PRESenting a Challenge: Posterior Reversible Encephalopathy Syndrome in Pediatric Patients With Guillain-Barré Syndrome: A Case Series and Review of Literature.

BACKGROUND: Guillain-Barré syndrome (GBS) is an autoimmune disorder characterized by demyelination of peripheral nerves. GBS-associated posterior reversible encephalopathy syndrome (PRES) is a rare and potentially life-threatening complication in the pediatric population. We aimed to report and analyze the clinical features, management, and outcomes of three cases of GBS-associated PRES in our setting in the light of the existing literature. METHODS: Medical records of 75 pediatric patients with GBS were reviewed for autonomic changes and GBS-associated PRES. Thirty-one developed dysautonomia while three were identified to have PRES. Clinical, radiological, laboratory, and treatment data were collected and analyzed. RESULTS: All three patients were male and presented with symptoms of acute flaccid paralysis and respiratory distress requiring mechanical ventilation. All three patients experienced various complications, including hypertension, seizures, and hyponatremia, and were subsequently diagnosed with PRES. Multimodal intensive care resulted in patient improvement and discharge in an ambulatory state after an average of 104 days of care. CONCLUSIONS: GBS-associated PRES is a rare and potentially life-threatening complication that can occur in pediatric patients with GBS. Our findings suggest that early recognition, prompt intervention, and multimodal intensive care can improve patient outcomes. Further studies are needed to determine optimal treatment strategies for GBS-associated PRES.

Mimics of Guillain-Barré Syndrome in Pediatric Patients Admitted to the Neuro-Intensive Care Unit of a Tertiary Care Hospital-A Case Series.

Guillain-Barré syndrome is the most common cause of acute flaccid paralysis in children, but several diseases mimic GBS. We aimed to identify and report the clinical pointers and battery of tests required to differentiate Guillain-Barré syndrome from its observed mimics in the pediatric population admitted to our neuro-critical care unit. We conducted a retrospective record analysis of all pediatric patients admitted over ten years from 2008-2018, whose initial presentation was compatible with a clinical diagnosis of GBS. Eighty-three patients were at first treated as GBS, of which seven (8.4%) were found to have an alternate diagnosis-three cases of paralytic rabies, one case each of acute disseminated encephalomyelitis, cervical myeloradiculopathy, neuromyelitis optica, and a case of community-acquired Staphylococcus aureus pneumonia associated sepsis. Neurophysiological and neuro-virological testing, central nervous system imaging, and sepsis screening helped to confirm the alternate diagnosis. Our case series provides knowledge of subtle clinical differences along with the mindful use of diagnostic testing to facilitate the accurate diagnosis of GBS mimics.

Expanding the spectrum on brain-heart interactions in cerebellopontine angle surgeries.

Lesions at the cerebellopontine angle (CP angle) are associated with various brain-heart interactions, which can include those from stimulation of the fifth cranial nerve along the scalp incision in a retrosigmoid suboccipital surgical approach. A 27-year-old male patient with recently diagnosed hypertension (on calcium channel blocker) underwent left CP angle lesion decompression. Transient episodes of bradycardia, hypotension, and bradypnea were observed from the skin incision onward, exacerbated during tumor manipulation. Most episodes subsided with cessation of the surgical stimulus while some required intervention. Postoperatively, blood pressure decreased below the pre-operative levels. Thus, trigeminocardiac reflex can occur as early as the skin incision even in a retrosigmoid approach due to stimulation of the mandibular division, when specific risk factors exist. Such episodes may serve as early warning signs for subsequent intraoperative occurrences. Brainstem compression can be a possible etiology of hypertension in young patients. It underscores the importance of considering brain-heart interactions in surgical interventions involving the CP angle.

Intelligent Alzheimer's Diseases Gene Association Prediction Model Using Deep Regulatory Genomic Neural Networks.

Alzheimer's disease (AD) is an illness that affects the nervous system, leading to a loss in cognitive and logical abilities. Gene regulatory expressions, which are the complex language exhibited by DNA, serve several functionalities, including the physical and biological life cycle processes in the human body. The gene expression sequence affects the pathology experienced by an individual, its longevity, and potential for a cure. The transcription factors, from DNA to RNA conversion, and the binding process determine the gene expression, which varies for every human organ and disease. This study proposes Deep convolutional neural network model that reads the gene regulatory expression sequence through various convolutional layers encoded to detect positive spikes in transcription factors. This results in the prediction of disease conversion probability from mild cognitive impairment to AD which is the key-requisite for affected geriatric cohorts.

