First microscopic, pathological, epidemiological, and molecular investigation of Leucocytozoon (Apicomplexa: Haemosporida) parasites in Egyptian pigeons.

Introduction: Leucocytozoon is an intracellular blood parasite that affects various bird species globally and is transmitted by blackfly vectors. This parasite is responsible for leucocytozoonosis, a disease that results in significant economic losses due to reduced meat and egg production. There is limited knowledge about the epidemiological pattern of leucocytozoonosis and its causative species in Egypt, particularly in pigeons. Methods: The current study involved the collection of 203 blood samples from domestic pigeons from various household breeders and local markets across Qena Province, Upper Egypt. Samples were initially examined for potential Leucocytozoon infection using blood smears, followed by an evaluation of associated risk factors. Molecular identification of the parasite in selected samples (n = 11), which had initially tested positive via blood smears, was further refined through nested PCR and sequence analysis of the mitochondrial cytochrome b gene to ascertain the Leucocytozoon species present. Additionally, histopathological examination of the liver, spleen, and pancreas was conducted on animals that tested positive by blood smears. Results: Interestingly, 26 out of 203 samples (12.08%) had confirmed Leucocytozoon infections based on microscopic analysis. Additionally, all 11 samples that initially tested positive via blood smears were confirmed positive through nested PCR analysis, and their sequencing revealed the presence of Leucocytozoon sabrazesi, marking the first report of this parasite in Egypt. The study into potential risk factors unveiled the prevalence of Leucocytozoon spp. seems host gender-dependent, with males exhibiting a significantly higher infection rate (33.33%). Additionally, adult birds demonstrated a significantly higher infection prevalence than squabs, suggesting an age-dependent trend in prevalence. Seasonality played a significant role, with the highest occurrence observed during summer (37.25%). Histopathological examination revealed the presence of numerous megaloschizonts accompanied by lymphocytic infiltration and multiple focal areas of ischemic necrosis. Conclusion: To our knowledge, this is the first study to shed light on the epidemiological characteristics and molecular characterization of leucocytozoonosis in pigeons in Egypt. Further research endeavors are warranted to curb the resurgence of Leucocytozoon parasites in other avian species across Egypt, thereby refining the epidemiological understanding of the disease for more effective control and prevention measures.

Cloning and catalytic profile of Hyalomma dromedarii leucine aminopeptidase.

Ticks have harmful impacts on both human and animal health and cause considerable economic losses. Leucine aminopeptidase enzymes (LAP) play important roles during tick infestation to liberate vital amino acids necessary for growth. The aim of the current study is to identify, express and characterize the LAP from the hard tick Hyalomma dromedarii and elucidate its biochemical characteristics. We cloned an open reading frame of 1560 bp encoding a protein of 519 amino acids. The LAP full-length was expressed in Escherichia coli BL21 (DE3) and purified. The recombinant enzyme (H.d rLAP- 6×His) had a predicted molecular mass of approximately 55 kDa. Purification and the enzymatic characteristics of H.d rLAP- 6×His were studied. The purified enzyme showed maximum activity at 37 °C and pH 8.0-8.5 using Leu-p-nitroanilide as a substrate. The activity of H.d rLAP- 6×His was sensitive to ß-mercaptoethanol, dl-dithiothreitol, 1,10- phenanthroline, bestatin HCl, and EDTA and completely abolished by 0.05 % SDS. In parallel, the enzymatic activity was enhanced by Ni2+, Mn2+ and Mg2+, partially inhibited by Na+, Cu2+, Ca2+ and completely inhibited by Zn2+.

Mast Cells in the Microenvironment of Hepatocellular Carcinoma Confer Favorable Prognosis: A Retrospective Study using QuPath Image Analysis Software.

