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ABSTRACT: The form of fat supplements, degree of saturation, and the fatty acid (FA) profile influence cows' production response. The objective was to determine the effects of supplemental fats in the form of calcium salts (CS) of FA (CSFA) with different ratios between palmitic (PA) and oleic (OA) acids on nutrient digestibility and cow performance. Forty-two dairy cows were assigned to 3 groups and fed (for 13 wk) rations that contained 2.2% CSFA (on a DM basis) with increasing PA-to-OA ratios as follows: (1) CS45:35, 45% PA and 35% OA; (2) CS60:30, 60% PA and 30% OA; and (3) CS70:20, 70% PA and 20% OA. Rumen and fecal samples were taken for VFA and digestibility measurements, respectively. Increasing the PA-to-OA ratio linearly decreased the milk and ECM yields, whereas a quadratic effect was observed for milk fat concentration (3.55%, 3.94%, and 3.87% in the CS45:35, CS60:30, and CS70:20 groups, respectively) and fat yield. Dry matter intake was highest in the CS60:30 group (33.7 kg/d) and lowest in the CS70:20 group (31.6 kg/d), and a tendency of quadratic effect was observed for calculated energy balance with no difference in BW gain among the groups. The milk-to-DMI ratio was decreased, and the ratio of ECM-to-DMI tended to decrease when the PA-to-OA ratio increased. The highest apparent total-tract digestibilities of DM, OM, and protein were observed in the CS60:30 cows, and NDF tended to decrease with increasing PA-to-OA ratio; however, digestibility of the total FA and FA subgroups (16- and 18-carbon FA) were not different among groups. Across treatments, the 18-carbon FA digestibility was higher than the 16-carbon FA digestibility. Under the current study conditions, the CS60:30 cows had the highest fat concentration and fat yield; energy output in milk; DMI; and digestibility of DM, OM, and protein. However, further research is required to fine tune the optimal FA ratio in supplemental fat sources to maximize production and efficiency under various conditions, such as production level, stage of lactation, and diet composition.

Abstract Well-documented sleep datasets from healthy adults are important for sleep pattern analysis and comparison with a wide range of neuropsychiatric disorders. Currently, available sleep datasets from healthy adults are acquired using low-density arrays with a minimum of four electrodes in a typical sleep montage. The low spatial resolution is thus prohibitive for the analysis of the spatial structure of sleep. Here we introduce an open-access sleep dataset from 29 healthy adults (13 female, aged 32.17 ± 6.30 years) acquired at the Montreal Neurological Institute. The dataset includes overnight polysomnograms with high-density scalp electroencephalograms incorporating 83 electrodes, electrocardiogram, electromyogram, electrooculogram, and an average of electrode positions using manual co-registrations and sleep scoring annotations. Data characteristics and group-level analysis of sleep properties were assessed. The database can be accessed through ( https://doi.org/10.17605/OSF.IO/R26FH ). This is the first high-density electroencephalogram open sleep database from healthy adults, allowing researchers to investigate sleep physiology at high spatial resolution. We expect that this database will serve as a valuable resource for studying sleep physiology and for benchmarking sleep pathology.

Abstract Objective Corticosteroids and adrenocorticotropic hormone (ACTH) are the therapy of choice to treat infantile spasms. However, systematic studies about their use in other types of childhood epilepsies remain rare and ACTH can have serious side effects. This study compares the interictal epileptic activity (IEA) burden (% of electroencephalography (EEG) time with IEDs) in children with genetic drug‐resistant epilepsy before and after a standardized treatment with pulsatile corticoid therapy (PCT). Methods Children with drug‐resistant epilepsy underwent a standardized protocol for PCT with cycles of high‐dose dexamethasone (20 mg/m2 body surface) intravenously. Patients were hospitalized for 3 days per PCT cycle and EEGs were obtained before initiation of treatment (baseline) and during the hospitalization around the time of every second cycle. EEG recordings during sleep and wakefulness were obtained. IEA burden was compared before and after PCT. Secondary outcome measures included the sleep spindle rate, the seizure frequency and subjective evaluation in a standardized interview. Results In the cohort of 24 children (10 female, 6.2 ± 3.4 years), IEA burden was lower in the EEG after PCT compared to the baseline (baseline: 5.4% [0.7–97.3] vs. after PCT: 1.5% [0–96.9], p = 0.001, d = −0.41). Sleep physiology expressed by sleep spindles improved after PCT with enhanced fast spindle rates (0.8/min [0–2.2] vs. 1.5/min [0.2–3.4], p = 0.045, d = 0.36). Seizure frequency was decreased in 17 of the 24 patients (70.8%) with one patient achieving seizure freedom. The majority of patients improved in quality of life (79.2%), and sleep (81.3%). No serious adverse effects were documented. Significance This study systematically assessed the effect of PCT in children with genetic / suspected genetic drug‐resistant epilepsy. PCT was found to not only reduce the IEA burden but also increase sleep spindle rates, which are important for cognitive functioning. Plain Language Summary In this study, children with a form of epilepsy, which is resistant against antiseizure medication, received a systematic treatment with corticosteroids over multiple cycles in the hospital. It was found that not only the epileptic activity was reduced but also the sleep of the patients was improved after the treatment. These findings could provide the basis for extending the use of corticosteroids in children with epilepsy.

