1,965 research outputs found

    Fat Body Mass and Vertebral Fracture Progression in Women With Breast Cancer

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    Importance Women with early breast cancer (EBC) exposed to aromatase inhibitors (AIs) may experience fragility fractures despite treatment with bone-active drugs. Risk factors for fractures in patients receiving AIs and denosumab have not been explored to date.Objectives To evaluate whether an association exists between dual x-ray absorptiometry (DXA)-measured fat body mass (FBM) and vertebral fracture (VF) progression in postmenopausal women with EBC undergoing adjuvant therapy with AIs in combination with denosumab and to examine whether VF was associated with common risk factors for bone fracture and parameters of body composition other than FBM.Design, Setting, and Participants For this prospective, single-center, cohort study, 237 patients with EBC who were undergoing adjuvant treatment with AIs and denosumab (60 mg every 6 months) were enrolled at the Breast Unit of the ASST Spedali Civili of Brescia from September 2014 to June 2018. Data analysis was conducted in June 2022.Exposure Body composition parameters, bone mineral density, and morphometric VFs were assessed by DXA at study entry and after 18 months of therapy.Main Outcomes and MeasuresVF progression, defined as either new or worsening of preexisting VFs, between the 2 time points.Results Of the 237 patients enrolled (median [range] age, 61 [28-84] years), 17 (4.4%) reported VF progression. Univariable analysis found an association between VF progression and a history of clinical fractures (odds ratio [OR], 3.22; 95% CI, 1.19-8.74; P = .02), Fracture Risk Assessment Tool (FRAX) score for major fractures (OR, 4.42; 95% CI, 1.23-13.79; P = .04), percentage of FBM (OR, 6.04; 95% CI, 1.69-21.63; P = .006), and android fat (OR, 9.58; 95% CI, 1.17-78.21; P = .04) and an inverse association with appendicular lean mass index-FBM ratio (OR, 0.25, 95% CI, 0.08-0.82; P = .02). Multivariable analysis revealed percentage of FBM (OR, 5.41; 95% CI, 1.49-19.59; P = .01) and FRAX score (OR, 3.95; 95% CI, 1.09-14.39; P = .04) as independent variables associated with VF progression.Conclusions and Relevance The findings of this study suggest that baseline FBM is an independent factor for VF progression in patients with EBC treated with adjuvant AIs and denosumab. This observation is new and indicates that diet and exercise may synergize with denosumab in the management of bone health in this patient setting

    From pupil to the brain: New insights for studying cortical plasticity through pupillometry

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    Pupil size variations have been associated with changes in brain activity patterns related with specific cognitive factors, such as arousal, attention, and mental effort. The locus coeruleus (LC), a key hub in the noradrenergic system of the brain, is considered to be a key regulator of cognitive control on pupil size, with changes in pupil diameter corresponding to the release of norepinephrine (NE). Advances in eye-tracking technology and open-source software have facilitated accurate pupil size measurement in various experimental settings, leading to increased interest in using pupillometry to track the nervous system activation state and as a potential biomarker for brain disorders. This review explores pupillometry as a non-invasive and fully translational tool for studying cortical plasticity starting from recent literature suggesting that pupillometry could be a promising technique for estimating the degree of residual plasticity in human subjects. Given that NE is known to be a critical mediator of cortical plasticity and arousal, the review includes data revealing the importance of the LC-NE system in modulating brain plasticity and pupil size. Finally, we will review data suggesting that pupillometry could provide a quantitative and complementary measure of cortical plasticity also in pre-clinical studies

    Convolutional neural network classifies visual stimuli from cortical response recorded with wide-field imaging in mice

