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Abstract Objectives Current evidence suggests a link between idiopathic intracranial hypertension (IIH) and spontaneous cerebrospinal fluid (sCSF) leak, as well as between IIH and dural venous sinus (DVS) narrowing. However, there are limited data linking DVS narrowing and sCSF leak. This study aims to determine the prevalence of DVS narrowing in patients with sCSF leak. Methods A retrospective review of all patients with sCSF leak that presented to a tertiary academic center from 2008 to 2019. Preoperative imaging was independently reviewed by two neuroradiologists to evaluate for DVS narrowing. Available literature was used to estimate the prevalence of DVS narrowing in the general population to allow for comparison. Data were analyzed using Exact binomial test. Results Analysis of 25 patients with appropriate imaging revealed the majority were women (21/25, 84%) with a mean age of 51.89 years (SD 13.96). The majority of these patients were found to have narrowing of the DVS (20/25, 80%). In patient with sCSF leaks, there was a significantly higher proportion of patients with DVS narrowing compared with published literature examining this condition in the general population (80% vs. 40%, CI 0.59–0.93, p

Detecting mineralogical alteration by hydrocarbon micro-seepage from trap to surface across the deformed structure, through Comparative analysis study of hyperspectral image (EO-1, Hyperion), and multispectral (landsat7 and Advanced land imager (Ali) to map soil alteration by petroleum seepage with applying remote sensing techniques as (band ratios, supervised, SAM classification, and hydrocarbon detection and index (HD and HI) calculation to detect the potentiality of hydrocarbon seepage in the area. The type of spectral resolution accuracy available for each space imaging platform can be used to choose which is best in determining the target and whether exploration yields oil. Hyperspectral remote sensing data are integrated with a GIS framework Weighted Sum (Spatial Analyst) classified hydrocarbon seepage prospects into five potential zones very good, good, intermediate, poor, and very poor probable potentiality. The spatial lithologic carbonaceous alteration appears closely coincident along reactivated leaking faults that cause hydrocarbon micro-seepage and altered surface lithology and mineralogical cement. The hyperspectral images have proven their worth in identifying and studying hydrocarbon leaks and the resulting environmental pollution and mineral alteration, as well as use micro-seeps as a pathfinder to locations of new oil explorations discoveries that can use as a pre-drill prediction of hydrocarbon occurrence and detected a prospect area for hydrocarbon drill.

The spectral signature curve behavior of basalt and its relationship with the surface reflectance (SR) values of Landsat 8 OLI data, (Operational Land Imager), is considered as the key factor for determination of the sensitive response bands for basalt interaction to be used in both Object-Oriented Principal Components (PCA) & Independent Component (ICA) analyses. Also, it is extremely beneficial in develop mathematical formulas which express the best band ratios for the precise illustration and mapping of basalts. The integration of those sensitive bands and the three mentioned methods are the main objectives of the present investigation. This should permit to create the basalt spatial distribution map for a given area. These methods were applied in west central Sinai, Egypt.The measured spectral signature reflectance curve of the basalt was resampled to meet the spectral characteristics of Landsat 8 bands, both curves were carefully examined to determine the most significant response bands for basalts; which were found to be bands 4, 5, 6 and 7. The examined spectral behavior led to three significant band ratios. Moreover, two false color composite (PC1, PC2, PC4) and (IC4, IC3, IC1) in RGB, were determined by execution and examination of the PCA and ICA images, respectively of the study area.ERDAS Imagine (2010) and ArcGIS 10.3 packages were used for digital/mathematical processing steps and to apply the resulted models on the study area.

