Karachi, Pakistan
Karachi, Pakistan
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Demarche S.F.,Giga Group | Demarche S.F.,The Interdisciplinary Center | Schleich F.N.,Giga Group | Paulus V.A.,Giga Group | And 3 more authors.
Journal of Allergy and Clinical Immunology: In Practice | Year: 2016

Background: Longitudinal trials have suggested that asthma control may be influenced by fluctuations in eosinophilic inflammation. This association has however never been confirmed in daily practice. Objective: To investigate the relationship between asthma control and sputum eosinophils in clinical practice. Methods: A retrospective longitudinal study was conducted on 187 patients with asthma with at least 2 successful sputum inductions at our Asthma Clinic. Linear mixed models were used to assess the relationship between asthma control and individual changes in sputum eosinophils. Receiver-operating characteristic curves were constructed to define minimal important differences (MIDs) of sputum eosinophils associated with a change of at least 0.5 in Asthma Control Questionnaire (ACQ) score. Then, a validation cohort of 79 patients with asthma was recruited to reassess this relationship and the accuracy of the MID values. Results: A multivariate analysis showed that asthma control was independently associated with individual fluctuations in sputum eosinophil count (P < .001). In patients with intermittent/persistently eosinophilic asthma, we calculated a minimal important decrease of 4.3% in the percentage of sputum eosinophils (area under the curve [AUC], 0.69; P < .001) or 3.4-fold (AUC, 0.65; P = .003) for a significant improvement in asthma control and a minimal important increase of 3.5% (AUC, 0.67; P = .004) or 1.8-fold (AUC, 0.63; P = .02) for a significant worsening in asthma control. The association between asthma control and sputum eosinophils and the accuracy of the MIDs of sputum eosinophils were confirmed in the validation cohort. Conclusions: At the individual level, asthma control was associated with fluctuations in sputum eosinophil count over time. © 2017 The Authors.

Ulgiati S.,Parthenope University of Naples | Ascione M.,University of Rome La Sapienza | Bargigli S.,Parthenope University of Naples | Cherubini F.,Norwegian University of Science and Technology | And 4 more authors.
Ecological Modelling | Year: 2011

Selected energy and material resource conversion systems are compared in this paper under an extended LCA point of view. A multi-method multi-scale assessment procedure is applied in order to generate consistent performance indicators based on the same set of input data, to ascertain the existence of constraints or crucial steps characterized by low conversion efficiency and to provide the basis for improvement patterns. Optimizing the performance of a given process requires that many different aspects are taken into account. Some of them, mostly of technical nature, relate to the local scale at which the process occurs. Other technological, economic and environmental aspects are likely to affect the dynamics of the larger space and time scales in which the process is embedded. These spatial and time scale effects require that a careful evaluation of the relation between the process and its surroundings is performed, so that hidden consequences and possible sources of inefficiency and impact are clearly identified. In this paper we analyse and compare selected electricity conversion systems, alternative fuels and biofuels, waste management strategies and finally the time evolution of an urban system, in order to show the importance of a multiple perspective point of view for the proper evaluation of a system's environmental and resource use performance. © 2010 Elsevier B.V.

Moermans C.,Giga Group | Heinen V.,CHU Liege | Nguyen M.,CHU Liege | Henket M.,CHU Liege | And 4 more authors.
Cytokine | Year: 2011

Background: Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammatory disease caused by repeated exposure to noxious gases or particles. It is now recognized that the disease also features systemic inflammation. The purpose of our study was to compare airway and systemic inflammation in COPD to that seen in healthy subjects and to relate the inflammation with the disease severity. Methods: Ninety-five COPD patients, encompassing the whole severity spectrum of the disease, were recruited from our outpatient clinic and rehabilitation center and compared to 33 healthy subjects. Induced sputum and blood samples were obtained for measurement of inflammatory cell count. Interleukin (IL)-4, IL-6, IL-10, TNF-α and IFN-γ produced by 24. h sputum and blood cell cultures were measured. Results: Compared to healthy subjects, COPD exhibited a prominent airway neutrophilic inflammation associated with a marked IL-10, IL-6 and TNF-α release deficiency that contrasted with a raised IFN-γ production. Neutrophilic inflammation was also prominent at blood level together with raised production of IFN-γ, IL-10 and TNF-α. Furthermore, sputum neutrophilia correlated with disease severity assessed by GOLD stages. Likewise the extent of TNF-α release from blood cells also positively correlated with the disease severity but negatively with that of sputum cell culture. Blood release of TNF-α and IL-6 negatively correlated with body mass index. Altogether, our results showed a significant relationship between cellular marker in blood and sputum but poor relationship between local and systemic release of cytokines. Conclusions: COPD is characterized by prominent neutrophilic inflammation and raised IFN-γ production at both bronchial and systemic level. Overproduction of TNF-α at systemic level correlates with disease severity and inversely with body mass index. © 2011 Elsevier Ltd.

