Risk factors for financial toxicity in patients with gynecologic cancer.

BACKGROUND: The cost of cancer care is high and rising. Evidence of increased patient cost burden is prevalent in the medical literature and has been defined as "financial toxicity," the financial hardship and financial concerns experienced by patients because of a disease and its related treatments. With targeted therapies and growing out-of-pocket costs, patient financial toxicity is a growing concern among patients with gynecologic cancer. OBJECTIVE: This study aimed to determine the prevalence of financial toxicity and identify its risk factors in patients with gynecologic cancer treated at a large cancer center using objective data. STUDY DESIGN: Using institutional databases, we identified patients with gynecologic cancer treated from January 2016 to December 2018. Patients with a preinvasive disease were excluded. Financial toxicity was defined according to institutionally derived metrics as the presence of ≥1 of the following: ≥2 bills sent to collections, application or granting of a payment plan, settlement, bankruptcy, financial assistance program enrollment, or a finance-related social work visit. Clinical characteristics were gathered using a 2-year look-back from the time of the first financial toxicity event or a randomly selected treatment date for those not experiencing toxicity. Risk factors were assessed using chi-squared tests. All significant variables on univariate analysis were included in the logistic regression model. RESULTS: Of the 4655 patients included in the analysis, 1155 (25%) experienced financial toxicity. In the univariate analysis, cervical cancer (35%), stage 3 or 4 disease (24% and 30%, respectively), younger age (35% for age <30 years), nonpartnered marital status (31%), Black (45%) or Hispanic (37%) race and ethnicity, self-pay (48%) or commercial insurance (30%), clinical trial participation (31%), more imaging studies (39% for ≥9), ≥1 emergency department visit (36%), longer inpatient stays (36% for ≥20 days), and more outpatient clinician visits (41% for ≥20 visits) were significantly associated with financial toxicity (P<.01). In multivariate analysis, younger age, nonpartnered marital status, Black and Hispanic race and ethnicity, commercial insurance, more imaging studies, and more outpatient physician visits were significantly associated with financial toxicity. CONCLUSION: Financial toxicity is an increasing problem for patients with gynecologic cancer. Our analysis, using objective measures of financial toxicity, has suggested that demographic factors and healthcare utilization metrics may be used to proactively identify at-risk patients for financial toxicity.

Altered white matter structure in the visual system following early monocular enucleation.

Partial visual deprivation from early monocular enucleation (the surgical removal of one eye within the first few years of life) results in a number of long-term morphological adaptations in adult cortical and subcortical visual, auditory, and multisensory brain regions. In this study, we investigated whether early monocular enucleation also results in the altered development of white matter structure. Diffusion tensor imaging and probabilistic tractography were performed to assess potential differences in visual system white matter in adult participants who had undergone early monocular enucleation compared to binocularly intact controls. To examine the microstructural properties of these tracts, mean diffusion parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were extracted bilaterally. Asymmetries opposite to those observed in controls were found for FA, MD, and RD in the optic radiations, the projections from primary visual cortex (V1) to the lateral geniculate nucleus (LGN), and the interhemispheric V1 projections of early monocular enucleation participants. Early monocular enucleation was also associated with significantly lower FA bidirectionally in the interhemispheric V1 projections. These differences were consistently greater for the tracts contralateral to the enucleated eye, and are consistent with the asymmetric LGN volumes and optic tract diameters previously demonstrated in this group of participants. Overall, these results indicate that early monocular enucleation has long-term effects on white matter structure in the visual pathway that results in reduced fiber organization in tracts contralateral to the enucleated eye. Hum Brain Mapp 39:133-144, 2018. © 2017 Wiley Periodicals, Inc.

Normal temporal binding window but no sound-induced flash illusion in people with one eye.