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    : ObjectiveThe optic nerve is a good location for a visual neuroprosthesis. It can be targeted when a subject cannot receive a retinal prosthesis and it is less invasive than a cortical implant. The effectiveness of an electrical neuroprosthesis depends on the combination of the stimulation parameters which must be optimized, and an optimization strategy might be performing closed-loop stimulation using the evoked cortical response as feedback. However, it is necessary to identify target cortical activation patterns and to associate the cortical activity with the visual stimuli present in the visual field of the subjects. Visual stimuli decoding should be performed on large areas of the visual cortex, and with a method as translational as possible to shift the study to human subjects in the future. The aim of this work is to develop an algorithm that meets these requirements and can be leveraged to automatically associate a cortical activation pattern with the visual stimulus that generated it.ApproachThree mice were presented with 10 different visual stimuli, and their primary visual cortex response was recorded using wide-field calcium imaging. Our decoding algorithm relies on a convolutional neural network (CNN), trained to classify the visual stimuli from the correspondent wide-field images. Several experiments were performed to identify the best training strategy and investigate the possibility of generalization.Main resultsThe best classification accuracy was 75.38%±4.77%, obtained pre-training the CNN on the MNIST digits dataset and fine-tuning it on our dataset. Generalization was possible pre-training the CNN to classify Mouse 1 dataset and fine-tuning it on Mouse 2 and Mouse 3, with accuracies of 64.14%±10.81% and 51.53%±6.48% respectively.SignificanceThe combination of wide-field calcium imaging and CNNs can be used to classify the cortical responses to simple visual stimuli and might be a viable alternative to existing decoding methodologies. It also allows us to consider the cortical activation as reliable feedback in future optic nerve stimulation experiments

    A Comprehensive Atlas of Perineuronal Net Distribution and Colocalization with Parvalbumin in the Adult Mouse Brain

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    Perineuronal nets (PNNs) surround specific neurons in the brain and are involved in various forms of plasticity and clinical conditions. However, our understanding of the PNN role in these phenomena is limited by the lack of highly quantitative maps of PNN distribution and association with specific cell types. Here, we present a comprehensive atlas of Wisteria Floribunda Agglutinin (WFA) positive PNNs and colocalization with parvalbumin (PV) cells for over 600 regions of the adult mouse brain. Data analysis shows that PV expression is a good predictor of PNN aggregation. In the cortex, PNNs are dramatically enriched in layer 4 of all primary sensory areas in correlation with thalamocortical input density, and their distribution mirrors intracortical connectivity patterns. Gene expression analysis identifies many PNN correlated genes. Strikingly, PNN anticorrelated transcripts are enriched in synaptic plasticity genes, generalizing PNN role as circuit stability factors

    Assessment of DXA derived bone quality indexes and bone geometry parameters in early breast cancer patients: A single center cross-sectional study

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    Background: Bone mineral density (BMD) lacks sensitivity in individual fracture risk assessment in early breast cancer (EBC) patients treated with aromatase inhibitors (AIs). New dual-energy X-ray absorptiometry (DXA) based risk factors are needed. Methods: Trabecular bone score (TBS), bone strain index (BSI) and DXA parameters of bone geometry were evaluated in postmenopausal women diagnosed with EBC. The aim was to explore their association with morphometric vertebral fractures (VFs). Subjects were categorized in 3 groups in order to evaluate the impact of AIs and denosumab on bone geometry: AI-naive, AI-treated minus (AIDen-) or plus (AIDen+) denosumab. Results: A total of 610 EBC patients entered the study: 305 were AI-naive, 187 AIDen-, and 118 AIDen+. In the AI-naive group, the presence of VFs was associated with lower total hip BMD and T-score and higher femoral BSI. As regards as bone geometry parameters, AI-naive fractured patients reported a significant increase in femoral narrow neck (NN) endocortical width, femoral NN subperiosteal width, intertrochanteric buckling ratio (BR), intertrochanteric endocortical width, femoral shaft (FS) BR and endocortical width, as compared to non-fractured patients. Intertrochanteric BR and intertrochanteric cortical thickness significantly increased in the presence of VFs in AIDen- patients, not in AIDen+ ones. An increase in cross-sectional area and cross-sectional moment of inertia, both intertrochanteric and at FS, significantly correlated with VFs only in AIDen+. No association with VFs was found for either lumbar BSI or TBS in all groups. Conclusions: Bone geometry parameters are variably associated with VFs in EBC patients, either AI-naive or AI treated in combination with denosumab. These data suggest a tailored choice of fracture risk parameters in the 3 subgroups of EBC patients

    Improved Coronary Artery Visualization Using Virtual Monoenergetic Imaging from Dual-Layer Spectral Detector CT Angiography

