Nevin Manimala

J Environ Manage. 2021 Aug 17;298:113504. doi: 10.1016/j.jenvman.2021.113504. Online ahead of print.

ABSTRACT

Understanding local stakeholders’ perceptions of co-management institutional activities serves a significant role in the proper functioning of the co-management institutions for the Sundarban mangrove forest conservation effort, but this currently remains unexplored. This study aimed to identify the current co-management institutions, co-management activities, and local people’s understanding of these activities in the implementation of the co-management approach. The study was conducted in four villages in the Chandpai range of the Sundarban mangrove forest. Thematic content analysis was conducted on the qualitative data, which had been collected through key informant interviews at the local, regional and national levels, followed by focus group discussions in the study villages. The key forest co-management activities and practices identified were: forest protection and monitoring; meetings; local livelihood initiatives; and organisational supports. These co-management activities were implemented through institutions largely situated at the local level, through Village Conservation Forum, People’s Forum and Community Patrol Group; higher-level institutions included the Co-management Committee, where local, district and national stakeholders were represented. Local people with forest dependency were participating in forest co-management activities and their awareness of forest conservation and social network had increased. In addition, people who had received training from government and non-government organisations reported benefits such as improved resource harvesting techniques, organisational skills and practical knowledge, which would be useful in times of natural disasters. However, local people also reported a range of issues affecting their full participation, which included top down decision-making, insignificant financial support, absence of alternate income sources, lack of meeting places for VCF members, gender inequality in participation, corruption and lack of skill-based training. A key governance issue for the local-level forest co-management institutions was limited access to the government organisations who oversaw policy and institutional control. In contrast, non-government organisations provided important institutional capacity-building support to local communities, and acted as a conduit to higher level committees. Broader impact could be achieved by fostering local participation, especially that of women, through genuine collaboration with other stakeholders, and extending the lessons learned from the study villages through exchange visits and sharing of ideas with other VCF villages in the area.

PMID:34426227 | DOI:10.1016/j.jenvman.2021.113504

Environ Pollut. 2021 Aug 13;289:117972. doi: 10.1016/j.envpol.2021.117972. Online ahead of print.

ABSTRACT

Rare earth elements have been increasingly used in modern societies and soils are likely to be the final destination of several REE-containing (by)products. This study reports REE contents for topsoils (0-20 cm) of 175 locations in reference (n = 68) and cultivated (n = 107) areas in Brazil. Benchmark soil samples were selected accomplishing a variety of environmental conditions, aiming to: i) establishing natural background and anthropogenic concentrations for REE in soils; ii) assessing potential contamination of soils – via application of phosphate fertilizers – with REE; and, iii) predicting soil-REE contents using biomes, soil type, parent material, land use, sand content, and biomes-land use interaction as forecaster variables through generalized least squares multiple regression. Our hypotheses were that the variability of soil-REE contents is influenced by parent material, pedogenic processes, land use, and biomes, as well as that cultivated soils may have been potentially contaminated with REE via input of phosphate fertilizers. The semi-total concentrations of REE were assessed by inductively coupled plasma mass spectrometry (ICP-MS) succeeding a microwave-assisted aqua regia digestion. Analytical procedures followed a rigorous QA/QC protocol. Soil physicochemical composition and total oxides were also determined. Natural background and anthropogenic concentrations for REE were established statistically from the dataset by the median plus two median absolute deviations method. Contamination aspects were assessed by REE-normalized patterns, REE fractionation indices, and Ce and Eu anomalies ratios, as well as enrichment factors. The results indicate that differences in the amounts of REE in cultivated soils can be attributed to land use and agricultural sources (e.g., phosphate-fertilizer inputs), while those in reference soils can be attributed to parent materials, biomes, and pedogenic processes. The biomes, land use, and sand content helped to predict concentrations of light REE in Brazilian soils, with parent material being also of special relevance to predict heavy REE contents in particular.