Integrating vision and hearing is an important way in which we process our rich sensory environment. Partial deprivation of the visual system from the loss of one eye early in life results in adaptive changes in the remaining senses (e.g., Hoover et al. in Exp Brain Res 216:565-74, 2012). The current study investigates whether losing one eye early in life impacts the temporal window in which audiovisual events are integrated and whether there is vulnerability to the sound-induced flash illusion. In Experiment 1, we measured the temporal binding window with a simultaneity judgement task where low-level auditory and visual stimuli were presented at different stimulus onset asynchronies. People with one eye did not differ in the width of their temporal binding window, but they took longer to make judgements compared to binocular viewing controls. In Experiment 2, we measured how many light flashes were perceived when a single flash was paired with multiple auditory beeps in close succession (sound induced flash illusion). Unlike controls, who perceived multiple light flashes with two, three or four beeps, people with one eye were not susceptible to the sound-induced flash illusion. In addition, they took no longer to respond compared to both binocular and monocular (eye-patched) viewing controls. Taken together, these results suggest that the lack of susceptibility to the sound-induced flash illusion in people with one eye cannot be accounted for by the width of the temporal binding window. These results provide evidence for adaptations in audiovisual integration due to the reduction of visual input from the loss of one eye early in life.

Vestibular-somatosensory interactions affect the perceived timing of tactile stimuli.

Passive rotation has been shown to alter temporal-order judgments for tactile stimuli delivered to the hands giving an advantage to the leading hand. Here we measure thresholds for detecting stimulus onset asynchrony for touches on the hands during tilt to the left or right and during galvanic vestibular stimulation (GVS) that evoked illusory tilt. During tilt to one side, the effect of gravity on the otoliths is equivalent to a physical acceleration away from that side (e.g., tilt left is equivalent to accelerating rightwards). We therefore predicted a "leading hand advantage" for the hand opposite to the tilt direction. Thresholds for detecting asynchronicity for left-hand-first and right-hand-first touches (defined as correct detection 75% of the time) were measured separately using interleaved adaptive staircases for 15 participants. For both physical and illusory tilt there was a temporal advantage for stimuli presented to the hand contralateral to the tilt-equivalent to the "leading hand" during passive rotation. That is, there was a temporal advantage for the upward hand (for physical tilt) and for the anodal-side hand (for illusory tilt caused by GVS). These results are discussed in terms of attention and direct sensory components evoking the "leading hand" bias. These findings add to the emerging understanding of the pervasive role of vestibular activity in many aspects of cognitive processing.

Emotional Intelligence in Hemodialysis Patients: The Impact of an Intradialytic Exercise Training Program.

The current study aimed to investigate whether there is a relationship between emotional intelligence (EI), functional capacity, fatigue, cognitive function, and quality of life (QoL) in HD patients and to assess the effect of a 9-month intradialytic exercise training program on EI levels. Seventy-eight dialysis patients (50 M/28 F, 60.6 ± 17.2 years) participated in the cross-sectional study. Afterward, a subgroup of 18 patients (15 M/3 F, 56.7 ± 12.3 years) completed a 9-month supervised intradialytic exercise training program (three times weekly). EI was assessed by the Schutte Self Report Emotional Intelligence Test (SSEIT) and the Wong and Law Emotional Intelligence Scale (WLEIS). Functional capacity was assessed by a battery of tests. Sleep quality, depression levels, and daily sleepiness were assessed via validated questionnaires. All assessments were carried out before and after the intervention. A significant positive correlation was found between the WLEIS scores and the physical component summary of the QoL questionnaire. In contrast, the WLEIS scores were negatively associated with general and physical fatigue. The SSEIT scores were positively associated with cognitive function. After nine months of exercise training, only the group with low WLEIS scores improved their EI score significantly compared to the baseline values (98.7 ± 7.0 vs. 73.0 ± 4.0, p = 0.020), while no changes were observed in the medium or high EI groups. In conclusion, patients with higher levels of EI showed increased quality of life and lower levels of fatigue. Patients with low levels of EI are more likely to benefit from an exercise training program compared to their medium- and high-level counterparts.

