First Report of Meloidogyne enterolobii Yang & Eisenback, 1983 (Guava Root-knot Nematode) Infecting Guava (Psidium guajava) in Egypt.

Meloidogyne enterolobii Yang & Eisenback, 1983 (guava root-knot nematode) is an important disease in subtropical to tropical climate in several areas of the world (Subbotin et al., 2021). It is a highly polyphagous root-knot nematode species causing major damage to a range of economically important crops. The expansion of this species is increasing worldwide creating a potential problem to the maintenance of resistance genes to other major Meloidogyne species (Castagnone-Sereno and Castillo, 2020). Additionally, the diagnosis of M. enterolobii can be challenging due to morphological similarities with other root-knot nematode species (Castagnone-Sereno, 2012). In the African continent, it has been cited in several countries of Equatorial and South Africa (Subbotin et al., 2021), but not in North Africa. Two guava groves (at Bany Salama, Natrn vally, El Beheira governorate, 30.322043N, 30.518529E; and Izbat Al Halawijah, Monshaah Alaweyah, Abu El Matamir, El Beheira governorate 30.9398050N, 30.1484430E), in Egypt, were found with significant symptoms of tree decline and root galling damage. The presence of egg masses and females of root-knot nematodes were found inside the galls (Figure 1A, B). Nematodes were extracted from soil samples with levels of 12300 and 12600 second-stage juveniles (J2s)/250 g of soil using a modified Baerman method (Hooper, 1986), respectively. Nematode root density was 24367 eggs/g of root, using the protocol described in Hussey and Barker (1973) for Izbat Al Halawijah population. For morphological and morphometrical identification, J2s and females were fixed using a hot formalin solution (4% v/v). DNA was isolated from single J2s specimen for: i) testing multiplex specific-PCR assay for M. incognita, M. javanica and M. arenaria (Kiewnick et al., 2013), and ii) amplifying and sequencing of cytochrome oxidase subunit II (COII) and the 16S rRNA mitochondrial region using the primer pair C2F3 (5'-GGTCAATGTTCAGAAATTTGTGG-3') (Powers and Harris, 1993) and MRH106 (5'- AATTTCTAAAGACTTTTCTTAGT-3') (Stanton et al., 1997). Perineal patterns of females for Izbat Al Halawijah population were typical of the species (Fig. 1D), body size (L: 520-774 µm; W: 214-487 µm), stylet length (12.5-13.7 µm) and ratio from distance from anterior end to excretory pore and stylet length (4.2) in females (n = 18), fitting with original description and others (Subbotin et al., 2021). J2s from Izbat Al Halawijah population (n=13) (Fig. 1C, E-H) showed: body length (393.5-475 µm), stylet length (11.5-13.5), excretory pore to anterior end (89-95.5 µm), tail length (50.0-60.0 µm), tail hyaline region (12.0-21.0 µm), a ratio (24.2-32.5), b ratio (4.9-6.5), c ratio (7.3-8.6) and c' (5.0-6.4), also fitting with original description and others (Subbotin et al., 2021). Specific PCR did not amplify any band (Kiewnick et al., 2013). Four J2s individuals were sequenced for COII-16S rRNA region for each population showing M. enterolobii as unique species and without intraspecific variability. Two identical DNA fragments of 814 bp obtained for both populations (OP434400 and OP434401) were compared with those in GenBank. A BLAST search indicated the sequences were 100% identical to several sequences of M. enterolobii (MF467278 and KX823371). On the basis of these results, the root-knot nematodes isolated from these two guava groves in Egypt were confirmed as M. enterolobii. This is a well-known pathogen of guava, causing important losses in this crop (Castagnone-Sereno and Castillo, 2020) and it is regulated as quarantine nematode in the Mediterranean region (EPPO).

Chimeric rabies SADB19-VSVg-pseudotyped lentiviral vectors mediate long-range retrograde transduction from the mouse spinal cord.

Lentiviral vectors have proved an effective method to deliver transgenes into the brain; however, they are often hampered by a lack of spread from the site of injection. Modifying the viral envelope with a portion of a rabies envelope glycoprotein can enhance spread in the brain by using long-range axon projections to facilitate retrograde transport. In this study, we generated two chimeric envelopes containing the extra-virion and transmembrane domain of rabies SADB19 or CVS-N2c with the intra-virion domain of vesicular stomatitis virus. Viral particles were packaged containing a green fluorescent protein reporter construct under the control of the phosphoglycerokinase promoter. Both vectors produced high-titer particles with successful integration of the glycoproteins into the particle envelope and significant transduction of neurons in vitro. Injection of the SADB19 chimeric viral vector into the lumbar spinal cord of adult mice mediated a strong preference for gene transfer to local neurons and axonal terminals, with retrograde transport to neurons in the brainstem, hypothalamus and cerebral cortex. Development of this vector provides a useful means to reliably target select populations of neurons by retrograde targeting.

