Neurological disorders and violence: a systematic review and meta-analysis with a focus on epilepsy and traumatic brain injury

The objectives of this study were to systematically review and meta-analyze the research literature on the association of common neurological disorders and violence. Keywords relating to neurological disorders and violence were searched between 1966 and August 2008. Case–control and cohort studies were selected. Odds ratios of violence risk in particular disorders compared with controls were combined using fixed-effects meta-analysis with the data presented in forest plots. Sensitivity analyses were conducted to identify possible differences in risk estimates across surveys. Information on risk factors for violence was extracted if replicated in more than one study. Nine studies were identified that compared the risk of violence in epilepsy or traumatic brain injury compared with unaffected controls. For the epilepsy studies, the overall pooled odds ratio for violent outcomes was 0.67 [95% confidence interval (CI) 0.46–0.96]. For traumatic brain injury, the odds ratio was 1.66 (95% CI 1.12–2.31). An additional 11 case–control studies investigated factors associated with violence in epilepsy and traumatic brain injury. It was not possible to meta-analyze these data. Comorbid psychopathology was associated with violence. Data on other neurological conditions was limited and unreplicated. In conclusion, although the evidence was limited and methodological quality varied, epilepsy and traumatic brain injury appeared to differ in their risk of violence compared with control populations. Longitudinal studies are required to replicate this review’s provisional findings that epilepsy is inversely associated with violence and that brain injury modestly increases the risk, and further research is needed to provide information on a broader range of risk factors.     

Radiologic percutaneous gastrostomy: Results in 56 patients with head and neck cancer

Objective: The establishment of a direct enteral feeding route is critical in the overall treatment of many patients with head and neck cancer. Use of radiologic percutaneous gastrostomy (RPG), the newest technique for gaining enteral access, has not been studied in such patients extensively. This study evaluated the indications, technique, success rate, and complications associated with RPG in patients with head and neck cancer. Study Design: Retrospective. Methods: A comprehensive chart review was undertaken of 56 patients with head and neck cancer treated at a tertiary care institution who had undergone successful or attempted RPG at some point during their treatment course. Results: Most study patients had advanced oropharyngeal squamous cell carcinoma. The most frequent indications for RPG were dysphagia/aspiration following tumor resection (n = 26) and dysphagia following completion of single- or combined-modality therapy (n = 22). The success rate of attempted RPGs was 98.2%. The overall complication rate for RPG was 12.7% (10.9% minor and 1.8% major). Conclusions: RPG is a valuable tool for establishing enteral nutrition in patients with head and neck cancer. Advantages of RPG include high success rate despite obstructing lesions, low complication rate, time efficiency and scheduling ease compared with intraoperative percutaneous gastrostomy (PEG) by a second team, no reported tumor seeding of the tube site, and the fact that postoperative RPG allows for more accurate selection of patients who require a gastrostomy tube.     

Congenital aortocaval fistula between right aortic sinus of Valsalva and superior vena cava: A rare case report

Thoracic aortocaval fistula is a very rare cause of left to right shunt. Drainage of fistula into the superior vena cava (SVC) is very uncommon. Clinical symptoms depend on the size of the shunt. We report a rare case of an asymptomatic 27‐year‐old woman with congenital aortocaval fistula to the SVC with a small amount of left to right shunt that was considered for serial medical follow‐up.     

Predicting long-term dynamics of soil salinity and sodicity on a global scale

Knowledge of spatiotemporal distribution and likelihood of (re)occurrence of salt-affected soils is crucial to our understanding of land degradation and for planning effective remediation strategies in face of future climatic uncertainties. However, conventional methods used for tracking the variability of soil salinity/sodicity are extensively localized, making predictions on a global scale difficult. Here, we employ machine-learning techniques and a comprehensive set of climatic, topographic, soil, and remote sensing data to develop models capable of making predictions of soil salinity (expressed as electrical conductivity of saturated soil extract) and sodicity (measured as soil exchangeable sodium percentage) at different longitudes, latitudes, soil depths, and time periods. Using these predictive models, we provide a global-scale quantitative and gridded dataset characterizing different spatiotemporal facets of soil salinity and sodicity variability over the past four decades at a ∼1-km resolution. Analysis of this dataset reveals that a soil area of 11.73 Mkm² located in nonfrigid zones has been salt-affected with a frequency of reoccurrence in at least three-fourths of the years between 1980 and 2018, with 0.16 Mkm² of this area being croplands. Although the net changes in soil salinity/sodicity and the total area of salt-affected soils have been geographically highly variable, the continents with the highest salt-affected areas are Asia (particularly China, Kazakhstan, and Iran), Africa, and Australia. The proposed method can also be applied for quantifying the spatiotemporal variability of other dynamic soil properties, such as soil nutrients, organic carbon content, and pH.