Keratin protein nanofibers from merino wool yarn: a top-down approach for the disintegration of hierarchical wool architecture to extract α-keratin protein nanofibers.

We report the extraction of keratin nanofibers from the medulla of a parent yarn after denaturing the cuticle and cortex microstructures of a merino wool yarn. Controlled alkaline hydrolysis, followed by high-speed blending in acetic acid, allowed for the extraction of keratin protein nanofibers with an average diameter of 25 nm and a length of less than 3 µm. SEM and AFM analyses showed the removal of cuticle cells from the yarn. FT-IR and DSC analyses confirmed the hydrolysis and denaturation of the sheet protein matrix of cuticle cells. XPS analysis provided strong evidence for the gradual removal of the epicuticle, cuticle cells, and cortex of the hierarchical wool structure with an increase in alkaline hydrolysis conditions. It was confirmed that the merino wool yarn subjected to hydrolysis under alkaline conditions exposed its internal fibrillar surface. In an acetic acid medium, these fibrillar surfaces obtained a surface charge, which further supported the defibrillation of the structure into its individual nanofibrils during high-speed blending. The extracted nanostructures constitute mainly α-helical proteins. The morphology of the nanofibers is composed of a uniform circular cross-section based on the images obtained using AFM, TEM, and SEM. The extracted nanofibers were successfully fabricated into transparent sheets that can be used in several applications.

Ilmenite-derived titanic acid species: exploring their outstanding light-independent antibacterial activity.

The emergence of resistance in detrimental pathogenic bacteria towards well-recognized antibiotics has greatly impacted global medicine, consequently exploring potent antibacterial compounds is becoming a potential area of research. Although photocatalytic metal oxides have been extensively explored in this regard, their applicability is diminished due to the requirement of photon energy. Therefore, in our study, we explored the light-independent antibacterial effect of two unexplored titanium species, known as metatitanic acid (MTA) and potassium titanate, against Staphylococcus aureus, Escherichia coli, and Pseudomonas spp. using the disk diffusion method in Luria-Bertani agar medium, where the well-known antibiotic, gentamicin, was used as the positive control. These two titanium compounds were readily synthesized through a novel process which was originally developed for the extraction of TiO2 from ilmenite. The synthesized MTA was characterized using FT-IR, Raman spectroscopy, XRD, TGA, UV-visible spectroscopy, and SEM. According to our findings, both MTA and potassium titanate exhibited superior light-independent antibacterial properties, where for some concentrations, the effect was even greater than gentamicin. However, nano-TiO2 totally failed as an antibacterial compound against the tested three strains under dark conditions.

A multi-cohort genome-wide association study in African ancestry individuals reveals risk loci for primary open-angle glaucoma.

Primary open-angle glaucoma (POAG), the leading cause of irreversible blindness worldwide, disproportionately affects individuals of African ancestry. We conducted a genome-wide association study (GWAS) for POAG in 11,275 individuals of African ancestry (6,003 cases; 5,272 controls). We detected 46 risk loci associated with POAG at genome-wide significance. Replication and post-GWAS analyses, including functionally informed fine-mapping, multiple trait co-localization, and in silico validation, implicated two previously undescribed variants (rs1666698 mapping to DBF4P2; rs34957764 mapping to ROCK1P1) and one previously associated variant (rs11824032 mapping to ARHGEF12) as likely causal. For individuals of African ancestry, a polygenic risk score (PRS) for POAG from our mega-analysis (African ancestry individuals) outperformed a PRS from summary statistics of a much larger GWAS derived from European ancestry individuals. This study quantifies the genetic architecture similarities and differences between African and non-African ancestry populations for this blinding disease.

Pneumothorax in Acute Neurologically Ill COVID-19 Positive Patients: A Brief Report.

