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This study aimed to assess the longitudinal predictions between glycated hemoglobin A1c (HbA1c) and physical performance scores in different epidemiological contexts of aging.Longitudinal data of 1,337 older people from three countries (Canada, Brazil and Colombia) of the International Mobility in Aging Study (IMIAS) were used to assess the relationship between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Linear Mixed Models grouped by sex and adjusted by Age, Study site, Chronic Conditions, Anthropometric Measures, and Inflammatory Level were used to estimate the influence of HbA1c and covariates on SPPB scores.At the IMIAS baseline, Latin American (LA) cities had higher HbA1c averages compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ± 1.49; 6,56 ± 1.70 respectively). SPPB scores were significantly lower in LA cities, and older people in Natal had lower SPPB averages in men (9.67 ± 2.38; p-value0.05) and women (8.52 ± 2.33; p-value0.05). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (β = -0.25, 95% CI: -0.39 to -0.12, p-value = 0.02) but not in women.High HbA1c levels at baseline were longitudinally associated in older adults from different countries, and this association was observed only in men and not in women. This study highlights a possible influence of gender on this relationship.

BACKGROUND: Dealing with multiple intracranial aneurysms (MIA) presenting with subarachnoid hemorrhage (SAH) is challenging. OBJECT: To make a proposal for the decision-making regarding which aneurysm to secure and how, as the most challenging part in the management of MIA. METHODS: This descriptive study included 25 patients presenting with SAH and having multiple intracranial aneurysms. All patients had a brain computed tomography (CT) scan, CT angiography (CTA), and digital subtraction angiography (DSA). Patients were treated in our institution using microsurgical clipping and/or endovascular embolization according to the clinical and radiological situation. Functional outcome was assessed by modified Rankin scale. RESULTS: Fifteen females and 10 males with average age of 48 years were included. All patients (100%) presented with hemorrhage. Ten patients (40%) were hunt and Hess (HH 19 patients (76%) had 2 aneurysms and 6 patients (24%) had 3 aneurysms. Clipping was done for 40 aneurysms (71%), wrapping for 2 aneurysms (3%), 4 aneurysms (7%) were followed up, 8 aneurysms (14%) were coiled, and 2 aneurysms (3%) were treated by flow diverters. Twenty patients (80%) had a good outcome on the modified Rankin scale, 4 patients (16%) had mental changes and one patient (4%) had residual neurological deficit. CONCLUSION: The ruptured one in multiple intracranial aneurysms can be suspected by its size and wall irregularity especially in the absence of localizing sign in the CT scan. High-resolution CTA and/or 3D DSA are highly helpful. These cases should be managed in specialized centers where the surgical and endovascular treatment modalities are available.

Objective In our technical note, we have presented a technique of cranioplasty for large skull defects. Methods A thin-slice computed tomography scan is performed. A model of the skull is constructed using a desktop 3-dimensional printer from the computed tomography scan. The skull model is filled with towels of soft cotton and inserted in a sterile thin plastic bag. The implant is molded intraoperatively on the skull model under sterile conditions. After surgical exposure of the skull defect, the implant is inserted and fixed using miniplates and miniscrews. The technique was used in 6 patients and described in 2 representative cases. Results The required time and cost are significantly lower than those for other techniques used for preoperative manufacture of implants. No technique-related complications occurred. The radiological and cosmetic results were satisfactory. In the present case series, no early or delayed complications occurred. Conclusion The presented technique is simple, safe, and time- and cost-effective. The technique and results are reproducible.