Soil salinization is one of the main land-degrading threats influencing soil fertility, stability, and biodiversity. Saline soils are ones with excess accumulation of soluble salts in the root zone (1). On the other hand, accumulation of high levels of sodium salt relative to other exchangeable cations is the main attribute of sodic soils (2). Wind, rainfall, and parent rock weathering are the main origins of these salts in “primary” soil salinization, whereas in “secondary” soil salinization excessive salt accumulation is human-induced (3). Saline and sodic soils, or in general salt-affected soils, mostly lie across arid and semiarid climates where the dominance of evaporation over precipitation concentrates the salts in the root zone (1, 4), leading to undesirable alterations in the physical, chemical, and biological functions of the soil (5, 6). Sodicity adversely influences the soil infiltration capacity (7), increases the susceptibility of water and wind-blown erosion (8), and exposes more soil organic matter to decomposing processes (9). Soil salinity, on the other side, distresses the soil respiration, nitrogen cycle, and decomposing functionality of soil microorganisms (9, 10). Salinity stress affects the vegetation growth directly by reducing the plant water uptake (osmotic stress) and/or by deteriorating the transpiring leaves (specific ion effects) (11), in turn reducing organic input to the soil and ultimately leading to desertification of lands (12, 13). Under extreme conditions, dispersion of saline dust (8, 14), poverty, migration, and high costs of soil reclamation are long-term socioeconomic consequences of soil salinization (15).Soil salinity and sodicity levels are spatially, vertically, and temporally dynamic (15, 16), particularly at the top 0- to 30-cm soil layer which is substantially affected by governing climatic conditions. Naturally occurring events, such as flash floods, El Niño and La Niña, alternative wet and dry years, and long periods of drought can considerably affect soil salinization and accumulation/leaching of the salts in/from the root zone at daily to multiyear temporal resolutions. Similarly, anthropogenic activities like irrigation and dryland management can affect soil salinization at different temporal resolutions. Given the high dynamism in soil salinization processes, updated spatial and temporal information on the extent of salt-affected soils is indispensable for devising appropriate sustainable action programs for managing land and soil resources (6, 17–19). This information can be also valuable for enhancing our understanding of terrestrial carbon dynamics (7, 20), food security and agricultural modeling (21, 22), climate change impacts (23, 24), water resources and irrigation management (25, 26), and efficiency of organic/inorganic reclamation practices (27, 28). Several statistics on the global distribution of salt-affected soils (17–19, 29–33) have been generated based on data from soil surveys and statistical extrapolation (1, 19), yet these estimations are mainly purely spatial (17, 34), not necessarily up-to-date (15, 17), and in some cases incomparable (3, 35). Therefore, there is still a need for a methodologically consistent dataset documenting long-term variations of the soil salinity and sodicity at high spatial resolutions (36)To address this need, we focused on two target variables: ground-derived measurements of soil EC_e (the ability of a water-saturated soil paste extract to conduct electrical current, representative of salinity severity) and ESP (exchangeable sodium percentage, representative of sodicity severity). We used 42,984 and 197,988 data, respectively, scattered over time from 1980 to 2018. We trained two-part predictive models for making four-dimensional (4D) predictions of soil salinity and sodicity as target variables (longitude, latitude, soil depth, and time; see Methods). Through mapping data-driven relations between soil EC_e/ESP observations and a collection of associated predictors generated from topographic, climatic, vegetative, soil, and landscape properties of the sampling locations (SI Appendix, Table S1), these two-part models enabled us to make long-term gridded predictions of soil salinity and sodicity at new locations with available predictors’ values. Note that “prediction” refers to the estimation by the trained models of soil salinity/sodicity on a global scale from 1980 to 2018 even in locations where there is no measurement available rather than to future projection of soil salinity/sodicity on the basis of current trends. The first part of the models classified the soil into saline/sodic and nonsaline/nonsodic classes (binary classification) and the second part predicted per-class severity of the salinity/sodicity issue (regression). Meaningful statistics derived from the EC_e and ESP predictions were then used to generate univariate thematic maps of the variability of different aspects of soil salinity/sodicity between 1980 and 2018 at ∼1-km spatial resolution (30 arc-seconds; e.g., Fig. 1). These were delimited to −55° and 55° latitudes, comprising tropics, subtropics, and temperate zones (see Data Availability). We focused on the topsoil layer (or surface soil), referring to the top 30 cm of the soil profile measured from the surface.Open in a separate windowFig. 1.Variability of different aspects of soil salinity and sodicity in the western United States. (A and D) SD of annually predicted soil salinity (EC_e) and sodicity (ESP), respectively, between 1980 and 2018. (B and E) Average of annually predicted EC_e and ESP, respectively (1980 to 2018). (C and F) Change in the likelihood (θ) of soils with an EC_e ≥4 dS⋅m⁻¹ or ESP ≥6% in the period 2000 to 2018 relative to 1981 to 1999 (the likelihood is dimensionelss, calculated by dividing the number of years with EC_e ≥4 dSm⁻¹ or ESP ≥6% by the total number of years in the studied period). Positive θ indicates that the likelihood has increased and negative shows that it has decreased.     

Interventional endoscopic ultrasound in pancreatic disease

The use of endoscopic ultrasound (EUS) in pancreatic disease is rapidly evolving as the field moves from a primarily diagnostic role to one of therapeutic intervention. Therapeutic EUS includes techniques such as the celiac block and transmural pseudocyst drainage. Newer techniques include EUS-guided fine-needle injection therapy in which a variety of agents are being investigated for the treatment of pancreatic cancer. Novel EUS-guided techniques are being devised to drain and alleviate pancreaticobiliary and gastroduodenal obstruction.     

Antibacterial Effects of Cinnamon: From Farm to Food,Cosmetic and Pharmaceutical Industries

Herbs and spices have been used since ancient times, because of their antimicrobial properties increasing the safety and shelf life of food products by acting against foodborne pathogens and spoilage bacteria. Plants have historically been used in traditional medicine as sources of natural antimicrobial substances for the treatment of infectious disease. Therefore, much attention has been paid to medicinal plants as a source of alternative antimicrobial strategies. Moreover, due to the growing demand for preservative-free cosmetics, herbal extracts with antimicrobial activity have recently been used in the cosmetic industry to reduce the risk of allergies connected to the presence of methylparabens. Some species belonging to the genus Cinnamomum, commonly used as spices, contain many antibacterial compounds. This paper reviews the literature published over the last five years regarding the antibacterial effects of cinnamon. In addition, a brief summary of the history, traditional uses, phytochemical constituents, and clinical impact of cinnamon is provided.