79 research outputs found

    PROGNOSTIC ROLE OF TROPONIN I ELEVATION AFTER ELECTIVE PCI

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    EEG Responses to TMS Are Sensitive to Changes in the Perturbation Parameters and Repeatable over Time

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    BACKGROUND: High-density electroencephalography (hd-EEG) combined with transcranial magnetic stimulation (TMS) provides a direct and non-invasive measure of cortical excitability and connectivity in humans and may be employed to track over time pathological alterations, plastic changes and therapy-induced modifications in cortical circuits. However, the diagnostic/monitoring applications of this technique would be limited to the extent that TMS-evoked potentials are either stereotypical (non-sensitive) or random (non-repeatable) responses. Here, we used controlled changes in the stimulation parameters (site, intensity, and angle of stimulation) and repeated longitudinal measurements (same day and one week apart) to evaluate the sensitivity and repeatability of TMS/hd-EEG potentials. METHODOLOGY/PRINCIPAL FINDINGS: In 10 volunteers, we performed 92 single-subject comparisons to evaluate the similarities/differences between pairs of TMS-evoked potentials recorded in the same/different stimulation conditions. For each pairwise comparison, we used non-parametric statistics to calculate a Divergence Index (DI), i.e., the percentage of samples that differed significantly, considering all scalp locations and the entire post-stimulus period. A receiver operating characteristic analysis showed that it was possible to find an optimal DI threshold of 1.67%, yielding 96.7% overall accuracy of TMS/hd-EEG in detecting whether a change in the perturbation parameters occurred or not. CONCLUSIONS/SIGNIFICANCE: These results demonstrate that the EEG responses to TMS essentially reflect deterministic properties of the stimulated neuronal circuits as opposed to stereotypical responses or uncontrolled variability. To the extent that TMS-evoked potentials are sensitive to changes and repeatable over time, they may be employed to detect longitudinal changes in the state of cortical circuits

    Quantitative dopamine transporter imaging assessment in Parkinson’s disease (PD) patients carrying GBA gene mutations compared with Idiopathic PD patients: A case-control study

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    Background: Genetic risk factors impact around 15% of Parkinson’s disease (PD) patients and at least 23 variants have been identified including Glucocerebrosidase (GBA) gene variants. Using different clinical and instrumental qualitative-based data, various studies have been published on GBA-PD cohorts which suggested possible differences in dopaminergic nigrostriatal denervation pattern, particularly in caudate and putamen nuclei. Methods: This retrospective study included two consecutive homogenous cohorts of GBA-PD and idiopathic (I-PD) patients. Each consecutive GBA-PD patient has been matched with a 1:1 pairing method with a consecutive I-PD subject according to age, age at disease onset, sex, Hoehn & Yahr (H&Y) staging scale and comorbidity level (CCI). Semiquantitative volumetric data by the DaTQUANTTM software integrated in the DaTSCAN exam performed at time of the diagnosis (SPECT imaging performed according to current guidelines of I-123 FPCIT SPECT imaging) were extrapolated. Bilateral specific binding ratios (SBR) at putamen and caudate levels were calculated, using the occipital lobes uptake. The Mann–Whitney test was performed to compare the two cohorts while the Spearman’s test was used to find correlations between motor and volumetric data in each group. Bonferroni correction was used to account for multiple comparisons. Results: Two cohorts of 25 patients each (GBA-PD and I-PD), were included. By comparing GBA-PD and I-PD patients, lower SBR values were found in the most affected anterior putamen and left caudate of the GBA-PD cohort. Furthermore, in the GBA-PD cohort the SBR of the most affected posterior putamen negatively correlated with the H&Y scale. However, none of these differences or correlations remained significant after Bonferroni correction for multiple comparisons. Conclusions: We observed differences in SBR values in GBA-PD patients compared with I-PD. However, these differences were no longer significant after Bonferroni multiple comparisons correction highlighting the need for larger, longitudinal studies

    Personalization of regorafenib treatment in metastatic gastrointestinal stromal tumours in real-life clinical practice

