Nevin Manimala

J Stroke Cerebrovasc Dis. 2021 Feb 27;30(5):105680. doi: 10.1016/j.jstrokecerebrovasdis.2021.105680. Online ahead of print.

ABSTRACT

INTRODUCTION: Body lateropulsion (BLP) is seen in neurological lesions involving the pathways responsible for body position and verticality. We report a case of isolated body lateropulsion (iBLP) as the presentation of lateral medullary infarction and conducted a systematic literature review.

METHODS: MEDLINE and EMBASE databases were searched up to December 3, 2020.

INCLUSION CRITERIA: age ≥ 18, presence of BLP, confirmed stroke on imaging.

EXCLUSION CRITERIA: age < 18, qualitative reviews, studies with inadequate patient data. Statistical analysis was performed using IBM® SPSS® Statistics 20.

RESULTS: A 64-year-old man presented with acute-onset iBLP. Brain MRI demonstrated acute infarction in the right caudolateral medulla. His symptoms progressed with ipsilateral Horner syndrome over the next 24 hours and contralateral hemisensory loss 10 days later. Repeat MRI showed an increase in infarct size. BLP resolved partially at discharge. Systematic review: 418 abstracts were screened; 59 studies were selected reporting 103 patients. Thirty-three patients had iBLP (32%). BLP was ipsilateral to stroke in 70 (68%) and contralateral in 32 (32%). The most common stroke locations were medulla (n = 63, 59%), pons (n = 16, 15%), and cerebellum (n = 16, 15%). Four strokes were cortical, 3 frontal and 1 temporoparietal (3%). The most common etiology was large-artery atherosclerosis (LAA) in 20 patients (32%), followed by small-vessel occlusion in 12 (19%). Seventeen (27%) had large-vessel occlusion (LVO), 12 involving the vertebral artery. Sixty (98%) had some degree of resolution of BLP; complete in 41 (70%). Median time-to-resolution was 14 days (IQR 10-21). There was no relationship between time-to-resolution and age, sex, side of BLP or side of stroke.

CONCLUSION: BLP was commonly seen with medullary infarction and was the isolated finding in one-third. LAA and LVO were the most common etiologies. Recovery of BLP was early and complete in most cases.

PMID:33652344 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105680

Sci Total Environ. 2021 Feb 18;776:145935. doi: 10.1016/j.scitotenv.2021.145935. Online ahead of print.

ABSTRACT

Data-driven landslide susceptibility models formally integrate spatial landslide information with explanatory environmental variables that describe predisposing factors of slope instability. Well-performing models are commonly utilized to identify landslide-prone terrain or to understand the causes of slope instability. In most cases, however, the available landslide data is affected by spatial biases (e.g. underrepresentation of landslides far from infrastructure or in forests) and does therefore not perfectly represent the spatial distribution of past slope instabilities. Literature shows that implications of such data flaws are frequently ignored. This study was built upon landslide information that systematically relates to damage-causing and infrastructure-threatening events in South Tyrol, Italy (7400 km²). The created models represent three conceptually different strategies to deal with biased landslide information. The aims were to demonstrate why an inference of geomorphic causation from apparently well-performing models is invalid under common landslide data bias conditions (Model 1), to test a novel bias-adjustment approach (Model 2) and to exploit the underlying data bias to model areas likely affected by potentially damaging landslides (Model 3; intervention index), instead of landslide susceptibility. The study offers a novel perspective on how biases in landslide data can be considered within data-driven models by focusing not only on the process under investigation (landsliding), but also on the circumstances that led to the registration of landslide information (data collection effects). The results were evaluated in terms of statistical relationships, variable importance, predictive performance, and geomorphic plausibility. The results revealed that none of the models reflected landslide susceptibility. Despite partly high predictive performances, the models were unable to create geomorphically plausible spatial predictions. The impact-oriented intervention index, however, enabled to identify damage-causing landslides with high accuracy. We conclude that the frequent practice of inferring geomorphic causation from well-performing models without accounting for data limitations is invalid.

PMID:33652311 | DOI:10.1016/j.scitotenv.2021.145935

Sci Total Environ. 2021 Feb 18;776:145926. doi: 10.1016/j.scitotenv.2021.145926. Online ahead of print.