Bovine Viral Diarrhea Virus (BVDV) is an important pathogen that plays a significant role in initiating Bovine Respiratory Disease Complex (BRDC) in cattle. The disease causes multi-billion dollar losses globally due to high calf mortality and increased morbidity leading to heavy use of antibiotics. Current commercial vaccines provide limited cross-protection with several drawbacks such as safety, immunosuppression, potential reversion to virulence, and induction of neonatal pancytopenia. This study evaluates two prototype vaccines containing multiple rationally designed recombinant mosaic BVDV antigens for their potential to confer cross-protection against diverse BVDV strains. Genes encoding three novel mosaic antigens, designated E2123, NS2-31, and NS2-32, were designed in silico and expressed in mammalian cells for the formulation of a prototype protein-based vaccine. The mosaic antigens contain highly conserved protective epitopes from BVDV-1a, -1b, and -2, and included unique neutralizing epitopes from disparate strains to broaden coverage. We tested immunogenicity and protective efficacy of Expi293TM-expressed mosaic antigens (293F-E2123, 293F-NS2-31, and 293F-NS2-32), and baculovirus-expressed E2123 (Bac-E2123) mosaic antigen in calves. The Expi293TM-expressed antigen cocktail induced robust BVDV-specific cross-reactive IFN-γ responses, broadly neutralizing antibodies, and following challenge with a BVDV-1b strain, the calves had significantly (p < 0.05) reduced viremia and clinical BVD disease compared to the calves vaccinated with a commercial killed vaccine. The Bac-E2123 antigen was not as effective as the Expi293TM-expressed antigen cocktail, but it protected calves from BVD disease better than the commercial killed vaccine. The findings support feasibility for development of a broadly protective subunit BVDV vaccine for safe and effective management of BRD.

Introduction: Parathyroid carcinoma is a rare malignancy that is challenging to diagnose, with metastasis regarded as the only true way to differentiate parathyroid carcinoma from adenoma. Case presentation: A 63 year-old woman presented to the emergency department with neck and right arm pain. She reported a previous parathyroidectomy for a mediastinal parathyroid adenoma. Admission labs showed hypercalcemia (serum calcium 13; ionized calcium 1.47; PTH 138.5). MRI-spine revealed a soft tissue mass causing destruction of the C4 vertebral body and spinal cord compression. Sestamibi showed intense tracer uptake in the vertebral mass with nonfocal physiologic thyroidal uptake. Otolaryngology was consulted to assist in the approach to the cervical spine lesion as well as address the hypercalcemia. Intraoperatively, the vertebral mass was exposed and resected; frozen section revealed hypercellular parathyroid and PTH dropped from 138.5 to 9.1. Discussion: Parathyroid carcinoma typically presents with comorbidities due to hypercalcemia. Novelties from the case, including the unusual presentation with spinal cord compression, are discussed. Keywords: Parathyroidectomy, Parathyroid glands, Malignancy, Metastasis, Cervical spine

Traditional above-the-knee amputation prosthetics utilize a stump-socket interface that is well-known for skin/socket problems, sitting difficulty, disuse osteopenia, and increased work of ambulation. As a result, we evaluated a novel osseointegrated transcutaneous implant in a large animal. The implant was designed to promote osseointegration at the bone-implant interface and minimize complications. As proof of concept, four Dorset sheep underwent a two-stage surgery for forelimb placement of an osseointegrated transcutaneous implant utilizing Compress® technology (Biomet, Inc., Warsaw, IN). Two sheep received a long anchor plug (90 mm long x 9 mm in diameter) and two received a short anchor plug (46 mm long x 9 mm in diameter). Sixteen weeks after the initial surgery, the operative limbs, along with the attached implant, underwent radiographic and histological analysis for osseointegration. Periprosthetic fractures occurred in the two animals that received the longer internal prosthesis; one healed with splinting and the other animal underwent a second surgical procedure to advance the amputation site more proximal. No fractures occurred in the shorter internal prosthesis group. There was no histological evidence of infection and none of the transcutaneous adapters failed. Bone-implant osseointegration was demonstrated in two of three limbs that underwent histological analysis. This unique implant demonstrated osseointegration without transcutaneous adapter failure, all while displaying minimal infection risk from the outside environment. Although it involved short-term follow-up in a limited number of animals, this pilot study provides a platform for further investigation into the valid concept of using Compress® technology as an endo-exo device.

