| 1. |
- Armandi, Angelo, et al.
(författare)
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Serum ferritin levels can predict long-term outcomes in patients with metabolic dysfunction-associated steatotic liver disease
- 2024
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Ingår i: Gut. - : BMJ PUBLISHING GROUP. - 0017-5749 .- 1468-3288.
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Tidskriftsartikel (refereegranskat)abstract
- Objective Hyperferritinaemia is associated with liver fibrosis severity in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), but the longitudinal implications have not been thoroughly investigated. We assessed the role of serum ferritin in predicting long-term outcomes or death. Design We evaluated the relationship between baseline serum ferritin and longitudinal events in a multicentre cohort of 1342 patients. Four survival models considering ferritin with confounders or non-invasive scoring systems were applied with repeated five-fold cross-validation schema. Prediction performance was evaluated in terms of Harrell's C-index and its improvement by including ferritin as a covariate. Results Median follow-up time was 96 months. Liver-related events occurred in 7.7%, hepatocellular carcinoma in 1.9%, cardiovascular events in 10.9%, extrahepatic cancers in 8.3% and all-cause mortality in 5.8%. Hyperferritinaemia was associated with a 50% increased risk of liver-related events and 27% of all-cause mortality. A stepwise increase in baseline ferritin thresholds was associated with a statistical increase in C-index, ranging between 0.02 (lasso-penalised Cox regression) and 0.03 (ridge-penalised Cox regression); the risk of developing liver-related events mainly increased from threshold 215.5 mu g/L (median HR=1.71 and C-index=0.71) and the risk of overall mortality from threshold 272 mu g/L (median HR=1.49 and C-index=0.70). The inclusion of serum ferritin thresholds (215.5 mu g/L and 272 mu g/L) in predictive models increased the performance of Fibrosis-4 and Non-Alcoholic Fatty Liver Disease Fibrosis Score in the longitudinal risk assessment of liver-related events (C-indices>0.71) and overall mortality (C-indices>0.65). Conclusions This study supports the potential use of serum ferritin values for predicting the long-term prognosis of patients with MASLD.
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| 2. |
- Bianco, Cristina, et al.
(författare)
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Non-invasive stratification of hepatocellular carcinoma risk in non-alcoholic fatty liver using polygenic risk scores.
- 2021
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Ingår i: Journal of hepatology. - : Elsevier BV. - 1600-0641 .- 0168-8278. ; 74:4, s. 775-782
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Tidskriftsartikel (refereegranskat)abstract
- Hepatocellular carcinoma (HCC) risk stratification in individuals with dysmetabolism is a major unmet need. Genetic predisposition contributes to non-alcoholic fatty liver disease (NAFLD). We aimed to exploit robust polygenic risk scores (PRS) that can be evaluated in the clinic to gain insight into the causal relationship between NAFLD and HCC, and to improve HCC risk stratification.We examined at-risk individuals (NAFLD cohort, n=2,566; 226 with HCC; and a replication cohort of 427 German patients with NAFLD) and the general population (UK Biobank [UKBB] cohort, n=364,048; 202 with HCC). Variants in PNPLA3-TM6SF2-GCKR-MBOAT7 were combined in a hepatic fat PRS (PRS-HFC), and then adjusted for HSD17B13 (PRS-5).In the NAFLD cohort, the adjusted impact of genetic risk variants on HCC was proportional to the predisposition to fatty liver (p=0.002) with some heterogeneity in the effect. PRS predicted HCC more robustly than single variants (p<10-13). The association between PRS and HCC was mainly mediated through severe fibrosis, but was independent of fibrosis in clinically relevant subgroups, and was also observed in those without severe fibrosis (p<0.05). In the UKBB cohort, PRS predicted HCC independently of classical risk factors and cirrhosis (p<10-7). In the NAFLD cohort, we identified high PRS cut-offs (≥0.532/0.495 for PRS-HFC/PRS-5) that in the UKBB cohort detected HCC with ∼90% specificity but limited sensitivity; PRS predicted HCC both in individuals with (p<10-5) and without cirrhosis (p<0.05).Our results are consistent with a causal relationship between hepatic fat and HCC. PRS improved the accuracy to detect HCC and may help stratify HCC risk in individuals with dysmetabolism, including those without severe liver fibrosis. Further studies are needed to validate our findings.
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| 3. |
- Carratú, Marco, et al.
