lymnaea stagnalis

Rhogocytes, also termed ‘pore cells’, exist free in the hemolymph or embedded in the connective tissue of different body parts of molluscs, notably gastropods. These unique cells can be round, elongated or irregularly shaped, and up to 30 μm in diameter. Their hallmark is the so-called slit apparatus: i.e. pocket-like invaginations of the plasma membrane creating extracellular lacunae, bridged by cytoplasmic bars. These bars form distinctive slits of ca. 20 nm width. A slit diaphragm composed of proteins establishes a molecular sieve with holes of 20 x 20 nm. Different functions have been assigned to this special molluscan cell type, notably biosynthesis of the hemolymph respiratory protein hemocyanin. It has further been proposed, but not proven, that in the case of red-blooded snail species rhogocytes might synthesize the hemoglobin. However, the secretion pathway of these hemolymph proteins, and the functional role of the enigmatic slit apparatus remained unclear. Additionally proposed functions of rhogocytes, such as heavy metal detoxification or hemolymph protein degradation, are also not well studied. This work provides more detailed electron microscopical, histological and immunobiochemical information on the structure and function of rhogocytes of the freshwater snails Biomphalaria glabrata and Lymnaea stagnalis. By in situ hybridization on mantle tissues, it proves that B. glabrata rhogocytes synthesize hemoglobin and L. stagnalis rhogocytes synthesize hemocyanin. Hemocyanin is present, in endoplasmic reticulum lacunae and in vesicles, as individual molecules or pseudo-crystalline arrays. The first 3D reconstructions of rhogocytes are provided by means of electron tomography and show unprecedented details of the slit apparatus. A highly dense material in the cytoplasmic bars close to the diaphragmatic slits was shown, by immunogold labeling, to contain actin. By immunofluorescence microscopy, the protein nephrin was localized at the periphery of rhogocytes. The presence of both proteins in the slit apparatus supports the previous hypothesis, hitherto solely based on similarities of the ultrastructure, that the molluscan rhogocytes are phylogenetically related to mammalian podocytes and insect nephrocytes. A possible secretion pathway of respiratory proteins that includes a transfer mechanism of vesicles through the diaphragmatic slits is proposed and discussed. We also studied, by electron microscopy, the reaction of rhogocytes in situ to two forms of animal stress: deprivation of food and cadmium contamination of the tank water. Significant cellular reactions to both stressors were observed and documented. Notably, the slit apparatus surface and the number of electron-dense cytoplasmic vesicles increased in response to cadmium stress. Food deprivation led to an increase in hemocyanin production. These observations are also discussed in the framework of using such animals as potential environmental biomarkers.

L'influenza della preferenza manuale nell'interpretazione di conferenza: un contributo sperimentale

This study is based on a former student’s work, aimed at examining the influence of handedness on conference interpreting. In simultaneous interpreting (IS) both cerebral hemispheres participate in the decoding of the incoming message and in the activation of the motor functions for the production of the output signal. In right-handers language functions are mainly located in the left hemisphere, while left-handers have a more symmetrical representation of language functions. Given that with the development of interpreting skills and a long work experience the interpreters’ brain becomes less lateralized for language functions, in an initial phase left-handers may be «neurobiologically better suited for interpreting tasks» (Gran and Fabbro 1988: 37). To test this hypothesis, 9 students (5 right-handers and 4 left-handers) participated in a dual test of simultaneous and consecutive interpretation (CI) from English into Italian. The subjects were asked to interpret one text with their preferred ear and the other with the non-preferred one, since according neuropsychology aural symmetry reflects cerebral symmetry. The aim of this study was to analyze:1) the differences between the number of errors in consecutive and simultaneous interpretation with the preferred and non-preferred ear; 2) the differences in performance (in terms of number of errors) between right-handed and left-handed, both with the preferred and non-preferred ear; 3) the most frequent types of errors in right and left-handers; 4) the influence of the degree of handedness on interpreting quality. The students’ performances were analyzed in terms of errors of meaning, errors of numbers, omissions of text, omissions of numbers, inaccuracies, errors of nexus, and unfinished sentences. The results showed that: 1) in SI subjects committed fewer errors interpreting with the preferred ear, whereas in CI a slight advantage of the non-preferred ear was observed. Moreover, in CI, right-handers committed fewer mistakes with the non-preferred ear than with the preferred one. 2) The total performance of left-handers proved to be better than that of right-handers. 3) In SI left-handers committed fewer errors of meaning and fewer errors of number than right-handers, whereas in CI left-handers committed fewer errors of meaning and more errors of number than right-handers 4) As the degree of left-handedness increases, the number of errors committed also increases. Moreover, there is a statistically significant left-ear advantage for right-handers and a right-ear one for left-handers. Finally, those who interpreted with their right ear committed fewer errors of number than those who have used their left ear or both ears.