Background: Pneumothorax is reported as a complication of coronavirus disease-2019 (COVID-19). The present report describes the incidence, clinical characteristics, and outcomes of pneumothorax in acute neurologically ill COVID-19 positive patients admitted to the COVID-19 neuro-intensive care unit (CNICU). Methods: In this retrospective study, pneumothorax was identified by reviewing chest radiographs of acute neurologically ill patients with and without associated COVID-19 admitted to the CNICU and non-COVID-19 NICU, respectively, from July to November 2020. The clinico-epidemiological characteristics of acute neurologically ill COVID-19 positive patients with pneumothorax are described. Results: The incidence of pneumothorax was 17% (8/47) in acute neurologically ill COVID-19 positive patients in the CNICU and 14.6% (6/41) in patients who received mechanical ventilation (MV). In contrast, the incidence of pneumothorax in acute neurologically ill non-COVID-19 patients admitted to the NICU was 3.7% (7/188) and 0.69% (1/143) in patients receiving MV. Conclusion: In our study, the incidence of pneumothorax was higher in patients with concomitant neurological and COVID-19 diseases than in acute neurologically ill non-COVID-19 patients managed during the same period in the ICUs.

Is Light Neutralino Thermal Dark Matter in the Phenomenological Minimal Supersymmetric Standard Model Ruled Out?

We explore the parameter space of the phenomenological minimal supersymmetric standard model with a light neutralino thermal dark matter (m_{χ[over ˜]_{1}^{0}}≤m_{h}/2) that is consistent with current collider and astrophysical constraints. We consider both positive and negative values of the higgsino mass parameter (µ). Our investigation shows that the recent experimental results from the LHC as well as from direct detection searches for dark matter by the LUX-ZEPLIN Collaboration rule out the Z-funnel region for the µ>0 scenario. The same results severely restrict the h-funnel region for positive µ; however, the allowed points can be probed easily with few more days of data from the LUX-ZEPLIN experiment. In the µ<0 scenario, we find that very light higgsinos in both the Z and h funnels might survive the present constraints from the electroweakino searches at the LHC, and dedicated efforts from experimental collaborations are necessary to make conclusive statements about their present status.

Comparision of traditional and laboratory methods of sulphur processing.

BACKGROUND: Since ancient times, the essential element sulphur has played an important role in different medical fields. It is one of the main materials used in herbo-mineral pharmaceutics in Ayurveda. However, for Ayurvedic pharmaceutical preparations, the purity of sulphur is crucial in avoiding any harmful reactions and to enhance the medicinal quality. Therefore, it is subjected to a process called 'gandhaka shodhana' using cow's milk, ghee or occasionally plant extracts. The plant, Eclipta alba (L.) Hassak, containing many bioactive compounds, is one of the extracts known to be used in the 'shodhana' process of sulphur. However, in comparison to the laboratory purification method of sulphur neither the effect of this 'shodhana' process in removing impurities from sulphur nor its effect on the structure and morphology of sulphur has been evaluated. OBJECTIVES: This study identifies physical, morphological, and structural changes that occur in sulphur when it is subjected to the 'shodhana' process compared to the changes that occur in sulphur obtained after simple laboratory purification. METHODOLOGY: Both samples were characterized using Scanning Electron Microscopy, Energy Dispersive X-ray Spectroscopy, X-ray Diffraction, Differential Scanning Calorimetry, Thermogravimetric Analysis, Fourier Transform Infrared spectroscopy, and Raman spectroscopy. Observed physical changes such as colour, allotropic form, odour, hardness, transparency, and lustre of the samples were also determined using recommended techniques. RESULTS: Although the laboratory purification method separates the sulphur from physical and chemical impurities, Ayurveda 'shodhana' process with E. alba converts the sulphur into a more pharmaceutically suitable form by making it more nebulous and introducing higher brittleness, FT-IR data shows removal of chemical impurities from sulphur during 'shodhana' process in contrast to laboratory purified sample.

Biochemical, pathological and molecular characterisation of Phomopsis vexans: A causative of leaf blight and fruit rot in brinjal.