(författare)
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A novel IVS procedure for handling Big Data with Artificial Neural Networks
- 2020
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Ingår i: 2020 IEEE International Instrumentation and Measurement Technology Conference (I2MTC). - : IEEE. - 9781728144603
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Konferensbidrag (refereegranskat)abstract
- In recent times, thanks to the availability of a large quantity of data coming from the industrial process, several techniques based on a data-driven approach could be developed. Between all the data-driven techniques, as Principle Component Regression, Support Vector Machines, Artificial Neural Networks, Neuro-Fuzzy Systems, and many others, the data on which they rely should be analyzed to find correlations and dependencies that could improve their design. For this reason, the Input variable Selection (IVS) process has become of great interest in the recent period. The classical IVS relies on classical statistics, as Pearson coefficients, able to discover linear dependencies among data; today, due to the significant amount of data available, the challenge of also discovering non-linear dependencies appears to be a necessary skill, mainly for the design and development of a neural network. This paper proposes the use of a novel statistical tool named Maximal Information Coefficient (MIC) for developing an IVS procedure able to discover dependencies in a considerable dataset and guide the IVS designer to the selection of input variables in a data-driven application. As a case study, the procedure will be applied to a real application developed in the context of the Swedish forest industry, in order to choose the input variables of a neural network able to estimate the timber bundles volume, which represents an expensive parameter to measure in this context.
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| 6. |
- Di Leo, Giuseppe, et al.
(författare)
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A vision system for the online quality monitoring of industrial manufacturing
- 2017
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Ingår i: Optics and lasers in engineering. - : Elsevier BV. - 0143-8166 .- 1873-0302. ; 89, s. 162-168
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Tidskriftsartikel (refereegranskat)abstract
- The design of an image based measurement system for the online inspection of electromechanical parts is described. A two-camera architecture is introduced in order to highlight all the required details involved in the measurements. The design takes into account both the interfacing and the real-time issues that assure an effective online operation. The description of the measurement system and the corresponding installation on the production line points out a methodological approach to the design of these kinds of measurement systems. The paper provides details about the algorithms for the localization and the measurement of the required quantities, as well as the calibration procedure and the error correction. Experimental tests for the performance evaluation are presented and discussed in terms of timing and accuracy.
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| 7. |
- Di Leo, Giuseppe, et al.
(författare)
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I3DermoscopyApp: Hacking Melanoma thanks to IoT technologies
- 2017
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Ingår i: Proceedings of the 50th Hawaii International Conference on System Sciences 2017. - 9780998133102 ; , s. 3587-3596
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Konferensbidrag (refereegranskat)abstract
- The paper introduces I3DermoscopyApp, a new declination of the Internet of Things (IoT) paradigm, designed to allow the early detection of melanoma. Even though artificial intelligence programs cannot outperform the diagnostic accuracy of expert dermatologists yet, they reveal to be very useful in providing second opinions to physicians with short clinical experience, thus improving significantly their diagnostic performance. Following this trend, an original integration of mobile app technology and well-known image processing algorithms allows the automatic analysis of pigmented skin lesions to help physicians apply a diagnostic method (Seven Point Check List) based on dermoscopy. The web-based platform makes the physician able to: i) store digital images captured by smartphones featured with a dermatoscope; ii) measure morphological and chromatic parameters of the skin lesion; iii) make a diagnostic decision according to the Seven Point Checklist method. A detailed description of the adopted techniques, together with the first validation results are reported.
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| 8. |
- Di Leo, Giuseppe, et al.
(författare)
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Smart Meters in Smart Cities : An Application of DLMS-COSEM on 169 MHz WM-Bus
- 2016
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Ingår i: Advanced Computer and Communication Engineering Technology. - Cham : Springer. - 9783319245829 ; , s. 735-746
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Konferensbidrag (refereegranskat)abstract
- Advanced Metering Infrastructures (AMI) are going to represent the backbone of all the Smart City projects where metering and other public services are supposed to be smart. The scenario proposed by OPEN METER project is taking shape in some urban areas where smart meters, concentrators and central access systems have been experiencing. In this paper some topics concerning the use of DLMS-COSEM (Device Language Message specification-Companion Specification for Energy Metering) protocol on a 169 MHz gateway network based on WM-bus for collecting and manage data coming from smart meters and other electronic devices are discussed by the authors. In particular, an innovative solution for water metering and the architecture of a data Central Access System, are described in detail.
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| 9. |
- Ferrucci, Veronica, et al.