Exercise training and depression in ESRD: a review.

Depression, a mental disorder with a high personal, societal, and economic impact, affects at least 20-30% of patients receiving hemodialysis therapy. It is associated with a high mortality rate, low adherence to medication, and a low perceived quality of life. Exercise training is a promising nonpharmacological intervention that can be safely applied to these patients. Beyond the well-publicized physiological benefits of exercise training, a number of studies have focused on the effects of exercise training on mental factors and quality of life parameters including its less appreciated effects on depression symptoms. This evidence-based review article reviews and discusses the effects of exercise training on depression in end-stage renal disease patients.

Assessment of implicit COVID-19 attitudes using affective priming for pro-vaccine and vaccine-hesitant individuals.

The COVID-19 pandemic has resulted in the introduction of pharmaceutical and non-pharmaceutical interventions such as precautionary behaviours. The current study used affective priming to evaluate COVID-19 attitudes in vaccine-hesitant and pro-vaccine participants. Explicitly, both groups rated their overall perception of risk associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. Pro-vaccine participants rated their perception of necessary precautions higher compared to vaccine-hesitant participants. During baseline measures, both groups classified COVID-19 affiliated words as unpleasant. Affective priming was observed for congruent prime-target pleasant and unpleasant word pairs but was not observed for COVID-19 related word pairs. Differences between groups in the perception of necessary public health precautions points to different underlying pathways for reduced perceived risk and lack of affective priming. These results refine previous findings indicating that implicit attitudes towards COVID-19 can be measured using the affective priming paradigm.

Perception of the McGurk effect in people with one eye depends on whether the eye is removed during infancy or adulthood.

Background: The visual system is not fully mature at birth and continues to develop throughout infancy until it reaches adult levels through late childhood and adolescence. Disruption of vision during this postnatal period and prior to visual maturation results in deficits of visual processing and in turn may affect the development of complementary senses. Studying people who have had one eye surgically removed during early postnatal development is a useful model for understanding timelines of sensory development and the role of binocularity in visual system maturation. Adaptive auditory and audiovisual plasticity following the loss of one eye early in life has been observed for both low-and high-level visual stimuli. Notably, people who have had one eye removed early in life perceive the McGurk effect much less than binocular controls. Methods: The current study investigates whether multisensory compensatory mechanisms are also present in people who had one eye removed late in life, after postnatal visual system maturation, by measuring whether they perceive the McGurk effect compared to binocular controls and people who have had one eye removed early in life. Results: People who had one eye removed late in life perceived the McGurk effect similar to binocular viewing controls, unlike those who had one eye removed early in life. Conclusion: This suggests differences in multisensory compensatory mechanisms based on age at surgical eye removal. These results indicate that cross-modal adaptations for the loss of binocularity may be dependent on plasticity levels during cortical development.

Nine Months of Hybrid Intradialytic Exercise Training Improves Ejection Fraction and Cardiac Autonomic Nervous System Activity.

Cardiovascular disease is the most common cause of death in hemodialysis (HD) patients. Intradialytic aerobic exercise training has a beneficial effect on cardiovascular system function and reduces mortality in HD patients. However, the impact of other forms of exercise on the cardiovascular system, such as hybrid exercise, is not clear. Briefly, hybrid exercise combines aerobic and strength training in the same session. The present study examined whether hybrid intradialytic exercise has long-term benefits on left ventricular function and structure and the autonomous nervous system in HD patients. In this single-group design, efficacy-based intervention, twelve stable HD patients (10M/2F, 56 ± 19 years) participated in a nine-month-long hybrid intradialytic training program. Both echocardiographic assessments of left ventricular function and structure and heart rate variability (HRV) were assessed pre, during and after the end of the HD session at baseline and after the nine-month intervention. Ejection Fraction (EF), both assessed before and at the end of the HD session, appeared to be significantly improved after the intervention period compared to the baseline values (48.7 ± 11.1 vs. 58.8 ± 6.5, p = 0.046 and 50.0 ± 13.4 vs. 56.1 ± 3.4, p = 0.054 respectively). Regarding HRV assessment, hybrid exercise training increased LF and decreased HF (p < 0.05). Both conventional Doppler and tissue Doppler imaging indices of diastolic function did not change after the intervention period (p > 0.05). In conclusion, long-term intradialytic hybrid exercise training was an effective non-pharmacological approach to improving EF and the cardiac autonomous nervous system in HD patients. Such exercise training programs could be incorporated into HD units to improve the patients' cardiovascular health.

