Higher serum levels of periostin and the risk of exacerbations in moderate asthmatics

BACKGROUND: In asthma, exacerbations and poor disease control are linked to airway allergic inflammation. Serum periostin has been proposed as a systemic biomarker of eosinophilic inflammation. This pilot study aims at evaluating whether in patients with moderate asthma, higher baseline levels of serum periostin are associated with a greater risk of exacerbation. METHODS: Fifteen outpatients with moderate allergic asthma were recruited. Serum concentrations of periostin were assessed (ELISA) at baseline, and the frequency of asthma exacerbations was recorded during a one-year follow-up. RESULTS: Patients (M/F: 10/5, mean age of 47.6\u2009\ub1\u200911.0 years) had mean ACQ score of 5.5\u2009\ub1\u20094.2 and FEV1%pred of 81.9\u2009\ub1\u200921.7 %. Baseline serum levels of periostin did not correlate with lung function parameters, nor with the ACQ score (p 650.05 for all analyses). Five subjects (33 % of the study group) reported one or more exacerbations during the following year. Baseline serum levels of periostin were significantly higher in subjects who experienced one or more exacerbations during the one year period of follow-up, compared with subjects with no exacerbations: median serum periostin level was 4047 ng/ml (range: 2231 to 4889 ng/ml) and 222 ng/ml (range 28.2 to 1631 ng/ml) respectively; p\u2009=\u20090.001. CONCLUSION: The findings of the present pilot study could form the basis for the design of larger studies aiming at developing strategies to identify asthmatic patients at risk for exacerbations

Inhibition of PI3K Prevents the Proliferation and Differentiation of Human Lung Fibroblasts into Myofibroblasts: The Role of Class I P110 Isoforms

Idiopathic pulmonary fibrosis (IPF) is a progressive fibroproliferative disease characterized by an accumulation of fibroblasts and myofibroblasts in the alveolar wall. Even though the pathogenesis of this fatal disorder remains unclear, transforming growth factor-β (TGF-β)-induced differentiation and proliferation of myofibroblasts is recognized as a primary event. The molecular pathways involved in TGF-β signalling are generally Smad-dependent yet Smad-independent pathways, including phosphatidylinositol-3-kinase/protein kinase B (PI3K/Akt), have been recently proposed. In this research we established ex-vivo cultures of human lung fibroblasts and we investigated the role of the PI3K/Akt pathway in two critical stages of the fibrotic process induced by TGF-β: fibroblast proliferation and differentiation into myofibroblasts. Here we show that the pan-inhibitor of PI3Ks LY294002 is able to abrogate the TGF-β-induced increase in cell proliferation, in α- smooth muscle actin expression and in collagen production besides inhibiting Akt phosphorylation, thus demonstrating the centrality of the PI3K/Akt pathway in lung fibroblast proliferation and differentiation. Moreover, for the first time we show that PI3K p110δ and p110γ are functionally expressed in human lung fibroblasts, in addition to the ubiquitously expressed p110α and β. Finally, results obtained with both selective inhibitors and gene knocking-down experiments demonstrate a major role of p110γ and p110α in both TGF-β-induced fibroblast proliferation and differentiation. This finding suggests that specific PI3K isoforms can be pharmacological targets in IPF

Economic risk evaluation in urban flooding and instability-prone areas: The case study of san giovanni rotondo (southern Italy)

Estimating economic losses caused on buildings and other civil engineering works due to flooding events is often a difficult task. The accuracy of the estimate is affected by the availability of detailed data regarding the return period of the flooding event, vulnerability of exposed assets, and type of economy run in the affected area. This paper aims to provide a quantitative methodology for the assessment of economic losses associated with flood scenarios. The proposed methodology was performed for an urban area in Southern Italy prone to hydrogeological instabilities. At first, the main physical characteristics of the area such as rainfall, land use, permeability, roughness, and slopes of the area under investigation were estimated in order to obtain input for flooding simulations. Afterwards, the analysis focused on the spatial variability incidence of the rainfall parameters in flood events. The hydraulic modeling provided different flood hazard scenarios. The risk curve obtained by plotting economic consequences vs. the return period for each hazard scenario can be a useful tool for local authorities to identify adequate risk mitigation measures and therefore prioritize the economic resources necessary for the implementation of such mitigation measures