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    Background: To evaluate if coronary CT angiography (CCTA) monoenergetic reconstructions, obtained with a dual-layer spectral detector computed tomography (DLCT) system, offer improved image quality compared with 120 kVp conventional images without affecting the quantitative assessment of coronary stenoses. Methods: Fifty CCTA datasets (30 men; mean age: 61.6 ± 12.3 years) acquired with a DLCT system were reconstructed using virtual monoenergetic images (VMI) from 40 to 100 keV with 10 keV increment and compared with conventional images. An analysis of objective image quality was performed, evaluating the signal- and contrast-to-noise ratio. For the subjective assessment, two readers used a 5-point Likert scoring system to evaluate sharpness, noise, demarcation of coronary plaques, vascular contrast, and an overall score. Furthermore, coronary stenoses were analyzed for each vessel to describe the diagnostic agreement between monoenergetic images and conventional images. Results: The objective image analysis showed that all reconstructions from 70 keV to 40 keV show higher SNR (from 61.33 ± 12.46 to 154.22 ± 42.91, respectively) and CNR (from 51.45 ± 11.19 to 135.63 ± 39.38, respectively) compared with conventional images (all p p Conclusions: The 40 keV virtual monoenergetic images obtained with a DLCT system allow the objective and subjective image quality of coronary CT angiography to be improved

    Selective Disruption of Perineuronal Nets in Mice Lacking Crtl1 is Sufficient to Make Fear Memories Susceptible to Erasure

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    The ability to store, retrieve, and extinguish memories of adverse experiences is an essential skill for animals' survival. The cellular and molecular factors that underlie such processes are only partially known. Using chondroitinase ABC treatment targeting chondroitin sulfate proteoglycans (CSPGs), previous studies showed that the maturation of the extracellular matrix makes fear memory resistant to deletion. Mice lacking the cartilage link protein Crtl1 (Crtl1-KO mice) display normal CSPG levels but impaired CSPG condensation in perineuronal nets (PNNs). Thus, we asked whether the presence of PNNs in the adult brain is responsible for the appearance of persistent fear memories by investigating fear extinction in Crtl1-KO mice. We found that mutant mice displayed fear memory erasure after an extinction protocol as revealed by analysis of freezing and pupil dynamics. Fear memory erasure did not depend on passive loss of retention; moreover, we demonstrated that, after extinction training, conditioned Crtl1-KO mice display no neural activation in the amygdala (Zif268 staining) in comparison to control animals. Taken together, our findings suggest that the aggregation of CSPGs into PNNs regulates the boundaries of the critical period for fear extinction

    Spectral CT Imaging of Prosthetic Valve Embolization after Transcatheter Aortic Valve Implantation

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    Transcatheter heart valve (THV) embolization is a rare complication of transcatheter aortic valve implantation (TAVI) generally caused by malpositioning, sizing inaccuracies and pacing failures. The consequences are related to the site of embolization, ranging from a silent clinical picture when the device is stably anchored in the descending aorta to potentially fatal outcomes (e.g., obstruction of flow to vital organs, aortic dissection, thrombosis, etc.). Here, we present the case of a 65-year-old severely obese woman affected by severe aortic valve stenosis who underwent TAVI complicated by embolization of the device. The patient underwent spectral CT angiography that allowed for improved image quality by means of virtual monoenergetic reconstructions, permitting optimal pre-procedural planning. She was successfully re-treated with implantation of a second prosthetic valve a few weeks later.</p

    Quantum Simulation of Bosons with the Contracted Quantum Eigensolver

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    Quantum computers are promising tools for simulating many-body quantum systems due to their potential scaling advantage over classical computers. While significant effort has been expended on many-fermion systems, here we simulate a model entangled many-boson system with the contracted quantum eigensolver (CQE). We generalize the CQE to many-boson systems by encoding the bosonic wavefunction on qubits. The CQE provides a compact ansatz for the bosonic wave function whose gradient is proportional to the residual of a contracted Schr\"odinger equation. We apply the CQE to a bosonic system, where NN quantum harmonic oscillators are coupled through a pairwise quadratic repulsion. The model is relevant to the study of coupled vibrations in molecular systems on quantum devices. Results demonstrate the potential efficiency of the CQE in simulating bosonic processes such as molecular vibrations with good accuracy and convergence even in the presence of noise
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