Marco J.,University of Madeira | Cerezo E.,Giga Group | Baldassarri S.,Giga Group
EICS'12 - Proceedings of the 2012 ACM SIGCHI Symposium on Engineering Interactive Computing Systems | Year: 2012

This paper presents "ToyVision", a software toolkit aimed to make easy the prototyping of tangible games in visual based tabletop devices. Compared to other software toolkits which offer very limited and tag-centered tangible possibilities, ToyVision provides designers and developers with intuitive tools for modeling innovative tangible controls and with higher level user's manipulations data. ToyVision is based on Reactivision open-source toolkit, which has been extended with new functionalities in its Hardware layer. The main design decision taken has been to split the Widget Layer from the lower abstraction layers. This new abstraction layer (the Widget layer) is the distinguishing feature of ToyVision and provides the developer with access to a set of encapsulated classes that give the status of any playing piece handled in the tabletop while the game is running. The toolkit has been complemented with a Graphic Assistant that gathers from the designer all the information needed by the toolkit to model all the tangible playing pieces. As a practical example, the process of prototyping a tangible game is described. Copyright 2012 ACM.

Ramadhas V.,Worley Parsons India Private Ltd. | Rampuri M.,Giga Group
Ports 2016: Port Engineering - Papers from Sessions of the 14th Triennial International Conference | Year: 2016

The Government of Iraq intends to improve efficiency of gas production through construction of facilities which will capture, treat and monetize associated gas currently being flared from southern fields. To limit in-country construction risk, it was decided that new facilities would be constructed using a modular construction philosophy, with a view that modules would be imported from fabrication facilities located overseas. For this project, a new module offloading facility (MOF) in Iraq was considered to be unviable and hence, evaluation and assessment of existing marine facilities to handle the proposed modules, was critical for overall project success. After a scoping study, an existing facility located south of Basrah was identified as the site with greatest potential to function as a MOF. This paper discusses the methodology used to assess the structural capacity of the existing marine facility, using a combination of reference information supported by strategic desktop and field surveys. © 2016 ASCE.

Bakakos P.,National and Kapodistrian University of Athens | Schleich F.,Giga Group | Alchanatis M.,National and Kapodistrian University of Athens | Louis R.,Giga Group
Current Medicinal Chemistry | Year: 2011

During recent years there has been a growing interest in using non-invasive biomarkers to understand and monitor the airway inflammation in subjects with respiratory tract disorders and mainly asthma and chronic obstructive pulmonary disease (COPD). Sputum induction is generally a well-tolerated and safe procedure and a European Respiratory Society Task Force has published a comprehensive review on sputum methodology. Induced sputum cell count and, to a lesser extent, mediator measurements have been particularly well validated. In asthma, the sputum and the cell culture supernatant can be used for the measurement of a variety of soluble mediators, including eosinophil-derived proteins, nitric oxide (NO) derivatives, cytokines and remodelling-associated proteins. Sputum eosinophilia (> 3%) is a classic feature of asthma although half of the patients seems to be non eosinophilic. Measuring the percentage of sputum eosinophils has proved to be useful in the clinical arena in helping to predict short term response to inhaled corticosteroids (ICS) and tailor the dose of ICS in the severe patients but there is scope for the application of other induced sputum markers potentially useful in clinical practice. The widespread application of induced sputum in asthma across the spectrum of disease severity has given insight into the relationship between airway function and airway inflammation, proposed new disease phenotypes and defined which of these phenotypes respond to current therapy, and perhaps most importantly provided an additional tool to guide the clinical management of asthmatic patients. To date sputum induction is the only non-invasive measure of airway inflammation that has a clearly proven role in asthma management. © 2011 Bentham Science Publishers Ltd.

PubMed | Giga Group
Type: Review | Journal: Journal of translational internal medicine | Year: 2016

Inhaled corticoids (ICS) made a dramatic breakthrough in the management of asthma in the late eighties resulting in a sharp reduction in morbidity and mortality in the following decades. Soon after, the association between ICS and long acting 2 agonists (LABA) soon became the gold standard of maintenance asthma treatment. With the advent of sputum induction it has become clear that asthma could not be considered as a unique entity but rather a display of several inflammatory phenotypes. Eosinophilic phenotype shows good response to ICS while non-eosinophilic, and in particular the neutrophilic phenotype, seems to be more resistant. Severe asthmatics show insufficient asthma control despite ICS/LABA. Those who are allergic and eosinophilic may benefit from add-on treatment with anti-IgE or anti-IL-5. Severe neutrophilic asthma could benefit from maintenance treatment with macrolides while thermoplasty offers some promise to those in whom airway smooth muscle hypertrophy contributes to disease instability.

