Building an ecologically valid facial expression database – Behind the scenes

Artificial Intelligence (AI) algorithms, together with a general increased computational performance, allow nowadays exploring the use of Facial Expression Recognition (FER) as a method of recognizing human emotion through the use of neural networks. The interest in facial emotion and expression recognition in real-life situations is one of the current cutting-edge research challenges. In this context, the creation of an ecologically valid facial expression database is crucial. To this aim, a controlled experiment has been designed, in which thirty-five subjects aged 18–35 were asked to react spontaneously to a set of 48 validated images from two affective databases, IAPS and GAPED. According to the Self-Assessment Manikin, participants were asked to rate images on a 9-points visual scale on valence and arousal. Furthermore, they were asked to select one of the six Ekman’s basic emotions. During the experiment, an RGB-D camera was also used to record spontaneous facial expressions aroused in participants storing both the color and the depth frames to feed a Convolutional Neural Network (CNN) to perform FER. In every case, the prevalent emotion pointed out in the questionnaires matched with the expected emotion. CNN obtained a recognition rate of 75.02%, computed comparing the neural network results with the evaluations given by a human observer. These preliminary results have confirmed that this experimental setting is an effective starting point for building an ecologically valid database

Hypertension in adult Fabry's disease: is cardiotrophin-1 a diagnostic biomarker?

Background: Cardiotrophin-1 (CT-1), a cytokine produced by cardiomyocytes and non-cardiomyocytes in conditions of stress, can be used as a biomarker of left ventricular hypertrophy and dysfunction in hypertensive patients. Hypertension is one of the main adverse events in the third and last phase of Fabry's disease (FD). We measured CT-1 in order to examine its correlation with the vascular and cardiac alterations at different ages and assess its potential for use as a biomarker of hypertension in FD. Findings: The level of CT-1 was clearly higher in hypertensive adults than in adult FD patients. FD patients show a small, non-significant decrease in plasma CT-1 with age, while in hypertensive patients CT-1 in plasma rises strongly and highly significantly with age. Conclusions: CT-1 can be considered a good biomarker of the progression of hypertension with age, but particular care is needed when following hypertension in FD patients, since CT-1 does not correlate the same way with this disease

PCSK9 Expression in Epicardial Adipose Tissue : Molecular Association with Local Tissue Inflammation

Epicardial adipose tissue (EAT) has the unique property to release mediators that nourish the heart in healthy conditions, an effect that becomes detrimental when volume expands and proinflammatory cytokines start to be produced. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a proinflammatory mediator involved in atherosclerosis, is also produced by visceral fat. Due to the correlation of inflammation with PCSK9 and EAT enlargement, we evaluated whether PCSK9 was expressed in EAT and associated with EAT inflammation and volume. EAT samples were isolated during surgery. EAT thickness was measured by echocardiography. A microarray was used to explore EAT transcriptoma. The PCSK9 protein levels were measured by Western Blot in EAT and ELISA in plasma. PCSK9 was expressed at both the gene and protein levels in EAT. We found a positive association with EAT thickness and local proinflammatory mediators, in particular, chemokines for monocytes and lymphocytes. No association was found with the circulating PCSK9 level. The expression of PCSK9 in EAT argues that PCSK9 is part of the EAT secretome and EAT inflammation is associated with local PCSK9 expression, regardless of circulating PCSK9 levels. Whether reducing EAT inflammation or PCSK9 local levels may have beneficial effects on EAT metabolism and cardiovascular risk needs further investigations

Correlative study on impaired prostaglandin E2 regulation in EAT and maladaptive cardiac remodeling via EPAC2 and ST2 signaling in overweight CVD subjects

There is recent evidence that the dysfunctional responses of a peculiar visceral fat deposit known as epicardial adipose tissue (EAT) can directly promote cardiac enlargement in the case of obesity. Here, we observed a newer molecular pattern associated with LV dysfunction mediated by prostaglandin E2 (PGE(2)) deregulation in EAT in a cardiovascular disease (CVD) population. A series of 33 overweight CVD males were enrolled and their EAT thickness, LV mass, and volumes were measured by echocardiography. Blood, plasma, EAT, and SAT biopsies were collected for molecular and proteomic assays. Our data show that PGE(2) biosynthetic enzyme (PTGES-2) correlates with echocardiographic parameters of LV enlargement: LV diameters, LV end diastolic volume, and LV masses. Moreover, PTGES-2 is directly associated with EPAC2 gene (r = 0.70, p < 0.0001), known as a molecular inducer of ST2/IL-33 mediators involved in maladaptive heart remodelling. Furthermore, PGE(2) receptor 3 (PTEGER3) results are downregulated and its expression is inversely associated with ST2/IL-33 expression. Contrarily, PGE(2) receptor 4 (PTGER4) is upregulated in EAT and directly correlates with ST2 molecular expression. Our data suggest that excessive body fatness can shift the EAT transcriptome to a pro-tissue remodelling profile, may be driven by PGE(2) deregulation, with consequent promotion of EPAC2 and ST2 signalling