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    Background: Regorafenib (REG) has now been approved as the standard third-line therapy in metastatic gastrointestinal stromal tumour (GIST) patients at the recommended dose and schedule of 160 mg once daily for the first 3 weeks of each 4-week cycle. However, it has a relevant toxicity profile that mainly occurs within the first cycles of therapy, and dose and schedule adjustments are often required to reduce the frequency or severity of adverse events and to avoid early treatment discontinuation. To date, large amounts of data on the use of REG in metastatic GIST patients in daily clinical practice are not available, and we lack information about how this treatment personalization really affects the quality of life (QoL) of patients. The aim of the present retrospective study is to build a comprehensive picture of all alternative REG strategies adopted in daily clinical practice for use in metastatic GIST patients. Methods: Metastatic GIST patients treated with dose adjustment or alternative schedules of REG at seven reference Italian centres were retrospectively included. Results: For a total of 62 metastatic GIST patients, we confirmed that REG treatment adjustment is common in clinical practice and that it is very heterogeneous, with approximately 20 different strategies being adopted. Independent of which strategy is chosen, treatment personalization has led to a clinical benefit defined as complete or partial resolution of side effects in almost all patients, affecting the duration of REG treatment. Conclusions: The personalization of REG, even if it is heterogeneous, seems to be crucial to maximize the overall treatment duration

    How Magnetic Activity Alters What We Learn from Stellar Spectra

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    Magnetic fields and stellar spots can alter the equivalent widths of absorption lines in stellar spectra, varying during the activity cycle. This also influences the information that we derive through spectroscopic analysis. In this study, we analyze high-resolution spectra of 211 sunlike stars observed at different phases of their activity cycles, in order to investigate how stellar activity affects the spectroscopic determination of stellar parameters and chemical abundances. We observe that the equivalent widths of lines can increase as a function of the activity index log R'HK during the stellar cycle, which also produces an artificial growth of the stellar microturbulence and a decrease in effective temperature and metallicity. This effect is visible for stars with activity indexes log RHK -5.0 (i.e., younger than 4-5 Gyr), and it is more significant at higher activity levels. These results have fundamental implications on several topics in astrophysics that are discussed in the paper, including stellar nucleosynthesis, chemical tagging, the study of Galactic chemical evolution, chemically anomalous stars, the structure of the Milky Way disk, stellar formation rates, photoevaporation of circumstellar disks, and planet hunting.L.S. and A.I.K. acknowledge financial support from the Australian Research Council (Discovery Project 170100521). A.R.C. acknowledges the support from the Australian Research Council (DECRA 190100656). J.M. thanks support by FAPESP (2018/04055-8) and CNPq (Bolsa de Produtividade). J.Y.G. acknowledges the support from CNPq. This research was supported by the Australian Research Council Centre of Excellence for All Sky Astrophysics in 3 Dimensions (ASTRO 3D), through project number CE17010001

    Stellar Population Astrophysics (SPA) with the TNG. Stock 2, a little-studied open cluster with an eMSTO

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    Stock 2 is a little-studied open cluster that shows an extended main-sequence turnoff (eMSTO). In order to investigate this phenomenon and characterise the cluster itself, we performed high-resolution spectroscopy in the framework of the Stellar Population Astrophysics project. We employed the High Accuracy Radial velocity Planet Searcher in the Northern hemisphere spectrograph at the Telescopio Nazionale Galileo (TNG). We completed our observations with additional spectra taken with the Catania Astrophysical Observatory Spectropolarimeter. We observed 46 stars (dwarfs and giants). They represent by far the largest sample collected for this cluster to date. We provide the stellar parameters, the extinction, and the radial and projected rotational velocities for most of the stars. Chemical abundances for 21 species with atomic numbers up to 56 have also been derived. We note a differential reddening in the cluster field with an average value of 0.27 mag. This appears the main cause for the observed eMSTO because it cannot be explained as the result of different rotational velocities, as found in other clusters. We estimate an age for Stock 2 of 450 ± 150 Ma, which corresponds to a MSTO stellar mass of ≈2.8 M⊙. The cluster mean radial velocity is about 8.0 km s−1. We find a solar-like metallicity for the cluster, [Fe/H] = −0.07 ± 0.06, compatible with its galactocentric distance. The chemical abundances of main-sequence stars and giants are compatible within the errors. The exceptions are barium and strontium, which are clearly overabundant in giants, and cobalt, which is only marginally overabundant. Finally, the chemical composition of Stock 2 is fully compatible with the composition observed in other open clusters of the Galactic thin-disc population. Based on observations made with the Italian Telescopio Nazionale Galileo (TNG) operated on the island of La Palma by the Fundación Galileo Galilei of the INAF (Istituto Nazionale di Astrofisica) at the Observatorio del Roque de los Muchachos. This study is part of the Large Program titled SPA - Stellar Population Astrophysics: the detailed, age-resolved chemistry of the Milky Way disk (PI: L. Origlia), granted observing time with HARPS-N and GIANO-B echelle spectrographs at the TNG