Abstract Stereo-electroencephalography (SEEG) is the gold standard to delineate surgical targets in focal drug-resistant epilepsy. SEEG uses electrodes placed directly into the brain to identify the seizure-onset zone (SOZ). However, its major constraint is limited brain coverage, potentially leading to misidentification of the ‘true’ SOZ. Here, we propose a framework to assess adequate SEEG sampling by coupling epileptic biomarkers with their spatial distribution and measuring the system’s response to a perturbation of this coupling. We demonstrate that the system’s response is strongest in well-sampled patients when virtually removing the measured SOZ. We then introduce the spatial perturbation map, a tool that enables qualitative assessment of the implantation coverage. Probability modelling reveals a higher likelihood of well-implanted SOZs in seizure-free patients or non-seizure free patients with incomplete SOZ resections, compared to non-seizure-free patients with complete resections. This highlights the framework’s value in sparing patients from unsuccessful surgeries resulting from poor SEEG coverage.

Summary: Background: Spinal degenerative disease represents a growing burden on our healthcare system, yet little is known about longitudinal trends in access and care. Our goal was to provide an essential portrait of surgical volume trends for degenerative spinal pathologies within Canada. Methods: The Canadian Institute for Health Information (CIHI) database was used to identify all patients receiving surgery for a degenerative spinal condition from 2006 to 2019. Trends in number of interventions, unscheduled vs scheduled hospitalizations, in-hours vs out-of-hours interventions, resource utilization and adverse events were analyzed retrospectively using linear regression models. Confidence intervals were reported in the expected count ratio scale (CR). Findings: A total of 338,629 spinal interventions and 256,360 hospitalizations between 2006 and 2019 were analyzed. The mean and SD of the annual mean age of patients was 55.5 (SD 1.6) for elective hospitalizations and 55.6 (SD 1.6) for emergent hospitalizations. The proportion of female patients was 47.8% (91,789/192,027) for elective hospitalizations and 41.4% (26,633/64,333) for emergent hospitalizations. Elective hospitalizations increased an average of 2.0% per year, with CR = 1.020 (95% CI 1.017–1.023, p

Abstract Background During the COVID-19 pandemic swift implementation of research cohorts was key. While many studies focused exclusively on infected individuals, population based cohorts are essential for the follow-up of SARS-CoV-2 impact on public health. Here we present the CON-VINCE cohort, estimate the point and period prevalence of the SARS-CoV-2 infection, reflect on the spread within the Luxembourgish population, examine immune responses to SARS-CoV-2 infection and vaccination, and ascertain the impact of the pandemic on population psychological wellbeing at a nationwide level. Methods A representative sample of the adult Luxembourgish population was enrolled. The cohort was followed-up for twelve months. SARS-CoV-2 RT-qPCR and serology were conducted at each sampling visit. The surveys included detailed epidemiological, clinical, socio-economic, and psychological data. Results One thousand eight hundred sixty-five individuals were followed over seven visits (April 2020—June 2021) with the final weighted period prevalence of SARS-CoV-2 infection of 15%. The participants had similar risks of being infected regardless of their gender, age, employment status and education level. Vaccination increased the chances of IgG-S positivity in infected individuals. Depression, anxiety, loneliness and stress levels increased at a point of study when there were strict containment measures, returning to baseline afterwards. Conclusion The data collected in CON-VINCE study allowed obtaining insights into the infection spread in Luxembourg, immunity build-up and the impact of the pandemic on psychological wellbeing of the population. Moreover, the study holds great translational potential, as samples stored at the biobank, together with self-reported questionnaire information, can be exploited in further research. Trial registration Trial registration number: NCT04379297, 10 April 2020.

