Nevin Manimala

Vet Parasitol. 2021 Jun 26;296:109510. doi: 10.1016/j.vetpar.2021.109510. Online ahead of print.

ABSTRACT

Bovine ostertagiasis causes significant production losses to the cattle industry. Protective immunity induced by natural infection is slow to develop and anthelmintic resistance is rapidly developing. There is a need to advance alternatives for control of gastrointestinal nematode parasites. The present study investigated the effects of repeated, drug-truncated infections (rDTI) on development of protective immunity and attenuation of a challenge infection by O. ostertagi. Helminth-free calves were randomly assigned to either a rDTI or a control group (n = 5). The rDTI group received daily oral infections of 5000 Ostertagia L3 for 5 consecutive days, then were drug-treated on 14 and 15 days post infection (dpi), to attenuate O. ostertagi at the late fourth larval (L4) through young adult stages. DTI was repeated 3 weeks after the drug treatment. A total of 5 DTIs were administered to the DTI-treated animals. Non-DTI-treated, control animals received tap water as infection control. All animals were drug-treated at the same time. Animals were challenge-infected 4 weeks following the final round of rDTI. The results show that eggs per gram of feces (EPG) in the rDTI group were significantly reduced (P < 0.05) from 21 to 39 dpi, with an overall reduction in cumulative EPG. The control group exhibited reduced (P = 0.0564) average weight gains when compared to those of the rDTI group during weeks 4-5 post infection, a period coinciding with peak EPG output of control animals. Antigen-specific IgG, IgE and IgA responses were detected after the 2nd DTI, and stronger antibody recall responses were elicited by challenge infection. High levels of antigen-specific peripheral blood mononuclear cell (PBMC)/T cell proliferation to whole worm and excretory-secretory (ES) antigens were detected in rDTI-treated animals. These data indicate that partial protective immunity against ostertagiasis, involving cell-mediated and humoral responses, can be attained by rDTI which allowed for maximal antigen exposure from staggered parasitic developmental stages. The data suggest that rDTI can be used as a model to study host-parasite interactions and identify parasite antigens responsible for eliciting host protective immune responses.

PMID:34217073 | DOI:10.1016/j.vetpar.2021.109510

Neural Netw. 2021 Jun 25;143:368-376. doi: 10.1016/j.neunet.2021.06.020. Online ahead of print.

ABSTRACT

We study distributed learning for regularized least squares regression in a reproducing kernel Hilbert space (RKHS). The divide-and-conquer strategy is a frequently used approach for dealing with very large data sets, which computes an estimate on each subset and then takes an average of the estimators. Existing theoretical constraint on the number of subsets implies the size of each subset can still be large. Random sketching can thus be used to produce the local estimators on each subset to further reduce the computation compared to vanilla divide-and-conquer. In this setting, sketching and divide-and-conquer are complementary to each other in dealing with the large sample size. We show that optimal learning rates can be retained. Simulations are performed to compare sketched and non-standard divide-and-conquer methods.

PMID:34217064 | DOI:10.1016/j.neunet.2021.06.020

Vision Res. 2021 Jun 30;187:55-65. doi: 10.1016/j.visres.2021.06.007. Online ahead of print.

ABSTRACT

Visual texture, defined by local image statistics, provides important information to the human visual system for perceptual segmentation. Second-order or spectral statistics (equivalent to the Fourier power spectrum) are a well-studied segmentation cue. However, the role of higher-order statistics (HOS) in segmentation remains unclear, particularly for natural images. Recent experiments indicate that, in peripheral vision, the HOS of the widely adopted Portilla-Simoncelli texture model are a weak segmentation cue compared to spectral statistics, despite the fact that both are necessary to explain other perceptual phenomena and to support high-quality texture synthesis. Here we test whether this discrepancy reflects a property of natural image statistics. First, we observe that differences in spectral statistics across segments of natural images are redundant with differences in HOS. Second, using linear and nonlinear classifiers, we show that each set of statistics individually affords high performance in natural scenes and texture segmentation tasks, but combining spectral statistics and HOS produces relatively small improvements. Third, we find that HOS improve segmentation for a subset of images, although these images are difficult to identify. We also find that different subsets of HOS improve segmentation to a different extent, in agreement with previous physiological and perceptual work. These results show that the HOS add modestly to spectral statistics for natural image segmentation. We speculate that tuning to natural image statistics under resource constraints could explain the weak contribution of HOS to perceptual segmentation in human peripheral vision.