Background Spontaneous obliteration of cerebral arteriovenous malformations is uncommon but could occur after partial embolization. Methods A retrospective study of 140 patients that underwent embolization for cerebral AVMs from 2005 to August 2019 using liquid embolic agents. The angiographic outcome of patients was classified as regard complete embolization, partial embolization, and complete obliteration after partial embolization. The parameters studied included size, location, number of arterial feeders, number of draining veins, rupture status, embolic agent, and patient factors as well. Results The study patients included 74 (53%) females and 66 (47%) males. Their age ranged from 7 to 43 years old. One hundred and eight patients (77%) presented with hemorrhage. The AVM grades were grade II in 57 (40.7%) patients and grade III in 56 (39.3%) patients. Sixty-one (43.57%) patients were treated by n-Butyl Cyanoacrylate and 71 (50.71%) patients were treated with Onyx, and both materials were used together in 8 cases. Follow-up angiography was done from 6 to 36 months after embolization. The rate of complete occlusion in all patients was 61.43% (86 patients). There were three groups of patients, the first group had complete occlusion of the nidus at the time of embolization and included 68 (48.57%) patients. The second group had partial embolization with partial occlusion of the nidus 54 patients (38.57%). The 3rd group included 18 patients (12.85%) with complete nidal occlusion on follow up after partial embolization. The delay in the venous drainage of the AVM to the late arterial phase or early venous phase with flow stasis was a significant predictor of future obliteration on follow up after partial embolization. Other significant parameters that were associated with the progressive disappearance of the AVM nidus on follow up after partial embolization are presentation with hemorrhage, AVMs size less than 3 cm, the presence of single draining or double draining veins, superficial venous drainage, and one or 2 arterial feeders. Conclusion Spontaneous closure of intracranial arteriovenous malformations after partial embolization may be encountered in cases of stasis of flow during embolization procedure with a delay of the venous drainage. A long-term follow-up of more cases over many years is required to confirm the validity of this conclusion.

Cropping systems are relatively more important for testing soybean genotypes under Egyptian conditions. A field experiment was carried out at the Agricultural Experiments and Research Station, Faculty of Agriculture, Cairo University, Giza, Egypt, during the 2016 and 2017 seasons to evaluate the productivity of thirty soybean genotypes collected from four countries in intercropping with corn. Intercropping two soybean ridges alternating with another two of corn (2:2) was used in a split plot distributed in randomized complete block design. Intercropping and solid systems were randomly assigned to the main plots, and the soybean genotypes were allocated in sub-plots. All over the genotypes, intercropping caused significant increases in maturity date, root length, and plant height; meanwhile, the reverse was true for each of total leaf chlorophyll content, numbers of branches and pods, as well as seed yield per plant. Soybean genotypes Giza 111, C1, Woodworth, C34, Hill, Hutcheson, and Holladay gave higher seed yield than the others. Allover cropping systems, soybean genotypes Giza 111, Woodworth, Hutcheson, and C1 had higher seed yield than the others under intercropping. A significant positive correlation was detected between pod number and seed yield under cropping systems. Early maturing genotypes under intercropping were correlated positively with a higher yield of plants, as well as relative values. Determinate soybean variety Woodworth was matured under intercropping and solid planting at the same time. Soybean genotypes Woodworth, C1, C34, Giza 35, Giza 82, and Giza 111 were tolerant than the others to intercropping. The six soybean genotypes offer useful genetic materials for soybean breeding programs to improve yield under intercropping.

Background We investigated the added value of combining information from direction-encoded color (DEC) maps with high-resolution structural magnetic resonance imaging scans (T1-weighted images [T1WIs]) to improve the identification of regions of interest (ROIs) for fiber tracking during preoperative planning for patients with brain tumors. Methods The dataset included 42 patients with gliomas and 10 healthy subjects from the Human Connectome Project. For identification of the ROIs, we combined the structural information from high-resolution T1WIs and the directional information from DEC maps. To test our hypothesis, we examined the interrater and intrarater agreement. Results We identified specific ROIs to extract the main white matter bundles. The directional information from the DEC maps combined with the T1WIs (T1WI–DEC maps) had significantly facilitated ROI identification in patients with brain tumors, especially patients in whom the tracts had been displaced by the mass effect of the tumor. Fiber tracking using the combined T1WI–DEC maps showed significantly greater inter- and intrarater agreement compared with using either T1WI or DEC maps alone. Conclusion Combining the information from diffusion-derived color-encoded maps with high-resolution anatomical details from structural imaging (T1WI–DEC map), especially in patients with brain tumors, could be useful for accurate identification of the ROIs.