Abstract Objective The use of electrical source imaging (ESI) in assessing the source of interictal epileptic discharges (IEDs) is gaining increasing popularity in presurgical work‐up of patients with drug‐resistant focal epilepsy. While vigilance affects the ability to locate IEDs and identify the epileptogenic zone, we know little about its impact on ESI. Methods We studied overnight high‐density electroencephalography recordings in focal drug‐resistant epilepsy. IEDs were marked visually in each vigilance state, and examined in the sensor and source space. ESIs were calculated and compared between all vigilance states and the clinical ground truth. Two conditions were considered within each vigilance state, an unequalized and an equalized number of IEDs. Results The number, amplitude, and duration of IEDs were affected by the vigilance state, with N3 sleep presenting the highest number, amplitude, and duration for both conditions (P 0.05). ESI maps showed no differences in distance, quality, extent, or maxima distances compared to the clinical ground truth for both conditions (P > 0.05). Only when an absolute reference (wakefulness) was used, the channel involvement (P

BackgroundFluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) is widely used for staging high-grade lymphoma, with the time to evaluate such studies varying depending on the complexity of the case. Integrating artificial intelligence (AI) within the reporting workflow has the potential to improve quality and efficiency. The aims of the present study were to evaluate the influence of an integrated research prototype segmentation tool implemented within diagnostic PET/CT reading software on the speed and quality of reporting with variable levels of experience, and to assess the effect of the AI-assisted workflow on reader confidence and whether this tool influenced reporting behaviour.MethodsNine blinded reporters (three trainees, three junior consultants and three senior consultants) from three UK centres participated in a two-part reader study. A total of 15 lymphoma staging PET/CT scans were evaluated twice: first, using a standard PET/CT reporting workflow; then, after a 6-week gap, with AI assistance incorporating pre-segmentation of disease sites within the reading software. An even split of PET/CT segmentations with gold standard (GS), false-positive (FP) over-contour or false-negative (FN) under-contour were provided. The read duration was calculated using file logs, while the report quality was independently assessed by two radiologists with >15 years of experience. Confidence in AI assistance and identification of disease was assessed via online questionnaires for each case.ResultsThere was a significant decrease in time between non-AI and AI-assisted reads (median 15.0 vs. 13.3 min, p

IntroductionFollowing a traumatic spinal cord injury (SCI) it is critical to document the level and severity of injury. Neurological recovery occurs dynamically after injury and a baseline neurological exam offers a snapshot of the patient's impairment at that time. Understanding when this exam occurs in the recovery process is crucial for discussing prognosis and acute clinical trial enrollment. The objectives of this study were to: (1) describe the trajectory of motor recovery in persons with acute cervical SCI in the first 14 days post-injury; and (2) evaluate if the timing of the baseline neurological assessment in the first 14 days impacts the amount of motor recovery observed.MethodsData were obtained from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) site in Vancouver and additional neurological data was extracted from medical charts. Participants with a cervical injury (C1–T1) who had a minimum of three exams (including a baseline and discharge exam) were included. Data on the upper-extremity motor score (UEMS), total motor score (TMS) and American Spinal Injury Association (ASIA) Impairment Scale (AIS) were included. A linear mixed-effect model with additional variables (AIS, level of injury, UEMS, time, time2, and TMS) was used to explore the pattern and amount of motor recovery over time.ResultsTrajectories of motor recovery in the first 14 days post-injury showed significant improvements in both TMS and UEMS for participants with AIS B, C, and D injuries, but was not different for high (C1–4) vs. low (C5–T1) cervical injuries or AIS A injuries. The timing of the baseline neurological examination significantly impacted the amount of motor recovery in participants with AIS B, C, and D injuries.DiscussionTiming of baseline neurological exams was significantly associated with the amount of motor recovery in cervical AIS B, C, and D injuries. Studies examining changes in neurological recovery should consider stratifying by severity and timing of the baseline exam to reduce bias amongst study cohorts. Future studies should validate these estimates for cervical AIS B, C, and D injuries to see if they can serve as an “adjustment factor” to control for differences in the timing of the baseline neurological exam.

