Lesion detection and classification in breast cancer: evaluation of approaches based on morphological features, tracer kinetic modelling and semi-quantitative parameters in MR functional imaging (DCE-MRI)

The diagnosis, grading and classification of tumours has benefited considerably from the development of DCE-MRI which is now essential to the adequate clinical management of many tumour types due to its capability in detecting active angiogenesis. Several strategies have been proposed for DCE-MRI evaluation. Visual inspection of contrast agent concentration curves vs time is a very simple yet operator dependent procedure, therefore more objective approaches have been developed in order to facilitate comparison between studies. In so called model free approaches, descriptive or heuristic information extracted from time series raw data have been used for tissue classification. The main issue concerning these schemes is that they have not a direct interpretation in terms of physiological properties of the tissues. On the other hand, model based investigations typically involve compartmental tracer kinetic modelling and pixel-by-pixel estimation of kinetic parameters via non-linear regression applied on region of interests opportunely selected by the physician. This approach has the advantage to provide parameters directly related to the pathophysiological properties of the tissue such as vessel permeability, local regional blood flow, extraction fraction, concentration gradient between plasma and extravascular-extracellular space. Anyway, nonlinear modelling is computational demanding and the accuracy of the estimates can be affected by the signal-to-noise ratio and by the initial solutions. The principal aim of this thesis is investigate the use of semi-quantitative and quantitative parameters for segmentation and classification of breast lesion. The objectives can be subdivided as follow: describe the principal techniques to evaluate time intensity curve in DCE-MRI with focus on kinetic model proposed in literature; to evaluate the influence in parametrization choice for a classic bi-compartmental kinetic models; to evaluate the performance of a method for simultaneous tracer kinetic modelling and pixel classification; to evaluate performance of machine learning techniques training for segmentation and classification of breast lesion.

Automatic induction of lexical features

This thesis concerns artificially intelligent natural language processing systems that are capable of learning the properties of lexical items (properties like verbal valency or inflectional class membership) autonomously while they are fulfilling their tasks for which they have been deployed in the first place. Many of these tasks require a deep analysis of language input, which can be characterized as a mapping of utterances in a given input C to a set S of linguistically motivated structures with the help of linguistic information encoded in a grammar G and a lexicon L: G + L + C → S (1) The idea that underlies intelligent lexical acquisition systems is to modify this schematic formula in such a way that the system is able to exploit the information encoded in S to create a new, improved version of the lexicon: G + L + S → L' (2) Moreover, the thesis claims that a system can only be considered intelligent if it does not just make maximum usage of the learning opportunities in C, but if it is also able to revise falsely acquired lexical knowledge. So, one of the central elements in this work is the formulation of a couple of criteria for intelligent lexical acquisition systems subsumed under one paradigm: the Learn-Alpha design rule. The thesis describes the design and quality of a prototype for such a system, whose acquisition components have been developed from scratch and built on top of one of the state-of-the-art Head-driven Phrase Structure Grammar (HPSG) processing systems. The quality of this prototype is investigated in a series of experiments, in which the system is fed with extracts of a large English corpus. While the idea of using machine-readable language input to automatically acquire lexical knowledge is not new, we are not aware of a system that fulfills Learn-Alpha and is able to deal with large corpora. To instance four major challenges of constructing such a system, it should be mentioned that a) the high number of possible structural descriptions caused by highly underspeci ed lexical entries demands for a parser with a very effective ambiguity management system, b) the automatic construction of concise lexical entries out of a bulk of observed lexical facts requires a special technique of data alignment, c) the reliability of these entries depends on the system's decision on whether it has seen 'enough' input and d) general properties of language might render some lexical features indeterminable if the system tries to acquire them with a too high precision. The cornerstone of this dissertation is the motivation and development of a general theory of automatic lexical acquisition that is applicable to every language and independent of any particular theory of grammar or lexicon. This work is divided into five chapters. The introductory chapter first contrasts three different and mutually incompatible approaches to (artificial) lexical acquisition: cue-based queries, head-lexicalized probabilistic context free grammars and learning by unification. Then the postulation of the Learn-Alpha design rule is presented. The second chapter outlines the theory that underlies Learn-Alpha and exposes all the related notions and concepts required for a proper understanding of artificial lexical acquisition. Chapter 3 develops the prototyped acquisition method, called ANALYZE-LEARN-REDUCE, a framework which implements Learn-Alpha. The fourth chapter presents the design and results of a bootstrapping experiment conducted on this prototype: lexeme detection, learning of verbal valency, categorization into nominal count/mass classes, selection of prepositions and sentential complements, among others. The thesis concludes with a review of the conclusions and motivation for further improvements as well as proposals for future research on the automatic induction of lexical features.