The wind profile in the atmospheric stable boundary layer over complex terrain and heterogeneous surfaces: limitations of local similarity theory

L'indagine ha riguardato il profilo del vento nei primi 30 metri dello strato limite atmosferico stabile nell'ambito della teoria di similarità locale. Ad oggi, diversi esperimenti hanno confermato la validità della teoria per strati-limite su terreni livellati e superfici omogenee. Tali condizioni ideali sono però infrequenti nella realtà ed è perciò importante capire quali siano i limiti della similarità locale per strati-limite su terreni complessi e superfici disomogenee. Entrambe le condizioni sono presenti a Ny-Alesund (Svalbard, Norvegia) dove il Consiglio Nazionale delle Ricerche (CNR), nel 2009, ha installato una torre di 30 m, la Amudsen-Nobile Climate Change Tower (CCT), per lo studio dello strato-limite artico. Il lavoro di tesi ha riguardato misure di vento e turbolenza acquisite sulla CCT da maggio 2012 a maggio 2014. Il confronto tra le velocità del vento misurate dagli anemometri installati sulla CCT, ha rivelato criticità nel dato sonico manifestatesi con sovrastime sistematiche e maggiore erraticità rispetto alle misure provenienti dagli anemometri a elica. Un test condotto fra diversi metodi per il calcolo dei gradienti verticali della velocità del vento ha rivelato scarsa sensibilità dei risultati ottenuti al particolare metodo utilizzato. Lo studio ha riguardato i gradienti verticali adimensionali della velocità del vento nei primi 30-m dello strato limite stabile. Deviazioni significative tra i tra le osservazioni e i valori predetti dalla similarità locale sono state osservate in particolare per i livelli più distanti dal suolo e per valori crescenti del parametro di stabilità z/L (L, lunghezza di Obukhov locale). In particolare, si sono osservati gradienti adimensionali inferiori a quelli predetti dalle più usate relazioni di flusso-gradiente. Tali deviazioni, presenti perlopiù per z/L>0.1, sono state associate ad un effetto di accentuazione della turbolenza da parte delle irregolarità del terreno. Per condizioni meno stabili, z/L<0.1, scarti positivi tra i gradienti osservati e quelli attesi sono stati attribuiti alla formazione di strati limite interni in condizioni di vento dal mare verso la costa. Sono stati proposti diversi metodi per la stima dell'effetto della self-correlazione nella derivazione delle relazioni di flusso-gradiente, dovuta alla condivisione della variabile u*. La formula per il coefficiente lineare di self correlazione e le sue distribuzioni di probabilità empiriche sono state derivate e hanno permesso di stimare il livello di self-correlazione presente nel dataset considerato.

First assessment on genetic structure and phylogeography of Mediterranean blue shark (prionace glauca, L. 1758) population using mitochondrial gene variation: a comparison with the Atlantic.

