Clinical 3-D Gait Assessment of Patients with Polyneuropathy Associated with Hereditary Transthyretin Amyloidosis

Hereditary amyloidosis associated with transthyretin V30M (ATTRv V30M) is a rare and inherited multisystemic disease, with a variable presentation and a challenging diagnosis, follow-up and treatment. This condition entails a definitive and progressive motor impairment that compromises walking ability from near onset. The detection of the latter is key for the disease's diagnosis. The aim of this work is to perform quantitative 3-D gait analysis in ATTRv V30M patients, at different disease stages, and explore the potential of the obtained gait information for supporting early diagnosis and/or stage distinction during follow-up. Sixty-six subjects (25 healthy controls, 14 asymptomatic ATTRv V30M carriers, and 27 symptomatic patients) were included in this case-control study. All subjects were asked to walk back and forth for 2 min, in front of a Kinect v2 camera prepared for body motion tracking. We then used our own software to extract gait-related parameters from the camera's 3-D body data. For each parameter, the main subject groups and symptomatic patient subgroups were statistically compared. Most of the explored gait parameters can potentially be used to distinguish between the considered group pairs. Despite of statistically significant differences being found, most of them were undetected to the naked eye. Our Kinect camera-based system is easy to use in clinical settings and provides quantitative gait information that can be useful for supporting clinical assessment during ATTRv V30M onset detection and follow-up, as well as developing more objective and fine-grained rating scales to further support the clinical decisions.This work was supported by the National funding agency, FCT—Fundação para a Ciência e a Tecnologia, in the context of the projects (UIDB/50014/2020; UIDB/00127/2020) and scholarship (SFRH/DB/110438/2015). This work was also supported by the Porto University Hospital Center (CHUP) in the context of the scholarship (BI.02/2018/UCA/CHP) as part of the research project [2014/167(119-DEFI/149-CES)]info:eu-repo/semantics/publishedVersio

Validation of a Single RGB-D Camera for Gait Assessment of Polyneuropathy Patients

Motion analysis systems based on a single markerless RGB-D camera are more suitable for clinical practice than multi-camera marker-based reference systems. Nevertheless, the validity of RGB-D cameras for motor function assessment in some diseases affecting gait, such as Transthyretin Familial Amyloid Polyneuropathy (TTR-FAP), is yet to be investigated. In this study, the agreement between the Kinect v2 and a reference system for obtaining spatiotemporal and kinematic gait parameters was evaluated in the context of TTR-FAP. 3-D body joint data provided by both systems were acquired from ten TTR-FAP symptomatic patients, while performing ten gait trials. For each gait cycle, we computed several spatiotemporal and kinematic gait parameters. We then determined, for each parameter, the Bland Altman's bias and 95% limits of agreement, as well as the Pearson's and concordance correlation coefficients, between systems. The obtained results show that an affordable, portable and non-invasive system based on an RGB-D camera can accurately obtain most of the studied gait parameters (excellent or good agreement for eleven spatiotemporal and one kinematic). This system can bring more objectivity to motor function assessment of polyneuropathy patients, potentially contributing to an improvement of TTR-FAP treatment and understanding, with great benefits to the patients' quality of life.This research was funded by ERDF – European Regional Development Fund through the Operational Program for Competitiveness and Internationalization - COMPETE 2020, and by national funds through the Porto Hospital Center (CHP) in the context of the scholarship BI.02/2018/UCA/CHP, and through the Portuguese Foundation for Science and Technology (FCT), in the context of scholarship SFRH/BD/110438/2015, and projects UID/CEC/00127/2019, UID/CEC/00127/2013, Incentivo/EEI/UI0127/2014, FCOMP-01-0124-FEDER-028943 and FCOMP-01-0124-FEDER-029673. It was also partially funded by NORTE2020 Integrated Project NanoSTIMA “NORTE-01-0145-FEDER-000016”, and POCI-01-0145-FEDER-028618 (PTDC/CCI-COM/28618/2017) - PERFECT, under the PORTUGAL 2020 Partnership Agreement, and through the European Regional Development Fundinfo:eu-repo/semantics/publishedVersio