    State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

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    Aim The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single test able to achieve an accurate diagnosis. The clinical use of 18F-fluorodeoxyglucose ([F-18]FDG) positron emission tomography/computed tomography (PET/CT) imaging in the assessment of inflammation and infection is increasing worldwide. The purpose of this paper is to achieve an Italian consensus document on [F-18]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. Methods In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [F-18]FDG PET/CT or PET/MRI in inflammatory and infectious diseases. The project was carried out thanks to the collaboration of 13 Italian nuclear medicine centers, with a consolidate experience in this field. With the endorsement of AIMN, IIFG contacted each center, and the pediatric diseases focus group (PDFC). IIFG provided for each team involved, a draft with essential information regarding the execution of [F-18]FDG PET/CT or PET/MRI scan (i.e., indications, patient preparation, standard or specific acquisition modalities, interpretation criteria, reporting methods, pitfalls and artifacts), by limiting the literature research to the last 20 years. Moreover, some clinical cases were required from each center, to underline the teaching points. Time for the collection of each report was from October to December 2020. Results Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectivess and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and reporting modalities were described afterwards. Moreover, a specific section was dedicated to pediatric and PET/MRI indications. A collection of images was described for each indication. Conclusions Currently, [F-18]FDG PET/CT in oncology is globally accepted and standardized in main diagnostic algorithms for neoplasms. In recent years, the ever-closer collaboration among different European associations has tried to overcome the absence of a standardization also in the field of inflammation and infections. The collaboration of several nuclear medicine centers with a long experience in this field, as well as among different AIMN focus groups represents a further attempt in this direction. We hope that this document will be the basis for a "common nuclear physicians' language" throughout all the country

    Results from the Cuore Experiment

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    The Cryogenic Underground Observatory for Rare Events (CUORE) is the first bolometric experiment searching for neutrinoless double beta decay that has been able to reach the 1-ton scale. The detector consists of an array of 988 TeO2 crystals arranged in a cylindrical compact structure of 19 towers, each of them made of 52 crystals. The construction of the experiment was completed in August 2016 and the data taking started in spring 2017 after a period of commissioning and tests. In this work we present the neutrinoless double beta decay results of CUORE from examining a total TeO2 exposure of 86.3kg yr, characterized by an effective energy resolution of 7.7 keV FWHM and a background in the region of interest of 0.014 counts/ (keV kg yr). In this physics run, CUORE placed a lower limit on the decay half- life of neutrinoless double beta decay of 130Te > 1.3.1025 yr (90% C. L.). Moreover, an analysis of the background of the experiment is presented as well as the measurement of the 130Te 2vo3p decay with a resulting half- life of T2 2. [7.9 :- 0.1 (stat.) :- 0.2 (syst.)] x 10(20) yr which is the most precise measurement of the half- life and compatible with previous results

    The commissioning of the CUORE experiment: the mini-tower run

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    CUORE is a ton-scale experiment approaching the data taking phase in Gran Sasso National Laboratory. Its primary goal is to search for the neutrinoless double-beta decay in 130Te using 988 crystals of tellurim dioxide. The crystals are operated as bolometers at about 10 mK taking advantage of one of the largest dilution cryostat ever built. Concluded in March 2016, the cryostat commissioning consisted in a sequence of cool down runs each one integrating new parts of the apparatus. The last run was performed with the fully configured cryostat and the thermal load at 4 K reached the impressive mass of about 14 tons. During that run the base temperature of 6.3 mK was reached and maintained for more than 70 days. An array of 8 crystals, called mini-tower, was used to check bolometers operation, readout electronics and DAQ. Results will be presented in terms of cooling power, electronic noise, energy resolution and preliminary background measurements
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