Periventricular hemorrhagic infarction (PVHI) associated with intraventricular hemorrhage (IVH) in premature infants: Outcome at 2 years of age.

OBJECTIVE: Neonates can develop periventricular hemorrhagic infarction (PVHI) in association with intraventricular hemorrhage (IVH). The prognosis of this condition remains under debate. The aim of this study was to compare the neurological outcome at 2 years of age for neonates who have IVH with and without PVHI. METHODS: This retrospective single-center study (2010-2017) included all neonates who had at least a grade II IVH on ultrasound (US). The population was divided into two groups: Group 1 had grade II-III IVH without PVHI and Group 2 had grade II-III IVH with PVHI. All clinical and imaging (US and magnetic resonance images) data were reviewed. Neurological sequelae were classified as either mild (favorable outcome), or moderate or severe (unfavorable outcome), based on the follow-up report at the age of 2 years. RESULTS: A total of 25 of the 46 infants meeting the inclusion criteria were excluded due to missing clinical or imaging data at diagnosis or follow-up. Of the remaining 21 infants, all were preterm and had grade II-III IVH, either with PVHI (n = 10) or without (n = 11). The neurological prognosis was unfavorable for both groups. Except for the size of the lesion, no radiological findings appeared to be significantly associated with an unfavorable prognosis. Overall, 11 of the infants died early in life; i.e., the mortality rate was 52% (n = 11/21). The deaths were not due to neurological complications of prematurity. C-section was more common in the PVHI group. CONCLUSION: PVHI does not appear to be predictive of an unfavorable outcome. Lesion size may be a predictive factor for an unfavorable prognosis in children with PVHI.

Role of fluid status markers as risk factors for suboptimal vancomycin concentration during continuous infusion in neonates: an observational study.

Vancomycin is widely used in neonatal sepsis but proportion of newborn reaching recommended concentration is variable. Fluid status impact on vancomycin level remains understudied. We aimed to study fluid factors impacting vancomycin concentration at 24 h of treatment. We performed a prospective and retrospective observational monocentric study of NICU patients requiring a vancomycin treatment. We used a continuous infusion protocol, with age-appropriate loading and maintenance doses. Vancomycin target serum concentration after 24 h (C24h) was above 20 mg/L. Demographic, infections, and organ failure variables were analyzed as potential predictors of C24h. Over the study period, 70 infective episodes in 52 patients were included. At treatment initiation, the median post-natal age was 12.5 days (IQR 7-23), post menstrual age 30 weeks (IQR 28-35), and median weight 1140 g (IQR 835-1722). Germs isolated were mainly gram-positive with 73.5% being coagulase-negative Staphylococci. Median C24h was 18.7 mg/L (IQR 15.4-22.4). Overall, 41 (58.6%) treatments had a C24h < 20 mg/L. After multivariate analysis, higher creatinine level (OR 1.03 (95% CI 1.002-1.06)) was associated with C24h ≥ 20 mg/L; weight gain the day before infection (OR 0.21 (95% CI 0.05-0.79)) and positive biomarkers of inflammation (OR 0.22 (0.05-0.94)) were associated with C24h < 20 mg/L. CONCLUSION: Vancomycin C24h was underdosed in 60% of patients and factors linked to changes in vancomycin pharmacokinetic such as volume of distribution and clearance, linked to creatinine level, inflammation, or weight gain, were identified. WHAT IS KNOWN: • Adjustment of vancomycin regimen remains difficult due to inter- and intra-individual variability of vancomycin pharmacokinetics. • Impact of fluid status on vancomycin concentration in critically ill neonates is incompletely studied. WHAT IS NEW: • Proportion of patients with adequate vancomycin concentration using a target adapted to nosocomial gram-positive bacteria MIC is low. • We confirmed the role of creatinine level and report two new factors associated with low vancomycin concentration: presence of systemic inflammation and weight gain.

COVID-19-associated spontaneous subacute subdural haematoma: report of two cases.

