Association between opportunistic vertebral bone density measurements and new vertebral fractures after percutaneous vertebral cementoplasty: a case-control study.

OBJECTIVES: To study the relationship between opportunistic CT bone density measurements and the occurrence of new vertebral fractures after percutaneous vertebral cementoplasty (PVC) of osteoporotic vertebral compression fractures (OVCF). METHODS: A prospective analysis of retrospective data of 275 patients with OVCF treated by PVC between 2014 and 2019 with a clinico-radiological follow-up one year after treatment was conducted. Opportunistic bone density measurements were obtained at the trabecular bone of the L1 or an adjacent vertebra in Hounsfield units performed on the preoperative CT study. These density measurements values ​​were then compared between patients with and without new OCVF and in various population subgroups. RESULTS: There were 275 patients included, with 53 (19%) presenting a new OCVF and 24 (9%) developing a fracture cascade. The median opportunistic density measurements ​​in patients with recurrent OCVF were lower than those without (median 52[40.5]) HU and 77[49] HU)(p < 0.00001). Among the patients with new OVCF the median opportunistic density measurements in patients with fracture cascades were also lower than those without (44 HU and 62 HU, respectively) (p < 0.0096). Patients with density measurements under 61 HU were 3.6 times more likely to present recurrent fractures and those with density under 54 HU were 9.8 times more likely to develop a fracture cascade. The 36 HU threshold yielded a high specificity (90-91%) for the prediction of recurrent fractures and fracture cascade but with low sensitivity (respectively 26% and 37%). CONCLUSION: Low opportunistic vertebral density measurements are associated with a higher risk of OVCF and fracture cascades after PVC. KEY POINTS: • Low opportunistic density measurements are associated with a higher risk of OVCF and fracture cascades after PVC. • Measuring bone density before performing a PVC could help predict the risk of new vertebral fracture after treatment • Patient management could be adapted according to bone density.

Suicide and suicide attempts after subthalamic nucleus stimulation in Parkinson disease.

OBJECTIVE: To determine the postoperative attempted and completed suicide rates after subthalamic nucleus deep brain stimulation (STN-DBS) in a single-center cohort and to determine factors associated with attempted and completed suicide. METHODS: We retrospectively included all patients with Parkinson disease (PD) who underwent bilateral STN-DBS surgery at the Grenoble University Hospital between 1993 and 2016. For each patient who committed or attempted suicide, 2 patients with PD with STN-DBS without any suicidal behaviors were matched for age (±1 year), sex, and year of surgery (±2 years). Clinical data were collected from medical records. Detailed preoperative and postoperative neuropsychological evaluations, including frontal and Beck Depression Inventory (BDI) scores, were gathered. RESULTS: A total of 534 patients with PD were included. Completed and attempted suicide percentages were 0.75% (4 of 534) and 4.11% (22 of 534), respectively. The observed suicide rate in the first postoperative year (187.20 of 100,000 per year, 1 of 534) was higher than the expected National Observatory on Suicide Risks rate adjusted for age and sex (standardized mortality ratio 8.1). This rate remained similar over the second and third postoperative years. In a comparison of the 26 patients completing/attempting suicide and the 52 controls, the first group showed more frequent history of suicidal ideation/suicide attempts and psychotic symptoms, higher percentage of family psychiatric history, higher psychiatric medication use, and higher preoperative frontal and BDI scores on neuropsychological evaluations. CONCLUSIONS: Suicide behaviors can occur after STN-DBS, especially during the first 3 years. A careful multidisciplinary assessment and long-term follow-up are recommended to recognize and treat this potentially preventable risk for mortality.

Visual control of walking velocity.

Even if optical correlates of self-motion velocity have already been identified, their contribution to the control of displacement velocity remains to be established. In this study, we used a virtual reality set-up coupled to a treadmill to test the role of both Global Optic Flow Rate (GOFR) and Edge Rate (ER) in the regulation of walking velocity. Participants were required to walk at a constant velocity, corresponding to their preferred walking velocity, while eye height and texture density were manipulated. This manipulation perturbed the natural relationship between the actual walking velocity and its optical specification by GOFR and ER, respectively. Results revealed that both these sources of information are indeed used by participants to control walking speed, as demonstrated by a slowing down of actual walking velocity when the optical specification of velocity by either GOFR or ER gives rise to an overestimation of actual velocity, and vice versa. Gait analyses showed that these walking velocity adjustments result from simultaneous adaptations in both step length and step duration. The role of visual information in the control of self-motion velocity is discussed in relation with other factors.

Environmental constraints modify the way an interceptive action is controlled.

This study concerns the process by which agents select control laws. Participants adjusted their walking speed in a virtual environment in order to intercept approaching targets. Successful interception can be achieved with a constant bearing angle (CBA) strategy that relies on prospective information, or with a modified required velocity (MRV) strategy, which also includes predictive information. We manipulated the curvature of the target paths and the display condition of these paths. The curvature manipulation had large effects on the walking kinematics when the target paths were not displayed (informationally poor display). In contrast, the walking kinematics were less affected by the curvature manipulation when the target paths were displayed (informationally rich display). This indicates that participants used an MRV strategy in the informationally rich display and a CBA strategy in the informationally poor display. Quantitative fits of the respective models confirm this information-driven switch between the use of a strategy that relies on prospective information and a strategy that includes predictive information. We conclude that agents are able of taking advantage of available information by selecting a suitable control law.

Review of the occurrence of anti-infectives in contaminated wastewaters and natural and drinking waters.