Bovine viral diarrhea virus (BVDV) plays a key role in bovine respiratory disease complex, which can lead to pneumonia, diarrhea and death of calves. Current vaccines are not very effective due, in part, to immunosuppressive traits and failure to induce broad protection. There are diverse BVDV strains and thus, current vaccines contain representative genotype 1 and 2 viruses (BVDV-1 & 2) to broaden coverage. BVDV modified live virus (MLV) vaccines are superior to killed virus vaccines, but they are susceptible to neutralization and complement-mediated destruction triggered by passively acquired antibodies, thus limiting their efficacy. We generated three novel mosaic polypeptide chimeras, designated NproE2123; NS231; and NS232, which incorporate protective determinants that are highly conserved among BVDV-1a, 1b, and BVDV-2 genotypes. In addition, strain-specific protective antigens from disparate BVDV strains were included to broaden coverage. We confirmed that adenovirus constructs expressing these antigens were strongly recognized by monoclonal antibodies, polyclonal sera, and IFN-γ-secreting T cells generated against diverse BVDV strains. In a proof-of-concept efficacy study, the multi-antigen proto-type vaccine induced higher, but not significantly different, IFN-γ spot forming cells and T-cell proliferation compared to a commercial MLV vaccine. In regards to the humoral response, the prototype vaccine induced higher BVDV-1 specific neutralizing antibody titers, whereas the MLV vaccine induced higher BVDV-2 specific neutralizing antibody titers. Following BVDV type 2a (1373) challenge, calves immunized with the proto-type or the MLV vaccine had lower clinical scores compared to naïve controls. These results support the hypothesis that a broadly protective subunit vaccine can be generated using mosaic polypeptides that incorporate rationally selected and validated protective determinants from diverse BVDV strains. Furthermore, regarding biosafety of using a live vector in cattle, we showed that recombinant human adenovirus-5 was cleared within one week following intradermal inoculation.

Minimally invasive parathyroidectomy is the procedure of choice for primary hyperparathyroidism due to parathyroid adenoma. Localization of the offending adenoma in minimally invasive parathyroidectomy (MIP) has been described in the literature aided by isotope, telescope or ultrasound guidance. We present a prospective study of two techniques based on surgeon experience. Thirty patients diagnosed with primary hyperparathyroidism at the Mater hospital in Dublin, Ireland were randomized to have a minimally invasive parathyroidectomy using surgical sonography (MIPUSS) or the conventional unilateral open procedure (OP) over a two year period. The age, sex and serum calcium/parathormone were comparable in both groups. There was no significant difference in complications between the two groups with temporary hypocalcemia occurring in 3 patients undergoing unilateral neck exploration and in 2 MIPUSS patients. There was one transient episode of recurrent laryngeal neuropraxia occurring in the OP group which resolved at 30 day follow-up. The incision size, operating time, hospital stay, and required post-operative analgesia were all markedly reduced in the MIPUSS group. In conclusion, MIPUSS is safe, effective and has advantages in terms of operating time, incision size and early discharge.

Scholars have voiced the emphasis of studies in sustainability on environmental sustainability over social sustainability. One of the dimensions of social sustainability is neighbourhood cohesion among residents of a neighbourhood. This paper compares the social sustainability of two neighbourhoods in Vancouver metropolitan area particularly in the city of Surrey, B.C. with respect to the sense of neighbourhood cohesion among their residents. Buckner’s (1988) instrument for measuring neighbourhood cohesion index is used with the addition of a few questions to probe for a new conception of space that may link the degree of accessibility and permeability of a neighbourhood (or degree of gated-ness) with the level of neighbourhood cohesion. Results of qualitative and quantitative analysis show that the neighbourhood having an enclosure model had a higher level of neighbourhood cohesion than the neighbourhood with an encounter model on both the affective and interactive dimensions of neighbourhood cohesion.