ABSTRACT

The estimation of geochemical background is complex in areas impacted by point sources of atmospheric emissions due to unknowns about pollutant dispersion, persistence of pollutants on the landscape, and natural concentrations of elements associated with parent material. This study combined mineralogical analysis with conventional statistical and geospatial methods to separate anthropogenically impacted soils from unimpacted soils in the Yellowknife area, Northwest Territories, Canada, a region that was exposed to 60 years of arsenic (As)-rich atmospheric mining emissions (1938-1999) and that hosts natural enrichments of As. High concentrations of As (up to 4700 mg kg^-1) were measured in publicly accessible soils near decommissioned roaster stacks in the region and strong relationships between As and distance from the main emission sources persisted in surface soils and soils at depth in the soil profile more than 60 years after the bulk of mining emissions were released. Mineralogical analysis provided unambiguous evidence regarding the source of As minerals and highlighted that most As in surface soils within 15 km of Yellowknife is hosted as anthropogenic arsenic trioxide (As₂O₃), produced by roaster stack emissions. Statistical protocols for the estimation of geochemical background were applied to an existing database of till geochemistry (N = 1490) after removing samples from mining impacted areas. Results suggested geochemical background for the region is 0.25-15 mg kg^-1 As, comparable to global averages, with upper thresholds elevated in volcanic units (30 mg kg^-1 As) that often host sulfide mineralization in greenstone belts in the region.

PMID:33652309 | DOI:10.1016/j.scitotenv.2021.145926

Sci Total Environ. 2021 Feb 23;776:146019. doi: 10.1016/j.scitotenv.2021.146019. Online ahead of print.

ABSTRACT

The inadequate management of soils and the absence of conservation practices favor the degradation of pastures and can trigger adverse environmental alterations and damage under the terms of Brazilian Federal Law no. 6.938/1981. Based on this premise, this study aimed to estimate soil losses caused by water erosion in pasture areas using the brightness index (BI) from the annual series of Landsat 8 images in different geological formations. A specifically prepared Google Earth Engine (GEE) script automatically extracted the BI from the images. The study occurred in the Environmental Protection Area (EPA) of Uberaba River basin (Minas Gerais, Brazil). To accomplish the goal, 180 digital 500-wide random buffers were selected from 3 geologic types (60 points per type), and then analyzed for zonal statistics of USLE (Universal Soil Loss Equation) soil loss and BI in a Geographic Information System. The regression models BI versus USLE soil loss allowed estimating BI soil losses over the pastures of EPA. The model fittings were remarkable. The validation of soil loss maps in the EPA occurred in pasture phytophysiognomies through the probing of penetration resistance in 37 randomly selected locations. The results were satisfactory, mostly those based on the BI. The BI losses increased for greater resistances. Amplified losses also occurred in regions exposed to environmental land use conflicts (actual uses that deviate from land capability or natural use). Overall, the BI approach proved efficient to accurately track soil losses and pasture degradation over large areas, with the advantage of standing on a single parameter easily accessed through remote sensed data. From an environmental standpoint, this is an important result, because the accurate diagnosis and prognosis of degraded pastures is paramount to implement mitigation measures following the “polluter pays principle”, even more in Brazil where the areas occupied by degraded pastures are enormous.

PMID:33652307 | DOI:10.1016/j.scitotenv.2021.146019

Arch Oral Biol. 2021 Feb 23;125:105091. doi: 10.1016/j.archoralbio.2021.105091. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate in vitro the effects of adrenaline and noradrenaline on the biofilm formation on orthodontic brackets, acid production and expression of virulence genes of Streptococcus mutans UA159 (S. mutans).

DESIGN: S. mutans UA159 biofilm was formed on orthodontic brackets under exposure to adrenaline (100 μM), noradrenaline (50 μM) or PBS solution (control group) in triptone-yeast extract with 1 % sucrose. After 24 h, biofilm formation was quantified through Colony Forming Units / mL (CFU/mL) and RNA was extracted to perform gene expression analysis through real-time reverse transcriptase-PCR (RT-qPCR). Evaluation of acid production was carried out on planktonic cultures for 6 h. One-way ANOVA followed by Tukey’s test was carried to determine statistical difference. The level of significance was set at 5 %.

RESULTS: Catecholamines stimulated biofilm formation of S. mutans in orthodontic brackets (p < 0,05) but did not interfere with acid production (pH reduction) or the expression of the tested genes related to biofilm formation (gtfB, gtfC, gbpA, gbpB, gbpC, gbpD and brpA), aciduric (relA) and acidogenic properties (ldh).