(författare)
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Metastatic group 3 medulloblastoma is driven by PRUNE1 targeting NME1–TGF-β–OTX2–SNAIL via PTEN inhibitio
- 2018
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Ingår i: Brain. - : Oxford University Press (OUP). - 0006-8950 .- 1460-2156. ; 141:5, s. 1300-1319
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Tidskriftsartikel (refereegranskat)abstract
- Genetic modifications during development of paediatric groups 3 and 4 medulloblastoma are responsible for their highly metastatic properties and poor patient survival rates. PRUNE1 is highly expressed in metastatic medulloblastoma group 3, which is characterized by TGF-β signalling activation, c-MYC amplification, and OTX2 expression. We describe the process of activation of the PRUNE1 signalling pathway that includes its binding to NME1, TGF-β activation, OTX2 upregulation, SNAIL (SNAI1) upregulation, and PTEN inhibition. The newly identified small molecule pyrimido-pyrimidine derivative AA7.1 enhances PRUNE1 degradation, inhibits this activation network, and augments PTEN expression. Both AA7.1 and a competitive permeable peptide that impairs PRUNE1/NME1 complex formation, impair tumour growth and metastatic dissemination in orthotopic xenograft models with a metastatic medulloblastoma group 3 cell line (D425-Med cells). Using whole exome sequencing technology in metastatic medulloblastoma primary tumour cells, we also define 23 common ‘non-synonymous homozygous’ deleterious gene variants as part of the protein molecular network of relevance for metastatic processes. This PRUNE1/TGF-β/OTX2/PTEN axis, together with the medulloblastoma-driver mutations, is of relevance for future rational and targeted therapies for metastatic medulloblastoma group 3.
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| 10. |
- Mozes, Ferenc E., et al.
(författare)
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Performance of non-invasive tests and histology for the prediction of clinical outcomes in patients with non-alcoholic fatty liver disease: an individual participant data meta-analysis
- 2023
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Ingår i: The Lancet Gastroenterology & Hepatology. - : ELSEVIER INC. - 2468-1253. ; 8:8, s. 704-713
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Tidskriftsartikel (refereegranskat)abstract
- Background Histologically assessed liver fibrosis stage has prognostic significance in patients with non-alcoholic fatty liver disease (NAFLD) and is accepted as a surrogate endpoint in clinical trials for non-cirrhotic NAFLD. Our aim was to compare the prognostic performance of non-invasive tests with liver histology in patients with NAFLD. Methods This was an individual participant data meta-analysis of the prognostic performance of histologically assessed fibrosis stage (F0-4), liver stiffness measured by vibration-controlled transient elastography (LSM-VCTE), fibrosis-4 index (FIB-4), and NAFLD fibrosis score (NFS) in patients with NAFLD. The literature was searched for a previously published systematic review on the diagnostic accuracy of imaging and simple non-invasive tests and updated to Jan 12, 2022 for this study. Studies were identified through PubMed/MEDLINE, EMBASE, and CENTRAL, and authors were contacted for individual participant data, including outcome data, with a minimum of 12 months of follow-up. The primary outcome was a composite endpoint of all-cause mortality, hepatocellular carcinoma, liver transplantation, or cirrhosis complications (ie, ascites, variceal bleeding, hepatic encephalopathy, or progression to a MELD score >= 15). We calculated aggregated survival curves for trichotomised groups and compared them using stratified log-rank tests (histology: F0-2 vs F3 vs F4; LSM: <10 vs 10 to <20 vs >= 20 kPa; FIB-4: <1<middle dot>3 vs 1<middle dot>3 to <= 2<middle dot>67 vs >2<middle dot>67; NFS: <-1<middle dot>455 vs -1<middle dot>455 to <= 0<middle dot>676 vs >0<middle dot>676), calculated areas under the time-dependent receiver operating characteristic curves (tAUC), and performed Cox proportional-hazards regression to adjust for confounding. This study was registered with PROSPERO, CRD42022312226.Findings Of 65 eligible studies, we included data on 2518 patients with biopsy-proven NAFLD from 25 studies (1126 [44<middle dot>7%] were female, median age was 54 years [IQR 44-63), and 1161 [46<middle dot>1%] had type 2 diabetes). After a median follow-up of 57 months [IQR 33-91], the composite endpoint was observed in 145 (5<middle dot>8%) patients. Stratified log-rank tests showed significant differences between the trichotomised patient groups (p<0<middle dot>0001 for all comparisons). The tAUC at 5 years were 0<middle dot>72 (95% CI 0<middle dot>62-0<middle dot>81) for histology, 0<middle dot>76 (0<middle dot>70-0<middle dot>83) for LSM-VCTE, 0<middle dot>74 (0<middle dot>64-0<middle dot>82) for FIB-4, and 0<middle dot>70 (0<middle dot>63-0<middle dot>80) for NFS. All index tests were significant predictors of the primary outcome after adjustment for confounders in the Cox regression.Interpretation Simple non-invasive tests performed as well as histologically assessed fibrosis in predicting clinical outcomes in patients with NAFLD and could be considered as alternatives to liver biopsy in some cases.
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