Analysis of the immunological and functional features of the Neisserial Heparin Binding Antigen (NHBA)

Neisserial Heparin Binding Antigen (NHBA) is a surface-exposed lipoprotein ubiquitously expressed by genetically diverse Neisseria meningitidis strains and is an antigen of the multicomponent protein-based 4CMenB vaccine, able to induce bactericidal antibodies in humans and to bind heparin-like molecules. The aim of this study is to characterize the immunological and functional properties of NHBA. To evaluate immunogenicity and the contribution of aminoacid sequence variability to vaccine coverage, we constructed recombinant isogenic strains that are susceptible to bactericidal killing only by anti-NHBA antibodies and engineered them to express equal levels of selected NHBA peptides. In these recombinant strains, we observed different titres associated with the different peptide variants. These recombinant strains were then further engineered to express NHBA chimeric proteins to investigate the regions important for immunogenicity. In natural strains, anti-NHBA antibodies were found to be cross-protective against strains expressing different peptides. To investigate the functional properties of this antigen, the recombinant purified NHBA protein was tested in in vitro binding studies and was found to be able to bind epithelial cells. The binding was abolished when cells were treated specifically with heparinase III, suggesting that the interaction with the cells is mediated by heparan sulfate proteoglycans (HSPG). Mutation of the Arg-rich tract of NHBA abrogated the binding, confirming the importance of this region in mediating the binding to heparin-like molecules. In a panel of N. meningitidis strains, the deletion of nhba resulted in a reduction of adhesion with respect to each isogenic wild type strain. Furthermore, the adhesion of the wild-type strain was prevented by using anti-NHBA polyclonal sera, demonstrating the specificity of the interaction. These results suggest that NHBA could be a novel meningococcal adhesin contributing to host-cell interaction. Moreover, we analysed NHBA NalP-mediated cleavage in different NHBA peptides and showed that not all NHBA peptides are cleaved.

Implementazione di un modello della memoria semantica e lessicale basato sull'utilizzo di features

L’elaborato utilizza un modello neurale, sviluppato nel lavoro di ricerca del prof. Ursino (2010) e successivamente modificato (2011 e 2012), al fine di analizzare alcuni meccanismi alla base della memoria semantica e lessicale. In particolare, la tesi si riferisce alla versione più recente del modello da cui ne deriva uno più semplificato come possibile modalità con cui l’uomo apprende i concetti, li immagazzina in opportune aree cerebrali e collega tali concetti alla parola corrispondente.

Geological and hydrogeological features affecting migration, multi-phase partitioning and degradation of chlorinated hydrocarbons through unconsolidated porous media.

Chlorinated solvents are the most ubiquitous organic contaminants found in groundwater since the last five decades. They generally reach groundwater as Dense Non-Aqueous Phase Liquid (DNAPL). This phase can migrate through aquifers, and also through aquitards, in ways that aqueous contaminants cannot. The complex phase partitioning to which chlorinated solvent DNAPLs can undergo (i.e. to the dissolved, vapor or sorbed phase), as well as their transformations (e.g. degradation), depend on the physico-chemical properties of the contaminants themselves and on features of the hydrogeological system. The main goal of the thesis is to provide new knowledge for the future investigations of sites contaminated by DNAPLs in alluvial settings, proposing innovative investigative approaches and emphasizing some of the key issues and main criticalities of this kind of contaminants in such a setting. To achieve this goal, the hydrogeologic setting below the city of Ferrara (Po plain, northern Italy), which is affected by scattered contamination by chlorinated solvents, has been investigated at different scales (regional and site specific), both from an intrinsic (i.e. groundwater flow systems) and specific (i.e. chlorinated solvent DNAPL behavior) point of view. Detailed investigations were carried out in particular in one selected test-site, known as “Caretti site”, where high-resolution vertical profiling of different kind of data were collected by means of multilevel monitoring systems and other innovative sampling and analytical techniques. This allowed to achieve a deep geological and hydrogeological knowledge of the system and to reconstruct in detail the architecture of contaminants in relationship to the features of the hosting porous medium. The results achieved in this thesis are useful not only at local scale, e.g. employable to interpret the origin of contamination in other sites of the Ferrara area, but also at global scale, in order to address future remediation and protection actions of similar hydrogeologic settings.