ABSTRACT: The form of a lipid supplement, its degree of saturation, and its fatty acid (FA) profile greatly influence digestibility and cow productive response. The objective in this study was to examine the effect of fat supplements that differ in their form or FA profile on nutrient digestibility and cow performance. Forty-two mid-lactation cows (128 ± 53 d) were assigned to 3 treatment groups according to milk yield, days in milk, and body weight. For 13 wk, the cows were fed rations that contained (on a dry matter basis) (1) 2.4% of calcium salts of fatty acids (CSFA) consisting of 45% palmitic acid (PA) and 35% oleic acid (OA; CS45:35); (2) 2.4% of CSFA consisting of 80% PA and 10% OA (CS80:10); or (3) 2.0% of free FA consisting of 80% PA and 10% OA (FF80:10). Rumen samples were taken to measure the ammonia and volatile FA concentrations, and fecal samples were taken to measure the digestibility. Preplanned comparisons were CS45:35 versus CS80:10 to assess 2 CSFA supplements with different FA profiles, and CS80:10 versus FF80:10 to assess similar FA profiles in different forms. Compared with CS45:35, CS80:10 decreased the milk yields, increased the fat percentage, and tended to increase the energy-corrected milk (ECM) yields. The fat percentage of milk was highest in the FF80:10 cows (4.02%), intermediate in the CS80:10 cows (3.89%), and lowest in the CS45:35 cows (3.75%). Compared with CS80:10, FF80:10 increased milk yields (50.1 vs. 49.4 kg/d, respectively), tended to increase fat percentage, and increased 4% fat-corrected milk (4% FCM; 49.1 vs. 47.7 kg/d, respectively) and ECM yields (49.5 vs. 48.2 kg/d, respectively). Treatment had no effect on dry matter intake (DMI), and compared with CS80:10 cows, the calculated energy balance was lower in the FF80:10 cows. The 4% FCM/DMI and ECM/DMI ratios were higher in the FF80:10 group compared with the CS80:10 group. Compared with the CS80:10 cows, the FF80:10 cows had a lower rumen pH, higher propionate, lower acetate/propionate ratio, and higher total VFA. Compared with CS45:35 cows, the apparent total-tract digestibilities of neutral detergent fiber and acid detergent fiber were higher in CS80:10 cows; whereas, the apparent total-tract digestibilities of dry matter, organic matter, protein, neutral detergent fiber, and acid detergent fiber were higher in the CS80:10 cows compared with the FF80:10 cows. Compared with the CS80:10 group, the apparent digestibility of total FA was 13.0 percentage points lower in the FF80:10 cows (79.1 vs. 66.1%, respectively), and similarly, the digestibilities of 16-carbon and 18-carbon FA were lower in the FF80:10 cows than in the CS80:10 cows. In conclusion, the form, more than the FA profile of fat supplements, influenced digestibility. Further, the CSFA supplements were more digestible than the free fatty acids, regardless of the FA profile. However, energy partitioning toward production appeared to be higher in the FF80:10 cows, although the digestibility of nutrients was lower than in the CSFA product with a similar FA profile.

IntroductionAdapting fertilizer use is crucial if smallholder agroecosystems are to attain the sustainable development goals of zero hunger and agroecosystem resilience. Poor soil health and nutrient variability characterize the smallholder farming systems. However, the current research at the field scale does not account for nutrient variability across landscape positions, posing significant challenges for targeted nutrient management interventions. The purpose of this research was to create a demand-driven and co-development approach for diagnosing farmer nutrient management practices and determining landscape-specific (hillslope, mid-slope, and foot slope) fertilizer applications for teff and wheat.MethodA landscape segmentation approach was aimed to address gaps in farm-scale nutrient management research as well as the limitations of blanket recommendations to meet local nutrient requirements. This approach incorporates the concept of interconnected socio-technical systems as well as the concepts and procedures of co-development. A smart mobile app was used by extension agents to generate crop-specific decision rules at the landscape scale and forward the specific fertilizer applications to target farmers through SMS messages or print formats.Results and discussionThe findings reveal that farmers apply more fertilizer to hillslopes and less to mid- and foot slopes. However, landscape-specific fertilizer application guided by crop-specific decision rules via mobile applications resulted in much higher yield improvements, 23% and 56% at foot slopes and 21% and 6.5% at mid slopes for wheat and teff, respectively. The optimized net benefit per hectare increase over the current extension recommendation was $176 and $333 at foot slopes and $159 and $64 at mid slopes for wheat and teff (average of $90 and $107 for wheat and teff), respectively. The results of the net benefit-to-cost ratio (BCR) demonstrated that applying landscape-targeted fertilizer resulted in an optimum return on investment ($10.0 net profit per $1.0 investment) while also enhancing nutrient use efficiency across the three landscape positions. Farmers are now cognizant of the need to reduce fertilizer rates on hillslopes while increasing them on parcels at mid- and foot-slope landscapes, which have higher responses and profits. As a result, applying digital advisory to optimize landscape-targeted fertilizer management gives agronomic, economic, and environmental benefits. The outcomes results of the innovation also contribute to overcoming site-specific yield gaps and low nutrient use efficiency, they have the potential to be scaled if complementing innovations and scaling factors are integrated.