Since March 2020, the pandemic of coronavirus disease 2019 (COVID-19) has become a threat to global health. Several kinds of coronavirus-associated disorders, including vascular involvements with neurological symptoms, have been reported worldwide. Here, we describe two individuals with COVID-19 with no history of traumatic brain injury nor of vascular injuries, who developed spontaneous subdural haematoma in a subacute process. Both individuals became lethargic and unresponsive during admission in the intensive care unit. Both have undergone emergent craniotomy with acceptable outcome. The first patient improved significantly and was discharged a week after surgery. However, the second individual had no improvement on her consciousness and died 3 days after surgery. Haemorrhagic events, including subdural haematoma, can happen during COVID-19 infection with several possible mechanisms. Brain imaging and further neurological evaluation must be performed in any individuals with COVID-19 who show signs of alteration in their state of consciousness.

The apoptotic effects of progesterone on breast cancer (MCF-7) and human osteosarcoma (MG-636) cells.

PURPOSE: Progesterone has been reported to inhibit the proliferation of breast cancer and osteosarcoma cells; however, its inhibitory mechanism has not yet been clarified. The aim of the present study was to clarify the effects of progesterone on apoptosis in breast cancer (MCF-7) and human osteosarcoma (MG-63) cells. MATERIALS AND METHODS: In this experimental study the cytotoxic effect of progesterone was measured in MCF-7 and MG-63 cells exposed to different concentrations of progesterone using MTT assay, and effective concentrations were identified. The expression levels of the Bax, P53 and Bcl-2 genes were evaluated by real-time PCR, and caspase-3, 8 and 9 activity levels were determined using a colorimetric method. Hoechst staining and flow cytometry were used to confirm apoptosis. The data were statistically analyzed using one-way analysis of variance (ANOVA) and independent-samples t-test. RESULTS: Compared to the control group, we observed a significant increase in the expression levels of the Bax and P53 genes and the activity levels of caspase-3 and 9, and a significant decrease in the expression level of the Bcl-2 gene in MCF-7 and MG-63 treated with effective concentration of progesterone. The caspase-8 activity level did not change significantly in treated MG-63 but increased in treated MCF-7 cells. Hoechst staining and flow cytometry results confirmed apoptosis in the cells exposed to effective concentration of progesterone. CONCLUSIONS: The cytotoxic effect of progesterone on breast cancer and osteosarcoma cells was mediated by apoptotic pathways. In this context, progesterone triggers the extrinsic and intrinsic apoptotic pathways in MCF-7 cells and induces the intrinsic apoptotic pathway in MG-63 cells.

Genetic and phenotypic aspects of early reproductive performance in Raeini Cashmere goats.

This study used pedigree information and data collected from 1979 to 2012 at the Raeini Cashmere goat breeding station, located in Baft City in Kerman Province in southeastern Iran. Genetic and phenotypic parameters for early reproductive traits of breeding does, including total numbers of kids born at first kidding (LSB1), total numbers of kids weaned at first kidding (LSW1), total birth weight of all kids born at first kidding (LWB1), total weaning weight of all kids weaned at first kidding (LWW1), and age at first kidding (AFK), were estimated using a Bayesian approach via Gibbs sampling. Posterior means for heritability estimates of LSB1, LSW1, LWB1, LWW1, and AFK were statistically significant, with values of 0.12, 0.23, 0.17, 0.15, and 0.46, respectively. Low-to-moderate additive genetic variation was present for the studied reproductive traits. Estimated genetic correlations among LSB1, LSW1, LWB1, and LWW1 were statistically significant and ranged from 0.12 between LWB1 and LWW1 to 0.72 between LSB1 and LSW1. Corresponding phenotypic correlation estimates were also statistically significant and ranged from 0.04 between LWB1 and LWW1 to 0.55 between LSB1 and LSW1. Posterior means of genetic and phenotypic correlations between AFK and other studied traits were statistically significant only for LSB1 and LWB1. For LSB1, LSW1, LWB1, and LWW1, we conclude that genetic and phenotypic improvement in any of these traits in Raeini Cashmere does would favorably influence all of the other traits. However, does that first kidded at younger ages have smaller litters at birth and lower litter birth weights at their first parity.

Possibility of modifying the growth trajectory in Raeini Cashmere goat.

