A realistic morpho-anatomical connection strategy for modelling full-scale point-neuron microcircuits

The modeling of extended microcircuits is emerging as an effective tool to simulate the neurophysiological correlates of brain activity and to investigate brain dysfunctions. However, for specific networks, a realistic modeling approach based on the combination of available physiological, morphological and anatomical data is still an open issue. One of the main problems in the generation of realistic networks lies in the strategy adopted to build network connectivity. Here we propose a method to implement a neuronal network at single cell resolution by using the geometrical probability volumes associated with pre- and postsynaptic neurites. This allows us to build a network with plausible connectivity properties without the explicit use of computationally intensive touch detection algorithms using full 3D neuron reconstructions. The method has been benchmarked for the mouse hippocampus CA1 area, and the results show that this approach is able to generate full-scale brain networks at single cell resolution that are in good agreement with experimental findings. This geometric reconstruction of axonal and dendritic occupancy, by effectively reflecting morphological and anatomical constraints, could be integrated into structured simulators generating entire circuits of different brain areas facilitating the simulation of different brain regions with realistic models

Cemiplimab in Ultra-Octogenarian Patients with Cutaneous Squamous Cell Carcinoma: The Real-Life Experience of a Tertiary Referral Center

Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is rapidly increasing, paralleling the aging of the population. cSCC predominantly affects chronically sun-exposed areas, such as the head and neck region. At our tertiary center, a multidisciplinary approach to non-melanoma skin cancer is provided for locally advanced cSCC. Methods: We retrospectively revised all patients with locally advanced/metastatic cSCC treated with anti-PD1 antibody (Cemiplimab) at our Institution from January 2020 to March 2023 (minimum follow-up of 4 months on treatment). Results: Overall, we consecutively treated 20 ultra-octogenarian patients, of whom 15 were males and 5 were females (median age: 86.9 years). Despite age, a median number of concomitant drugs, and comorbidities, efficacy, and safety were superimposable with the available literature. No patients reported treatment-related adverse events of grade 3 or higher. Grade 2 adverse events were reported in 25% of patients. Overall, the response rate was 65%, with 50% partial responses and 20% long-lasting stable disease. The median duration of response was 14 months. The G8 elderly score was assessed in all patients, and the median score was 12 (range 9–14). Conclusions: Among ultra-octogenarian patients, a clinical benefit from Cemiplimab was obtained in most, including tumor shrinkage and pain relief. Cemiplimab confirmed its effectiveness in elderly patients in a real-life setting, with no new safety concerns

The Future of Breast Cancer Research in the Survivorship Field

Prevalence of survivors of breast cancer has been steadily increasing in the last 20 years. Currently, more than 90% of women diagnosed with early-stage breast cancer are expected to be alive at 5 years from diagnosis thanks to early detection and breakthrough innovations in multimodal treatment strategies. Alongside this advancement in clinical outcomes, survivors of breast cancer might experience several specific challenges and present with unique needs. Survivorship trajectories after diagnosis and treatment of breast cancer can be significantly impacted by long-lasting and severe treatment-related side effects, including physical problems, psychological distress, fertility issues in young women, and impaired social and work reintegration, which add up to patients’ individual risk of cancer recurrence and second primary malignancies. Alongside cancer-specific sequelae, survivors still present with general health needs, including management of chronic preexisting or ensuing conditions. Survivorship care should implement high-quality, evidence-based strategies to promptly screen, identify, and address survivors’ needs in a comprehensive way and minimize the impact of severe treatment sequelae, preexisting comorbidities, unhealthy lifestyles, and risk of recurrence on quality of life. This narrative review focuses on core areas of survivorship care and discuss the state of the art and future research perspectives in key domains including selected long-term side effects, surveillance for recurrences and second cancers, well-being promotion, and specific survivors’ needs.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Critères, échantillonnage et méthodes analytiques pour la surveillance et le contrôle de la conformité règlementaire des produits du tabac et produits duvapotage sur le marché français: Avis de l’AnsesRapport d’expertise collective

