Probabilistic techniques for bridging the semantic gap in schema alignment

Connecting pieces of informations from heterogeneous sources sharing the same domain is an open challenge in Semantic Web, Big Data and business communities. The main problem in this research area is to bridge the expressiveness gap between relational databases and ontologies. In general, an ontology is more expressive and captures more semantic information behind data than a relational database does. On the other side, databases are the most common used persistent storage system and they grant benefits such as security and data integrity but they need to be managed by expert users. The problem is quite significant above all when enterprise or corporate ontologies are used to share infomations coming from different databases and where a more efficient data management is auspicable for interoperability purposes. The main motivations on this thesis are related to the database access via ontology, as in the OBDA (Ontology Based Data Access) scenario, wich provides a formal specification of the domain close to the human’s view, while technical details of the database are hidden from end-user, and also the persistent storageof ontologies in databases for facilitating search and retrieval, keeping the benefits of database management systems. In these cases the assertion component (A-Box) is usually stored into a database, and terminological one (T-Box) is mantained in an ontology. So it is more necessary to align schemas than matching instances. The term alignment can be used to define the whole process comprising the mapping process between two existent heterogeneous sources, such as ontology and relational database, and the trasformation process from a representation to the other one, such as ontology-to-database and database-to-ontology. Defining mappings manually is an hard task expecially for large and complex data representations and existing methodologies fail in loosing some contents and several elements are left unaligned. In this thesis are discussed various aspects of the alignment in all these senses. The presented techniques are based on a probabilistic approach that fits well on the uncertain alignment process, where are involved two different representations with a different level of expressiveness. In the methodology ontologies and databases are described in terms of Ontology Web Language (OWL) and Entity-Relationship Diagram (ERD) lexical descriptions. So, the ontologies are represented by a set of OWL axioms while a properly defined Context-Free Grammar (CFG) is used to represent ERDs (Entity-Relationship Diagrams) as a set of sentences. Both the OWL → ERD transformation and the mapping rely on HMMs (Hidden Markov Models) to estimate the most likely sequence of ERD symbols observing OWL symbols. In the model definition OWL constructs are the observable states, while the ERD symbols are the hidden states. The tools developed, one for OWL → ERD transformation purpose, called OMEGA (Ontology → Markov → ERD Generator Application) and one for mapping OWL and ERD, called HOwErd (HMM OWL-ERD) own their own GUI interface for showing the alignment results. Finally, HOwErd is compared with the most widespread tools in the reference literature

REGIONAL MAPPING OF MYOCARDIAL HIBERNATION PHENOTYPE IN IDIOPATHIC END-STAGE DILATED CARDIOMYOPATHY

Myocardial hibernation (MH) is a well-known feature of human ischaemic cardiomyopathy (ICM), whereas its presence in human idiopathic dilated cardiomyopathy (DCM) is still controversial. We investigated the histological and molecular features of MH in left ventricle (LV) regions of failing DCM or ICM hearts. We examined failing hearts from DCM (n = 11; 41.9 ± 5.45 years; left ventricle-ejection fraction (LV-EF), 18 ± 3.16%) and ICM patients (n = 12; 58.08 ± 1.7 years; LVEF, 21.5 ± 6.08%) undergoing cardiac transplantation, and normal donor hearts (N, n = 8). LV inter-ventricular septum (IVS) and antero-lateral free wall (FW) were transmurally (i.e. sub-epicardial, mesocardial and sub-endocardial layers) analysed. LV glycogen content was shown to be increased in both DCM and ICM as compared with N hearts (P < 0.001), with a U-shaped transmural distribution (lower values in mesocardium). Capillary density was homogenously reduced in both DCM and ICM as compared with N (P < 0.05 versus N), with a lower decrease independent of the extent of fibrosis in sub-endocardial and sub-epicardial layers of DCM as compared with ICM. HIF1-α and nestin, recognized ischaemic molecular hallmarks, were similarly expressed in DCM-LV and ICM-LV myocardium. The proteomic profile was overlapping by ~50% in DCM and ICM groups. Morphological and molecular features of MH were detected in end-stage ICM as well as in end-stage DCM LV, despite epicardial coronary artery patency and lower fibrosis in DCM hearts. Unravelling the presence of MH in the absence of coronary stenosis may be helpful to design a novel approach in the clinical management of DCM

Hyaluronan mixed esters of butyric and retinoic acid drive cardiac and endothelial fate in term placenta human mesenchymal stem cells and enhance cardiac repair in infarcted rat hearts.