The blue shark, Prionace glauca, is one of the most vagile shark species worldwide distributed. The particular body shape allows blue sharks make transoceanic movements, leading to a circumglobal distribution. Due to its reproductive cycle, an extraordinarily high number of specimens is globally registered but, even if it is still a major bycatch of longline fishery rather than a commercial target, it is characterized by a high vulnerability. In this perspective it is important to increase the amount of informations regarding its population extent in the different worldwide areas, evaluating the possible phylogeographic patterns between different locations. This study, included in the "MedBlueSGen" European project, aims exactly at filling a gap in knowledges regarding the genetic population structure of the Mediterranean blue sharks, which has never been investigated before, with a comparison with the North-Eastern Atlantic blue shark population. To reach this objective, we used a dataset of samples from different Mediterranean areas implementing it with some samples from North-Eastern Atlantic. Analyzing the variability of the two mitochondrial markers control region and cytochrome b, with the design of new species-specific primer pairs, we assessed the mitochondrial genetic structure of Mediterranean and North-Eastern Atlantic samples, focusing on the analysis of their possible connectivity, and we tried to reconstruct their demographic history and population size. Data analyses highlighted the absence of a genetic structuring within the Mediterranean and among it and North-Eastern Atlantic, suggesting that the Strait of Gibraltar doesn't represent a phylogeographic barrier. These results are coherent to what has been found in similar investigations on other worldwide blue shark populations. Analysis of the historical demographic trend revealed a general stable pattern for the cytochrome-b and a slightly population expansion for the control region marker.

Expression of human cathepsin L or human cathepsin V in mouse thymus mediates positive selection of T helper cells in cathepsin L knock-out mice

A genetic deficiency of the cysteine protease cathepsin L (Ctsl) in mice results in impaired positive selection of conventional CD4+ T helper cells as a result of an incomplete processing of the MHC class II associated invariant chain or incomplete proteolytic generation of positively selecting peptide ligands. The human genome encodes, in contrast to the mouse genome, for two cathepsin L proteases, namely cathepsin L (CTSL) and cathepsin V (CTSV; alternatively cathepsin L2). In the human thymic cortex, CTSV is the predominately expressed protease as compared to CTSL or other cysteine cathepsins. In order to analyze the functions of CTSL and CTSV in the positive selection of CD4+ T cells we employed Ctsl knock-out mice crossed either with transgenic mice expressing CTSL under the control of its genuine human promoter or with transgenic mice expressing CTSV under the control of the keratin 14 (K14) promoter, which drives expression to the cortical epithelium. Both human proteases are expressed in the thymus of the transgenic mice, and independent expression of both CTSL and CTSV rescues the reduced frequency of CD4+ T cells in Ctsl-deficient mice. Moreover, the expression of the human cathepsins does not change the number of CD4+CD25+Foxp3+ regulatory T cells, but the normalization of the frequency of conventional CD4+ T cell in the transgenic mice results in a rebalancing of conventional T cells and regulatory T cells. We conclude that the functional differences of CTSL and CTSV in vivo are not mainly determined by their inherent biochemical properties, but rather by their tissue specific expression pattern.

Controversies in cardiovascular medicine: Chronic stable coronary artery disease: drugs vs. revascularization

Coronary artery disease remains the leading cause of mortality in most industrialized countries, although age-standardized mortality related to coronary artery disease (CAD) has decreased by more than 40% during the last two decades. Coronary atherosclerosis may cause angina pectoris, myocardial infarction, heart failure, arrhythmia, and sudden death. Medical management of atherosclerosis and its manifestation aims at retardation of progression of plaque formation, prevention of plaque rupture, and subsequent events and treatment of symptoms, when these occur as well as treatment of the sequelae of the disease. Revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) is performed as treatment of flow-limiting coronary stenosis to reduce myocardial ischaemia. In high-risk patients with acute coronary syndromes (ACS), a routine invasive strategy with revascularization in most patients provides the best outcome with a significant reduction in death and myocardial infarction compared with an initial conservative strategy. Conversely, the benefit of revascularization among patients with chronic stable CAD has been called into question. This review will provide information that revascularization exerts favourable effects on symptoms, quality of life, exercise capacity, and survival, particularly in those with extensive CAD and documented moderate-to-severe ischaemia. Accordingly, CABG and PCI should be considered a valuable adjunct rather than an alternative to medical therapy.

Impact of non-steroidal anti-inflammatory drugs (NSAIDs) on cardiovascular outcomes in patients with stable atherothrombosis or multiple risk factors

We aimed to assess whether the use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of cardiovascular (CV) events in stable patients with established atherothrombosis or multiple risk factors.