PMID:34217005 | DOI:10.1016/j.visres.2021.06.007

Mult Scler Relat Disord. 2021 Jun 24;54:103104. doi: 10.1016/j.msard.2021.103104. Online ahead of print.

ABSTRACT

BACKGROUND: When the novel coronavirus disease 2019 (COVID-19) appeared, concerns about its course in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) arose. This study aimed to evaluate the incidence, severity and risk factors of the more severe COVID-19 course among MS and NMOSD patients.

METHODS: From March 1, 2020, to February 28, 2021, 12 MS centres, representing 70% of the Czech MS and NMOSD population, reported laboratory-confirmed COVID-19 cases via the Czech nationwide register of MS and NMOSD patients (ReMuS). The main outcome was COVID-19 severity assessed on an 8-point scale with a cut-off at 4 (radiologically confirmed pneumonia) according to the World Health Organisation´s (WHO) COVID-19 severity assessment.

RESULTS: We identified 958 MS and 13 NMOSD patients, 50 MS and 4 NMOSD patients had pneumonia, 3 MS and 2 NMOSD patients died. The incidence of COVID-19 among patients with MS seems to be similar to the general Czech population. A multivariate logistic regression determined that higher body mass index (BMI [OR 1.07, 95% CI, 1.00-1.14]), older age (OR per 10 years 2.01, 95% CI, 1.41-2.91), high-dose glucocorticoid treatment during the 2 months before COVID-19 onset (OR 2.83, 95% CI, 0.10-7.48) and anti-CD20 therapy (OR 7.04, 95% CI, 3.10-15.87) were independent variables associated with pneumonia in MS patients. Increase odds of pneumonia in anti-CD20 treated MS patients compared to patients with other disease-modifying therapy (same age, sex, BMI, high-dose glucocorticoid treatment during the 2 months before COVID-19 onset, presence of pulmonary comorbidity) were confirmed by propensity score matching (OR 8.90, 95% CI, 3.04-33.24). Reports on COVID-19 infection in patients with NMOSD are scarce, however, data available up to now suggest a high risk of a more severe COVID-19 course as well as a higher mortality rate among NMOSD patients. In our cohort, 4 NMOSD patients (30.77%) had the more severe COVID-19 course and 2 patients (15.39%) died.

CONCLUSION: The majority of MS patients had a mild COVID-19 course contrary to NMOSD patients, however, higher BMI and age, anti-CD20 therapy and high-dose glucocorticoid treatment during the 2 months before COVID-19 onset were associated with pneumonia. Based on this study, we have already started an early administration of anti-SARS-CoV-2 monoclonal antibodies and preferential vaccination in the risk group of patients.

PMID:34216998 | DOI:10.1016/j.msard.2021.103104

Cancer Epidemiol. 2021 Jun 30;73:101970. doi: 10.1016/j.canep.2021.101970. Online ahead of print.

ABSTRACT

BACKGROUND: Screening mammography for breast cancer (BC) is a current strategy that reduces the mortality of BC by up to 30 %. Although mastectomy has been an important component of treatment for decades, conservative surgery (lumpectomy) has become the gold-standard approach for most cases, yet it depends on early detection of the BC.

METHODS: This was an epidemiological study performed through DATASUS (2010-2018). We evaluated the temporal trend of screening mammograms, deaths from BC, and surgical procedures at national, regional and state levels. Statistical analysis was performed on VassarStat®-Website for Statistical Computation (Vassar College, New York, USA) and the R-software (R Foundation, v.4.0.3).

RESULTS: During 2010-2018 there were 67,392 oncological mastectomies and 48,567 lumpectomies in Brazil’s health system. Mastectomies decreased in the Northeast (-3.67 % ± 0.43 per year) and in Bahia state (-3.58 % ± 0.24 per year). Lumpectomies increased in Brazil (median 2.19 (-9.6 to 20.96)), the Northeast (median -12.07 (-25.8 to 9.43)) and Bahia (median 0.16 (-29.1 to 1.9)). Also, screening mammograms increased in Brazil (3.29 % ± 0.43), the Northeast (6.36 % ± 0.49) and Bahia (5.51 % ± 0.31), with 35,317,728 exams during this period. Deaths from BC increased annually in Brazil (+4.13 % ± 0.86), the Northeast (+4.76 % ± 1.45) and Bahia (+5.65 % ± 0.83).

CONCLUSION: The number of mammograms related to the screening program increased in the years 2010-2018 in Brazil. Furthermore, we identified an increase in lumpectomies as opposed to mastectomies, and this approach is associated with a reduction in hospitalization days by almost a half, which in turn might result in a cost decrease and probably an earlier return to work.