Adipokines and Sexual Hormones Associated with the Components of the Metabolic Syndrome in Pharmacologically Untreated Subjects: Data from the Brisighella Heart Study

We evaluated the association of the sex hormone pattern and the serum level of the main adipokines to metabolic syndrome (MS) and its components in 199 pharmacologically untreated subjects. Men and women included in the age-class subgroups were matched for body mass index, waist circumference, blood pressure, heart rate, fasting plasma glucose, and plasma lipids. Men without MS had significantly lower leptin/adiponectin ratio than men with MS. Women without MS had lower leptin and leptin/adiponectin ratio than women with MS but had significantly higher adiponectin, estrone, and dehydroepiandrosterone levels. In men, the leptin/adiponectin ratio is the main factor associated to MS diagnosis (OR: 3.36, 95% CI 1.40–8.08), while in women adiponectin alone appears to be a protective factor (OR: 0.87, 95% CI 0.79–0.95). In conclusion, in a sample of pharmacologically untreated subjects, leptin/adiponectin ratio seems to be the factor more strongly associated to MS and its components

Hypertrophic Epicardial Adipose Tissue is a Source of EPAC Proteins Directly Associate to ST2 Production and Heart Dilation and may be Potential Index of Heart Remodeling in CVDs Patients

Introduction: Epicardial adipose tissue (EAT) is a myocardial fat from which released molecules can directly reach the heart. In pathological conditions, the ubiquitously tissue hypertrophy mediators are the exchange proteins directly activated by cAMP (EPACs), named EPAC1 and EPAC2. In the heart the main protective signalling against detrimental remodelling is the ST2 and IL33 molecules. ST2 exists both as transmembrane receptor (ST2L) and soluble (sST2) form and in case of physiological stretch ST2L bind IL33 promoting anti-fibrotic signals. Contrarily in CVDs, sST2 is up regulated functioning as scavenger of IL33 and promoting heart dilatation. Interesting is that ST2 can be also produced by adipose tissue in normal condition. Due to EPACs properties to induce hyperplasia, our hypothesis is that larger EAT cells may also produce sST2 that can local amplify its detrimental role on myocardium. For these reasons we want to verified in CVDs patients first if larger EAT cells are able to up regulate EPAC proteins and second if EPACs may be associate to sST2 EAT production and heart dilatation. Methods: 50 CVD patients are enrolled and stratified according to EAT median thickness (8mm). plasma and EAT biopsies are collected during surgery. Indexed left ventricular mass (hLVM), end-diastolic posterior wall (EDPW), relative wall thickness (RWT), left ventricular mass (LVM) values are used as cardiac dilatation indexes commonly approved in clinical practice. Gene expression and protein assays are performed to investigate EPACs, ST2, IL33 mRNA and protein production. Results: Our data demonstrated that CVDs patients with EAT >8mm have significantly positive correlation with RWT and they also presented higher EPAC1 and ST2 mRNA and protein levels than CVDs patients 8mm and up-regulated in CVDs patients < 8mm. CVDs patients with hypertrophic EAT both EPAC1 and EPAC2presented positive correlation with hLVM, EDPW, LVM indexes and ST2 mRNA levels. Conclusion: Our results demonstrated that EPACs are directly associate to EAT hyperplasia and sST2 local production suggesting their implication in detrimental heart hyperplasia. From these results we can suggest that EAT thickness can be a potential newer parameter of detrimental heart remodelling in the prevention of CVDs complications

Irisin : A Potential Link between Physical Exercise and Metabolism : An Observational Study in Differently Trained Subjects, from Elite Athletes to Sedentary People