Abstract Background Headache is among the most common comorbidities in epilepsy. This study examined the distribution of different primary headache disorders in a large cohort of patients with diagnosed epilepsy. Headache types were analysed with regard to gender, type of epilepsy and antiepileptic drugs (AEDs). Methods In this prospective single-centre study, 500 patients with epilepsy (250 female, mean age: 45.52 ± 17.26 years) were evaluated with regards to primary headache types using a validated German headache questionnaire categorizing for migraine (MIG), tension-type headache (TTH) or trigeminal autonomic cephalalgias (TAC), their combinations and unclassifiable headache. Data regarding type of epilepsy, seizure-associated headache, AED treatment and seizure freedom were collected. Results Of 500 patients with epilepsy, 163 (32.6%) patients (108 female and 55 male) reported suffering from headaches at least 1 day per month. MIG (without aura, with aura) and TTH were the most frequent headache type (MIG 33.1%, TTH 33.1%). Female epilepsy patients reported headaches significantly more often than male patients (x 2 = 8.20, p = 0.0042). In contrast, the type of epilepsy did not significantly affect headache distribution. Of 163 patients with headache, 66 (40.5%) patients reported seizure-associated headache and AEDs were used by 157 patients. Of importance, patients with AED monotherapy suffered from MIG less often when compared to patients on polytherapy (x 2 = 4.79, p = 0.028). Conclusion MIG and TTH are the most common headache types in epilepsy patients and headache is more frequent among female epilepsy patients. Monotherapy in AEDs might have a beneficial effect on the frequency of headache compared to polytherapy.

Abstract Sleep spindles are the hallmark of N2 sleep and are attributed a key role in cognition. Little is known about the impact of epilepsy on sleep oscillations underlying sleep-related functions. This study assessed changes in the global spindle rate in patients with epilepsy, analysed the distribution of spindles in relation to the epileptic focus, and performed correlations with neurocognitive function. Twenty-one patients with drug-resistant focal epilepsy (12 females; mean age 32.6 ± 10.7 years [mean ± SD]) and 12 healthy controls (3 females; 24.5 ± 3.3 years) underwent combined whole-night high-density electroencephalography and polysomnography. Global spindle rates during N2 were lower in epilepsy patients compared to controls (mean = 5.78/min ± 0.72 vs. 6.49/min ± 0.71, p = 0.02, d = − 0.70). Within epilepsy patients, spindle rates were lower in the region of the epileptic focus compared to the contralateral region (median = 4.77/min [range 2.53–6.18] vs. 5.26/min [2.53–6.56], p = 0.02, rank biserial correlation RC = − 0.57). This decrease was driven by fast spindles (12–16 Hz) (1.50/min [0.62–4.08] vs. 1.65/min [0.51–4.28], p = 0.002, RC = − 0.76). The focal reduction in spindles was negatively correlated with two scales of attention (r = − 0.54, p = 0.01; r = − 0.51, p = 0.025). Patients with focal epilepsy show a reduction in global and local spindle rates dependent on the region of the epileptic focus. This may play a role in impaired cognitive functioning. Future work will show if the local reduction in spindles can be used as potential marker of the epileptic focus.

In sheep, ~30% of fetuses do not survive till parturition, and 17.7% of the multifetal pregnancies experience partial litter loss (PLL). In humans, multifetal pregnancies are associated with a higher risk of perinatal mortality. Therefore, the objectives were to examine the association between partial litter loss, fetal sex, dam's metabolic and physiological state, and pregnancy outcome in multifetal pregnant ewes. The study includes two parts. The first was a retrospective study, in which we analyzed data of 675 lambings and examined the PLL incidence according to male ratio (MR) for all litter sizes (range 2-6). Lambings were categorized as having a low male ratio (LMR; 50% males). In the second part, we monitored 24 ewes from 80 to 138 days in pregnancy every 10 days, and then daily until lambing, by ultrasound scanning for maternal heart rate (HR), and Doppler ultrasound for litter vitality. Blood samples were taken from dams on the days of scanning. Male ratio strongly affected PLL, where the general survival rate (for all lambings) was reduced from 90% in LMR lambings to 85% in HMR lambings. The odds ratio for PLL in HMR vs. LMR litters was 1.82. Birth body weight and the survival rate of female was higher in LMR than HMR lambings, with no differences for male lambs in both parameters. In the second part, dams' HR during the last trimester was 9.4% higher in LMR than in HMR pregnancies, with no differences in fetuses' HR. The plasma glucose and insulin concentrations were not significantly different between groups, but plasma β-hydroxybutyrate and nonesterified fatty acid concentrations were, respectively, 31% and 20% lower in HMR vs. LMR ewes. In conclusion, male fetuses negatively affect pregnancy outcomes and influence dams' metabolic and physiological state in sheep.