The insights provided by in-situ detection of immune cells within hepatocellular carcinoma (HCC) might present information on patient outcomes. Studies investigating the expression and localization of immune cells within tumor tissues are associated with several challenges, including a lack of precise annotation for tumor regions and random selection of microscopic fields of view. QuPath is an open-source, user-friendly software that could meet the growing need for digital pathology in whole-slide image (WSI) analysis. The infiltration of HCC and adjacent tissues by CD1a+ immature dendritic cells (iDCs), CD117+ mast cells, and NKp46+ natural killer cells (NKs) cells was assessed immunohistochemically in representative specimens of 67 patients with HCC who underwent curative resection. The area fraction (AF) of positively stained cells was assessed automatically in WSIs using QuPath in the tumor center (TC), inner margin (IM), outer margin (OM), and peritumor (PT) area. The prognostic significance of immune cells was evaluated for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS). The AF of mast cells was significantly greater than the AF of NKs, and the AF of iDCs was significantly lower compared to NKs in each region of interest. High AFs of mast cells in the IM and PT areas were associated with longer DFS. In addition, high AF of mast cells in IM was associated with longer OS. Computer-assisted analysis using this software is a suitable tool for obtaining prognostic information for tumor-infiltrating immune cells (iDCs, mast cells, and NKs) in different regions of HCC after resection. Mast cells displayed the greatest AF in all regions of interest (ROIs). Mast cells in the peritumor region and IM showed a positive prognostic significance.

A parasitic patch loaded staircase shaped UWB MIMO antenna having notch band for WBAN applications.

A staircase-shaped quasi-fractal antenna is presented to meet the requirements of compact electronics operating in UWB or E-UWB spectrum. A conventional broadband monopole antenna is converted into UWB antenna utilizing three iterations of fractal patches. The resultant antenna offers wide impedance bandwidth ranges 2.3-17.8 GHz, having a notch band at 6.1-7.2 GHz. Afterwards, a two-port MIMO antenna is created by placing the second element orthogonally with an edge-to-edge distance of 8.5 mm, that is λ/15 where λ corresponds to free space wavelength at the lowest cut-off frequency. Hereafter, a meandered line-shaped stub is inserted to reduce the mutual coupling between closely spaced MIMO elements to less than -25 dB. As the intended application of the proposed work is On-body, Specific Absorption Rate (SAR) analyses are carried out at 2.4, 5.8 and 8 GHz, showing an acceptable range for both 1-g and 10-g averaged tissues standards. Moreover, various parameters of the MIMO antenna are studied, and a comparison is made between simulated and measured results as well as those of the state of the art.

Prognostic role of macrophages and mast cells in the microenvironment of hepatocellular carcinoma after resection.

BACKGROUND: The prognostic significance of mast cells and different phenotypes of macrophages in the microenvironment of hepatocellular carcinoma (HCC) following resection is unclear. We aimed in this study to assess the local distribution of infiltrating macrophages and mast cells of specific phenotypes in tissues of HCC and to evaluate their prognostic values for survival of post-surgical patients. METHODS: The clinicopathological and follow-up data of 70 patients with HCC, who underwent curative resection of tumor from 1997 to 2019, were collected. The infiltration of CD68+ and CD163+ macrophages and CD117+ mast cells was assessed immunohistochemically in representative resected specimens of HCC and adjacent tissues. The area fraction (AF) of positively stained cells was estimated automatically using QuPath image analysis software in several regions, such as tumor center (TC), inner margin (IM), outer margin (OM), and peritumor (PT) area. The prognostic significance of immune cells, individually and in associations, for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS) was evaluated using Kaplan-Meier and Cox regression analyses. RESULTS: High AF of CD68+ macrophages in TC and IM and high AF of mast cells in IM and PT area were associated with a longer DFS. High AF of CD163+ macrophages in PT area correlated with a shorter DFS. Patients from CD163TChigh & CD68TClow group had a shorter DFS compared to all the rest of the groups, and cases with CD163IMlow & CD68IMhigh demonstrated significantly longer DFS compared to low AF of both markers. Patients from CD68IMhigh & CD163PTlow group, CD117IMhigh & CD163PTlow group, and CD117PThigh & CD163PTlow group had a significantly longer DFS compared to all other combinations of respective cells. CONCLUSIONS: The individual prognostic impact of CD68+ and CD163+ macrophages and mast cells in the microenvironment of HCC after resection depends on their abundance and location, whereas the cumulative impact is built upon combination of different cell phenotypes within and between regions.