Citation suggérée : Anses. (2022). Critères, échantillonnage et méthodes analytiques pour la surveillance et le contrôle de la conformité règlementaire des produits du tabac et produits du vapotage sur le marché français. (saisine 2020-SA-0015). Maisons-Alfort : Anses, 120 p.La directive 2014/40/UE sur les produits du tabac (ci-après, « la directive ») établit des règles concernant la fabrication, la présentation et la vente des produits du tabac et produits connexes. Elle instaure notamment une obligation de déclaration des produits avant toute commercialisation. Cet enregistrement des produits ne relève pas d’un processus d’autorisation de mise sur le marché (AMM).Les produits du tabac et produits connexes sont classés en trois catégories :- Les produits du tabac ;- Les produits du vapotage ;- Les produits à fumer à base de plantes autres que le tabac.Certaines informations à transmettre sont communes à ces trois catégories de produits, notamment la composition en ingrédients et additifs avec leurs quantités. D’autres informations sont spécifiques à la catégorie : il s’agit notamment des mesures à l’émission de composés formés lors de l’utilisation des produits du vapotage.La déclaration auprès des autorités de chaque État membre concerné est un processus informatique centralisé selon les modalités du point d'entrée électronique commun de l'Union européenne . Mis au point par la Commission européenne, il est opérationnel pour réceptionner les déclarations depuis le 20 mai 2016, date d’entrée en application de la directive.En France, la directive a été transposée par l’ordonnance N°2016-623 du 19 mai 2016 qui introduit les nouvelles dispositions au titre Ier du livre V de la troisième partie du Code de la santé publique (CSP). Les décrets des 11 et 22 août 2016 ainsi que les arrêtés du 19 mai et 22 août 2016 viennent compléter le cadre règlementaire national. L’autorité administrative compétente est le ministère chargé de la santé.Dans le cadre de cette transposition, l’Agence nationale de sécurité sanitaire de l’alimentation, de l’environnement et du travail (Anses) a été désignée pour assurer la réception, le stockage, le traitement et l’analyse des informations transmises par les déclarants sur leurs produits. L’obligation règlementaire de déclarer ces informations doit permettre d’améliorer les connaissances quant à la composition des produits, l’impact sur la santé et l’évolution de la demande et de l’offre des produits du tabac et produits connexes.En outre, certains ingrédients et additifs sont interdits : il s’agit notamment des substances cancérogènes, mutagènes et toxiques pour la reproduction, des vitamines, des stimulants tels que la caféine ou la taurine (articles L. 3512-16 et L. 3513-7 CSP).La mission confiée à l’Anses se traduit par la conduite de travaux d’expertise portant sur l’identification et l’évaluation des dangers des substances chimiques auxquelles le consommateur ou son entourage sont exposés lors de l’utilisation de ces produits. Au-delà de la fumée de tabac dont les effets sanitaires sont connus, l’enjeu porte plus particulièrement sur les substances émises par les produits du vapotage et les nouveaux produits du tabac chauffé lors de leur utilisation.[Saisine liée 2018-SA-0189 Produits du tabac : bilan 2016 - 2020

SARS-CoV-2 perinatal transmission and neonatal outcomes across four different waves of COVID-19 pandemic: A nationwide prospective cohort study from the Italian Society of Neonatology

Objectives: To describe how SARS-CoV-2 infection at the time of delivery affected maternal and neonatal outcomes across four major waves of the COVID-19 pandemic in Italy. Methods: This is a large, prospective, nationwide cohort study collecting maternal and neonatal data in case of maternal peripartum SARS-CoV-2 infection between February 2020 and March 2022. Data were stratified across the four observed pandemic waves. Results: Among 5201 COVID-19-positive mothers, the risk of being symptomatic at delivery was significantly higher in the first and third waves (20.8-20.8%) than in the second and fourth (13.2-12.2%). Among their 5284 neonates, the risk of prematurity (gestational age <37 weeks) was significantly higher in the first and third waves (15.6-12.5%). The risk of intrauterine transmission was always very low, while the risk of postnatal transmission during rooming-in was higher and peaked at 4.5% during the fourth wave. A total of 80% of positive neonates were asymptomatic. Conclusion: The risk of adverse maternal and neonatal outcomes was significantly higher during the first and third waves, dominated by unsequenced variants and the Delta variant, respectively. Postnatal transmission accounted for most neonatal infections and was more frequent during the Omicron period. However, the paucity of symptoms in infected neonates should lead us not to separate the dyad

Expanded access program with Nusinersen in SMA type I in Italy: Strengths and pitfalls of a successful experience

Expanded access program with Nusinersen in SMA type

An observational study of functional abilities in infants, children, and adults with type 1 SMA

ObjectiveTo report cross-sectional clinical findings in a large cohort of patients affected by type 1 spinal muscular atrophy.MethodsWe included 122 patients, of age ranging between 3 months and 22 years, 1 month. More than 70% (85/122) were older than 2 years and 25% (31/122) older than 10 years. Patients were classified according to the severity of phenotype and to the number of SMN2 copies.ResultsPatients with the more common and the most severe phenotype older than 2 years were, with few exceptions, on noninvasive ventilation and, with increasing age, more often had tracheostomy or &gt;16-hour ventilation and a gastrostomy inserted. In contrast, 25 of the 28 patients with the mildest phenotype older than 2 years had no need for tracheostomy or other ventilatory or nutritional support. In patients older than 2 years, the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders scores were generally lower compared to those found in younger patients and showed distinct levels of functional abilities according to the severity of the phenotype. Similar findings were also observed on the Hammersmith Infant Neurological Examination.ConclusionsOur findings confirm that, after the age of 2 years, patients with type 1 spinal muscular atrophy generally survive only if they have gastrostomy and tracheostomy or noninvasive ventilation &gt;16 hours and have low scores on the functional scales. More variability, however, can be expected in those with the mildest phenotype, who achieve head control. These data provide important baseline information at the time treatments are becoming available