Objectives: We aimed to identify patient specific characteristics associated with a favourable telehealth experience in patients undergoing outpatient spine consultation. Methods: We enrolled consecutive patients undergoing telehealth spine consultation during the initial months of the COVID 19 pandemic. We used an online, patient reported survey that collected demographic and disease specific information, as well as validated patient reported outcome measures. Survey items also assessed patients’ perspective of their telehealth experience. We performed univariate analysis to assess for any relationship between patient satisfaction and demographic and disease specific factors, and also collected qualitative responses regarding telehealth. Results: 170 unique responses were collected. 35.8% of patients were satisfied with telehealth. When stratified into satisfied (n = 61) and unsatisfied (n = 109), female patients were exclusively unsatisfied with their experience (100% unsatisfied vs male patients 30% unsatisfied, p

Abstract Hepatic steatosis is strongly associated with chronic liver disease and systemic metabolic disorder. Adipose lipolysis is a recognized principal source of intrahepatic fat in various metabolic disorders, including non-alcoholic fatty liver disease. We hypothesized that, in the premorbid state, hepatic de novo lipogenesis (DNL) driven by excess carbohydrates abundance might play a more significant role. We employed a novel nutritional model in sheep of two distinct carbohydrates abundances. During 4 months of the dietary treatment, lambs were monitored for metabolic and terminal liver parameters. Lambs grown on the high-calorie (HC) diet were consistently more hyperglycemic and hyperinsulinemic than lambs grown on the lower-calorie (LC) diet (P

Abstract Background This prospective study was conducted between January 2015 and June 2018 and included 50 patients (mean age of 52.12 ± 2.0 years), all presented with acute pancreatitis and admitted to the ICU 1–3 days after the onset. All patients underwent contrast-enhanced CT, and images are evaluated by 2 independent radiologists for the modified CTSI parameters and retroperitoneal extension parameters to detect the severity of pancreatitis. The aim of this study is to compare the results of the modified CT severity index and retroperitoneal interfascial extension CT grading system in the grading of the severity of acute pancreatitis and compare both grading systems to the clinical course of the disease and its complications. Results Both grading systems show a statistical significant correlation in terms of the length of hospital stay, the need for interventions, and the development of organ failure. Conclusion In conclusion, a good correlation was observed between the modified CTSI and retroperitoneal extension grading systems in grading the severity of acute pancreatitis. We think that we can apply Ishikawa et al. grading system as a prognostic indicator if there is a contraindication to contrast administration.

Abstract Background Causes of encephalopathy in neonates/pediatrics include hypoxic-ischemic injury (which is the most frequent cause and is defined as any impairment to the brain caused by insufficient blood flow and oxygenation), trauma, metabolic disorders, and congenital and infectious diseases. The aim of this study is to evaluate the value of MRI in detection and possible differentiation of different non-traumatic, non-infectious causes of acute neonatal/pediatric encephalopathy among NICU/PICU patients. Results This retrospective study included 60 selected patients according to the study inclusion and exclusion criteria; all presented with positive MRI findings for non-traumatic, non-infectious acute brain injury. Females (32, 53.3%) were affected more than males (28, 46.7%) with a mean age of 1.1 ± 1.02 years; all presented with variable neurological symptoms and signs that necessitate neonatal intensive care unit/pediatric intensive care unit (NICU/PICU) admission. The final diagnosis of the study group patients were hypoxic ischemia injury (HII) in 39 patients (65%), metachromatic leukodystrophy in 6 patients (10%), biotin-thiamine-responsive basal ganglia disease (BTBGD) and Leigh disease each in 4 patients (6.7%), periventricular leukomalacia (PVL) in 3 patients (5%), and mitochondrial encephalopathy with lactic acidosis and stroke-like episodes syndrome (MELAS) and non-ketotic hyperglycinemia (NKH) each in 2 patients (3.3%). Conclusion Much attention should be paid to pediatric non-traumatic brain injuries. MRI is a safe modality and should be the first radiological investigation if neurological causes are suggested but should be aided by meticulous clinical evaluation and dedicated laboratory investigations for better characterization and differentiation of various causes of non-traumatic, non-infective brain encephalopathy among NICU/PICU patients. When interpreting MRI, it is essential to have thorough relevant clinical data, gestational age at birth which is prognostic of the pattern of hypoxic-ischemic injury, and the time lag between the onset of HII and the time of performing the MR study.