Objective In this study we present the nature and characteristic of the fluctuation of blood oxygen level–dependent (BOLD) signals measured from brain tumors. Methods Supratentorial astrocytomas, which were neither operated nor previously managed with chemotherapy or radiotherapy, were segmented, and the time series of the BOLD signal fluctuations were extracted. The mean (across patients) power spectra were plotted for the different World Health Organization tumor grades. One-way analysis of variance (ANOVA) was performed to identify significant differences between the power spectra of different tumor grades. Results were considered significant at P Results A total of 58 patients were included in the study. This group of patients included 1 patient with grade I glioma; 15 with grade II; 12 with grade III; and 30 with grade IV. The power spectra of the tumor time series were individually inspected, and all tumors exhibited high peaks at the lower frequency signals, but these were more pronounced in high-grade tumors. ANOVA showed a significant difference in power spectra between groups (P = 0.000). Post hoc analysis with Bonferroni correction showed a significant difference between grade II and grade III (P = 0.012) and grade IV (P = 0.000). There was no significant power spectra difference between grade III and IV tumors (P = 1). Conclusions The power spectra of BOLD signals from tumor tissue showed fluctuations in the low-frequency signals and were significantly correlated with tumor grade. These signals could have a misleading effect when analyzing resting state functional magnetic resonance imaging and could be also viewed as a potential method of tumor characterization.

Objective Measuring functional connectivity (FC) and resting state networks (RSNs) using resting state functional magnetic resonance imaging is a method of preoperative planning in patients with brain tumors. However, the baseline FC and RSNs are altered in patients with brain tumors. In this study, we examined changes in inter-network FC in patients with brain tumors. Methods We performed region of interest (ROI) analysis of FC in 34 patients with supratentorial gliomas and 14 healthy subjects. We performed bivariate correlation analyses at the level of each subject. Resulting correlations were Fischer Z-transformed. The used nodes included 132 ROIs from the automated anatomical labeling atlas in addition to 32 ROIs representing the different functional brain networks. We investigated second-level effects by contrasting dummy encoded covariates representing the effects of group membership on functional connectivity. The significant 2-sided P value with corrected false discovery rate was set to 0.05. We set the t contrast between the group of patients with brain tumors and the group of healthy subjects to detect the effects of tumors on inter-network connectivity. Results Overall, the inter-network FC was significantly higher in patients with brain tumors compared with healthy subjects. The anterior and posterior cerebellar networks, as well as the supratentorial network, showed significantly higher connectivity in patients with brain tumors than in healthy subjects. Conclusion Although brain tumors affect the FC and RSNs, the current study showed higher baseline inter-network connectivity in patients with brain tumors, which could indicate an intrinsic neural compensatory mechanism.

Egyptian medicinal and aromatic plants (MAPs) sector suffers from poor drying conditions of the product in terms of quality and safety standards, lack of professional advisory services, in addition to a high undeveloped value chain. Four designs were established in this study and focused on different methods for chamomile drying, the results of the 8/9/2 (B) design of the solar-assisted stack dryer were a masterpiece and promising for drying chamomile plant. The results of volatile oil extraction showed that an increased yield of volatile oil extraction by 30 % compared with traditional drying methods (control). GC-MS analysis indicated the essential oil chemical composition for the new drying method, were found to be the main active compound Bisabolol oxide A which were 54% in 8/9/2 (B) design of the solar- assisted stack dryer compared with the control which was 38.36% in control. The study method was promising and distinctive because it increases the yield of volatile oil extraction, maintains chemical structure compared with the control.

Background: Broomrape (Orobanche crenata Forsk.) is a major biotic stress of faba bean and affects the yield adversely. The impact of intercropping to curb the spread and progress of parasite was tested by using two faba bean cultivars under heavily soil infested conditions of broomrape. The present study was aimed to evaluate intercropping of fenugreek, flax, garlic or radish with two faba bean cultivars on broomrape incidence to increase faba bean yield, land usage and economic return in heavy soil infestation of broomrape.Methods: This study was carried out at Giza Agricultural Research Station (Lat. 30°00′30″ N, Long. 31°12′43″ E, 26 m a.s.l), Agricultural Research Center, Giza, Egypt.During winter seasons of 2017/2018 and 2018/2019, the treatments were the combinations of two faba bean cultivars (Nubaria 1 and Nubaria 2) and four intercrops (fenugreek, flax, garlic and radish), as well as sole plantings of all the tested crops under heavily infestation of broomrape were tested in field conditions. A split-plot design with three replicates was used. Faba bean cultivars were assigned in the main plots and intercropping and sole plantings of faba bean were arranged in sub plots.Result: Results showed that Nubaria 2 had two mechanisms to broomrape offensive, mainly including cell wall build-up and stamping of vascular tissues. It also had higher soil oxalic and ascorbic acid concentrations than Nubaria 1. Sole Nubaria 1 rhizosphere had higher soil formic acid whereas, fenugreek + Nubaria 2 had higher soil oxalic, ascorbic and salicylic acids concentrations in faba bean rhizosphere. Lower number of spikes per m2 and their dry weight per m2 were obtained by radish + Nubaria 2 followed by flax + Nubaria 2. Radish + Nubaria 2 recorded higher land equivalent ratio and economic return followed by flax + Nubaria 2. Growing one row of radish or flax between two rows of Nubaria 2 in ridges 60 cm width could be an integrated control strategy to increase faba bean productivity, land usage and economic return under heavily soil infested with broomrape.