Development of an optical sensor for the determination of phenolic compounds in environmental samples.

A new optical sensor was developed for the rapid sensing of total phenolic content, which is simple, cheap, and sensitive, using the Eu(III)-(NTA)2-(Phen) complex [NTA = 1-(2-naphthoyl)-3,3,3-trifluoroacetone and Phen = 1,10 phenanthroline] as a luminescent probe at pH 7.5 using PIPES buffer. This method was based on luminescence quenching. The type of quenching during the reaction between the Eu(III)-(NTA)2-(Phen) complex and the phenolic compounds is dynamic quenching; the binding site is close to 1, and the reaction is endothermic, spontaneous, and involves hydrophobic attraction forces. The calibration curves were plotted using a sigmoidal fit giving an LOD of 0.01 µg mL-1, and the correlation coefficients are more than 0.99. For the first time, the time-resolved fluorescence technique was utilized in microtiter plates to enable the determination of 96 samples within two minutes with high sensitivity and selectivity. The proposed method was applied to three industrial wastewater samples and compared with the standard method for phenolic content determination, yielding high recoveries. This is the first luminescence method based on lanthanide complexes as probes for determining the total phenolic content in water samples.

Enhancing isolation performance of tilted Beam MIMO antenna for short-range millimeter wave applications.

The research paper discusses the detailed designing of a compact, simple, and low-profile antenna that provides several desirable features. The antenna is engineered by using a substrate material called Roger 6002, and its dimensions are 12 mm × 6 mm × 1.52 mm. The single antenna element achieves a wideband frequency coverage of 24-30.2 GHz and a high gain of 9 dBi. To enhance the antenna's capabilities, a two-port multiple-input multiple-output (MIMO) configuration is employed by adding a second antenna element orthogonal to the first one. Although the operational band remains the same, the isolation between the two elements is found to be unsatisfactory. A C-shaped decoupling structure is established to address this issue, which effectively improves the isolation. Including the parasitic patch enhances the isolation from -18 dB to -29 dB. An antenna hardware sample is built and tested to validate the recommended work, and the outcomes are compared to the predicted results obtained from the software. The experimental and simulated data exhibit close agreement, confirming the accuracy of the design. Additionally, this outstanding performance in bandwidth and isolation compares with existing literature, presented in the form of a table. Various MIMO parameters are also examined, and it is found that they fall within acceptable ranges. The antenna demonstrates an Envelope Correlation Coefficient (ECC) of approximately 0.005 and a Diversity Gain (DG) of around 9.99 dB. The recommended antenna design is highly suitable for future miniature devices used in Internet of Things (IoT) applications.

Ab initio insight into the physical properties of MgXH3 (X = Co, Cu, Ni) lead-free perovskite for hydrogen storage application.