Spatio-temporal diversity of Megistozoobenthos in the Antalya Gulf and relationships with environmental features

Antalya Gulf is situated in the Levantine Sea, the second biggest and most eastern basin in the Mediterranean Sea. This area is an ultra-oligotrophic basin, strongly affected by anthropogenic inputs, in particular in the fishing areas. For this characteristic, in the Levantine Sea, there is a strong pressure on the natural resources and benthic assemblages. Furthermore, many alien species enter from Suez Canal and are well established in the area. All these pressures are leading to a degradation of the Levantine Sea. For this reason it is important to have tools to study and monitoring the functioning of the marine ecosystem. Benthic organisms are superior to many other biological groups for their response to environmental stresses. The variability of benthic assemblages on a site can reflect, in an integrative mode, the entire functioning of the marine ecosystem. In this study, that wants to analyze the spatial and temporal distribution of the benthic macrofaunal assemblages of Antalya Gulf, 90 benthic species divided in 8 taxa (Annelida, Cnidaria, Echinodermata, Echiura, Mollusca, Porifera, Sipunculida and Tunicata) were found. All the analyses conducted on the entire benthic class and later on Mollusca and Echinodermata separately highlighted the importance of depth on structuring benthic community.

Rapid spontaneous malignant progression of supratentorial tanycytic ependymoma with sarcomatous features - "Ependymosarcoma"

By analogy to gliosarcoma, the term "ependymosarcoma" has recently been coined to thematize the rare phenomenon of a malignant mesenchymal component arising within an ependymoma. We report on an example of this paradigm, involving tanycytic ependymoma as the host tumor in a 40-year-old female who underwent two tumor extirpation procedures at one-year interval. She first presented with severe headaches, and was seen by imaging to harbor a moderately enhancing mass 2.5cm in diameter at the rostral septum pellucidum accompanied by occlusive hydrocephalus. Microscopically, the tumor consisted of solid, wavy fascicles of elongated cells that were occasionally interrupted by vague perivascular pseudorosettes. Mitotic activity was absent, and less than 1% of nuclei immunoreacted for MIB-1. A histological diagnosis of tanycytic ependymoma (WHO grade II) was rendered, and no adjuvant therapy given. At recurrence, the lesion was 3.5cm in diameter, intensely enhancing, and had already seeded into the subarachnoid space. Histology showed a biphasic glial-sarcomatous architecture with remnants of the original ependymoma now displaying hypercellularity and atypical - yet not frankly anaplastic - features. The sarcomatous moiety consisted of spindle and epithelioid cells densely interwoven with reticulin fibers. While the ependymal component was GFAP and S100 protein positive, and featured punctate staining for EMA, none of these markers was expressed in the adjacent sarcoma. Instead, the latter reacted for vimentin and smooth muscle actin. To the best of our knowledge, this is the first documentation of tanycytic ependymoma undergoing malignant transformation, one driven by a highly anaplastic mesenchymal component, corresponding to "ependymosarcoma".

Inherited cavernous malformations of the central nervous system: clinical and genetic features in 19 Swiss families

Cavernous malformations (CCMs) are benign, well-circumscribed, and mulberry-like vascular malformations that may be found in the central nervous system in up to 0.5% of the population. Cavernous malformations can be sporadic or inherited. The common symptoms are epilepsy, hemorrhages, focal neurological deficits, and headaches. However, CCMs are often asymptomatic. The familiar form is associated with three gene loci, namely 7q21-q22 (CCM1), 7p13-p15 (CCM2), and 3q25.2-q27 (CCM3) and is inherited as an autosomal dominant trait with incomplete penetrance. The CCM genes are identified as Krit 1 (CCM1), MGC4607 (CCM2), and PDCD10 (CCM3). Here, we present the clinical and genetic features of CCMs in 19 Swiss families. Furthermore, surgical aspects in such families are also discussed.

The ocular motor features of adult-onset alexander disease: a case and review of the literature

A 51-year-old Chinese man presented with gaze-evoked nystagmus, impaired smooth pursuit and vestibular ocular reflex cancellation, and saccadic dysmetria, along with a family history suggestive of late-onset autosomal dominant parkinsonism. MRI revealed abnormalities of the medulla and cervical spinal cord typical of adult-onset Alexander disease, and genetic testing showed homozygosity for the p.D295N polymorphic allele in the gene encoding the glial fibrillary acidic protein. A review of the literature shows that ocular signs are frequent in adult-onset Alexander disease, most commonly gaze-evoked nystagmus, pendular nystagmus, and/or oculopalatal myoclonus, and less commonly ptosis, miosis, and saccadic dysmetria. These signs are consistent with the propensity of adult-onset Alexander disease to cause medullary abnormalities on neuroimaging.

EFFECT OF AGING ON MACULAR FEATURES OF X-LINKED RETINOSCHISIS ASSESSED WITH OPTICAL COHERENCE TOMOGRAPHY

X-linked retinoschisis (XLRS) is one of the most common causes of macular degeneration in young men. The purpose of this study was to use optical coherence tomography combined with ophthalmoscopy to study the effects of aging on the morphologic changes associated with XLRS.