CONCLUSIONS: The present study was the first to demonstrate that catecholamines can stimulate S. mutans UA159 biofilm formation. These findings can contribute to clarify the role of stress on bacterial metabolism and contribute to the understanding of a possible role on caries development, mainly in orthodontic patients.

PMID:33652302 | DOI:10.1016/j.archoralbio.2021.105091

Clin Imaging. 2021 Feb 24;77:86-91. doi: 10.1016/j.clinimag.2021.02.031. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate whether textural analysis (TA) of MRI heterogeneity may play a role in the clinical assessment and classification of breast tumors.

MATERIALS AND METHODS: For this retrospective study, patients with breast masses ≥1 cm on contrast-enhanced MRI were obtained in 69 women (mean age: 51 years; range 21-78 years) with 77 masses (38 benign, 39 malignant) from 2006 to 2018. The selected single slice sagittal peak post-contrast T1-weighted image was analyzed with commercially available TA software [TexRAD Ltd., UK]. Eight histogram TA parameters were evaluated at various spatial scaling factors (SSF) including mean pixel intensity, standard deviation of the pixel histogram (SD), entropy, mean of the positive pixels (MPP), skewness, kurtosis, sigma, and Tx_sigma. Additional statistical tests were used to determine their predictiveness.

RESULTS: Entropy showed a significant difference between benign and malignant tumors at all textural scales (p < 0.0001) and kurtosis was significant at SSF = 0-5 (p = 0.0026-0.0241). The single best predictor was entropy at SSF = 4 with AUC = 0.80, giving a sensitivity of 95% and specificity of 53%. An AUC of 0.91 was found using a model combining entropy with sigma, which yielded better performance with a sensitivity of 92% and specificity of 79%.

CONCLUSION: TA of breast masses has the potential to assist radiologists in categorizing tumors as benign or malignant on MRI. Measurements of entropy, kurtosis, and entropy combined with sigma may provide the best predictability.

PMID:33652269 | DOI:10.1016/j.clinimag.2021.02.031

Cancer Treat Rev. 2021 Feb 16;94:102167. doi: 10.1016/j.ctrv.2021.102167. Online ahead of print.

ABSTRACT

BACKGROUND: The Fragility Indexquantifies the reliability of positive trials by estimating the number of events, which would change statistically significant results to non-significant results.

METHODS: We identified randomized trials supporting drug approvals by the US FDA between 2009 and 2019 in lung, breast, prostate, and colon cancers and in melanoma. We reconstructed survival tablesand calculated the number of events, which would result in a non-significant result for the primary endpoint. The FI was then compared to the number of patients in each trial who withdrew consent or were lost to follow-up. Regression analyses were used to explore associations between RCT characteristics and FI and trials in which FI was lower or equal to number of participants who withdrew consent or were lost to follow-up.

RESULTS: Among 81 RCTs, the median FI was 28. The median number of patients who withdrew consent or were lost to follow up was 27. FI was equal or lower than the number of patients who withdrew consent or were lost to follow-up in 47 trials (58%). There was a modest increase in FI over time (p = 0.02). Trials with overall survival as the primary endpoint (p = 0.006) and those in the palliative setting (p < 0.001) had lower FI. There was no association with trial sample size or duration of follow-up.

FINDINGS: Statistical significance of RCTs in common solid tumours can be reversed often with a small number of additional events. Post-approval RCTs or real-world data analyses should be performed to ensure results of registration trials are robust.

PMID:33652263 | DOI:10.1016/j.ctrv.2021.102167

Environ Int. 2021 Feb 27;151:106455. doi: 10.1016/j.envint.2021.106455. Online ahead of print.

ABSTRACT

OBJECTIVES: Given the role of exposures related to residence in the development of nasopharyngeal carcinoma (NPC) has not been well explored, present study aims to investigate the magnitude and pattern of associations for NPC with lifelong residential exposures.

MATERIALS AND METHODS: We carried out a multi-center, population-based case-control study with 2533 incident NPC cases and 2597 randomly selected population controls in southern China between 2010 and 2014. We performed multivariate logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of NPC associated with residential exposures.