No Colavita effect: equal auditory and visual processing in people with one eye.

Previous research has shown that people with one eye have enhanced spatial vision implying intra-modal compensation for their loss of binocularity. The current experiments investigate whether monocular blindness from unilateral eye enucleation may lead to cross-modal sensory compensation for the loss of one eye. We measured speeded detection and discrimination of audiovisual targets presented as a stream of paired objects and familiar sounds in a group of individuals with monocular enucleation compared to controls viewing binocularly or monocularly. In Experiment 1, participants detected the presence of auditory, visual or audiovisual targets. All participant groups were equally able to detect the targets. In Experiment 2, participants discriminated between the visual, auditory or bimodal (audiovisual) targets. Both control groups showed the Colavita effect, that is, preferential processing of visual over auditory information for the bimodal stimuli. The monocular enucleation group, however, showed no Colavita effect, and further, they demonstrated equal processing of visual and auditory stimuli. This finding suggests a lack of visual dominance and equivalent auditory and visual processing in people with one eye. This may be an adaptive form of sensory compensation for the loss of one eye and could result from recruitment of deafferented visual cortical areas by inputs from other senses.

Virtual reality hope machines in a curative imaginary: recommendations for neurorehabilitation research from a critical disability studies perspective.

PURPOSE: This paper provides recommendations for neurorehabilitative research informed by insights from critical disability studies (CDS) and a research study that tested an augmented neurorehabilitative technology prototype. METHODS: The methodology combines critical reflection, feminist science studies and CDS to analyze how neurorehabilitation and disability studies conceptualize notions of disability and cure. It offers recommendations for reconciling the conflicting ideologies of cure that operate within neurorehabilitative research. RESULTS: The prototype acted as a kind of virtual reality hope machine that tapped into different emotions and language games regarding disability and cure. The result is five recommendations about the ways that a CDS perspective might inform neurorehabilitation research: (I) ensure clarity in recruitment materials to account for dominant social views on disability and the possibility of cure; (II) build "strong objectivity" into research methods through attention to social context and multiple meanings of terms; (III) engage in critical reflection about research processes and findings; (IV) incorporate principles of crip technoscience; and (V) include CDS perspectives in neurorehabilitation education. CONCLUSIONS: Bridging a conversation between neurorehabilitative research and CDS can address the discrepancies between ideologies of cure, and situate rehabilitation within the wider concerns of social determinants of health and disability justice.Implications for rehabilitationBridging connections between rehabilitation studies and critical disability studies can generate productive insights that open up conversations with disabled people and a commitment to disability justice.Disability and cure are social constructs and may have different meanings for patients and rehabilitation professionals.Clinicians should be mindful of the conflicting ideological constructs and socio-political dimensions of disability and cure that are operating below the surface in the rehabilitation profession and in interactions between clinicians and patients.As technology continues to transform clinical rehabilitation care through virtual reality and other innovative paradigms, rehabilitation clinicians should recognize the potential for these technologies to become "hope machines," generating patient expectations that are idealized constructions of hoped-for outcomes of returning to a previous state or level of functionality rather than predictive expectations of likely results.

The effect of a 9-month hybrid intradialytic exercise training program on nerve conduction velocity parameters in patients receiving hemodialysis therapy.