Abstract Background Valve infective endocarditis (IE) is a potentially life-threatening condition that affects patients’ livelihoods. Current surgical options in mitral valve IE include mitral valve repair (MVr) or replacement (MVR). While each procedure boasts its merits, doubt remains as to which type of surgery is superior. Methods We searched PubMed, Scopus, Web of Science, and Cochrane literature databases for studies comparing MVR and MVr in mitral valve IE. Any randomized controlled trial (RCT) or observational studies that compare MVR vs. MVr in mitral valve IE were eligible. Our dichotomous outcomes were extracted in the form of event and total, and risk and hazard ratio (RR)(HR) with 95% confidence interval (CI) and were pooled and calculated using RevMan 5.0. Results Our study included 23 studies with a total population of 11,802 patients. Compared to MVR, MVr had statistically significant lower risks of both early mortality with RR [0.44; 95% CI, 0.38–0.51; p

Abstract Background Beyond the observed alterations in cellular structure and mitochondria, the mechanisms linking rare genetic mutations to the development of heart failure in patients affected by desmin mutations remain unclear due in part, to the lack of relevant human cardiomyocyte models. Methods To shed light on the role of mitochondria in these mechanisms, we investigated cardiomyocytes derived from human induced pluripotent stem cells carrying the heterozygous DES E439K mutation that were either isolated from a patient or generated by gene editing. To increase physiological relevance, cardiomyocytes were either cultured on an anisotropic micropatterned surface to obtain elongated and aligned cardiomyocytes, or as a cardiac spheroid to create a micro-tissue. Moreover, when applicable, results from cardiomyocytes were confirmed with heart biopsies of suddenly died patient of the same family harboring DES E439K mutation, and post-mortem heart samples from five control healthy donors. Results The heterozygous DES E439K mutation leads to dramatic changes in the overall cytoarchitecture of cardiomyocytes, including cell size and morphology. Most importantly, mutant cardiomyocytes display altered mitochondrial architecture, mitochondrial respiratory capacity and metabolic activity reminiscent of defects observed in patient’s heart tissue. Finally, to challenge the pathological mechanism, we transferred normal mitochondria inside the mutant cardiomyocytes and demonstrated that this treatment was able to restore mitochondrial and contractile functions of cardiomyocytes. Conclusions This work highlights the deleterious effects of DES E439K mutation, demonstrates the crucial role of mitochondrial abnormalities in the pathophysiology of desmin-related cardiomyopathy, and opens up new potential therapeutic perspectives for this disease.

Background Revisional surgery is increasing after different bariatric surgeries, especially after laparoscopic sleeve gastrectomy (LSG), where laparoscopic re-sleeve gastrectomy is a proposed option as one of the revisional surgeries. The aim of this study was to evaluate the outcome of weight loss results in patients who underwent revisional re-sleeve gastrectomy after LSG for weight loss failure with dilated stomach. Patients and methods This was a cohort prospective study conducted on 40 patients who underwent LSG and failed to lose weight effectively or experienced weight regain with either dilated stomach only or associated with presence of retained fundus and then were subjected to re-sleeve gastrectomy and were followed up for one year with correlation to their weight loss results. This study was conducted at the Bariatric Surgery Unit of Ain Shams University Hospitals starting from October 2020 till the end of October 2022. Results This study results concerning group A, which underwent re-sleeve gastrectomy after initial LSG with dilated stomach and associated with retained fundus, showed % of excess weight loss in the range of 5.3–18.3%, 9–58.4%, and 13.2–94.2% in 1, 6, and 12 months postoperatively, respectively. However, group B, which underwent re-sleeve gastrectomy after initial LSG with homogenously dilated stomach only, showed % of excess weight loss in the range of 7.2–20.7%, 8.9–56.7%, and 10.6–95.6% at 1, 6, and 12 months postoperatively, respectively. This study results concerning group A showed initial BMI and follow-up BMI in the range of 36.6–48.3, 34.9–45.6, 30.2–42.6, and 25.1–41.7 initially and in 1, 6, and 12 months postoperatively, respectively, whereas group B showed initial BMI and follow-up BMI in the range of 37.6–47.3, 35.1–45.3, 30.3–45, and 24.8–44.9 initially and at 1, 6, and 12 months postoperatively, respectively. Conclusion Re-sleeve gastrectomy is a safe and good surgical option for patients who underwent LSG and failed to lose weight effectively or experienced weight regain with either dilated stomach only or associated with presence of retained fundus, resulting in significant weight loss results after 1-year follow-up, without significant differences between the two groups. [ABSTRACT FROM AUTHOR]