RESULTS: Compared with those living in a building over lifetime, risk of NPC was higher for individuals living in a cottage (OR: 1.56; 95% CI: 1.34-1.81) or in a boat (3.87; 2.07-7.21). NPC risk was also increased in individuals using wood (1.34; 1.03-1.75), coal (1.70; 1.17-2.47), or kerosene (3.58; 1.75-7.36) vs. using gas/electricity as cooking fuel; using well water (1.57; 1.34-1.83), river water (1.80; 1.47-2.21), or spring/pond/stream water (2.03; 1.70-2.41) vs. tap water for source of drinking water; living in houses with smaller-sized vs. larger windows in the bedroom (3.08; 2.46-3.86), hall (1.89; 1.55-2.31) or kitchen (1.67; 1.34-2.08); and increasing exposure to cooking smoke [(1.53; 1.20-1.94) for high exposure)] or burned incense [(1.59; 1.31-1.95) for daily use)]. Weighted Cox regression analysis corroborated these results.

CONCLUSION: Poorer residential conditions and household air pollution are associated with an increased risk of NPC. Large-scale studies in other populations or longitudinal studies are warranted to further corroborate these findings.

PMID:33652252 | DOI:10.1016/j.envint.2021.106455

Poult Sci. 2021 Jan 23;100(4):101012. doi: 10.1016/j.psj.2021.01.034. Online ahead of print.

ABSTRACT

The objective of present study was to estimate the efficiency of lysine utilization by meat quail of 21 to 35 d of age. A total of 500 meat quails were distributed in a completely randomized design in a 2 × 5 factorial arrangement, with 2 sexes (male and female) and 5 digestible lysine levels (0.714, 0.816, 0.918, 1.020, and 1.122%) and 5 replications of 10 birds each. The variables studied were feather-free body weight (FFBW), feed intake (FI), lysine intake (LysI), feather-free body protein deposition (FFBPD), feather-free body lysine deposition (FFBLysD), feather-free body fat deposition (FFBFatD), feather weight (FW), feather protein deposition, feather lysine deposition, and feather fat deposition. The FFBW, FFBPD, FFBLysD, and FFBFatD were regressed as a function of LysI for each sex to estimate the efficiency of lysine utilization in the feather-free body (ELysFFB), and the individual equations were compared. In addition, a multiple regression without intercept was also used to estimate the ELysFFB and in feathers (ELysF) individually. To compare the ELysFFB obtained by the different methods, the t-statistic was used. There was no effect on sex × lysine level interactions for any variable. The females showed higher FFBW (5.07%) and FFBFatD (26.23%) than males. All variables increased with the level of dietary lysine, with the exception of FI, FW, and the deposition of nutrients within them. The ELysFFB values obtained by simple linear regression and multiple linear regression were 48.0 and 44.6%, respectively. As there was no difference in the efficiencies estimated by the different methodologies, the best estimate of ELysFFB was 46.3%, that is, the average. The best estimate of ELysF was 18.1%, obtained by multiple linear regression.

PMID:33652243 | DOI:10.1016/j.psj.2021.01.034

J Biomech. 2021 Feb 17;119:110329. doi: 10.1016/j.jbiomech.2021.110329. Online ahead of print.

ABSTRACT

Time continuous analyses, such as statistical parametric mapping (SPM), have been increasingly used in biomechanics research to determine differences between populations, interventions and methodologies. Currently, it is not known how sensitive time-continuous analyses are to timing variability that occur in gait data. We evaluated this sensitivity by examining the frequency of significant SPM outcomes between two walking speeds when lower limb kinematics and kinetics were segmented and aligned based on 40 repeatable gait events. These events, defined in the supplementary material, include a commonly used event like foot contact and other events that have been previously demonstrated to be repeatable. Repeatable gait events were determined from joint and segment kinematics, joint kinetics as well as ground reaction forces. We examined the frequency of statistical outcomes for a single subject with different numbers of strides analyzed and for a cohort of 10 subjects. Our findings demonstrate that gait interventions, such as changes in walking speed, can induce temporal shifts that affect time-continuous outcomes for both cohort- and subject-level analyses. As both timing and magnitude are important in gait data, researchers are encouraged to perform additional analyses to understand how both of these variables affect time-continuous analysis outcomes. Finally, we demonstrate that multiple SPM tests can be performed to determine if statistical outcomes are due to temporal shifting or differences in magnitude. It is important to understand how both timing and magnitude of biomechanical data influences time continuous analyses as these analyses inform injury prevention, device development and basic understanding of biomechanics.

PMID:33652238 | DOI:10.1016/j.jbiomech.2021.110329