Knowledge-based isocenter selection in radiosurgery planning.

PURPOSE: We present a new method for knowledge-based isocenter selection for treatment planning in radiosurgery. Our objective is to develop a prediction model that can learn from past manually designed treatment plans. We leverage recent advances in deep learning to predict isocenter locations in treatment plans in order to provide a decision support tool. METHODS: The proposed method adapts a geometric approach using orthogonal moment expansions as a feature vector for describing the shape of the tumor. Our approach accounts primarily for tumor shape and OAR proximity, the two factors that are known to greatly affect the isocenter placement. We solve the prediction problem by training a residual neural network with skip connections on the formed shape descriptors. Our network was trained on 533 patient cases and was validated on a set of out-of-sample cases. RESULTS: Our method generates heatmap predictions for isocenter locations that are in most cases comparable to the experienced human planners, which shows that the method can be used in treatment planning to guide the users for determining the isocenters. CONCLUSIONS: Our numerical experiments indicate a positive predictive value on an independent validation set when compared against a test dataset that was not seen by the model during training.

Assessment of Patient Radiation Dose during Conventional Diagnostic X-ray Examinations in Three Public Hospitals in Northern Jordan using TLDs.

This study aims to measure entrance surface doses during routine chest and abdomen x-ray examinations of adult and child patients. Radiation dose measurements were performed using thermoluminescent dosimeters TLD-100s in three major public hospitals in northern Jordan on a total of 100 patients. Wide variations in entrance surface doses were observed within and between hospitals, which might be attributed to significant variations of the selected exposure parameters. For adult patients, the results have shown that the majority of entrance surface dose values from both chest and abdomen examinations were within recommended values of diagnostic reference levels. For child patients, the mean entrance surface dose from chest examinations in three age groups were 0.131 mGy (0-1 y), 0.136 mGy (1-5 y), and 0.191 mGy (5-10 y). These values were considered relatively high compared to the European reference levels and published results in the literature. However, for abdomen examinations, entrance surface dose values were relatively lower than European reference levels. Patient effective doses were estimated using a PCXMC 2.0 Monte Carlo program. The results for both adults and children were found to be relatively lower than the values reported by international publications. Due to the wide variations of entrance surface dose and the higher radiation doses delivered to child patients, this study recommends implementing a quality assurance program in such hospitals to achieve optimization between good image quality and minimum dose according to the as low as reasonably achievable principle. Moreover, the results of this work will provide a useful base for establishing local diagnostic reference levels for chest and abdomen examinations in Jordan.

A linear programming approach to inverse planning in Gamma Knife radiosurgery.

PURPOSE: Leksell Gamma Knife® is a stereotactic radiosurgery system that allows fine-grained control of the delivered dose distribution. We describe a new inverse planning approach that both resolves shortcomings of earlier approaches and unlocks new capabilities. METHODS: We fix the isocenter positions and perform sector-duration optimization using linear programming, and study the effect of beam-on time penalization on the trade-off between beam-on time and plan quality. We also describe two techniques that reduce the problem size and thus further reduce the solution time: dualization and representative subsampling. RESULTS: The beam-on time penalization reduces the beam-on time by a factor 2-3 compared with the naïve alternative. Dualization and representative subsampling each leads to optimization time-savings by a factor 5-20. Overall, we find in a comparison with 75 clinical plans that we can always find plans with similar coverage and better selectivity and beam-on time. In 44 of these, we can even find a plan that also has better gradient index. On a standard GammaPlan workstation, the optimization times ranged from 2.3 to 26 s with a median time of 5.7 s. CONCLUSION: We present a combination of techniques that enables sector-duration optimization in a clinically feasible time frame.

Simultaneous optimization of isocenter locations and sector duration in radiosurgery.

Stereotactic radiosurgery is an effective technique to treat brain tumors for which several inverse planning methods may be appropriate. We propose an integer programming model to simultaneous sector duration and isocenter optimization (SDIO) problem for Leksell Gamma Knife® IconTM (Elekta, Stockholm, Sweden) to tractably incorporate treatment time. We devise a Benders decomposition scheme to solve the SDIO problem to optimality. The performances of our approaches are assessed using anonymized data from eight previously treated cases, and obtained treatment plans are compared against each other and against the clinical plans. The plans generated by our SDIO model all meet or exceed clinical guidelines while demonstrating high conformity.