PMID:34426210 | DOI:10.1016/j.envpol.2021.117972

Environ Pollut. 2021 Aug 4;289:117914. doi: 10.1016/j.envpol.2021.117914. Online ahead of print.

ABSTRACT

Chronic arsenic exposure can induce cardiovascular diseases through oxidative stress injury, inflammation and endothelial dysfunction. However, evidence for hypertension related to chronic arsenic exposure remains limited and inconclusive. To investigate the association of arsenic exposure with hypertension, we reviewed cross-sectional, case-control and longitudinal studies among general population (only excluded pregnant woman and children). Compared with non-exposure (or low exposure) group, we assessed relationship between the exposure (or high exposure) of arsenic and hypertension or blood pressure. We also examined the dose-response relationship to provide a theoretical basis for precision interventions in the population by conducting a two-stage random-effects dose-response meta-analysis. The weighted mean difference (WMD) was calculated to compare the blood pressure of exposed and reference arsenic exposure groups. Twenty-seven studies comprising 117,769 participants were included. The pooled OR and RR for hypertension compared the highest with lowest arsenic exposure categories were 1.14 [95 % confidence interval (CI): 1.06-1.23] and 1.30 [95 % CI: 0.91-1.84], respectively. A dose-response assessment of six studies with the necessary data available demonstrated that the OR of hypertension increased with an increasement of arsenic exposure. The differences in systolic blood pressure levels between the exposed and reference groups were 4.03 mmHg (95 % CI: 1.24-6.82). The meta-analysis further revealed the significant association of chronic arsenic exposure with hypertension among cross-sectional studies and the marginal significance in cohort studies. Besides, arsenic was mainly associated with increasing systolic blood pressure but not significantly related to diastolic blood pressure. We also demonstrated statistical evidence of a nonlinear dose-response association. Details on mechanisms and cohort studies are required to elucidate population-wide health influence of chronic arsenic exposure.

PMID:34426185 | DOI:10.1016/j.envpol.2021.117914

Stat Med. 2021 Aug 23. doi: 10.1002/sim.9173. Online ahead of print.

ABSTRACT

We abstract the concept of a randomized controlled trial as a triple (β,b,s) , where β is the primary efficacy parameter, b the estimate, and s the standard error ( s>0 ). If the parameter β is either a difference of means, a log odds ratio or a log hazard ratio, then it is reasonable to assume that b is unbiased and normally distributed. This then allows us to estimate the joint distribution of the z-value z=b/s and the signal-to-noise ratio SNR=β/s from a sample of pairs (bi,si) . We have collected 23 551 such pairs from the Cochrane database. We note that there are many statistical quantities that depend on (β,b,s) only through the pair (z,SNR) . We start by determining the estimated distribution of the achieved power. In particular, we estimate the median achieved power to be only 13%. We also consider the exaggeration ratio which is the factor by which the magnitude of β is overestimated. We find that if the estimate is just significant at the 5% level, we would expect it to overestimate the true effect by a factor of 1.7. This exaggeration is sometimes referred to as the winner’s curse and it is undoubtedly to a considerable extent responsible for disappointing replication results. For this reason, we believe it is important to shrink the unbiased estimator, and we propose a method for doing so. We show that our shrinkage estimator successfully addresses the exaggeration. As an example, we re-analyze the ANDROMEDA-SHOCK trial.

PMID:34425632 | DOI:10.1002/sim.9173

Tierarztl Prax Ausg G Grosstiere Nutztiere. 2021 Aug;49(4):234-246. doi: 10.1055/a-1525-0868. Epub 2021 Aug 23.

ABSTRACT

OBJECTIVE: This study aimed to establish reference intervals for Mn in whole blood, plasma and serum of healthy, adult warmblood horses with known dietary Mn intake and to compare 2 methods of analysis.

