A modular telerehabilitation architecture for upper limb robotic therapy

Several factors may prevent post-stroke subjects from participating in rehabilitation protocols, for example, geographical location of rehabilitation centres, socioeconomic status, economic burden and lack of logistics surrounding transportation. Early supported discharge from hospitals with continued rehabilitation at home represents a well-defined regimen of post-stroke treatment. Information-based technologies coupled with robotics have promoted the development of new technologies for telerehabilitation. In this article, the design and development of a modular architecture for delivering upper limb robotic telerehabilitation with the CBM-Motus, a planar unilateral robotic machine that allows performing state-of-the-art rehabilitation tasks, have been presented. The proposed architecture allows a therapist to set a therapy session on his or her side and send it to the patient's side with a standardized communication protocol; the user interacts with the robot that provides an adaptive assistance during the rehabilitation tasks. Patient's performance is evaluated by means of performance indicators, which are also used to update robot behaviour during assistance. The implementation of the architecture is described and a set of validation tests on seven healthy subjects are presented. Results show the reliability of the novel architecture and the capability to be easily tailored to the user's needs with the chosen robotic device

Confocal light sheet microscopy: micron-scale neuroanatomy of the entire mouse brain.

Elucidating the neural pathways that underlie brain function is one of the greatest challenges in neuroscience. Light sheet based microscopy is a cutting edge method to map cerebral circuitry through optical sectioning of cleared mouse brains. However, the image contrast provided by this method is not sufficient to resolve and reconstruct the entire neuronal network. Here we combined the advantages of light sheet illumination and confocal slit detection to increase the image contrast in real time, with a frame rate of 10 Hz. In fact, in confocal light sheet microscopy (CLSM), the out-of-focus and scattered light is filtered out before detection, without multiple acquisitions or any post-processing of the acquired data. The background rejection capabilities of CLSM were validated in cleared mouse brains by comparison with a structured illumination approach. We show that CLSM allows reconstructing macroscopic brain volumes with sub-cellular resolution. We obtained a comprehensive map of Purkinje cells in the cerebellum of L7-GFP transgenic mice. Further, we were able to trace neuronal projections across brain of thy1-GFP-M transgenic mice. The whole-brain high-resolution fluorescence imaging assured by CLSM may represent a powerful tool to navigate the brain through neuronal pathways. Although this work is focused on brain imaging, the macro-scale high-resolution tomographies affordable with CLSM are ideally suited to explore, at micron-scale resolution, the anatomy of different specimens like murine organs, embryos or flies. (C) 2012 Optical Society of Americ

3T MRI-radiomic approach to predict for lymph node status in breast cancer patients

Simple SummaryBreast cancer is the most common cancer in women worldwide. The axillary lymph node status is one of the main prognostic factors. Currently, the methods to define the lymph node status are invasive and not without sequelae (from biopsy to lymphadenectomy). Radiomics is a new tool, and highly varied, but with high potential that has already shown excellent results in numerous fields of application. In our study, we have developed a classifier validated on a relatively large number of patients, which is able to predict lymph node status using a combination of patients clinical features, primary breast cancer histological features and radiomics features based on 3 Tesla post contrast-MR images. This approach can accurately select breast cancer patients who may avoid unnecessary biopsy and lymphadenectomy in a non-invasive way.Background: axillary lymph node (LN) status is one of the main breast cancer prognostic factors and it is currently defined by invasive procedures. The aim of this study is to predict LN metastasis combining MRI radiomics features with primary breast tumor histological features and patients' clinical data. Methods: 99 lesions on pre-treatment contrasted 3T-MRI (DCE). All patients had a histologically proven invasive breast cancer and defined LN status. Patients' clinical data and tumor histological analysis were previously collected. For each tumor lesion, a semi-automatic segmentation was performed, using the second phase of DCE-MRI. Each segmentation was optimized using a convex-hull algorithm. In addition to the 14 semantics features and a feature ROI volume/convex-hull volume, 242 other quantitative features were extracted. A wrapper selection method selected the 15 most prognostic features (14 quantitative, 1 semantic), used to train the final learning model. The classifier used was the Random Forest. Results: the AUC-classifier was 0.856 (label = positive or negative). The contribution of each feature group was lower performance than the full signature. Conclusions: the combination of patient clinical, histological and radiomics features of primary breast cancer can accurately predict LN status in a non-invasive way