OBJECTIVE: Anti-infectives are constantly discharged at trace levels in natural waters near urban centers and agricultural areas. They represent a cause for concern because of their potential contribution to the spread of anti-infective resistance in bacteria and other effects on aquatic biota. We compiled data on the occurrence of anti-infectives published in the last 24 years in environmental water matrices. The collected information was then compared with the available ecotoxicologic values to evaluate potential environmental concerns. DATA SOURCES: We used Web of Science and Google Scholar to search for articles published in peer-reviewed journals written in the English language since 1984. DATA EXTRACTION: Information on compound concentrations in wastewaters and natural and drinking waters, the source of contamination, country of provenance of the samples, year of publication, limits of quantification, and method of analysis was extracted. DATA SYNTHESIS: From the 126 different substances analyzed in environmental waters, 68 different parent compounds and 10 degradation products or metabolites have been quantified to date. Environmental concentrations vary from about 10(-1) to 10(9) ng/L, depending on the compound, the matrix, and the source of contamination. CONCLUSIONS: Detrimental effects of anti-infectives on aquatic microbiota are possible with the constant exposure of sensitive species. Indirect impact on human health cannot be ruled out when considering the potential contribution of high anti-infective concentrations to the spreading of anti-infective resistance in bacteria.

Effect of copper on soil functional stability measured by relative soil stability index (RSSI) based on two enzyme activities.

Copper can affect essential processes in soils, often for long periods. Enzyme activity is considered a sensitive indicator to evaluate soil health and the potential toxic impact of a soil contaminant. Nevertheless, there is heterogeneity in the responses from enzyme activity assays because of the influence of pH and other physicochemical parameters on both enzyme activity and metal speciation. This leads to complications when comparing soils and limits the validity of the results. To overcome these problems, this paper evaluates resistance and recovery, quantified by using a relative soil stability index (RSSI), of the beta-glucosidase and protease activities towards an additional heat disturbance (17 h at 60 degrees C) in soils where soil organic matter, pH and Cu content were modified in a factorial setup. Chemical analyses (dissolved Cu, pCu(2+), dissolved organic carbon, pH) were performed both before the heat-perturbation and after the enzyme activity monitoring period. Results show that soil pH did not interfere with the RSSI scores of both enzymes. beta-glucosidase RSSI scores were scarcely affected by copper, making it inappropriate for evaluating copper-induced stress to soils. Protease activity shows stimulations of up to 2.5 times the activity of the unperturbed control in uncontaminated samples only. Thus, the protease RSSI score seems a good indicator for soil health relative to copper contamination given that all samples were affected by the presence of copper and high correlations were observed between RSSI scores and the different copper forms.

Biotests and biosensors in ecotoxicological risk assessment of field soils polluted with zinc, lead, and cadmium.

The combined chemical and ecotoxicological hazard evaluation study was conducted on 60 smelter-influenced soils containing 1 to 13, 50 to 653, and 100 to 1,198 mg/kg of Cd, Pb, and Zn, respectively. For these soils (liquid-to-soil ratio = 10), water extractability of Zn, Cd, and Pb was less than 0.19% (median values). Acetic acid (0.11 M) extracted 23, 9.7, and 0.7% of Cd, Zn, and Pb, respectively. Although heavy metal concentrations in the studied soils were high, the toxic effects of water extracts were observed only in few samples and in few biotests (algae Selenastrum capricornutum and metal detector assay). For most of the aquatic test organisms (e.g., crustaceans, photobacteria), the bioavailable concentrations of metals in soil-water extracts were either subtoxic, or the adverse effects were compensated by soil nutrients, etc. However, analysis of the soils with recombinant Cd sensor Bacillus subtilis (pTOO24) showed that about 65% of these apparently subtoxic samples contained bioavailable Cd when analyzed in the suspension assay (detection limit 1.5 mg Cd/kg soil), indicating the desorption of Cd induced by direct contact of bacteria with soil particles. The median bioavailable fraction of Cd (1%) was 23-fold lower than the fraction extracted by acetic acid. The Pb-Cd sensor Staphylococcus aureus (pT0024) detected bioavailable Pb only in the suspensions of five of the most lead-polluted soils (>417 mg Pb/kg): the median bioavailability of Pb was 0.42%. Consequently, the hazard assessment relying on total metal levels in soils should be revised by critical comparison with data obtained from bioassays. Development and use of biosensors (excellent tools for mechanistic studies and signaling hazard already at subtoxic level) should be encouraged.

Recombinant luminescent bacterial sensors for the measurement of bioavailability of cadmium and lead in soils polluted by metal smelters.

Environmental hazard of heavy metals in soils depends to a large extent on their bioavailability. The approach used in this study enables the determination of bioavailable metals in solid-phase samples. Two recombinant bacterial sensors, one responding specifically to cadmium and the other to lead and cadmium by increase of luminescence (firefly luciferase was used as a reporter) were used to determine the bioavailability of these metals in soil-water suspensions (a contact assay) and respective particle-free extracts. Fifty agricultural soils sampled near zinc and lead smelters in the Northern France containing up to (mg/kg) 20.1 of Cd, 1050 of Pb and 1390 of Zn were analysed. As the soil matrix interferes with the assay, recombinant luminescent control bacteria lacking the metal recognizing protein and corresponding promoter (thus, being not metal-inducible) but otherwise comparable to the sensor bacteria (the same host bacterium and plasmid encoding luciferase) were used in parallel to take into account the possible quenching and/or stimulating effects of the sample on the luminescence of the sensor bacteria. Both, chemical and sensor analysis showed that only microg/l levels of metals were extracted from the soil into the water phase (0.1% of the total Cd, 0.07% of Pb and 0.5% of Zn). However, 115-fold more Cd and 40-fold more Pb proved bioavailable if the sensor bacteria were incubated in soil suspensions (i.e., in the contact assay). The bioavailability of metals in different soils varied (depending probably on soil type) ranging from 0.5% to 56% for cadmium and from 0.2% to 8.6% for lead.