INTRODUCTION AND AIMS: Neurological complications such as peripheral neuropathy are very common in the end-stage renal disease (ESRD) patients, occurring in 60-80% of this specific population. The aim of the present study was to examine whether a 9-month hybrid intradialytic exercise training program could alter motor and sensory nerve conduction study (NCS) parameters in hemodialysis population. METHODS: Seventeen stable patients undergoing HD with no clinical evidence of uremic polyneuropathy were included in the study (15 M/2F, 59 ± 13.7 years). All patients completed a 9-month supervised exercise training program composed of both aerobic cycling and resistance training (hybrid) during HD. Functional capacity was assessed by a battery of tests, while pain levels and fatigue profile were assessed via validated questionnaires. Motor and sensory NCS on bilateral median, ulnar, peroneal and tibial nerves as well as F-wave were assessed using a full neurographic electromyography (EMG) assessment. RESULTS: After the 9-month exercise training intervention, exercise capacity was increased by 65% and functional capacity by an average of 40%. The neurological assessment showed that conduction velocity from tibial and peroneal nerves was improved by 3.7% and 4.2%, respectively, while tibial F-wave latency and peroneal and sural nerve distal latency were significantly improved by 4.2%, 4.9% and 10%, respectively. Fatigue and pain were improved after the exercise intervention while fatigue score was positively correlated with conduction velocity and amplitude values. CONCLUSIONS: The results of the current study demonstrate that 9-month hybrid exercise training induces beneficial effects on both sensory and motor NCS parameters, improving conduction velocity and F-wave latency. Improvements in neural activity were accompanied by changes in fatigue score and pain-related aspects. The parallel improvement in motor nerve conduction velocity and its correlations with functional tests supports the hypothesis that exercise could be beneficial for preventing a decline in neural function in HD patients.

A single bout of hybrid intradialytic exercise did not affect left-ventricular function in exercise-naïve dialysis patients: a randomized, cross-over trial.

INTRODUCTION: Cardiovascular diseases are the leading cause of mortality in end-stage renal disease (ESRD) patients, especially those receiving hemodialysis (HD) therapy. HD has many side effects that are related to patients' hearts, such as recurrent myocardial ischemia and global or segmental left-ventricular dysfunction, which is associated with intradialytic hypotension, long-term loss of systolic function, and high incidence of cardiovascular events and death. Systematic exercise training has a beneficial effect on measures of cardiovascular fitness and reducing cardiovascular risk factors in ESRD. Whether there is an acute benefit of exercise during HD on left-ventricular function is not well known. The current study aimed to investigate whether a single bout of hybrid (aerobic and resistance) intradialytic exercise could affect left-ventricular function during HD sessions. METHODS: Twenty-one exercise naïve and clinically stable HD patients participated in the study. All participants completed two different HD trials on two different days, separated by 1 week: (1) standard HD and (2) HD including a single bout of hybrid intradialytic exercise. Hybrid intradialytic training included the usual intradialytic cycling followed by resistance training using elastic bands and dumbbells. Echocardiographic assessment of left-ventricular function was completed before HD, half an hour before the end of HD, and 30 min after the end of HD. RESULTS: Cohort data for left-ventricular function indices were not different between trials and did not change across time in either the standard HD or HD plus exercise trial. Cohort data for the change in ejection fraction from baseline to during HD did mask considerable inter-individual variability (HD - 0 ± 15; HD plus exercise (- 2 ± 20). Despite this, the variability was not mediated by the addition of intradialytic hybrid exercise. CONCLUSION: A single bout of hybrid intradialytic exercise did not affect left-ventricular function during the HD therapy. It is important to determine whether chronic exercise training could beneficially affect left-ventricular function abnormalities often observed during the HD therapy. TRIAL REGISTRATION NUMBER: The study is registered at ClinicalTrials.gov (NCT01721551) as a clinical trial.