PubMed | Giga Group
Type: | Journal: Clinical EEG and neuroscience | Year: 2016

Electroencephalography (EEG) has been proposed as a supplemental tool for reducing clinical misdiagnosis in severely brain-injured populations helping to distinguish conscious from unconscious patients. We studied the use of spectral entropy as a measure of focal attention in order to develop a motor-independent, portable, and objective diagnostic tool for patients with locked-in syndrome (LIS), answering the issues of accuracy and training requirement. Data from 20 healthy volunteers, 6 LIS patients, and 10 patients with a vegetative state/unresponsive wakefulness syndrome (VS/UWS) were included. Spectral entropy was computed during a gaze-independent 2-class (attention vs rest) paradigm, and compared with EEG rhythms (delta, theta, alpha, and beta) classification. Spectral entropy classification during the attention-rest paradigm showed 93% and 91% accuracy in healthy volunteers and LIS patients respectively. VS/UWS patients were at chance level. EEG rhythms classification reached a lower accuracy than spectral entropy. Resting-state EEG spectral entropy could not distinguish individual VS/UWS patients from LIS patients. The present study provides evidence that an EEG-based measure of attention could detect command-following in patients with severe motor disabilities. The entropy system could detect a response to command in all healthy subjects and LIS patients, while none of the VS/UWS patients showed a response to command using this system.

PubMed | University of Western Ontario, Giga Group, Irccs Sdn Instituto Of Ricerca Diagnostica E Nucleare Naples, Harvard University and University of Liège
Type: | Journal: Frontiers in cellular neuroscience | Year: 2016

Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half of minimally conscious state (MCS) patients. Although the rising evidences about its possible role in the treatment of many neurological and psychiatric conditions exist, no evidences exist about brain functional connectivity substrates underlying tDCS response. We retrospectively evaluated resting state functional Magnetic Resonance Imaging (fMRI) of 16 sub-acute and chronic MCS patients (6 tDCS responders) who successively received a single left dorsolateral prefrontal cortex (DLPFC) tDCS in a double-blind randomized cross-over trial. A seed-based approach for regions of left extrinsic control network (ECN) and default-mode network (DMN) was performed. tDCS responders showed an increased left intra-network connectivity for regions co-activated with left DLPFC, and significantly with left inferior frontal gyrus. Non-responders (NR) MCS patients showed an increased connectivity between left DLPFC and midline cortical structures, including anterior cingulate cortex and precuneus. Our findings suggest that a prior high connectivity with regions belonging to ECN can facilitate transitory recovery of consciousness in a subgroup of MCS patients that underwent tDCS treatment. Therefore, resting state-fMRI could be very valuable in detecting the neuronal conditions necessary for tDCS to improve behavior in MCS.

PubMed | Allergist, Giga Group and University of Bologna
Type: Journal Article | Journal: United European gastroenterology journal | Year: 2016

Gastro-esophageal reflux disease (GERD) leads to frequent medical visits, and available therapies fail in up to 40% of patients. Food allergies may be involved in GERD pathogenesis; however, allergens other than food have received little attention. Nickel allergy is common in the general population and some high-nickel foods are associated with GERD. However, the potential relationship between nickel allergy and GERD remains unaddressed.This study aimed to evaluate the prevalence of nickel sensitization in patients with and without GERD and to compare clinical and demographic features.This prospective, multicenter study included 210 adult GERD patients and 140 patients without GERD who presented at the general practitioner. All GERD patients had undergone treatment with proton pump inhibitors and upper digestive endoscopy within the previous five years. Demographic and clinical data were collected by questionnaire and patients underwent a nickel patch allergy test.Patients with and without GERD presented similar characteristics, with the exception of nickel sensitization, which was significantly more prevalent among GERD patients than controls (39.5% vs. 16.4%; p=0.001). Nickel-positive GERD patients were more frequently female (90.4% vs. 65.4%, p=0.003) and asthmatic (18.1% vs. 4.7%; p=0.038), compared to nickel-negative GERD patients. At six-month follow-up, most of the patients, with or without nickel sensitization, reported improved symptoms without differences in drug prescription.Nickel sensitization is particularly prevalent in GERD patients seen in general practice. Whether allergies other than food allergy play a role in GERD remains to be elucidated.

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