Renewable energy systems are vital for a sustainable future, where solid-state hydrogen storage can play a crucial role. Perovskite hydride materials have attracted the scientific community for hydrogen storage applications. The current work focuses on the theoretical study using density functional theory (DFT) to evaluate the characteristics of MgXH3 (X = Co, Cu, Ni) hydrides. The structural, vibrational, electronic, mechanical, thermodynamic, and hydrogen storage properties of these hydrides were investigated. The equilibrium lattice parameters were calculated using the Birch-Murnaghan equation of state-to-energy volume curves. The elastic constants (Cij) and relevant parameters, such as Born criteria, were calculated to confirm the mechanical stability of the hydrides. The Cauchy pressure (Cp) revealed brittle or ductile behavior. The outcomes of the Pugh ratio, Poisson ratio, and anisotropy were also calculated and discussed. The absence of negative lattice vibrational frequencies in phonon dispersion confirmed the lattice's dynamic stability. The heat capacity curves of thermodynamic properties revealed that hydrides can conduct thermal energy. The metallic character and ample interatomic distances of hydrides were confirmed by the band structure and population analysis, which confirmed that hydrides can conduct electrical energy and adsorb hydrogen. The density of state (DOS) and partial DOS unveiled the role of specific atoms in the DOS of the crystal. The calculated gravimetric hydrogen storage capacity of MgCoH3, MgCuH3, and MgNiH3 hydrides was 3.64, 3.32, and 3.49wt%, respectively. Our results provide a deeper understanding of its potential for hydrogen storage applications through a detailed analysis of MgXH3 (X = Co, Cu, Ni) perovskite hydride material.

Comparative assessment of homemade ELISA and lateral flow assay (LFA)in the rapid, specific and sensitive detection of SARS-CoV-2 anti-nucleocapsid protein in sera of Egyptian patients.

Several diagnostic measures have been employed to precisely detect the SARS-CoV-2 viral infection using viral antigens, nucleic acids, and other serological approaches. The sensitivity and specificity of the serological tests remain a challenging need. Here, we describe the detection of human anti-SARS-CoV-2 IgG and IgM antibodies qualitatively through two optimized in-house ELISA and lateral flow immunoassay. Both approaches are based on the prokaryotic expression of 50 kDa SARS-CoV-2 recombinant nucleocapsid protein. This SARS-CoV-2rN-6×His was used either to coat ELISA plates or to be conjugated to gold nanoparticles followed by colorimetric detection of bound human IgG or IgM. In the LFA, we show the optimization of nanoparticle size, protein-binding capacity, membrane treatment, and finally testing the potential capacity of using either the optimized ELISA or LFA in detecting antibodies raised against viral infection. Assessment of both methods was carried out using human sera-positive and negative SARS-CoV-2 antibodies. The ELISA and LFA tests showed 86%, 96.5% sensitivity, 92%, 93.75% specificity, 97%, 98.2% PPV, and 64%, 88.2% NPV, respectively. In conclusion, both approaches were able to successfully detect human antibodies against SARS-CoV-2 nucleocapsid protein. The importance of both protocols cannot be overstated in the detection and diagnosis of viral infections, especially in developing countries.

The role of miRNAs in the pathogenesis and therapeutic resistance of endometrial cancer: a spotlight on the convergence of signaling pathways.

Endometrial cancer (EC) is the 2nd common cancer in females after breast cancer. Besides, it's the most common among gynecological cancers. Several epigenetic factors such as miRNAs have been reported to affect EC aspects including initiation, progression, angiogenesis, and resistance to therapy. miRNAs could regulate the expression of various genes involved in EC pathogenesis. This effect is attributed to miRNAs' effects in proliferation, apoptosis, cell cycle, angiogenesis, invasion, and metastasis. miRNAs also influence crucial EC-related mechanistic pathways such as JAK/STAT axis, EGFR, TGF-ß signaling, and P53. Beside pathogenesis, miRNAs also have the potential to affect EC response to treatments including radio and chemotherapy. Thus, this review aims to illustrate the link between miRNAs and EC; focusing on the effects of miRNAs on EC signaling pathways.

Bilateral Persistent Placoid Maculopathy Following COVID-19 Vaccines: Real or Coincidence?