Targeting the Mitotic Kinesin KIF18A in Chromosomally Unstable Cancers: Hit Optimization Toward an In Vivo Chemical Probe.

Chromosomal instability (CIN) is a hallmark of cancer that results from errors in chromosome segregation during mitosis. Targeting of CIN-associated vulnerabilities is an emerging therapeutic strategy in drug development. KIF18A, a mitotic kinesin, has been shown to play a role in maintaining bipolar spindle integrity and promotes viability of CIN cancer cells. To explore the potential of KIF18A, a series of inhibitors was identified. Optimization of an initial hit led to the discovery of analogues that could be used as chemical probes to interrogate the role of KIF18A inhibition. Compounds 23 and 24 caused significant mitotic arrest in vivo, which was sustained for 24 h. This would be followed by cell death either in mitosis or in the subsequent interphase. Furthermore, photoaffinity labeling experiments reveal that this series of inhibitors binds at the interface of KIF18A and tubulin. This study represents the first disclosure of KIF18A inhibitors with in vivo activity.

Double auricles of the right atrium: a unique anatomic deformity.

BACKGROUND: Anatomic deviations, especially those detected during the course of an operation, are medically intriguing, as they raise concerns about their clinical significance and putative complications. CASE PRESENTATION: We present, to our knowledge, for the first time a case of an anatomic deviation in the form of a second right atrial auricle in a 70 year-old, coronary bypass-operated male Caucasian patient of Greek origin. No complications were noted intra-or postoperatively. CONCLUSIONS: A second right atrial auricle was found intraoperatively, without causing any clinical complications, or obstructing the normal course of a surgical procedure.

Lack of affective priming indicates attitude-behaviour discrepancy for COVID-19 affiliated words.

The ongoing novel coronavirus (COVID-19) pandemic has resulted in the enforcement of national public health safety measures including precautionary behaviours such as border closures, movement restrictions, total or partial lockdowns, social distancing, and face mask mandates in order to reduce the spread of this disease. The current study uses affective priming, an indirect behavioural measure of implicit attitude, to evaluate COVID-19 attitudes. Explicitly, participants rated their overall risk perception associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. During baseline trials, participants explicitly rated COVID-19 affiliated words as unpleasant, similar to traditional unpleasant word stimuli. Despite rating the COVID-19 affiliated words as unpleasant, affective priming was not observed for congruent prime-target COVID-19 affiliated word pairs when compared to congruent prime-target pleasant and unpleasant words. Overall, these results provide quantitative evidence that COVID-19 affiliated words do not invoke the same implicit attitude response as traditional pleasant and unpleasant word stimuli, despite conscious explicit rating of the COVID-19 words as unpleasant. This reduction in unpleasant attitude towards COVID-19 related words may contribute towards decreased fear-related behaviours and increased incidences of risky-behaviour facilitating the movement of the virus.

Long-term intradialytic hybrid exercise training on fatigue symptoms in patients receiving hemodialysis therapy.

PURPOSE: Hemodialysis (HD) patients suffer from generalized weakness, exercise intolerance and muscle atrophy, all leading to generalized fatigue and lack of energy. HD patients spend at least 50% of their time in a functionally "switch off" mode with their fatigue sensations reaching a peak in the immediate hours after the dialysis session. The purpose of the current study was to assess the effectiveness of a nine-month hybrid intradialytic exercise program on fatigue symptoms occurring during and after hemodialysis session. METHODS: Twenty stable hemodialysis patients were included in the study (59 ± 13.7 years; 16 males). All patients completed a 9-month supervised exercise training program composed of both aerobic cycling and resistance training during HD. Aspects related to physical and generalized fatigue were assessed via validated questionnaires, while physical performance was assessed by a battery of tests, before and after the intervention period. RESULTS: Exercise capacity and physical performance were increased by an average of 65 and 40%, respectively. Patients reported feeling better during post-dialysis hours in question 1 (p = 0.000), question 3 (p = 0.009) and question 4 (p = 0.003) after the 9-month intervention. In addition, exercise training improved scores in cognitive function (p = 0.037), vitality (p = 0.05), depression (p = 0.000) and fatigue (p = 0.039). CONCLUSION: The present study showed that a 9-month hybrid (aerobic + resistance) exercise training program improved symptoms of post-dialysis fatigue and overall general perception of fatigue. Hybrid exercise training is a safe and effective non-pharmacological approach to ameliorate fatigue symptoms in HD patients. TRIAL REGISTRATION NUMBER: Trial registration number The study is registered at ClinicalTrials.gov (NCT01721551, 2012) as a clinical trial.