The objective of this study was to investigate the possibility of modifying the growth trajectory in Raeini Cashmere goat breed. In total, 13,193 records on live body weight collected from 4788 Raeini Cashmere goats were used. According to Akanke's information criterion (AIC), the sing-trait random regression model included fourth-order Legendre polynomial for direct and maternal genetic effect; maternal and individual permanent environmental effect was the best model for estimating (co)variance components. The matrices of eigenvectors for (co)variances between random regression coefficients of direct additive genetic were used to calculate eigenfunctions, and different eigenvector indices were also constructed. The obtained results showed that the first eigenvalue explained 79.90% of total genetic variance. Therefore, changing the body weights applying the first eigenfunction will be obtained rapidly. Selection based on the first eigenvector will cause favorable positive genetic gains for all body weight considered from birth to 12 months of age. For modifying the growth trajectory in Raeini Cashmere goat, the selection should be based on the second eigenfunction. The second eigenvalue accounted for 14.41% of total genetic variance for body weights that is low in comparison with genetic variance explained by the first eigenvalue. The complex patterns of genetic change in growth trajectory observed under the third and fourth eigenfunction and low amount of genetic variance explained by the third and fourth eigenvalues.

Cortical Auditory-Evoked Responses in Preterm Neonates: Revisited by Spectral and Temporal Analyses.

Characteristic preterm EEG patterns of "Delta-brushes" (DBs) have been reported in the temporal cortex following auditory stimuli, but their spatio-temporal dynamics remains elusive. Using 32-electrode EEG recordings and co-registration of electrodes' position to 3D-MRI of age-matched neonates, we explored the cortical auditory-evoked responses (AERs) after 'click' stimuli in 30 healthy neonates aged 30-38 post-menstrual weeks (PMW). (1) We visually identified auditory-evoked DBs within AERs in all the babies between 30 and 33 PMW and a decreasing response rate afterwards. (2) The AERs showed an increase in EEG power from delta to gamma frequency bands over the middle and posterior temporal regions with higher values in quiet sleep and on the right. (3) Time-frequency and averaging analyses showed that the delta component of DBs, which negatively peaked around 550 and 750 ms over the middle and posterior temporal regions, respectively, was superimposed with fast (alpha-gamma) oscillations and corresponded to the late part of the cortical auditory-evoked potential (CAEP), a feature missed when using classical CAEP processing. As evoked DBs rate and AERs delta to alpha frequency power decreased until full term, auditory-evoked DBs are thus associated with the prenatal development of auditory processing and may suggest an early emerging hemispheric specialization.

Evaluation of removal efficiency of residual diclofenac in aqueous solution by nanocomposite tungsten-carbon using design of experiment.

Wastewater containing pharmaceutical residual components must be treated before being discharged to the environment. This study was conducted to investigate the efficiency of tungsten-carbon nanocomposite in diclofenac removal using design of experiment (DOE). The 27 batch adsorption experiments were done by choosing three effective parameters (pH, adsorbent dose, and initial concentration) at three levels. The nanocomposite was prepared by tungsten oxide and activated carbon powder in a ratio of 1 to 4 mass. The remaining concentration of diclofenac was measured by a spectrometer with adding reagents of 2, 2'-bipyridine, and ferric chloride. Analysis of variance (ANOVA) was applied to determine the main and interaction effects. The equilibrium time for removal process was determined as 30 min. It was observed that the pH had the lowest influence on the removal efficiency of diclofenac. Nanocomposite gave a high removal at low concentration of 5.0 mg/L. The maximum removal for an initial concentration of 5.0 mg/L was 88.0% at contact time of 30 min. The results of ANOVA showed that adsorbent mass was among the most effective variables. Using DOE as an efficient method revealed that tungsten-carbon nanocomposite has high efficiency in the removal of residual diclofenac from the aqueous solution.

Disturbance observer based hierarchical control of coaxial-rotor UAV.

This paper propose an hierarchical controller based on a new disturbance observer with finite time convergence (FTDO) to solve the path tracking of a small coaxial-rotor-typs Unmanned Aerial Vehicles (UAVs) despite of unknown aerodynamic efforts. The hierarchical control technique is used to separate the flight control problem into an inner loop that controls attitude and an outer loop that controls the thrust force acting on the vehicle. The new disturbance observer with finite time convergence is intergated to online estimate the unknown uncertainties and disturbances and to actively compensate them in finite time.The analysis further extends to the design of a control law that takes the disturbance estimation procedure into account. Numerical simulations are carried out to demonstrate the efficiency of the proposed control strategy.