The pathogen Phomopsis vexans causes leaf blight, fruit rot, and damping off in brinjal plants, all of which are extremely detrimental. The pathogen affects host plant photosynthetic efficiency and fruit quantity and quality. An appreciation of the pathogenicity of P. vexans is essential for the effective control of infections in the field. Consequently, the goal of this study was to characterise P. vexans in terms of their biochemistry, molecular diversity, and pathogenicity. In terms of cellulase (97.7 U), catalase (12.2 U), and ascorbate peroxidase (147.3 U) activity, isolate PV1 performed best, followed by PV5 (CL-97.0 U, CAT-11.1 U and APX-144.4 U), and PV8 (CL-88.8 U, CAT-9.8 U and APX-141.9 U). In a greenhouse pathogenicity test, isolate PV1 had the highest incidence (97%) and severity (88.6%) of disease, whereas isolate PV6 showed the lowest incidence (57.2%) and severity (70%) of disease. The biochemical enzyme activity of P. vexans corresponds well with its greenhouse pathogenicity results, and its combination can be exploited to identify pathogenic P. vexans isolates. Using RAPD and ISSR primers, molecular characterisation indicated genetic diversity but could not distinguish isolates by geographical origin or pathogenicity. The pathogen P. vexans was verified by ITS1 and ITS4 molecular analysis, and the sequences were subsequently deposited in the NCBI database. In conclusion, the enzyme activity relevant to pathogenicity (CL, CAT and APX) in conjunction with the invivo pathogenicity assay might be utilised to differentiate between pathogenic (virulent) and non-pathogenic (avirulent) P. vexans isolates and develop suitable disease management strategies.

The blending effect of natural polysaccharides with nano-zirconia towards the removal of fluoride and arsenate from water.

Nano-zirconia (ZO) was synthesized using a microwave-assisted one-pot precipitation route. Two biopolymers, chitosan (CTS) and carboxymethyl cellulose were blended with ZO at different w/w ratios. The formulation with 30% w/w chitosan (ZO-CTS) was found to give enhanced uptake of F- and As(V). ZO and the most effective ZO-CTS system were characterized using Fourier transform infrared spectroscopy, scanning electron microscopy, X-ray diffraction and X-ray photoelectron spectroscopy. These confirmed the formation of a composite system containing nanoparticles of 50 nm in size, in which ZO was present in the amorphous form. It was observed that the combination of ZO with CTS improved the F- and As(V) adsorption capacity most notably at pH 5.5. Fluoride adsorption by ZO-CTS followed the Freundlich isotherm model, with an adsorption capacity of 120 mg g-1. Adsorption of As(V) by ZO-CTS could be fitted with both the Langmuir and Freundlich isotherm models and was found to have a capacity of 14.8 mg g-1. Gravity filtration studies conducted for groundwater levels indicated the effectiveness of ZO-CTS in adsorbing As(V) and F- at a pH of 5.5. The ability of the ZO-CTS in removing Cd(II) and Pb(II) was also investigated, and no such enhancement was observed, and found the neat ZO was the most potent sorbent here.

N-acetylcysteine and cysteamine bitartrate prevent azide-induced neuromuscular decompensation by restoring glutathione balance in two novel surf1-/- zebrafish deletion models of Leigh syndrome.

SURF1 deficiency (OMIM # 220110) causes Leigh syndrome (LS, OMIM # 256000), a mitochondrial disorder typified by stress-induced metabolic strokes, neurodevelopmental regression and progressive multisystem dysfunction. Here, we describe two novel surf1-/- zebrafish knockout models generated by CRISPR/Cas9 technology. While gross larval morphology, fertility, and survival into adulthood appeared unaffected, surf1-/- mutants manifested adult-onset ocular anomalies and decreased swimming activity, as well as classical biochemical hallmarks of human SURF1 disease, including reduced complex IV expression and enzymatic activity and increased tissue lactate. surf1-/- larvae also demonstrated oxidative stress and stressor hypersensitivity to the complex IV inhibitor, azide, which exacerbated their complex IV deficiency, reduced supercomplex formation, and induced acute neurodegeneration typical of LS including brain death, impaired neuromuscular responses, reduced swimming activity, and absent heartrate. Remarkably, prophylactic treatment of surf1-/- larvae with either cysteamine bitartrate or N-acetylcysteine, but not other antioxidants, significantly improved animal resiliency to stressor-induced brain death, swimming and neuromuscular dysfunction, and loss of heartbeat. Mechanistic analyses demonstrated cysteamine bitartrate pretreatment did not improve complex IV deficiency, ATP deficiency, or increased tissue lactate but did reduce oxidative stress and restore glutathione balance in surf1-/- animals. Overall, two novel surf1-/- zebrafish models recapitulate the gross neurodegenerative and biochemical hallmarks of LS, including azide stressor hypersensitivity that was associated with glutathione deficiency and ameliorated by cysteamine bitartrate or N-acetylcysteine therapy.