Brain Activation for Audiovisual Information in People With One Eye Compared to Binocular and Eye-Patched Viewing Controls.

Blindness caused by early vision loss results in complete visual deprivation and subsequent changes in the use of the remaining intact senses. We have also observed adaptive plasticity in the case of partial visual deprivation. The removal of one eye, through unilateral eye enucleation, results in partial visual deprivation and is a unique model for examining the consequences of the loss of binocularity. Partial deprivation of the visual system from the loss of one eye early in life results in behavioral and structural changes in the remaining senses, namely auditory and audiovisual systems. In the current study we use functional neuroimaging data to relate function and behavior of the audiovisual system in this rare patient group compared to controls viewing binocularly or with one eye patched. In Experiment 1, a whole brain analysis compared common regions of cortical activation between groups, for auditory, visual and audiovisual stimuli. People with one eye demonstrated a trend for increased activation for low-level audiovisual stimuli compared to patched viewing controls but did not differ from binocular viewing controls. In Experiment 2, a region of interest (ROI) analysis for auditory, visual, audiovisual and illusory McGurk stimuli revealed that people with one eye had an increased trend for left hemisphere audiovisual activation for McGurk stimuli compared to binocular viewing controls. This aligns with current behavioral analysis and previous research showing reduced McGurk Effect in people with one eye. Furthermore, there is no evidence of a correlation between behavioral performance on the McGurk Effect task and functional activation. Together with previous behavioral work, these functional data contribute to the broader understanding of cross-sensory effects of early sensory deprivation from eye enucleation. Overall, these results contribute to a better understanding of the sensory deficits experienced by people with one eye, as well as, the relationship between behavior, structure and function in order to better predict the outcome of early partial visual deafferentation.

Remediation of a Riparian Site in the Brazilian Atlantic Forest Reached by Contaminated Tailings from the Collapsed Fundão Dam with Native Woody Species.

The failure of the Fundão dam in Brazil spilled alkaline contaminated sediments (pH ~8) into the Doce River basin. The contaminated sediments had high levels of ether amine (6 mg/kg) and Na (54 mg/kg) in relation to those in preserved sites. In the present study, a riparian forest was established over contaminated sediment using 2 main remediation strategies: phytoremediation with species native to the Atlantic forest and previously selected for their tolerance to sediment toxicity, and physicochemical remediation by incorporating organic matter (OM) into the sediment. In the experimental site (ES), the tolerant native woody species were cultivated in 2 treatments: T1, scraping of the sediments and incorporation of the OM, and T2, nonmanaged sediment and superficial deposition of the OM. The results were compared with the findings from a degraded site (DS), which was reached by the contaminated sediments but lacked vegetation, and a preserved site (PS), which was composed of a fragment of preserved Atlantic forest. Six months after transplanting, the plants from T1 showed a better height growth performance and survival index in relation to those from T2. Furthermore, T1 showed a significant decline in the pH (to ~6) concomitant with a reduction in the ether amine and Na contents (to ~0.4 mg/kg and 23 mg/kg, respectively). There was an improvement in the soil fertility and total microbial biomass in both treatments, especially in T1. Therefore, the adopted phyto- and physicochemical remediation procedures are recommended to reclaim zones reached by dam tailings containing Na and ether amine. Integr Environ Assess Manag 2020;16:669-675. © 2020 SETAC.