A molecular genome scan to identify DNA segments associated with live weight in Japanese quail.

Japanese quail is an animal model in biological studies and also a commercial bird for eggs and meat production. This study was conducted to map quantitative trait loci (QTL) affecting live weight in Japanese quail. An F2 mapping population was developed by crossing two diverse lines (meat type and egg layer) of Japanese quail. A total number of 34 F1 and 422 F2 progeny were produced by reciprocal crossing of eight pairs of parental birds. All the birds from three generations were genotyped for SSR markers that were spread across all the autosomal linkage groups. The studied traits were hatching weight and live weights at 1-5 weeks of age. QTL analysis was conducted by the regression interval mapping. Significant QTL were detected on chromosomes 1, 2, 3 (chromosome-wide significant) and 5 (genome-wide significant, P < 0.05) for body weight. Although the additive effect of the detected QTL on chromosome 5 was significant, the dominance and imprinting effects were not significant. This finding is the first report of a genome-wide significant QTL associated with live weight in Japanese quail. Our results point out to candidate DNA regions affecting live weight, a trait of great economic relevance to the Japanese quail breeding. Although these results enhance our current knowledge about the genetic control of live weight in the Japanese quail, it should be noted that the initial QTL results from the experimental designs such as backcross or F2 cannot be applied directly to the breeding programs and require further validation within the commercial lines.

Relationship between calving difficulty and fertility traits in first-parity Iranian Holsteins under standard and recursive models.

The main objective of this study was to estimate the genetic and phenotypic relationships between calving difficulty (CD) and fertility traits, including success at first service (SF), number of inseminations to conception (INS), interval from calving to first service (CTFS), interval between first and last service (IFL) and days open (DO), in first-parity Iranian Holsteins under standard (SMMs) and recursive (RMMs) mixed models. The data analysed in this paper included 29 950 records on CD and fertility traits, collected in the time period from 1995 to 2014 by the Animal Breeding and Improvement Center of Iran. Under all observed SMMs and RMMs, five bivariate sire-maternal grandsire models (ten bivariate analyses in total) were used for the analyses. Recursive models were applied with a view to consider that CD influences the fertility traits in the subsequent reproductive cycle and the genetic determination of CD and fertility traits by fitting CD as covariate for any of the fertility traits studied. The existence of such cause-and-effect is considered in RMMs but not in SMMs. Our results implied a statistically non-zero magnitude of the causal relationships between CD and all the fertility traits studied, with the former influencing the latter. The causal effects of CD on SF (on the observed scale, %), INS, CTFS, IFL and DO were -2.23%, 0.10 services, 1.93 days, 3.76 days and 5.61 days, respectively. Direct genetic correlations between CD and the fertility traits under both models were not statistically different from zero (95% HPD interval included zero), except for the correlation between CD and CTFS, which were 0.197 and 0.134 under SMM and RMM, respectively, indicating that genes associated with difficult births also increase intervals between calving and the first insemination afterwards. Comparison of both models by the deviance information criterion (DIC) demonstrated the plausibility of RMMs over SMMs.

Inhalative steroids as an individual treatment in symptomatic lung cancer patients with radiation pneumonitis grade II after radiotherapy - a single-centre experience.