COVID-19 vaccinations have been accompanied by reports of inflammatory uveitis. Herein, we report the first case of bilateral persistent placoid maculopathy (PPM) following COVID-19 vaccinations in a previously healthy 58-year-old man who presented with bilateral decrease in vision approximately 2 weeks after the second dose of AstraZenaca® ChAdOx1-S/nCoV-19 vaccine. Fundus examination revealed bilateral well-delineated whitish plaque-like macular lesions involving the fovea. Clinical and multimodal imaging findings were suggestive of PPM. Infective and autoimmune screen were all negative except for a raised MPO-ANCA. Medical review excluded systemic autoimmune and infectious diseases. Patient was monitored closely and his visual acuity improved and stabilised after a tapering regime of oral prednisolone. Mycophenolate mofetil was given as long-term steroid sparing immunosuppression. Our case demonstrated a likely localised autoimmune inflammatory response to the COVID-19 vaccine affecting choriocapillaris. Further research is needed to clarify the association between COVID-19 vaccines and inflammatory placoid lesions of the retina.

Metamaterials and Their Application in the Performance Enhancement of Reconfigurable Antennas: A Review.

Metamaterials exhibit properties in terms of subwavelength operation or phase manipulation, among others, that can be used in a variety of applications in 5G communication systems. The future and current 5G devices demand high efficiency, high data rate, computational capabilities, cost-effectiveness, compact size, and low power consumption. This variation and advancement are possible when the antenna design is revised to operate over wideband, high gain, and multiband and has characteristics of compact size, reconfiguration, absorption, and simple ease of fabrication. The materials loaded with antennas or, in the same cases, without antennas, offer the aforementioned characteristics to bring advancement in order to facilitate users. A number of works on designing metasurfaces capable of improving bandwidth, gain efficiency, and reducing the size and cost of antennas are available in the literature for this purpose. Not only are these applications possible, but the intelligent metasurfaces are also designed to obtain reconfiguration in terms of frequency and polarization. The number of absorbers loaded with metamaterials is also designed to improve the absorption percentage used for radar applications. Thus, in this paper, the general overview of different types of metamaterials and their role in performance enhancement and application in 5G and 6G communication systems is discussed.

A Low-Profile Antenna for On-Body and Off-Body Applications in the Lower and Upper ISM and WLAN Bands.

The article presents a Co-planar Waveguide (CPW) fed antenna of a low-profile, simple geometry, and compact size operating at the dual band for ISM and WLAN applications for 5G communication devices. The antenna has a small size of 30 mm × 18 mm × 0.79 mm and is realized using Rogers RT/Duroid 5880 substrate. The proposed dual-band antenna contains a CPW feedline along with the triangular patch. Later on, various stubs are loaded to obtain optimal results. The proposed antenna offers a dual band at 2.4 and 5.4 GHz while covering the impedance bandwidths of 2.25-2.8 GHz for ISM and 5.45-5.65 GHz for WLAN applications, respectively. The proposed antenna design is studied and analyzed using the Electromagnetic (EM) High-Frequency Structure Simulator (HFSSv9) tool, and a hardware prototype is fabricated to verify the simulated results. As the antenna is intended for on-body applications, therefore, Specific Absorption Rate (SAR) analysis is carried out to investigate the Electromagnetic effects of the antenna on the human body. Moreover, a comparison between the proposed dual-band antenna and other relevant works in the literature is presented. The results and comparison of the proposed work with other literary works validate that the proposed dual-band antenna is suitable for future 5G devices working in Industrial, Scientific, Medical (ISM), and Wireless Local Area Network (WLAN) bands.

A Shorted Stub Loaded UWB Flexible Antenna for Small IoT Devices.

In this manuscript, a compact in size yet geometrically simple Ultra-Wideband (UWB) antenna is demonstrated. The flexible-by-nature substrate ROGERS 5880, having a thickness of 0.254 mm, is utilized to design the proposed work. The antenna configuration is an excerpt of a traditional rectangular monopole antenna resonating at 5 GHz. Initially, a pair of triangular slots are employed to extend the impedance bandwidth of the antenna. In addition, a semi-circular-shaped, short-ended stub is connected at the upper edges of the patch to further increase the operational bandwidth. After optimization, the proposed antenna offers UWB ranging from 2.73-9.68 GHz, covering almost the entire spectrum allocated globally for UWB applications. Further, the antenna offers a compact size of 15 × 20 mm2 that can easily be integrated into small, flexible electronics. The flexibility analysis is done by bending the antenna on both the x and y axes. The antenna offers performance stability in terms of return loss, radiation pattern, and gain for both conformal and non-conformal conditions. Furthermore, the strong comparison between simulated and measured results for both rigid and bent cases of the antenna, along with the performance comparison with the state-of-the-art, makes it a potential candidate for present and future compact-sized flexible devices.