Using the Chick Embryo Model to Examine the Effects of Hypoxia Pre-conditioning of Uveal Melanoma Cells on Tumor Growth and Metastasis.

PURPOSE: Highly dynamic oxygen gradients occur within tumors that can result in a hypoxic response, contributing to tumor progression and metastasis. Evidence in uveal melanoma (UM) suggests an upregulated hypoxia response in some poor prognosis UM characterized by HIF1α signaling. We aimed to investigate the effects of exposure to hypoxia on tumor growth and dissemination in the chick embryo chorioallantoic membrane (CAM) model. METHODS: UM cell lines (MP41, 92.1, MP46, and OMM1) were grown in two-dimensional culture and pre-exposed to hypoxic (1% O2) conditions for 72 h. The effects of this hypoxia pre-conditioning on cell number and clonogenicity as compared with 21% O2 ("normoxia") were investigated prior to transplantation of the cells onto the CAM. Nodule-forming efficiency (NFE), nodule size, and the presence/absence of tumor cell dissemination were determined macroscopically and histologically. RESULTS: Exposure of UM cell lines to hypoxia upregulated HIF1α expression compared to cells cultured in normoxia. A 72-h pre-exposure to hypoxia significantly reduced cell number and clonogenicity in the MP41 and OMM1 cell lines while it had little effect in 92.1 and MP46 cells. When 72-h hypoxia pre-conditioned cells were grown in three-dimensions on the CAM, a reduction in NFE and nodule size was observed when compared with normoxic UM cells. All nodules were composed of proliferating (Ki-67+) Melan-A + cells and displayed chick blood vessel recruitment. Spread of UM cells into the adjacent CAM was observed; however, dissemination to the chick liver was only seen with 92.1 cells grown under normoxia. CONCLUSIONS: Hypoxia pre-conditioning does not appear to drive a metastatic phenotype in UM; however, further understanding of how oxygen dynamics within the tumor microenvironment regulates HIF1 signaling is needed to determine whether inhibitors of HIF signaling represent a therapeutic option in metastatic UM.

Normalization of low frontal regional cerebral oxygenation after evacuation of chronic subdural hematoma in a patient with bilateral internal carotid artery stenosis.

Near infrared spectroscopy (NIRS) technology is frequently used to measure regional cerebral tissue oxygen saturation (rSO2). The measurement of rSO2 has diverse range of clinical application for its easy bed-side applicability, continuous monitoring, interpretation and valuable information on cerebral oxygenation. However, it also has few technical limitations; absorption by skull tissues, presence of hematomas, and other pigments such as melanin, bilirubin can affect the rSO2 measurements and thus interfere with the accuracy of monitoring. We report a case wherein low values of frontal rSO2 normalized after evacuation of bilateral fronto-temporo-parietal (FTP) chronic subdural hematoma (CSDH) in a patient with bilateral internal carotid artery (ICA) stenosis.

MiR-4638-3p regulates transforming growth factor-ß1-induced activating transcription factor-3 and cell proliferation, invasion, and apoptosis in human breast cancer cells.

TGF-ß1 (transforming growth factor-beta1), a secreted polypeptide cytokine, stimulates ATF-3 (activating transcription factor-3) expression in a sustained and prolonged manner in human breast cancer cells (MDA-MB231), but not in normal human mammary epithelial cells (MCF-10A). Cyclin A (cell proliferation gene), Runx2 (metastasis gene), and MMP-13 (matrix metalloproteinase-13; invasive gene) were identified as ATF-3 target genes in these cells. Because ATF-3 has very few druggable sites, its direct targeting is difficult. Recent evidence has indicated that microRNAs (miRNAs) are key players in the post-transcriptional modulation of gene expression under several conditions. Bioinformatic analysis suggested a list of putative miRNAs that target ATF-3. Therefore, we hypothesized that TGF-ß1 downregulates the miRNAs that target ATF-3, resulting in the activation of genes that participate in breast cancer progression and skeletal metastasis. Our findings indicate that TGF-ß1 downregulated the expression of miR-4638-3p in MDA-MB231 cells. At the molecular level, forced expression of miR-4638-3p reduced the expression of ATF-3 and its downstream targets, Runx2 and MMP-13, in these cells. At the cellular level, overexpression of miR-4638-3p reduced proliferation, invasion, and migration, and induced G0/G1 cell cycle arrest and apoptosis in MDA-MB231 cells. Overall, this study highlights the possibility of utilizing miR-4638-3p as a therapeutic molecule to curb skeletal metastasis of breast cancer cells.