PURPOSE: To assess efficacy of our single-centre experience with inhalative steroids (IS) in lung cancer patients with symptomatic radiation pneumonitis (RP) grade II. MATERIAL AND METHODS: Between 05/09 and 07/10, 24 patients (female, n = 8; male, n = 16) with lung cancer (non-small cell lung carcinoma [NSCLC]: n = 19; small cell lung cancer [SCLC]: n = 3; unknown histology: n = 2) and good performance status (ECOG ≤1) received definitive radiotherapy to the primary tumour site and involved lymph nodes with concurrent chemotherapy (n = 18), sequential chemotherapy (n = 2) or radiation only (n = 4) and developed symptomatic RP grade II during follow-up. No patient presented with oxygen requiring RP grade III. The mean age at diagnosis was 66 years (range: 50-82 years). Nine patients suffered from chronic obstructive pulmonary disease (COPD) before treatment, and 18 patients had a smoking history (median pack years: 48). The mean lung dose was 15.5 Gy (range: 3.0-23.1 Gy). All patients were treated with IS. If a patient's clinical symptoms did not significantly improve within two weeks of IS therapy initiation, their treatment was switched to oral prednisolone. RESULTS: All 24 patients were initially treated with a high dose IS (budesonide 800 µg 1-0-1) for 14 days. Of the patients, 18 showed a significant improvement of clinical symptoms and 6 patients did not show significant improvement of clinical symptoms and were classified as non-responders to IS. Their treatment was switched to oral steroids after two weeks (starting with oral prednisolone, 0.5 mg/kg bodyweight; at least 50 mg per day). All of these patients responded to the prednisolone. None of non-responders presented with increased symptoms of RP and required oxygen and / or hospitalization (RP grade III). The median follow-up after IS treatment initiation was 18 months (range: 4-66 months). The median duration of IS treatment and prednisolone treatment was 8.2 months (range: 3.0-48.3 months) and 11.4 months (range: 5.0-44.0 months), respectively. Of the 18 IS treatment responders, 2 (11.1 %) patients with pre-existing grade 2 COPD still required IS (400 µg twice a day) 45.0 and 48.3 months after radiotherapy, respectively. For the remaining 16 responders (88.9 %), IS therapy was stopped after 7.7 months (range: 3.0-18.2 months). None of the patients treated with IS developed any specific IS-related side effects such as oral candidiasis. CONCLUSION: This single-centre experience shows that high-dose IS is an individual treatment option for radiation-induced pneumonitis grade II in patients with a good performance status.

Extended State Observer based control for coaxial-rotor UAV.

This paper considers the problem of controlling the position and the orientation of a Coaxial-Rotor Unmanned Aerial Vehicle -CRUAV- despite unknown aerodynamic efforts. A hierarchical flight controller is designed, allowing the trajectory tracking and the stabilization of the vehicle. The designed controller is build through a hierarchical approach yielding two control loops, an inner one to control the attitude and an outer one to control the translational trajectory of the rotorcraft. An Extended State Observer -ESO- is used to estimate the state and the unknown aerodynamic disturbances. The analysis further extends to the design of a control law that takes the disturbance estimation procedure into account. Numerical simulations are carried out to demonstrate the efficiency of the proposed control strategy.

Solitary dural plasmacytoma with parenchymal invasion.

Primary solitary dural plasmacytoma is an uncommon neoplasm of plasma cell. The clinical presentation and neuroradiological findings of these tumors may be deceptive and resemble to the other most prevalent brain tumors. Solitary plasmacytoma mostly shows a benign behavior and malignant features like local invasion is so rare. We describe the case of parenchymal brain involvement by solitary dural plasmacytoma.

A new robust control for minirotorcraft unmanned aerial vehicles.

This paper presents a new robust control based on finite-time Lyapunov stability controller and proved with backstepping method for the position and the attitude of a small rotorcraft unmanned aerial vehicle subjected to bounded uncertainties and disturbances. The dynamical motion equations are obtained by the Newton-Euler formalism. The proposed controller combines the advantage of the backstepping approach with finite-time convergence techniques to generate a control laws to guarantee the faster convergence of the state variables to their desired values in short time and compensate for the bounded disturbances. A formal proof of the closed-loop stability and finite-time convergence of tracking errors is derived using the Lyapunov function technique. Simulation results are presented to corroborate the effectiveness and the robustness of the proposed control method.

Absolute quantification of free tumor cells in the peripheral blood of gastric cancer patients.

Gastric cancer remains the third most common cancer in the world. Metastatic disease is a major cause of death in about half of the patients; therefore, early diagnosis is crucial for successful outcome. This study applied a sensitive method for the detection of circulating tumor cells using specific tumor markers for early detection. A total of 80 blood samples from 40 patients and 40 age-matched healthy controls were collected for the study. Circulating mRNA levels of two tumor markers, tumor endothelial marker 8 (TEM-8) and carcinoembryogenic antigen (CEA) were evaluated using absolute quantitative real-time PCR assay in the Stratagene Mx-3000P real-time PCR system. GAPDH was used to normalize the data. TEM-8 and CEA were detected in patients' blood more than in controls, 22/40 vs 9/40, P=0.005, and 30/40 vs 11/40, P=0.008, respectively. The mRNA level of these markers in patients was significantly higher in comparison to normal controls (P=0.018, 0.01). This panel showed an overall sensitivity of 64% and specificity of 73%. Statistical analysis for demographic variants did not show any significant differences. Both markers were detected more frequently and in significantly higher levels in blood samples of patients compared to samples from normal individuals. Copy number of CEA and TEM-8 mRNA, as detected by real-time quantitative PCR, appears to be a promising marker to evaluate the risk of tumor spread.