Activated Hepatic Stellate Cells in Hepatocellular Carcinoma: Their Role as a Potential Target for Future Therapies.

Hepatocellular carcinoma (HCC) is a global healthcare challenge, which affects more than 815,000 new cases every year. Activated hepatic stellate cells (aHSCs) remain the principal cells that drive HCC onset and growth. aHSCs suppress the anti-tumor immune response through interaction with different immune cells. They also increase the deposition of the extracellular matrix proteins, challenging the reversion of fibrosis and increasing HCC growth and metastasis. Therapy for HCC was reported to activate HSCs, which could explain the low efficacy of current treatments. Conversely, recent studies aimed at the deactivation of HSCs show that they have been able to inhibit HCC growth. In this review article, we discuss the role of aHSCs in HCC pathophysiology and therapy. Finally, we provide suggestions for the experimental implementation of HSCs in HCC therapies.

Electronically reconfigurable and conformal triband antenna for wireless communications systems and portable devices.

This paper presents the design of a triband antenna that can be electronically configured to operate at different frequencies. The proposed antenna is design to operate at sub-6GHz bands at 2.45 GHz (ISM, Wi-Fi, and WLAN), 3.3, 3.5 & 3.9 GHz (WiMAX), and 4.1 & 4.9 GHz (4G & 5G). This is achieved by connecting two open-ended stubs to a modified triangular patch radiator using PIN diodes. The antenna's performance was optimized using a 3D electromagnetic solver and its performance was verified through measurements. Moreover, the conformal analysis done on the antenna shows that the proposed technique can be used in moderately flexible wireless devices without compromising the antenna's gain, radiation efficiency and radiation patterns. These characteristics makes the proposed antenna applicable for various wireless communication systems and devices.

Psychometric evaluation of the depression anxiety stress scale 8-items (DASS-8)/DASS-12/DASS-21 among family caregivers of patients with dementia.

Patients with dementia express a set of problematic and deteriorating symptoms, along with self-care dependency. Over time, the mental health of family caregivers of persons with dementia may be affected, putting them at a high risk for psychopathology, which may be associated with endangered wellbeing of people with dementia. This cross-sectional instrumental design study examined the psychometric properties of the Depression Anxiety Stress Scale 8-items (DASS-8), DASS-12, and DASS-21 in a convenient sample of 571 caregivers from northern Italy and southern Switzerland (mean age = 53 years, SD = 12, range = 24-89 years). A bifactor structure of the three measures had the best fit; some items of the DASS-12/DASS-21 failed to load on their domain-specific factors. The three-factor structure was invariant across various groups (e.g., gender and education), expressed adequate reliability and convergent validity, and had strong positive correlation with the three-item UCLA Loneliness Scale (UCLALS3). Distress scores did not differ among carers of different types of dementia (Alzheimer's disease vs. other types, e.g., vascular dementia). However, distress scores were significantly high among female individuals, adult children caregivers, those caring for dependent patients, and those who received help with care. For 54.9 and 38.8% of the latter, care was provided by relatives and health professionals, respectively. Since the DASS-8 expresses adequate psychometrics comparable with the DASS-21, it may be used as a brief measure of distress in this population.

Isolation Improvement of Parasitic Element-Loaded Dual-Band MIMO Antenna for Mm-Wave Applications.