A multi-modal approach to creating routines for smart speakers

Smart speakers can execute user-defined routines, namely, sequences of actions triggered by specific events or conditions. This paper presents a new approach to the creation of routines, which leverages the multi-modal features (vision, speech, and touch) offered by Amazon Alexa running on Echo Show devices. It then illustrates how end users found easier to create routines with the proposed approach than with the usual interaction with the Alexa app

Creating Routines for IoT Ecosystems through Conversation with Smart Speakers

Nowadays, end users can create routines for Amazon Echo and Google Nest devices using a companion app (Amazon Alexa and Google Home, respectively) running on smartphones. Our work explores the possibility of transferring this End-User Development activity directly to the smart speakers, with and without a touchscreen. To this aim, we designed and developed two Amazon Skills (one for Amazon Echo Show and the other for Amazon Echo Dot) and two Google Actions (one for Google Nest Hub and the other for Google Home Speaker). Then, we carried out two controlled experiments, involving 40 participants, to compare routine creation through multi-modal interaction (based on vision, speech, and touch) with routine creation through speech-only interaction. Driven by our research questions, we found that for routine creation the multi-modal interaction is preferred to the speech-only one and the perceived quality of interaction seems to depend on the brand of the smart speaker

Cerebral Aspergillosis in a liver transplant recipient

Cerebral aspergillosis is a life-threatening complication in liver transplant recipients, with mortality rates approaching 100%; treatment with amphotericin B is of limited efficacy because of its poor distribution in the cerebrospinal fluid and its systemic side effects. We report the case of a liver transplant recipient who developed recurrent cerebral Aspergillus fumigatus infection, and was successfully treated by combined surgical excision of the lesion and administration of liposomal amphotericin B. This first report of long-term complication-free survival in a liver transplant recipient suggests that therapy with liposomal amphotericin B may reduce the risk of recurrence of cerebral aspergillosis in these immunocompromised patients. PMID:9551693[PubMed - indexed for MEDLINE

Combined liver and islet transplantation:about one case

Combined liver and islet transplantation: about one case

Higher serum levels of periostin and the risk of exacerbations in moderate asthmatics

Background: In asthma, exacerbations and poor disease control are linked to airway allergic inflammation. Serum periostin has been proposed as a systemic biomarker of eosinophilic inflammation. This pilot study aims at evaluating whether in patients with moderate asthma, higher baseline levels of serum periostin are associated with a greater risk of exacerbation. Methods: Fifteen outpatients with moderate allergic asthma were recruited. Serum concentrations of periostin were assessed (ELISA) at baseline, and the frequency of asthma exacerbations was recorded during a one-year follow-up. Results: Patients (M/F: 10/5, mean age of 47.6 ± 11.0 years) had mean ACQ score of 5.5 ± 4.2 and FEV1%pred of 81.9 ± 21.7 %. Baseline serum levels of periostin did not correlate with lung function parameters, nor with the ACQ score (p ≥0.05 for all analyses). Five subjects (33 % of the study group) reported one or more exacerbations during the following year. Baseline serum levels of periostin were significantly higher in subjects who experienced one or more exacerbations during the one year period of follow-up, compared with subjects with no exacerbations: median serum periostin level was 4047 ng/ml (range: 2231 to 4889 ng/ml) and 222 ng/ml (range 28.2 to 1631 ng/ml) respectively; p = 0.001. Conclusion: The findings of the present pilot study could form the basis for the design of larger studies aiming at developing strategies to identify asthmatic patients at risk for exacerbations