We compared irisin levels among groups of differently trained healthy individuals to explore the role of irisin as a physiological linker between exercise and metabolic health. Irisin and biochemical parameters of glucose and lipid metabolism were assessed in 70 healthy volunteers stratified for sport performance level into four groups: (1) 20 elite athletes of national level, (2) 20 subelite athletes of local level, (3) 20 recreational athletes, and (4) 10 sedentary subjects. All biochemical parameters were within the ranges of normality. Fasting glucose, HOMA-IR, and total cholesterol levels were inversely related to the degree of physical activity. HbA1c was higher in elite athletes compared to all the other groups (p < 0.01). A U-shaped relation between free fatty acids and the degree of physical activity was observed. All groups showed similar plasma irisin levels. After correction for the degree of insulin resistance (irisin/HOMA-IR), elite athletes showed higher levels compared to sedentary and recreational subjects (p < 0.01 and p < 0.05, resp.). In addition, the number of metabolic parameters correlated with irisin increased at increasing the training status. Our study suggests a correlation between sport performance, insulin sensitivity, and irisin levels. Irisin may be one potential mediator of the beneficial effects of exercise on metabolic profile

Glycated albumin for glycemic control in t2dm population: A multi-dimensional evaluation

Purpose: To investigate the glycated albumin (GA) introduction implications, as an add-on strategy to traditional glycemic control (Hb1Ac and fasting plasma glucose – FPG) instruments, considering insulin-naïve individuals with type 2 diabetes mellitus (T2DM), treated with oral therapies. Methods: A Health Technology Assessment was conducted in Italy, as a multi-dimensional approach useful to validate any innovative technology. The HTA dimensions, derived from the EUnetHTA Core Model, were deployed by means of literature evidence, health economics tools and qualitative questionnaires, filled-in by 15 professionals. Results: Literature stated that the GA introduction could lead to a higher number of individuals achieving therapeutic success after 3 months of therapy (97.0% vs 71.6% without GA). From an economic point of view, considering a projection of 1,955,447 T2DM insulinnaïve individuals, potentially treated with oral therapy, GA introduction would imply fewer individuals requiring a therapy switch (−89.44%), with a 1.06% in costs reduction, on annual basis, thus being also the preferable solution from a cost-effectiveness perspective (costeffectiveness value: 237.74 vs 325.53). According to experts opinions, lower perceptions on GA emerged with regard to equity aspects (0.13 vs 0.72, p-value&gt;0.05), whereas it would improve both individuals (2.17 vs 1.33, p-value=0.000) and caregivers quality of life (1.50 vs 0.83, p-value=0.000). Even if in the short term, GA required additional investments in training courses (−0.80 vs 0.10, p-value = 0.036), in the long run, GA could become the preferable technology (0.30 vs 0.01, p-value=0.018) from an organisational perspective. Conclusion: Adding GA to traditional glycaemic control instruments could improve the clinical pathway of individuals with T2DM, leading to economic and organisational advantages for both hospitals and National Healthcare Systems

Circulating irisn is reduced in male patients with type 1 and type 2 Myotonic Dystrophies

Context: Myotonic dystrophies (DM) are dominantly inherited muscle disorders characterized by myotonia, muscle weakness, and wasting. The reasons for sarcopenia in DMs are uncleared and multiple factors are involved. Irisin, a positive hormone regulator of muscle growth and bone, may play a role. Objectives: To investigate (1) circulating irisin in a series of DM1 and DM2 male patients compared with healthy controls and (2) the relationships between irisin and anthropometric, metabolic and hormonal parameters. Design and study participants: This is a cross-sectional study. Fasting blood samples for glucometabolic, gonadic, bone markers, and irisin were collected from 28 ambulatory DM1, 10 DM2, and 23 age-matched healthy male subjects. Body composition and bone mineralization [bone mineral density (BMD)] were measured by DEXA. Echocardiographic assessment and visceral adiposity, namely, liver and epicardial fat, were investigated by ultrasound. Irisin released from cultured myotubes derived from 3 DM1, 3 DM2, and 3 healthy donors was assayed. Results: Plasma irisin levels were definitely lower in both DM1 and DM2 patients than in controls with no difference between DM1 and DM2. Irisin released from DM1 and DM2 myotubes was similar to that released from myotubes of the non-DM donors, though diabetic DM2 myotubes released more irisin than DM1 myotubes. There was no correlation between irisin and muscle strength or lean mass in both DM1 and DM2 patients. In DM1 patients, plasma irisin levels correlated negatively with oxygen consumption and positively with insulin resistance, while in DM2 patients plasma irisin levels positively correlated with fat mass at arms and legs levels. No correlation with visceral fat, left ventricular mass, and gonadal hormones could be detected. In both DM1 and DM2 patients, legs BMD parameters positively correlated with plasma irisin levels. Conclusion: Plasma irisin is reduced in both DM1 and DM2 male patients likely reflecting muscle mass reduction. Moreover, insulin resistance may contribute to modulation of plasma irisin in DM1 patients. The irisin-mediated cross talk muscle\u2013adipose tissue\u2013bone may be active also in the male myotonic dystrophies\u2019 model