AVALIAÇÃO DA AROEIRA (SCHINUS TEREBINTHIFOLIUS RADDI) NO TRATAMENTO DA MUCOSITE ORAL INDUZIDA PELA RADIOTERAPIA EXCLUSIVA OU ASSOCIADA À QUIMIOTERAPIA: ESTUDO PILOTO

Objetivo: Avaliar o uso da Aroeira no tratamento da mucosite oral induzida pela radioterapia exclusiva ou associada à quimioterapia em pacientes com câncer de cabeça e pescoço. Método: Foi realizado um ensaio clínico controlado, randomizado e duplo-cego, onde doze indivíduos foram alocados em dois grupos: intervenção e controle e orientados a aplicar a pomada três vezes por dia. A avaliação diária do grau da mucosite e da nota da dor referida pelo paciente permitiram observar a regressão ou não da sua manifestação. Foram também aplicados formulários referentes à situação clínica, sociodemográfica e de higiene bucal dos participantes. Uma análise descritiva dos dados foi realizada. Resultados: No grupo controle, 50% (3) dos participantes apresentaram regressão do grau de mucosite; já no grupo de intervenção 17% (1). Em relação a nota da dor, 83% do grupo placebo relatou regressão e 50% do grupo intervenção. Conclusões: Neste estudo o uso da aroeira não mostrou-se eficaz no tratamento da mucosite, em relação ao uso do placebo. por outro lado apresentou uma porcentagem significativa de redução da nota da dor. Devido às limitações do estudo não se pode comprovar o efeito fitoterápico da aroeira neste tipo de abordagem.

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Gait characterization and analysis of hereditary amyloidosis associated with transthyretin patients: a case series

Hereditary amyloidosis associated with transthyretin (ATTRv), is a rare autosomal dominant disease characterized by length-dependent symmetric polyneuropathy that has gait impairment as one of its consequences. The gait pattern of V30M ATTRv amyloidosis patients has been described as similar to that of diabetic neuropathy, associated with steppage, but has never been quantitatively characterized. In this study we aim to characterize the gait pattern of patients with V30M ATTRv amyloidosis, thus providing information for a better understanding and potential for supporting diagnosis and disease progression evaluation. We present a case series in which we conducted two gait analyses, 18 months apart, of five V30M ATTRv amyloidosis patients using a 12-camera, marker based, optical system as well as six force platforms. Linear kinematics, ground reaction forces, and angular kinematics results are analyzed for all patients. All patients, except one, showed a delayed toe-off in the second assessment, as well as excessive pelvic rotation, hip extension and external transverse rotation and knee flexion (in stance and swing phases), along with reduced vertical and mediolateral ground reaction forces. The described gait anomalies are not clinically quantified; thus, gait analysis may contribute to the assessment of possible disease progression along with the clinical evaluation.info:eu-repo/semantics/publishedVersio

Portable RGB-D Camera-Based System for Assessing Gait Impairment Progression in ATTRv Amyloidosis

Hereditary Amyloidosis associated with variant Transthyretin (ATTRv Amyloidosis) is a progressive and highly disabling neurological disorder that affects gait. Quantitative motion analysis is useful for assessing motor function, including gait, in diseases affecting movement. A single markerless RGB-D camera enables 3D full-body motion capture in a less expensive and intrusive, and more portable way than multi-camera marker-based systems. In this study, we examine whether a gait analysis system based on an RGB-D camera can be used to detect significant changes in the gait of ATTRv amyloidosis patients over time, when compared with a 12-camera system. We acquired 3D data provided by both systems from six ATTRv amyloidosis patients, while performing a simple gait task, once (T0) and 18 months later (T1). A direct comparison of systems has already been conducted. In this work, however, for each patient, we investigated if the RGB-D camera system detects statistically significant differences between the two different acquisitions in a similar way to the reference system, and whether it is reliable to use during patients’ follow-up. The obtained results show that the differences detected between T0 and T1 for both systems follow the same tendency for 65% of the spatiotemporal gait parameters, and for 38% of the kinematic parameters (38%). The most reliable parameters were: stride duration/length, gait speed (and its variability), and arm/foot swing velocity, all with an almost perfect strength of agreement