A dual-band, compact, high-gain, simple geometry, wideband antenna for 5G millimeter-wave applications at 28 and 38 GHz is proposed in this paper. Initially, an antenna operating over dual bands of 28 and 38 GHz was designed. Later, a four-port Multiple Input Multiple Output (MIMO) antenna was developed for the same dual-band applications for high data rates, low latency, and improved capacity for 5G communication devices. To bring down mutual coupling between antenna elements, a parasitic element of simple geometry was loaded between the MIMO elements. After the insertion of the parasitic element, the isolation of the antenna improved by 25 dB. The suggested creation was designed using a Rogers/Duroid RT-5870 laminate with a thickness of 0.79 mm. The single element proposed has an overall small size of 13 mm × 15 mm, while the MIMO configuration of the proposed work has a miniaturized size of 28 mm × 28 mm. The parasitic element-loaded MIMO antenna offers a high gain of 9.5 and 11.5 dB at resonance frequencies of 28 GHz and 38 GHz, respectively. Various MIMO parameters were also examined, and the results generated by the EM tool CST Studio Suite® and hardware prototype are presented. The parasitic element-loaded MIMO antenna offers an Envelop Correlation Coefficient (ECC) < 0.001 and Channel Capacity Loss (CCL) < 0.01 bps/Hz, which are quite good values. Moreover, a comparison with existing work in the literature is given to show the superiority of the MIMO antenna. The suggested MIMO antenna provides good results and is regarded as a solid candidate for future 5G applications according to the comparison with the state of the art, results, and discussion.

Psychometric evaluation of the Depression Anxiety Stress Scale 8 among women with chronic non-cancer pelvic pain.

Psychiatric comorbidity and abusive experiences in chronic pelvic pain (CPP) conditions may prolong disease course. This study investigated the psychometrics of the Depression Anxiety Stress Scale 8 (DASS-8) among women with CPP (N = 214, mean age = 33.3 ± 12.4 years). The DASS-8 expressed excellent fit, invariance across age groups and menopausal status, good know-group validity (differentiating women with psychiatric comorbidity from those without comorbidity: U = 2018.0, p = 0.001), discriminant validity (HTMT ratios < 0.85), excellent reliability (alpha = 0.90), adequate predictive and convergent validity indicated by strong correlation with the DASS-21 (r = 0.94) and high values of item-total correlations (r = 0.884 to 0.893). In two-step cluster analysis, the DASS-8 classified women into low- and high-distress clusters (n = 141 and 73), with significantly higher levels of distress, pain severity and duration, and physical symptoms in cluster 2. The DASS-8 positively correlated with pain severity/duration, subjective symptoms of depression/anxiety, experiences of sexual assault, fatigue, headache severity, and collateral physical symptoms (e.g., dizziness, bloating, fatigue etc.) at the same level expressed by the parent scale and the DASS-12, or even greater. Accordingly, distress may represent a target for early identification of psychiatric comorbidity, CPP severity, experiences of sexual assault, and collateral physical complaints. Therefore, the DASS-8 is a useful brief measure, which may detect mental distress symptoms among women with CPP.

Rare presentation of central retinal vein occlusion sparing the superotemporal quadrant in a patient with congenital cardiovascular disease.

A young Asian man with a diagnosis of complex congenital heart disease and visceral situs inversus presented to the eye casualty with a recent onset of blurred vision in his left eye. Funduscopic examination of the left eye showed the presence of intraretinal haemorrhages in the inferior and superonasal quadrants, sparing the superotemporal arcade. Optical coherence tomography showed presence of macular oedema and fundus fluorescein angiography confirmed the diagnosis of central retinal vein occlusion sparing the superotemporal branch. Intravitreal antivascular endothelial growth factor treatment was administered, with favourable anatomic and functional outcomes. The presentation of an incomplete central retinal vein occlusion is extremely unusual, especially in a patient with significant cardiac malformation. With the current advances in interventional cardiac procedures, more patients are having longer lifespan and are presenting to ophthalmologists with ocular consequences of circulatory disorders, emphasising the need for multidisciplinary management.