MATERIAL AND METHODS: Between May 2018 and November 2019 a single blood sample was taken from a total of 270 clinically healthy horses (age: 3-25 years) in 3 stud farms. In lithium-heparin (LH) whole blood, LH plasma and serum Mn concentrations were analyzed by means of atomic absorption spectrometry (AAS) and inductively coupled plasma mass spectrometry (ICP-MS). The reference intervals were calculated according to the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the Clinical and Laboratory Standards Institute (CLSI) comprising the range between 2.5 and 97.5 percentile of the analyzed Mn concentrations. Concurrent to blood sampling feed samples were taken and analyzed in order to determine the Mn content of the corresponding feeding ration.

RESULTS: The horses’ whole-blood Mn levels were significantly (p < 0.0001) higher with a median Mn concentration of 12.4 μg/l (reference interval: 4.99-25.1 μg/l [AAS]; 5.99-25.3 μg/l [ICP-MS]) than in the corresponding serum (median: 1.65 μg/l, reference interval: 0.60-3.50 μg/l [AAS]; 1.11-2.96 μg/l [ICP-MS]) or LH plasma (median: 1.35 μg/l, reference interval: 0.22-2.68 μg/l [AAS]; 0.59-2.45 μg/l [ICP-MS]). In the comparison of methods, there were statistically significant differences in the Mn determinations for LH plasma and serum between AAS and ICP-MS, whereas they yielded comparable results for whole blood.

CONCLUSION AND CLINICAL RELEVANCE: Whole blood shows an average of 10-fold higher Mn concentrations than serum or LH plasma. When evaluating blood Mn concentrations, consideration must be granted to the sample material under analysis as well as to which method is employed since relevant differences were found between AAS and ICP-MS in serum and LH plasma.

PMID:34425615 | DOI:10.1055/a-1525-0868

Oper Dent. 2021 Aug 23. doi: 10.2341/20-045-L. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: The strength of some bioactive materials can be compromised by cariogenic challenges. This may impact the clinical longevity of restorations, especially in stress-bearing areas.

SUMMARY: This study determined the mechanical performance of bioactive restoratives in cariogenic environments and compared the flexural properties of various bioactive materials. The materials evaluated included a conventional resin-based composite (Filtek Z350 [FZ]) and 3 bioactive restoratives, namely an alkasite (Cention N [CN]), a giomer (Beautifil-bulk Restorative [BB]), and an enhanced resin-modified glass ionomer (Activa Bioactive Restorative [AV]). Beam-shaped specimens (12 x 2 x 2 mm) were produced, randomly allocated to 4 groups (n=10), and conditioned in deionized solution, remineralizing solution, demineralizing solution (DE), or pH cycled for 14 days at 37°C. After conditioning/pH cycling, the specimens were subjected to 3-point flexural testing. Flexural data were subjected to statistical analysis using analysis of variance or Tukey’s test (α=0.05). Mean flexural modulus and strength ranged from 3.54 ± 0.33 to 7.44 ± 0.28 GPa, and 87.07 ± 8.99 to 123.54 ± 12.37 MPa, respectively. While the flexural modulus of the bioactive restoratives was not affected by cariogenic/acidic conditions, flexural strength usually decreased, with the exception of CN. The strength of BB was significantly reduced by DE and pH cycling, while that of AV was lowered by DE. For all conditioning mediums, AV had a significantly lower modulus than the other materials. Apart from conditioning in DE, where differences in flexural strength was insignificant, FZ and AV were generally significantly stronger than BB and CN. The effect of cariogenic environments on flexural strength was found to be material dependent, and aside from the alkasite material (CN), cariogenic conditions were observed to significantly decrease the strength of bioactive restoratives.

PMID:34425586 | DOI:10.2341/20-045-L

Oncology. 2021 Aug 23:1-4. doi: 10.1159/000517843. Online ahead of print.

ABSTRACT

BACKGROUND: The Oncotype DX Recurrence Score (ODx RS) is the most widely adopted genomic assay used to guide treatment for patients with early-stage, hormone-positive (HR+) breast cancer (BC), with higher scores predicting greater risk of recurrence and benefit from chemotherapy. Patients with ODx RS >25 typically recieve adjuvant chemotherapy; however, data regarding efficacy of chemotherapy for reducing recurrence in this population have been mixed.

