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Background and Objective Endoscopic endonasal surgery (EES) for the management of sellar, suprasellar, and anterior skull base lesions is gaining popularity. Our aim was to analyze and present the clinical outcomes of EES for the management of these lesions in a community hospital setting. Methods We retrospectively reviewed the charts of 56 patients with sellar, suprasellar, and anterior skull base lesions who underwent EES between 2010 and 2018. Results There was male predominance (53.6%) with a mean age of 54.9 ± 13.7 years. Lesions were 45 pituitary adenomas, 5 meningiomas, 3 metastatic, 1 craniopharyngioma, 1 Rathke cyst, and 1 mucocele. Gross total excision was achieved in 57.1%, subtotal excision occurred in 37.5%, and decompression and biopsy were achieved in 5.4% patients. Postoperative vision normalized or improved in 27 patients (86.1%) and was stable in 4 patients (13.9%). Recovery of a preexisting hormonal deficit occurred in 13 (23.2%) patients, and a new hormonal deficit occurred in 9 patients (16.1%). The mean hospital stay was 6.1 ± 4.9 days. Postoperative complications included cerebrospinal fluid leak in 8 patients (14.3%). Four patients (7.1%) had meningitis. Diabetes insipidus was present in 19 patients (33.9%), and postoperative intracranial hematoma requiring evacuation was necessary in 2 patients (3.6%). The mean follow-up duration was 47.5 ± 25.8 months. Lesion progression or recurrence requiring redo surgery occurred in 5 patients (8.9%). Regarding the learning curve, the postoperative cerebrospinal fluid leak, meningitis, new hormonal deficits, and diabetes insipidus decreased in the second half of the patients. Conclusions EES provides an effective and safe surgical option with low morbidity and mortality for the treatment of sellar, suprasellar, and anterior skull base lesions in a community hospital setting.

Background Ground glass opacity (GGO) is the main HRCT feature representing alveolitis in systemic sclerosis-associated interstitial lung disease (SSc-ILD), but may also represent other conditions such as atelectasis or edema. It is unclear how much this is affected by the HRCT scan protocol used. We aimed to compare the performance of three different HRCT protocols to evaluate the degree of SSc-ILD related changes. Methods Eleven patients with SSc underwent chest HRCT scan by three different protocols: First, a supine scan after lying down for 15 minutes, then two scans in alternating order: A prone position scan, and a supine position scan after performing 10 deep breaths using a positive expiratory pressure (PEP) device. The HRCT scans were evaluated by the Warrick score system for ILD-related findings. Results The three HRCT protocols were compared and resulted in different mean (95% CI) Warrick scores: 9.4 (5.3–13.4) in supine after rest; 7.5 (95% CI 3.8–11.1) in prone and 7.6 (95% CI 4.2–11.1) in supine after PEP. When comparing supine after rest to prone and supine after PEP, the latter two scans had a significantly lower score (p = 0.001 for both comparisons). In all cases, only sub-scores for ground glass opacities differed, while sub-scores for fibrosis-related changes did not change. Conclusions Different HRCT scan protocols significantly altered the Warrick severity score for SSc-ILD findings, primarily because of changes in ground glass opacities. These differences may be clinically meaningful.

The creation of discrete, covalent bonds between a protein and a functional molecule like a drug, fluorophore, or radiolabeled complex is essential for making state-of-the-art tools that find applications in basic science and clinical medicine. Photochemistry offers a unique set of reactive groups that hold potential for the synthesis of protein conjugates. Previous studies have demonstrated that photoactivatable desferrioxamine B (DFO) derivatives featuring a para-substituted aryl azide (ArN

Glioblastoma is one of the most aggressive types of cancer with median survival of only 15 months. Successful therapy is hampered by the existence of treatment resistant populations of stem-like tumour initiating cells (TICs) and poor blood-brain barrier drug penetration. Therapies capable of effectively targeting the TIC population are in high demand. Here, we synthesize spherical diketopyrrolopyrrole (DPP)-based conjugated polymer nanoparticles (CPNs) with an average diameter of 109 nm. The CPN were designed to include fluorescein-conjugated hyaluronic acid (HA), a ligand for the CD44 receptor present on one population of TICs. We demonstrate blood-brain barrier permeability of this system and concentration and cell cycle phase-dependent selective uptake of HA-CPNs in CD44 positive GBM-patient derived cultures. Interestingly, we found that uptake alone decreases stemness, invasive properties and proliferation of the CD44-TIC population in zebrafish PDX models in vivo. This study is the first to show surface moiety-driven selectivity of conjugated polymer nanoparticles in targeting TIC populations in brain cancer.