Enhancement of Release and Solubility of Curcumin from Electrospun PEO-EC-PVP Tripolymer-Based Nanofibers: A Study on the Effect of Hydrogenated Castor Oil.

This study reveals the state-of-the-art fabrication of a tripolymer-based electrospun nanofiber (NF) system to enhance the release, solubility, and transdermal penetration of curcumin (Cur) with the aid of in situ release of infused castor oil (Co). In this regard, Cur-loaded Co-infused polyethylene oxide (PEO), ethyl cellulose (EC), and polyvinyl pyrrolidone (PVP) tripolymer-based NF systems were developed to produce a hybridized transdermal skin patch. Weight percentages of 1-4% Cur and 3-10% of Co were blended with PEO-EC-PEO and PEO-EC-PVP polymer systems. The prepared NFs were characterized by SEM, TEM, FT-IR analysis, PXRD, differential scanning calorimetry (DSC), and XPS. Dialysis membranes and vertical Franz diffusion cells were used to study the in vitro drug release and transdermal penetration, respectively. The results indicated that maintaining a Cur concentration of 1-3 wt % with 3 wt % Co in both PEO-EC-Co-Cur@PEO and PEO-EC-Co-Cur@PVP gave rise to nanofibers with lowered diameters (144.83 ± 48.05-209.26 ± 41.80 nm and 190.20 ± 59.42-404.59 ± 45.31 nm). Lowered crystallinity observed from the PXRD patterns and the disappearance of exothermic peaks corresponding to the melting point of Cur suggested the formation of an amorphous NF structure. Furthermore, the XPS data revealed that the Cur loading will possibly take place at the inner interface of PEO-EC-Co-PEO and PEO-EC-Co-PVP NFs rather than on the surface. The beneficiary role of Co on the release and dermal penetration of Cur was further confirmed from the respective release data which indicated that PEO-EC-Co-Cur@PEO would lead to a rapid release (4-5 h), while PEO-EC-Co-Cur@PVP would lead to a sustained release over a period of 24 h in the presence of Co. Transdermal penetration of the released Cur was further evidenced with the development of color in the receiver compartment of the diffusion cell. DPPH results further corroborated that a sustained antioxidant activity is observed in the released Cur where the free-radical scavenging activity is intact even after subjecting to an electrospinning process and under extreme freeze-thaw conditions.

Reliability of Pre-Induction Inferior Vena Cava Assessment with Ultrasound for the Prediction of Post-Induction Hypotension in Neurosurgical Patients Undergoing Intracranial Surgery.

Background: Hypotension is one of the most common complications following induction of general anesthesia. Preemptive diagnosis and correcting the hypovolemic status can reduce the incidence of post-induction hypotension. However, an association between preoperative volume status and severity of post-induction hypotension has not been established in neurosurgical patients. We hypothesized that preoperative ultrasonographic assessment of intravascular volume status can be used to predict post-induction hypotension in neurosurgical patients. Our study objective was to establish the relationship between pre-induction maximum inferior vena cava (IVC) diameter, collapsibility index (CI), and post-induction reduction in mean arterial blood pressure in neurosurgical patients. Materials and Methods: A prospective observational study was conducted including 100 patients undergoing elective intracranial surgeries. IVC assessment was done before induction of general anesthesia. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of maximum and minimum IVC diameter (IVCDmax and IVCDmin, respectively) and CI for prediction of hypotension. Results: Post-induction hypotension was observed in 41% patients. Patients with small IVCDmax and higher CI% developed hypotension. The areas under the ROC curve (AUCs) were 0.64 (0.53-0.75) for IVCDmax and 0.69 (0.59-0.80) for IVCDmin. The optimal cutoff values were1.38 cm for IVCDmax and 0.94 cm for IVCDmin. The AUC for CI was 0.65 (0.54-0.77) and the optimal cutoff value was 37.5%. Conclusion: Pre-induction IVC assessment with ultrasound is a reliable method to predict post-induction hypotension resulting from hypovolemia in neurosurgical patients.