OBJECTIVES: This study aimed to evaluate outcomes of patients with early-stage HR+ BC with high-risk ODx RS (26-30 and ≥31) in order to assess treatment patterns and outcomes. We hypothesized that the benefit of chemotherapy in these groups may be minimal and that select patients may forgo chemotherapy in favor of more aggressive endocrine therapy and ovarian suppression.

METHODS: We performed a retrospective analysis of 515 patients with early-stage, HR+ BC with high-risk ODx RS 26-30 and ≥31 treated between 2006 and 2018. Patients were stratified by RS: low-risk (≤10), intermediate-risk (11-25), and high-risk (≥26). The Kaplan-Meier method was used to estimate the time to secondary invasive breast events (SIBE) or distributions overall and among different RS groups with the log rank test used to compare distributions between groups.

RESULTS: Rates of chemotherapy administration were 7% among the low-risk group, 18% among the intermediate-risk group, and 83% among high-risk patients with 41 SIBE (8%) reported. When stratified by ODx RS, 5-year rates of SIBE were 4%, 6%, and 16% for low-risk, intermediate-risk, and high-risk RS, respectively. Among the 27 lymph node (LN)-negative patients with ODx RS 26-30, 74% received chemotherapy. The 5-year rate of SIBE was 25% among patients who received chemotherapy and 33% among those who did not (p = 0.5489). Among the 23 LN-negative patients with ODx RS ≥31, 91% of patients received chemotherapy. The 5-year rate of SIBE was 0% both with and without chemotherapy.

CONCLUSIONS: There was no statistically significant difference in SIBE for patients with high-risk ODx RS based on chemotherapy treatment. More aggressive endocrine therapy with ovarian suppression has become an alternative to chemotherapy among patients with intermediate-risk ODx RS (16-25). This approach may be useful among patients with high-risk ODx RS, with additional studies needed in this patient population.

PMID:34425579 | DOI:10.1159/000517843

J Environ Radioact. 2021 Aug 20;237:106722. doi: 10.1016/j.jenvrad.2021.106722. Online ahead of print.

ABSTRACT

The paper presents the monitoring results of the temporal variability of daily ⁷Be activity concentration in the atmospheric surface layer at Sevastopol in 2011-2020. The ⁷Be activity concentration in individual samples of atmospheric aerosols varies from 0.1 to 13.3 mBq m^-3 and averages 4.0 ± 2.0 Bq m^-3. Higher ⁷Be activity concentrations have been observed during the period from May to August while lower concentrations have been measured from December to January. Quantitative estimates of the influence of precipitation (amount, duration, intensity) on the temporal variability of ⁷Be activity concentration have been obtained. It has been found that daily ⁷Be activity concentration decrease by 2-82% on the first day with precipitation. It has been shown that an increase in precipitation duration and a decrease in its intensity lead to a more significant decrease in the daily ⁷Be activity concentration. The estimates of the scavenging coefficient have been obtained; the average value is 0.6 ± 1.0 h^-1. An increase in the precipitation intensity or amount is accompanied by a decrease in the ⁷Be scavenging coefficient. Mean 0.5-folding and residence times of ⁷Be activity concentration in the atmosphere during a moderate rain event are 2.9 ± 2.2 and 15.4 ± 13.6 h, respectively. The recovery of ⁷Be activity concentration in the atmosphere after precipitation has been investigated. It has been found that this process takes 1-2 days. The mean value of the reload coefficient is 0.94 ± 0.34 d^-1. The relationship between the value of the reload coefficient and local meteorological parameters (air temperature, relative humidity, atmospheric pressure, wind speed, surface net solar radiation flux) has been investigated. No statistically significant correlations at a 95% confidence level between the reload coefficient and the considered meteorological parameters have been revealed. Parameterization describing a decrease in the daily ⁷Be activity concentration in the atmosphere due to precipitation and its recovery during the precipitation-free period has been introduced.