PMID:34216956 | DOI:10.1016/j.canep.2021.101970

Int J Surg Case Rep. 2021 Jun 10;84:106095. doi: 10.1016/j.ijscr.2021.106095. Online ahead of print.

ABSTRACT

INTRODUCTION: Primary adult degenerative scoliosis is one of the adult scoliosis group that presents in adult patient without history of scoliosis during childhood or adolescence. This condition may be asymptomatic, mild low back pain, radiculopathy symptoms, or may be causing severe low back pain and major neurological symptoms including weakness and numbness of the lower extremities which can affect the patient quality of life.

CASE PRESENTATION: In this study, we presented seven cases of primary degenerative adult scoliosis that was treated either with decompression alone, decompression with short segment fusion and deformity correction, and decompression with long segment fusion and deformity correction. The parameters measured in this study were lumbar regional angle, Cobb angle, and pelvic parameters. The functional status of the patient was measured using Oswestry Disability Index (ODI).

DISCUSSION: The main purpose for surgical treatment in primary degenerative adult scoliosis depends on the clinical presentation and also the patient’s expectations .From the study, we found that all patient underwent surgery had improvement of functional status that measured with ODI score. The mean of pre operative ODI score was 49.70 (± 13.61 SD) (severe disability) and for post operative was 21.8 (± 13.40 SD) (moderate disability). Surgery decompressed the neural element and stabilize the spine.

CONCLUSION: Surgery treatment in patients with degenerative adult scoliosis was shown to have better functional outcomes regardless of the technique used. Further study with bigger sample with corresponding statistical analytic is mandatory.

PMID:34216917 | DOI:10.1016/j.ijscr.2021.106095

Am J Otolaryngol. 2021 Jun 19;42(5):103132. doi: 10.1016/j.amjoto.2021.103132. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to retrospectively evaluate the efficacy of Li Maneuver as a repositioning maneuver for geotropic HC-BPPV, compared with Gufon Maneuver.

METHODS: Data of geotropic HC-BPPV patients treated at our department between January 2009 and January 2020 was retrospectively collected and analyzed. Enrolled cases were divided into Gufoni Group and Li Group. Follow-up results were recorded on the first, third, and seventh day after the first therapeutic maneuver.

RESULTS: A total of 254 cases were enrolled, with 87 cases in Gufoni Group, and 167 cases in Li Group. The cure rate at the first, third, and seventh days of follow-up was 62.22%, 77.01%, and 90.80% respectively for Gufoni Group, while for Li Group the number was 60.48%, 72.46%, and 89.22% respectively. Statistical analysis showed no significant difference.

CONCLUSIONS: Li Maneuver for geotropic HC-BPPV was as effective as Gufoni Maneuver but much simpler and faster. By introducing Li Maneuver, we may help physicians to treat geotropic HC-BPPV patients more willingly, which would decrease the chance of delayed treatment and ease the burden of the health-care system.

PMID:34216878 | DOI:10.1016/j.amjoto.2021.103132

Am J Otolaryngol. 2021 Jun 18;42(5):103128. doi: 10.1016/j.amjoto.2021.103128. Online ahead of print.

ABSTRACT

OBJECTIVES: Esophageal dilation (ED) may be performed in the office under local anesthesia or in a procedure/operating room under general anesthesia or intravenous (IV) sedation. However, indications for type of anesthesia during these procedures have not been established. The purpose of this review is to assess outcomes of esophageal dilation performed using different types of anesthesia to assess the safety of office-based techniques.

METHODS: We conducted a systematic review and meta-analysis comparing the outcomes of anesthesia techniques for ED in adults. Exclusion criteria included reviews, small case series, use of stents, diagnoses with high morbidity, and rare diseases. A comprehensive literature search of the PubMed, CINAHL, and EMBASE databases was performed for articles relating to esophageal dilation.

RESULTS: 876 papers were identified of which 164 full text studies were assessed and 25 were included in the analysis using the PRISMA guidelines. Data regarding demographics, dilation technique, and adverse events were extracted. The DerSimonian-Laird random-effect models with inverse-variance weighting were fit to estimate the combined effects. There were no statistically significant differences among mortality, perforation, or bleeding based on anesthetic.

CONCLUSIONS: With office-based procedures gaining popularity in laryngology, there is a need to profile their safety. Office-based ED appears to have equivalent safety to general and IV sedation, although further research is necessary to define indications favoring office-based techniques.