Background In this study, we evaluated the changes in resting-state networks (RSNs) under anesthesia in neurosurgical patients. Methods RSNs were analyzed in 12 patients with pituitary adenoma presented by chiasma compression operated via standard transsphenoidal approach under propofol anesthesia before and after tumor resection. All the patients had suprasellar tumor extension with compression of the optic chiasma. We investigated second-level effects by contrasting dummy-encoded covariates representing the effects of the sessions (first vs. second) on RSNs. We corrected for multiple comparisons using a false discovery rate of 0.05 (2-sided). Results Connectivity between the right and left precentral gyri (motor network) decreased significantly from the first to the second session (P = 0.0002), as did the connectivity between the postcentral gyri (P = 0.009). The same was valid for connectivity between the visual cortices (P = 0.0002). The salience network showed a significant decrease in the connectivity of the anterior part of the cingulate gyrus and insular cortex (P = 0.0001). The default mode network showed a decrease in the connectivity between the posterior part of the cingulate gyrus, parietal, and frontal cortices (P = 0.0002). There was no significant correlation between the reduction in connectivity and dose or duration of anesthesia. Conclusions Different RSNs could be identified under anesthesia and used for intraoperative brain mapping and remapping during tumor resection. However, RSNs showed a significant decrease in connectivity with the continuation of anesthesia.

Background Purpose: Vein of Galen aneurysmal malformations (VGAM) may carry life-threatening and catastrophic sequelae in children. Their clinical presentations are differently variable between cardiac and cerebral syndromes. There may be a possible relationship between the Galenic angioarchitecture and the clinical presentation. We aimed to study the effect of the venous outflow impairment on the incidence of high-flow heart failure and the incidence of hydrocephalus. Materials and Methods: The angiographies of 21 patients with true VGAM have been studied. MR angiography, 3-dimensional CT angiogram (3D CTA), and conventional digital subtraction angiography were performed for all patients with true VGAM. Transarterial embolization was done in 1 or more sessions for all cases. Results: Among the 21 cases, 14 cases were mural type, 5 cases were choroidal type, and 2 cases were mixed. Hydrocephalus was observed more in infants (92.3%), mural types (92.9%), giant and supergiant (87.5%) aneurysms, and in cases with persistent limbic circle (90.91%). All cases of hydrocephalus were associated with significant stenosis (>70%) of the Falcine sinus draining system (100%). Conclusion: Significant stenosis (>70%) of the draining sinus is a significant factor for VGAM aneurysmal enlargement and occurrence of hydrocephalus. Probably, venous outflow impairment decreases the incidence of high-flow heart failure and increases the incidence of hydrocephalus.

Although ventriculoperitoneal shunt (VPS) is the most common procedure performed by pediatric neurosurgeons, it is still associated with frustrating complications, most common of which are obstruction and infection. Traumatic occipital artery pseudoaneurysm is a very rare complication of VPS procedure. To the best of our knowledge, there is no similar case reported in the English language literature. A 12-month-old patient suffered posthemorrhagic hydrocephalus of prematurity, and multiple other complications due to extreme prematurity, including immature lung disease, retinopathy of prematurity, necrotizing enterocolitis, bowel perforation, short bowel syndrome resulting in total parenteral nutrition-dependence, and hydrocephalus which was treated by insertion of VPS. Four weeks after the shunt, a slowly enlarging pulsatile swelling distal to the valve under the catheter altering the shunt function was noted. The swelling was diagnosed as a pseudoaneurysm of the occipital artery and treated by excision of the aneurysm. The child developed isolated dilated fourth ventricle, which was treated by endoscopic fourth ventriculostomy. Traumatic occipital artery pseudoaneurysm as a result of tunneling of VPS catheter is a very rare complication of VPS. Clinical and radiological imaging is diagnostic of the aneurysm. Surgical repair should be considered in such cases. This case report is aimed to raise the awareness among physicians about this rare complication.