Myofibrillar myopathy (MFM) is a rare genetic disorder characterized by muscular dystrophy that is often associated with cardiac disease. This disease is caused by mutations in several genes, among them DES (encoding desmin) is the most frequently affected. Peripheral blood mononuclear cells from 5 different MFM patients with different DES mutations were reprogrammed into induced pluripotent stem cells (IPSC) using non-integrative vectors. For each patient, one IPSC clone was selected and demonstrated pluripotency hallmarks without genomic abnormalities. SNP profiles were identical to the cells of origin and all the clones have the capacity to differentiate into all three germ layers.

A new broadband monolithic passive quadrature differential coupler has been realized at millimeter-wave frequencies. The new coupler is implemented on a multidielectric layer structure to achieve a broadband performance from 15 to 45 GHz in a simple coplanar configuration. The coupler has been monolithically fabricated using the IBM SIGEHP (BICMOS 5HP) process. Measured return loss better than 20 dB, with an isolation of 15 dB, and adequate phase and amplitude mismatch have been achieved over 3:1 bandwidth centered at 30 GHz. This performance is especially important to the intended use with wideband double-balanced mixers and amplifiers. To shrink the overall coupler area, a slow-wave technique has been introduced, resulting in an overall size reduction of the coupler by almost 38%. The fabricated slow-wave differential coupler measured results show return loss better than 25 dB, isolation better than 15 dB, and phase and amplitude mismatch within [+ or -] 5[degrees] and [+ or -] 1 dB, respectively. Index Terms--Balanced mixers, differential coupler, monolithic microwave integrated circuits (MMICs), passive devices, quadrature hybrids, SiGe process.

The likely pathogenic variant c.407A>T p.Asp136Val of the LMNA gene has been recently described in a young woman presenting with atypical progeroid syndrome, associated with severe aortic valve stenosis. We further describe the cardiovascular involvement associated with the syndrome in her family. We identified seven members with a general presentation suggestive of progeroid syndrome. All of them presented heart conduction abnormalities: degenerative cardiac diseases such as coronary artery disease (two subjects) and aortic stenosis (three subjects) occurred in the 3rd–5th decade, and a young patient developed a severe dilated cardiomyopathy, leading to death at 15 years of age. The likely pathogenic variant was found in all the patients who consented to carry out the genetic test. This diverse family cardiologic phenotype emphasizes the complex molecular background at play in lamin-involved cardiac diseases, and the need for early and thorough cardiac evaluations in patients with laminopathic progeroid syndromes.

Abstract The aim of the Protocole National De Diagnostic et de Soins/French National Protocol for Diagnosis and Healthcare (PNDS) is to provide advice for health professionals on the optimum care provision and pathway for patients with glycogen storage disease type III (GSD III).The protocol aims at providing tools that make the diagnosis, defining the severity and different damages of the disease by detailing tests and explorations required for monitoring and diagnosis, better understanding the different aspects of the treatment, defining the modalities and organisation of the monitoring. This is a practical tool, to which health care professionals can refer. PNDS cannot, however, predict all specific cases, comorbidities, therapeutic particularities or hospital care protocols, and does not seek to serve as a substitute for the individual responsibility of the physician in front of his/her patient.