PMID:34216877 | DOI:10.1016/j.amjoto.2021.103128

Orthop Traumatol Surg Res. 2021 Jun 30:103001. doi: 10.1016/j.otsr.2021.103001. Online ahead of print.

ABSTRACT

INTRODUCTION: The tip-apex distance (TAD) is the only predictor for mechanical failure after internal fixation of trochanteric fractures. The main objective of our study was to assess whether the intraoperative visual estimation of the TAD concurred with the measurement taken on postoperative digital X-rays. We hypothesized that there was a good concordance between these 2 different methods of measurement.

MATERIALS AND METHODS: Patients with an isolated trochanteric fracture were included in our study. A hardcopy of the intraoperative X-rays were printed, and the TAD was calculated manually. Radiological and clinical follow-ups were scheduled at 6 weeks, 3 months and 6 months during which numerical measurements of the TAD were taken. We also recorded the fracture type (AO/OTA classification), degree of osteoporosis (Singh index), surgeon experience, age and ASA score.

RESULTS: A total of 98 patients were included in our study. Of these, 70 had a 6-month follow-up and interpretable postoperative X-rays. The mean age was 87 years, with 77.14% women and a mean ASA score of 3. The coefficient of concordance between the intra and postoperative TAD was 0.7202 (95% CI = 0.4905-0.9499). The secondary displacement rate was 3.28%. The univariate analysis showed no statistically significant association between an intraoperative TAD > 25 mm and fracture type (P = .7290), degree of osteoporosis (P = .5701) and surgeon experience (P = 1).

DISCUSSION/CONCLUSIONS: There was a high degree of concordance between intraoperative visual estimation of the TAD and its measurement on postoperative digital X-rays. The treatment of unstable fractures in osteoporotic bone by junior surgeons was not a risk factor for intraoperative TAD > 25 mm. It is therefore important to educate young surgeons on the concept of TAD and its intraoperative visual estimation technique as it ensures that the cephalic screw is positioned properly during the fixation of trochanteric fractures.

LEVEL OF EVIDENCE: II.

PMID:34216841 | DOI:10.1016/j.otsr.2021.103001

Bone. 2021 Jun 30:116096. doi: 10.1016/j.bone.2021.116096. Online ahead of print.

ABSTRACT

BACKGROUND: Prior data demonstrated three weeks of sleep restriction and concurrent circadian disruption uncoupled bone turnover markers (BTMs), indicating decreased bone formation and no change or increased bone resorption. The effect of insufficient sleep with or without ad libitum weekend recovery sleep on BTMs is unknown.

METHODS: BTMs were measured in stored serum from 20 healthy adults randomized to one of three study groups consisting of a control group (N = 3 men; 9 h/night) or one of two nocturnal sleep restriction groups in an inpatient laboratory environment. One Sleep Restriction group (“SR”; N = 9; 4 women) had 5 h sleep opportunity per night for nine nights. The other sleep restriction group had an opportunity for ad libitum Weekend Recovery sleep (“WR”; N = 8; 4 women) after four nights of 5 h sleep opportunity per night. Food intake was energy balanced at baseline and ad libitum thereafter. Fasted morning BTM levels and hourly 24 h melatonin levels were obtained on study days 3 (baseline), 5 (after 1 night of sleep restriction for WR and SR), and 11 (after a sleep restricted workweek with weekend recovery sleep in WR or 7 nights of sleep restriction in SR). Linear mixed-effects modeling was used to examine the effect of study duration (e.g., change over time), study condition, age, and sex on BTMs. Pearson correlations were used to determine associations between changes in BTMs and changes in weight and morning circadian misalignment (i.e., duration of high melatonin levels after wake time).

RESULTS: There was no significant difference between the three study groups in change over time (p ≥ 0.4 for interaction between assigned group and time for all BTMs), adjusted for age and sex. There was no significant change in N-terminal propeptide of procollagen type I (P1NP), osteocalcin, or C-telopeptide of type I collagen (CTX) from baseline to day 11 (all p ≥0.3). In women <25 years old, there was a non-significant decline in P1NP from day 3 to day 5 (-15.74 ± 7.80 ng/mL; p = 0.06). Change in weight and morning circadian misalignment from baseline to day 11 were correlated with statistically non-significant changes in BTMs (all p ≤ 0.05).

CONCLUSION: In this small secondary analysis, we showed that nine nights of prescribed sleep restriction with or without weekend recovery sleep and ad libitum food intake did not alter BTMs. It is possible that age, sex, weight change and morning circadian misalignment modify the effects of sleep restriction on bone metabolism.

PMID:34216838 | DOI:10.1016/j.bone.2021.116096