Comprehensive optical and data management infrastructure for high-throughput light-sheet microscopy of whole mouse brains

Comprehensive mapping and quantification of neuronal projections in the central nervous system requires high-throughput imaging of large volumes with microscopic resolution. To this end, we have developed a confocal light-sheet microscope that has been optimized for three-dimensional (3-D) imaging of structurally intact clarified whole-mount mouse brains. We describe the optical and electromechanical arrangement of the microscope and give details on the organization of the microscope management software. The software orchestrates all components of the microscope, coordinates critical timing and synchronization, and has been written in a versatile and modular structure using the LabVIEW language. It can easily be adapted and integrated to other microscope systems and has been made freely available to the light-sheet community. The tremendous amount of data routinely generated by light-sheet microscopy further requires novel strategies for data handling and storage. To complete the full imaging pipeline of our high-throughput microscope, we further elaborate on big data management from streaming of raw images up to stitching of 3-D datasets. The mesoscale neuroanatomy imaged at micron-scale resolution in those datasets allows characterization and quantification of neuronal projections in unsectioned mouse brains

E2 regulates epigenetic signature on neuroglobin enhancer-promoter in neuronal cells

Estrogens are neuroprotective factors in several neurological diseases. Neuroglobin (NGB) is one of the estrogen target genes involved in neuroprotection, but little is known about its transcriptional regulation. Estrogen genomic pathway in gene expression regulation is mediated by estrogen receptors (ERα and ERβ) that bind to specific regulatory genomic regions. We focused our attention on 17β-estradiol (E2)-induced NGB expression in human differentiated neuronal cell lines (SK-N-BE and NT-2). Previously, using bioinformatics analysis we identified a putative enhancer in the first intron of NGB locus. Therefore, we observed that E2 increased the enrichment of the H3K4me3 epigenetic marks at the promoter and of the H3K4me1 and H3K27Ac at the intron enhancer. In these NGB regulatory regions, we found estrogen receptor alpha (ERα) binding suggesting that ERα may mediate chromatin remodeling to induce NGB expression upon E2 treatment. Altogether our data show that NGB expression is regulated by ERα binding on genomic regulatory regions supporting hormone therapy applications for the neuroprotection against neurodegenerative diseases

CNN-Based Approaches with Different Tumor Bounding Options for Lymph Node Status Prediction in Breast DCE-MRI

Background: The axillary lymph node status (ALNS) is one of the most important prognostic factors in breast cancer (BC) patients, and it is currently evaluated by invasive procedures. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), highlights the physiological and morphological characteristics of primary tumor tissue. Deep learning approaches (DL), such as convolutional neural networks (CNNs), are able to autonomously learn the set of features directly from images for a specific task. Materials and Methods: A total of 155 malignant BC lesions evaluated via DCE-MRI were included in the study. For each patient’s clinical data, the tumor histological and MRI characteristics and axillary lymph node status (ALNS) were assessed. LNS was considered to be the final label and dichotomized (LN+ (27 patients) vs. LN− (128 patients)). Based on the concept that peritumoral tissue contains valuable information about tumor aggressiveness, in this work, we analyze the contributions of six different tumor bounding options to predict the LNS using a CNN. These bounding boxes include a single fixed-size box (SFB), a single variable-size box (SVB), a single isotropic-size box (SIB), a single lesion variable-size box (SLVB), a single lesion isotropic-size box (SLIB), and a two-dimensional slice (2DS) option. According to the characteristics of the volumes considered as inputs, three different CNNs were investigated: the SFB-NET (for the SFB), the VB-NET (for the SVB, SIB, SLVB, and SLIB), and the 2DS-NET (for the 2DS). All the experiments were run in 10-fold cross-validation. The performance of each CNN was evaluated in terms of accuracy, sensitivity, specificity, the area under the ROC curve (AUC), and Cohen’s kappa coefficient (K). Results: The best accuracy and AUC are obtained by the 2DS-NET (78.63% and 77.86%, respectively). The 2DS-NET also showed the highest specificity, whilst the highest sensibility was attained by the VB-NET based on the SVB and SIB as bounding options. Conclusion: We have demonstrated that a selective inclusion of the DCE-MRI’s peritumoral tissue increases accuracy in the lymph node status prediction in BC patients using CNNs as a DL approach