We have developed a mixed ester of hyaluronan with butyric and retinoic acid (HBR) that acted as a novel cardiogenic/vasculogenic agent in human mesenchymal stem cells isolated from bone marrow, dental pulp, and fetal membranes of term placenta (FMhMSCs). HBR remarkably enhanced vascular endothelial growth factor (VEGF), KDR, and hepatocyte growth factor (HGF) gene expression and the secretion of the angiogenic, mitogenic, and antiapoptotic factors VEGF and HGF, priming stem cell differentiation into endothelial cells. HBR also increased the transcription of the cardiac lineage-promoting genes GATA-4 and Nkx-2.5 and the yield of cardiac markerexpressing cells. These responses were notably more pronounced in FMhMSCs. FMhMSC transplantation into infarcted rat hearts was associated with increased capillary density, normalization of left ventricular function, and significant decrease in scar tissue. Transplantation of HBR-preconditioned FMhM-SCs further enhanced capillary density and the yield of human vWF-expressing cells, additionally decreasing the infarct size. Some engrafted, HBR-pretreated FMhMSCs were also positive for connexin 43 and cardiac troponin I. Thus, the beneficial effects of HBR-exposed FMhMSCs may be mediated by a large supply of angiogenic and antiapoptotic factors, and FMhMSC differentiation into vascular cells. These findings may contribute to further development in cell therapy of heart failure

Graphene oxide-polysulfone hollow fibers membranes with synergic ultrafiltration and adsorption for enhanced drinking water treatment

Polysulfone-graphene oxide hollow fiber membranes (PSU-GO HFs) with simultaneous adsorption and ultrafiltration capabilities are herein described and proposed for enhanced and simplified Point-of-Use (POU) drinking water purification. The PSU-GO HFs were prepared by phase inversion extrusion by a customized semi-industrial plant and their morphology, surface properties, and porosity were investigated by combined Scanning Electron Microscopy (SEM), contact angle and Raman confocal microscopy, in relation to different GO:PSU ratios (1–5% w/w GO vs PSU) and to the final adsorption-ultrafiltration properties. Filtration modules of PSU-GO HFs of filtering surface (FS) in the range 0,015–0,28 m2 showed same ultrafiltration capability of PSU-HF standard filters. Synergic adsorption properties were demonstrated by studying the adsorption maximum capacity of ciprofloxacin antibiotic (CIPRO) vs GO ratio in dead end in-out configuration, the standard configuration used for PSU HFs commercial modules. Loading of 3,5% GO vs PSU was selected as case study, representing the best compromise between performance and GO nanofiller amount. Heavy metals (Pb, Cu and Cr(III)) and polyfluoroalkyl substances (PFAS) removal capabilities from tap water were competitive and in some cases outperformed Granular Activated Carbon (GAC), the standard industrial sorbent. Ciprofloxacin removal from tap water was also under real operational conditions. Moreover, release of GO from working PSU-GO modules was excluded by Surface Enhanced Raman Spectroscopy (SERS) analysis of treated water having the state-of-the-art limit of quantification of 0.1 μg/L for GO nanosheets

Detection of 3D Cardiac metabolism after injection of hyperpolarized [1-13C]pyruvate

Introduction MRI with hyperpolarised 13C represents a promising modality for in-vivo spectroscopy and provides a unique opportunity for non-invasive assessment of cardiac regional metabolism. Purpose We present a method based on a volumetric IDEAL spiral CSI acquisition for obtaining spatial information on the metabolism of the whole heart after intravenous injection of hyperpolarized [1-13C]pyruvate in a large animal model with a clinical 3T scanner. Methods Three healthy male mini-pigs (38±2 kg) were maintained under deep sedation; a dose of 20 mL of 230 mM [1-13C]pyruvate was administered over about 10 s by manual injection. Animal experiments were performed on a 3T GE Signa HDx scanner with a 13C quadrature birdcage coil. [1-13C]pyruvate was polarized using a HyperSense DNP polariser with subsequent dissolution. The final injection solution contained 230 mM sodium [1-13C]pyruvate, 100 mM TRIS buffer, 0.27 mM Na2EDTA and 20 μM Dotarem with T≈37°C and pH ≈ 7.6. Anatomical reference images were acquired in the axial plane with standard FIESTA sequence (body coil FOV=30x30 cm2, FA=20°, TE/TR=3.8ms/7.52ms, matrix 224x160, slice thickness 5 mm, 20 slices). Metabolic information covering the heart were obtained using a 3D IDEAL spiral CSI prescribed on the same region imaged by the reference anatomical sequence (FOV= 30x30 cm, slab thickness=100mm) starting 20 seconds after the beginning of the hyperpolarized [113C]-pyruvate injection. The IDEAL spiral CSI concept was implemented into a multi-slice, pulse-and-acquire sequence with a 2D spiral readout and phase encoding along the third dimension. A constant echo time shift of TE=0.9ms, 11 encoding steps and FA=7° were used to optimize the study for the considered frequencies. The data was reconstructed using spectrally-preconditioned, minimum-norm CS inversion followed by gridding reconstruction implemented in Matlab. The reconstruction on cardiac short axis (SA) and image fusion was performed by PMOD software. Results Pyruvate and its metabolic products lactate and bicarbonate were detected in the heart. Metabolic maps overlaid on anatomical images are shown in Figure 1. On SA sections the metabolites signal resulted correctly localized in cardiac structures: pyruvate more evident in ventricular cavity, bicarbonate in myocardial wall

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P &lt; 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p &lt; 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population