A study to demonstrate the use of FNA cytology rather than biopsy in the diagnosis of neonatal biliary atresia.

OBJECTIVE: To study the use of fine needle aspiration (FNA) cytology in neonatal biliary atresia (BA). METHODS: Twelve female and nine male patients (age range, 3-7 months; mean age, 4.5 months) with a pre-operative diagnosis of BA, who were scheduled for Kasia portoenterostomy and selected for intraoperative FNA, were studied. RESULTS: Cholestasis, bile deposits, bile infarcts, hepatitic rosettes enclosing bile plugs, feathery degeneration of hepatocytes and inflammatory cells were seen in the cytological slides. Bile infarcts, rosette formation and inflammatory cells were mainly noticed in type 3 BA. Bile infarcts and hepatitic rosettes are surrogate findings for the diagnosis of the obstructive type of cholestasis. CONCLUSION: With the help of imaging studies, FNA in a multidisciplinary setting can be diagnostic of neonatal BA when cytological features suggest the obstructive nature of cholestasis, but this procedure cannot replace completely liver biopsy for this diagnosis.

New trends to support independence in persons with mild dementia: a mini-review.

Our research was motivated by the growing aging population worldwide and the need to concentrate research efforts on a specific target group; it focuses on elderly persons with physical and cognitive deficiencies. The primary goal is to enable persons with mild dementia to maximize their physical and mental functions through assistive technologies in order to be able to continue to participate in social networks and lead independent and purposeful lives. Persons with mild dementia usually have problems in performing activities of daily living due to episodic memory decline. These can include simple activities, such as bathing, changing clothes and preparing meals. Through extended field test trials involving end users, we have demonstrated that assistive technology that provides timely prompts, alarms and reminders can enable them to preserve their abilities and improve their quality of life. Understanding the user context, especially when targeting demented individuals, and providing the required personalized assistive services is the objective of our research work. Finding the appropriate user interface to interact with the provided services is often a barrier. Thus, we have adopted the approach of a multimodal interactive system with the living environment including a TV set, iPad-like tablets, sensors/actuators, and wireless speakers connected to a reasoning engine that is able to consider the complexity of the users' profile defined by his/her cognitive abilities. In this paper we will mainly focus on the interaction level with the system as well as on the validation stages performed to meet the users' requirements. This is the result of several years' work since 2006 in the frame of two projects (IST-FP6 COGKNOW European completed project and AMUPADH ongoing project in Singapore).

[Rigid bronchoscopy for pin extraction in children at the Children's Hospital in Rabat, Morocco]. / Bronchoscopie rigide pour extraction d'épingle chez l'enfant à l'hôpital d'enfants de Rabat, Maroc.

PURPOSE: The aim of this work is to present the clinical and therapeutic aspects of pin inhalation in the airways, as well as the benefit of rigid bronchoscopy for extraction in children. MATERIALS AND METHODS: Five hundred and twenty-four cases of inhaled foreign body are identified in the multipurpose pediatric intensive care unit in the children's hospital in Rabat between January 2005 and December 2010. Thirty-six (6.8%) of them are due to pin inhalation. A retrospective study was conducted to define the epidemiological characteristics, clinical treatment and outcome of pin inhalation in the airways. RESULTS: Thirty-six cases of pin inhalation are identified, all females. The age varies from 10 to 15 years. The consultation period is 2 days. Symptoms are dominated by coughing and stinging sensation. In 61.11% (22 cases), the pin is lodged in the right airways, in 22.22% (eight cases) in the left airways and in 5.5% (two cases) at the trachea. In 63.8% (23 cases), the pin is removed at the first attempt. We did not record any severe complications. No deaths recorded. CONCLUSION: Pin inhalation is a common occurrence in young girls. The extraction can be done safely by rigid bronchoscopy under general anesthesia. Particular attention should be paid to prevention and educational programs to reduce the incidence of pin inhalation.