Abstract Background Classifications of intra-articular masses are infectious granulomatous diseases, non-infectious synovial proliferative processes (synovial chondromatosis, lipoma arborescens, rheumatoid arthritis, pigmented villonodular synovitis [PVNS]), vascular malformations, deposition disorders, neoplastic, and miscellaneous conditions. The aim of this study is to correlate the results of MRI with arthroscopy in characterization of different varieties of intra-articular synovial masses and mass-like lesions. This observational prospective study was conducted between February 2018 and August 2019. We screened 1000 routine musculoskeletal MRI examination during this period, 32 of which showed intra-articular synovial masses/mass-like lesions. The selected 32 patients (20 males and 12 females) have a mean age of 49.20 ± 2.0 years; all presented with joint swelling, pain, or difficulty of movement according to the joint affected. All patients underwent arthroscopy for histopathological correlation. Results The final diagnosis was synovial chondromatosis in 14 patients (43.8%), PVNS in ten patients (31.3%), and lipoma arborescens in five patients (15.6%). Synovial chondrosarcoma, synovial hematoma, and synovial ganglion cyst each in one patient (3.1%). The concordance of MRI to arthroscopy was 96.6% accuracy, 91.7% sensitivity, 99% specificity, 52.3% PPV, and 99.9% NPV. Conclusion Good correlation was observed between MRI and arthroscopy in diagnosis of intra-articular synovial masses/mass-like lesions.

Multiple lineages of SARS-CoV-2 have been identified featuring distinct sets of genetic changes that confer to the virus higher transmissibility and ability to evade existing immunity. The continuous evolution of SARS-CoV-2 may pose challenges for current treatment options and diagnostic tools. In this study, we have first evaluated the performance of the 14 WHO-recommended real-time reverse transcription (RT)-PCR assays currently in use for the detection of SARS-CoV-2 and found that only one assay has reduced performance against Omicron. We then developed a new duplex real-time RT-PCR assay based on the amplification of two ultra-conserved elements present within the SARS-CoV-2 genome. The new duplex assay successfully detects all of the tested SARS-CoV-2 variants of concern (including Omicron sub-lineages BA.4 and BA.5) from both clinical and wastewater samples with high sensitivity and specificity. The assay also functions as a one-step droplet digital RT-PCR assay. This new assay, in addition to clinical testing, could be adopted in surveillance programs for the routine monitoring of SARS-CoV-2’s presence in a population in wastewater samples. Positive results with our assay in conjunction with negative results from an Omicron-specific assay may provide timely indication of the emergence of a novel SARS-CoV-2 variant in a certain community and thereby aid public health interventions.

Background: Whole-genome sequencing is one of the best ways to investigate resistance mechanisms of clinical isolates as well as to detect and identify circulating multi-drug-resistant (MDR) clones or sub-clones in a given hospital setting. Methods: Here, we sequenced 37 isolates of Acinetobacter baumannii, 10 Klebsiella pneumoniae, and 5 Pseudomonas aeruginosa collected from the biobank of the hospital setting of the King Fahad Medical City. Complete phenotypic analyses were performed, including MALDI-TOF identification and antibiotic susceptibility testing. After the genome assembly of raw data, exhaustive genomic analysis was conducted including full resistome determination, genomic SNP (gSNP) analysis, and comparative genomics. Results: Almost all isolates were highly resistant to all tested antibiotics, including carbapenems and colistin. Resistome analysis revealed many antibiotic resistance genes, including those with resistance to β-lactams, aminoglycosides, macrolides, tetracyclines, sulfamids, quinolones, and phenicols. In A. baumannii isolates, the endemic carbapenemase blaOXA-23 gene was detected in 36 of the 37 isolates. Non-synonymous mutations in pmrB were detected in almost all of the isolates and likely mediated colistin resistance. Interestingly, while classical analyses, such as MLST, revealed the predominance of an ST2 clone in A. baumannii isolates, the genomic analysis revealed the presence of five circulating sub-clones and identified several isolate transmissions between patients. In the 10 K. pneumoniae isolates, several resistance genes were identified, and the observed carbapenem resistance was likely mediated by overexpression of the detected extended-spectrum-β-lactamase (ESBL) genes associated with low membrane permeability as few carbapenemase genes were detected with just blaOXA-48 in three isolates. Colistin resistance was mediated either by non-synonymous mutations in the MgrB regulator, PmrA, PmrB, and PhoQ proteins or the presence of the MCR-1 protein. Here, gSNP analysis also revealed the existence of bacterial clones and cases of isolate transmissions between patients. The five analyzed P. aeruginosa isolates were highly resistant to all tested antibiotics, including carbapenems mediated by loss or truncated OprD porin, and colistin resistance was associated with mutations in the genes encoding the PmrA, PmrB, or PhoQ proteins. Conclusion: We demonstrate here the usefulness of whole-genome sequencing to exhaustively investigate the dissemination of MDR isolates at the sub-clone level. Thus, we suggest implementing such an approach to monitor the emergence and spread of new clones or sub-clones, which classical molecular analyses cannot detect. Moreover, we recommend increasing the surveillance of the endemic and problematic colistin resistance mcr-1 gene to avoid extensive dissemination.