Glioblastoma is one of the most aggressive types of cancer with median survival of only 15 months. Successful therapy is hampered by the existence of treatment resistant populations of stem-like tumour initiating cells (TICs) and poor blood-brain barrier drug penetration. Therapies capable of effectively targeting the TIC population are in high demand. Here, we synthesize spherical diketopyrrolopyrrole (DPP)-based conjugated polymer nanoparticles (CPNs) with an average diameter of 109 nm. The CPN were designed to include fluorescein-conjugated hyaluronic acid (HA), a ligand for the CD44 receptor present on one population of TICs. We demonstrate blood-brain barrier permeability of this system and concentration and cell cycle phase-dependent selective uptake of HA-CPNs in CD44 positive GBM-patient derived cultures. Interestingly, we found that uptake alone decreases stemness, invasive properties and proliferation of the CD44-TIC population in zebrafish PDX models in vivo. This study is the first to show surface moiety-driven selectivity of conjugated polymer nanoparticles in targeting TIC populations in brain cancer.

The valuable work of Shahnameh, Ferdowsi Tusi is well-known and famous epic in Persian, by the people of Iran has for a long time been considered, and due to the story’s context of this art work throughout history, this combination enabled us to build a close relationship with it. This unique collection contains narratives of the heroes of the Shahnameh and other Iranian heroic texts, tangled with symbolic and mythical themes. To the extent, reflections of Ferdowsi's themes and concepts can be seen in various works such as Mazandaran artworks. As far as it's a nice replication on the strength of the themes and concepts of Ferdowsi's Shahnameh which is seen especially in various works contained in the art works of Mazandaran. The purpose of writing this article is the evaluation and analysis of the symbolic themes of Ferdowsi's Shahnameh in the art works of Mazandaran, through descriptive-analytical method, based on quantitative content analysis and the data derived from observation, library studies. In other words, examples of the artistic works of this area proved almost symbolic for the themes of the Shahnameh which were classified and analyzed. The results of this research show that although the symbols commonly are used in some of these the artistic works have undergone a profound industrial change, however, a wide range of uses of symbolic and mythological for themes of Ferdowsi's Shahnameh can be mentioned in them.

In this paper, a new real-time model order reduction technique for stability prediction in the smart grid is proposed. The proposed method uses an online proper orthogonal decomposition algorithm. A snapshot matrix on a sliding sampling window is used for extracting the main components of the system states by performing a randomized singular value decomposition. After reducing the order of the system, a local linear model is estimated for this snapshot matrix. Then, the state of the system is predicted in a sliding prediction window. Finally, a suitable stability index is calculated and the stability of the system is forecasted in this prediction window. The proposed method is capable of predicting the transient stability, unstable/critical machines and the stability limit. In addition, it can be used for the first swing and multiswing instability detection. The simulations on three test systems show that the proposed technique can predict system stability with the high precision in real time. The computational burden and the length of prediction horizon is suitable for practical applications and the proposed algorithm has significant advantages in case of large-scale power systems.

Background: Type 1 spinal arteriovenous malformations (AVM) are dural fistulas which classically present due to progressive congestive myelopathy. Acute hemorrhage resulting in a spinal subdural hematoma is exceedingly rare with only three reported cases. Methods: This 46-year-old female experienced rapidly progressive paraplegia over several hours. There was no history of anti-coagulant use, trauma, fever, or infection. On examination, she had 0/5 in the lower extremities bilaterally and decreased sensation to pinprick below the T6 level on both sides. She also had loss of bowel and bladder control. MRI demonstrated evidence of an intra-dural extramedullary lesion located anteriorly causing significant compression on the spinal cord from T4 down to T7 level. Results: She underwent thoracic laminectomy from T4 – T7. After dural opening, a well organized sub-dural hematoma with significant mass effect on a distorted spinal cord was evacuated. Subsequently, a large abnormal artery leading into a dilated serpiginous vein on the dorsal aspect of spinal cord at the T7 level was visualized. Indocyanine green angiography confirmed our suspicion of a dural arteriovenous fistula which was disconnected. Conclusions: Type I spinal AVM in rare cases can present acutely as subdural hematoma and should be kept in the differential diagnosis for acute paraplegia.