Artificial intelligence in bone metastases: an MRI and CT imaging review

Background: The purpose of this review is to study the role of radiomics as a supporting tool in predicting bone disease status, differentiating benign from malignant bone lesions, and characterizing malignant bone lesions. (2) Methods: Two reviewers conducted the literature search independently. Thirteen articles on radiomics as a decision support tool for bone lesions were selected. The quality of the methodology was evaluated according to the radiomics quality score (RQS). (3) Results: All studies were published between 2018 and 2021 and were retrospective in design. Eleven (85%) studies were MRI-based, and two (15%) were CT-based. The sample size was <200 patients for all studies. There is significant heterogeneity in the literature, as evidenced by the relatively low RQS value (average score = 22.6%). There is not a homogeneous protocol used for MRI sequences among the different studies, although the highest predictive ability was always obtained in T2W-FS. Six articles (46%) reported on the potential application of the model in a clinical setting with a decision curve analysis (DCA). (4) Conclusions: Despite the variability in the radiomics method application, the similarity of results and conclusions observed is encouraging. Substantial limits were found; prospective and multicentric studies are needed to affirm the role of radiomics as a supporting tool

The impact of tumor edema on T2-weighted 3T-MRI invasive breast cancer histological characterization: a pilot radiomics study

Background: to evaluate the contribution of edema associated with histological features to the prediction of breast cancer (BC) prognosis using T2-weighted MRI radiomics. Methods: 160 patients who underwent staging 3T-MRI from January 2015 to January 2019, with 164 histologically proven invasive BC lesions, were retrospectively reviewed. Patient data (age, menopausal status, family history, hormone therapy), tumor MRI-features (location, margins, enhancement) and histological features (histological type, grading, ER, PgR, HER2, Ki-67 index) were collected. Of the 160 MRI exams, 120 were considered eligible, corresponding to 127 lesions. T2-MRI were used to identify edema, which was classified in four groups: peritumoral, pre-pectoral, subcutaneous, or diffuse. A semi-automatic segmentation of the edema was performed for each lesion, using 3D Slicer open-source software. Main radiomics features were extracted and selected using a wrapper selection method. A Random Forest type classifier was trained to measure the performance of predicting histological factors using semantic features (patient data and MRI features) alone and semantic features associated with edema radiomics features. Results: edema was absent in 37 lesions and present in 127 (62 peritumoral, 26 pre-pectoral, 16 subcutaneous, 23 diffuse). The AUC-classifier obtained by associating edema radiomics with semantic features was always higher compared to the AUC-classifier obtained from semantic features alone, for all five histological classes prediction (0.645 vs. 0.520 for histological type, 0.789 vs. 0.590 for grading, 0.487 vs. 0.466 for ER, 0.659 vs. 0.546 for PgR, and 0.62 vs. 0.573 for Ki67). Conclusions: radiomic features extracted from tumor edema contribute significantly to predicting tumor histology, increasing the accuracy obtained from the combination of patient clinical characteristics and breast imaging data

A versatile clearing agent for multi-modal brain imaging

Extensive mapping of neuronal connections in the central nervous system requires high-throughput um-scale imaging of large volumes. In recent years, different approaches have been developed to overcome the limitations due to tissue light scattering. These methods are generally developed to improve the performance of a specific imaging modality, thus limiting comprehensive neuroanatomical exploration by multimodal optical techniques. Here, we introduce a versatile brain clearing agent (2,2'-thiodiethanol; TDE) suitable for various applications and imaging techniques. TDE is cost-efficient, water-soluble and low-viscous and, more importantly, it preserves fluorescence, is compatible with immunostaining and does not cause deformations at sub-cellular level. We demonstrate the effectiveness of this method in different applications: in fixed samples by imaging a whole mouse hippocampus with serial two-photon tomography; in combination with CLARITY by reconstructing an entire mouse brain with light sheet microscopy and in translational research by imaging immunostained human dysplastic brain tissue.Comment: in Scientific Reports 201