We report on reversible and continuously deformable soft micro-resonators and the control of their resonance split and directional emission. Assisted by computerized holographic-tweezers, functioning as an optical deformer of our device, we gradually deform the shape and change the functionality of a droplet whispering-gallery cavity. For example, we continuously deform hexagonal cavities to rectangular ones and demonstrate switching to directionally emitting mode-of-operation, or splitting a resonant mode to a 10-GHz separated doublet. A continuous trend of improving spatial light modulators and tweezers suggests that our method is scalable and can control the shape and functionality of many individual devices. We also demonstrate optional solidification, proving the feasibility of transformer-enabled applications, including in printing optical circuits and multiwavelength optical networks.

Instability in grain prices led to continuing worldwide growth in the proportion of fat supplements in lactating cows’ rations. However, fat supplementation was associated with decreases in feed intake, rumen fermentation, and feed digestibility. The present objectives were to test the effects of high-fat diets from calcium salts of palm oil fatty acids (CS-PFA) in lactating cow rations containing high proportions of concentrate, on feed intake, milk yields, rumen environment, and digestibility. Forty-two multiparous mid-lactation dairy cows were assigned to three treatments, designated as low fat (LF), moderate fat (MF), and high fat (HF) that contained (on DM basis), respectively, (i) 4.7% total fat with 1.7% CS-PFA, (ii) 5.8% total fat with 2.8% CS-PFA, and (iii) 6.8% total fat with 3.9% CS-PFA. Rumen samples were collected for pH, ammonia, and volatile fatty acid (VFA) measurements, and fecal grab samples were collected for digestibility measurements. A numerical trend of decreasing dry matter intake with increasing CS-PFA in diet was observed: 28.7, 28.5, and 28.1 kg/day in LF, MF, and HF, respectively (p < 0.20). No differences between treatments were observed in milk yields and milk-fat percentages, but protein percentage in milk tended to fall with increasing dietary CS-PFA content (p < 0.08), which resulted in 6.4% smaller protein yields in the HF than in the LF group (p < 0.01). Milk urea nitrogen was 15.3% higher in HF than in LF cows (p < 0.05). Rumen pH was higher at all sampling times in the MF and HF than in the LF cows. Concentrations of propionic acid and total VFA were higher in LF than in MF and HF cows. The apparent total-tract digestibility of dry matter was higher with LF than with HF (p < 0.002), and that of organic matter was lowest with the HF diet (p < 0.005). The apparent NDF digestibility declined with increasing dietary fat content, and it was 8.5 percentage points lower in HF than in LF cows (p < 0.009). Apparent fat digestibility increased with increasing dietary fat content, and it was higher by 10.4 percentage points in the HF than in the LF group (p < 0.004). In conclusion, diets with high concentrate-to-forage ratios, containing up to 6.8% total fat and 3.9% CS-PFA, negatively affected rumen fermentation and NDF digestibility in high-yielding dairy cows; however, the effects on yields were minor, indicating that, under specific circumstances, the inclusion of large amounts of CS-PFA in dairy cows’ rations with low fiber content is feasible.

Microcrystal electron diffraction (MicroED) has emerged as a powerful technique for unraveling molecular structures from microcrystals too small for X-ray diffraction. However, a significant hurdle arises with plate-like crystals that consistently orient themselves flat on the electron microscopy grid. If the normal of the plate correlates with the axes of the crystal lattice, the crystal orientations accessible for measurement are restricted because the crystal cannot be arbitrarily rotated. This limits the information that can be acquired, resulting in a missing cone of information. We recently introduced a novel crystallization strategy called suspended drop crystallization and proposed that crystals in a suspended drop could effectively address the challenge of preferred crystal orientation. Here we demonstrate the success of the suspended drop approach in eliminating the missing cone in two samples that crystallize as thin plates: bovine liver catalase and the SARS‑CoV‑2 main protease (Mpro). This innovative solution proves indispensable for crystals exhibiting systematic preferred orientations, unlocking new possibilities for structure determination by MicroED.

Quantitative analysis of complex mixtures, including compounds having similar chemical properties, is demonstrated using an automatic and high throughput approach to microcrystal electron diffraction (MicroED). Compositional analysis of organic and inorganic compounds can be accurately executed without the need of diffraction standards. Additionally, with sufficient statistics, small amounts of compounds in mixtures can be reliably detected. These compounds can be distinguished by their crystal structure properties prior to structure solution. In addition, if the crystals are of good quality, the crystal structures can be generated on the fly, providing a complete analysis of the sample. MicroED is an effective method for analyzing the structural properties of sub-micron crystals, which are frequently found in small-molecule powders. By developing and using an automatic and high throughput approach to MicroED, and with the use of SerialEM for data collection, data from thousands of crystals allow sufficient statistics to detect even small amounts of compounds reliably.