PMID:34425548 | DOI:10.1016/j.jenvrad.2021.106722

Oral Oncol. 2021 Aug 20;121:105494. doi: 10.1016/j.oraloncology.2021.105494. Online ahead of print.

ABSTRACT

BACKGROUND: Our previous trial confirmed that induction chemotherapy (IC) improved long-term survival outcomes in patients with locoregionally advanced nasopharyngeal carcinoma (NPC). In this study, we investigated the impact of IC on long-term quality of life (QoL) in this cohort.

METHODS: Our trial was a randomised, open-label phase 3 trial comparing IC followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in patients with stage III-IVB (except T3N0-1) NPC. All participants completed two self-administered questionnaires, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQ-C30) and the EORTC QLQ Head and Neck Cancer-Specific Module (H&N35). As per protocol, the questionnaires had to be completed before knowledge of treatment allocation by the patient (baseline). Patients were then approached to enroll at the time of the present study period.

RESULTS: Ultimately, QoL data from 228 patients were included in the analysis. Most scales were both statistically and clinically decreased in both groups between baseline and the latest follow-up. The IC followed by CCRT group had significantly better outcome in role functioning, cognitive functioning, social functioning, fatigue, pain, and constipation in QLQ-C30 scales at the last follow-up. Similarly, in H&N35 scales, a significantly better result was observed in pain, sexuality, sticky saliva, pain killers use, nutritional supplements, and weight loss, but a poorer result in senses problems, for those treated by IC followed by CCRT.

CONCLUSION: IC followed by CCRT seemed to have better long-term QoL outcomes compared with CCRT alone in patients with locoregionally advanced NPC.

PMID:34425533 | DOI:10.1016/j.oraloncology.2021.105494

Atherosclerosis. 2021 Aug 12;333:48-55. doi: 10.1016/j.atherosclerosis.2021.08.020. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Coronary artery disease (CAD) is a complex disease with a strong genetic basis. While previous studies have combined common single-nucleotide polymorphisms (SNPs) into a polygenic risk score (PRS) to predict CAD risk, this association is poorly characterised. We performed a meta-analysis to estimate the effect of PRS on the risk of CAD.

METHODS: Online databases were searched for studies reporting PRS and CAD. PRS computation was based on log-odds (PRS_LN), pruning or clumping and thresholding (PRS_{P/C + T}), Lassosum regression (PRS_Lassosum), LDpred (PRS_LDpred), or metaGRS (PRS_metaGRS). The reported odds ratio (OR), hazard ratio (HR), C-indexes and their corresponding 95% confidence interval (95% CI) were pooled in a random-effects meta-analysis.

RESULTS: Forty-nine studies were included (979,286 individuals). There was a significant association between 1-standard deviation [SD] increment in PRS and adjusted risks of both incident and prevalent CAD (OR [95% CI]: 1.67 [1.57-1.77] for PRS_metaGRS, 1.46 [1.26-1.68] for PRS_LDpred). The risk of incident CAD was highest for PRS_{P/C + T} (HR [95% CI]: 1.49 [1.26-1.78]), PRS_metaGRS (1.37 [1.27-1.47]), and PRS_LDpred (1.36 [1.31-1.42]). Analysis of model performance demonstrated that PRS predicted incident CAD with C-index of up to 0.71. Importantly, addition of PRS to clinical risk scores resulted in modest but statistically significant improvements in CAD risk prediction, with 1.5% observed for PRS_{P/C + T} (p < 0.001) and 1.6% for PRS_LDpred (p < 0.001).

CONCLUSIONS: Polygenic risk score is strongly associated with increased risks of CAD. Future prospective studies should explore the usefulness of polygenic risk scores for identifying individuals at a high risk of developing CAD.

PMID:34425527 | DOI:10.1016/j.atherosclerosis.2021.08.020