A ruptura da Barragen de Fundão em Mariana (Brazil) lançou um sedimento alcalino (pH ~8) ao longo da Bacia do Rio Doce. O sedimento contaminado apresentou altos níveis de éter-amina (6 mg/kg) e Na (54 mg/kg) em relação aqueles encontrados na área preservada. No presente estudo, uma floresta riparia foi estabelecida sobre este sedimento contaminado usando-se 2 estratégias de remediação: Fito-remediação com espécies nativas da Mata Atlântica, previamente selecionadas pela tolerância à toxicidade do sedimento, e remediação físico química pela raspagem superficial do sedimento e aplicação de matéria orgânica (OM). Na área experimental (ES) as espécies arbóreas da mata Atlântica selecionadas foram plantadas sob 2 tratamentos: T1, Raspagem superficial do sedimento e incorporação da OM, e T2, sedimento não foi manejado e recebeu aplicação superficial de OM. Os resultados foram comparados com aqueles obtidos na área degradada (DS), atingida pelo sedimento contaminado e sem vegetação, assim como com aqueles obtidos em uma área preservada (PS), constituída de um fragmento de Mata Atlântica. Após seis meses do plantio as plantas de T1 apresentaram um maior crescimento em altura e maior taxa de sobrevivência que as plantas de T2. Além disto ES, especialmente T1 mostraram um significante declínio do pH (~6.0) e concomitante redução nos teores de éter-amina e Na (~0.4 mg/kg e 23 mg/kg, respectivamente). Os procedimentos de remediação permitiram também um significativo aumento da fertilidade química e da biomassa microbiana do sedimento em ambos os tratamentos, especialmente em T1. Assim, os procedimentos de remediação físico-quimica e fitoremediação aqui adotados, são recomendados para recuperar as zonas atingidas pelo rejeito da barragem contaminado com sódio e éter-amina. Integr Environ Assess Manag 2020;16:669-675.

Motorcycle-related trauma:effects of age and site of injuries on mortality. A single-center, retrospective study.

BACKGROUND: Motorcyclists are often victims of road traffic incidents. Though elderly patients seem to have worse survival outcomes and sustain more severe injuries than younger patients, concordance in the literature for this does not exist. The aim of the study is to evaluate the impact of age and injury severity on the mortality of patients undergoing motorcycle trauma. METHODS: Data of 1725 patients consecutively admitted to our Trauma Center were selected from 2002 to 2016 and retrospectively analyzed. The sample was divided into three age groups: ≤ 17 years, 18-54 years, and ≥ 55 years. Mortality rates were analyzed for the overall population and patients with Injury Severity Score (ISS) ≥ 25. Differences in survival among age groups were evaluated with log-rank test, and multivariate logistic regression models were created to identify independent predictors of mortality. RESULTS: A lower survival rate was detected in patients older than 55 years (83.6% vs 94.7%, p = 0.049) and in those sustaining critical injuries (ISS ≥ 25, 61% vs 83%, p = 0.021). Age (p = 0.027, OR 1.03), ISS (p < 0.001, OR 1.09), and Revised Trauma Score (RTS) (p < 0.001, OR 0.47) resulted as independent predictors of death. Multivariate analysis identified head (p < 0.001, OR 2.04), chest (p < 0.001, OR 1.54), abdominal (p < 0.001, OR 1.37), and pelvic (p = 0.014, OR 1.26) injuries as independent risk factors related to mortality as well. Compared to the theoretical probability of survival, patients of all age groups showed a survival advantage when managed at a level I trauma center. CONCLUSIONS: We detected anatomical injury distributions and mortality rates among three age groups. Patients aging more than 55 years had an increased risk of death, with a prevalence of severe chest injuries, while younger patients sustained more severe head trauma. Age represented an independent predictor of death. Management of these patients at a level I trauma center may lead to improved outcomes.