Modeling and comparison of alternative approaches for sector duration optimization in a dedicated radiosurgery system.

Stereotactic radiosurgery (SRS) is an effective technique to treat brain metastasis for which several inverse planning methods may be appropriate. We compare three different optimization models for segment duration optimization in SRS using Leksell Gamma Knife® IconTM (Elekta, Stockholm, Sweden). We investigate (1) a linear programming approach, (2) a piecewise quadratic penalty approach, and (3) an unconstrained convex moment-based penalty approach. We examine the performances of these approaches using anonymized data from 14 previously treated cases. In addition, we investigate the important modeling question of selecting weights for the objective functions where we use a simulated annealing algorithm to determine these weights for each model. The inverse plans obtained via optimization models are compared against each other and against the clinical plans. The three inverse planning models can all yield optimal treatment plans in a reasonable amount of time and the treatment plans obtained by these models meet or exceed clinical guidelines while displaying high conformity.

Long-term Graft Survival After Kidney Allograft Torsion: Rapid Diagnosis and Surgical Management Key to Reversibility of Injury.

INTRODUCTION: Kidney allograft torsion (KAT) is a rare complication of kidney transplantation (KT) that occurs when the transplanted kidney rotates around its vascular pedicle, which may result in a catastrophic compromise of the graft's blood supply, deterioration of kidney function, and eventually premature graft death. CASE REPORT: We report the case of a patient who had an acute kidney injury (AKI) episode from KAT. Her diagnosis was ascertained expeditiously and she had prompt surgical management. Five years after the KAT event, her baseline creatinine (Cr) stabilized around 1.6 mg/dL and she has achieved >8-year graft survival. DISCUSSION: This case illustrates the reversibility of injury that can occur after a KAT event with a commensurate return to baseline kidney function when KAT is promptly diagnosed and treated. A high index of suspicion of this uncommon but catastrophic complication of KT must be maintained to achieve desirable long-term outcomes. A diagnosis of KAT must be considered when routine etiologies of an acute deterioration of kidney allograft function have been excluded. Finally, prophylactic nephropexy must be strongly considered with intraperitoneal placement of a kidney allograft to avoid KAT.

Induction of Defense-Related Physiological and Antioxidant Enzyme Response against Powdery Mildew Disease in Okra (Abelmoschus esculentus L.) Plant by Using Chitosan and Potassium Salts.

Foliar sprays of three plant resistance inducers, including chitosan (CH), potassium sorbate (PS) (C6H7kO2), and potassium bicarbonates (PB) (KHCO3), were used for resistance inducing against Erysiphe cichoracearum DC (powdery mildew) infecting okra plants. Experiments under green house and field conditions showed that, the powdery mildew disease severity was significantly reduced with all tested treatments of CH, PS, and PB in comparison with untreated control. CH at 0.5% and 0.75% (w/v) plus PS at 1.0% and 2.0% and/or PB at 2.0% or 3.0% recorded as the most effective treatments. Moreover, the highest values of vegetative studies and yield were observed with such treatments. CH and potassium salts treatments reflected many compounds of defense singles which leading to the activation power defense system in okra plant. The highest records of reduction in powdery mildew were accompanied with increasing in total phenolic, protein content and increased the activity of polyphenol oxidase, peroxidase, chitinase, and ß-1,3-glucanase in okra plants. Meanwhile, single treatments of CH, PS, and PB at high concentration (0.75%, 2.0%, and/or 3.0%) caused considerable effects. Therefore, application of CH and potassium salts as natural and chemical inducers by foliar methods can be used to control of powdery mildew disease at early stages of growth and led to a maximum fruit yield in okra plants.

Primary care and ophthalmology in the United Kingdom.

The National Health Service is now primary care led. There are different definitions for primary care and in this review they are analysed and related to ophthalmology to produce a working definition for ophthalmic primary care, summarised as the provision of first contact care for all ophthalmic conditions and follow up, preventive, and rehabilitative care of selected ophthalmic conditions, in a variety of settings, by a diverse workforce. The attributes of primary care are first contact, accessibility, continuity, longitudinality, comprehensiveness, coordination, equity, and accountability. The delivery of ophthalmic primary care should be governed by these and evaluated accordingly. The clinical content of primary care consists of the first presentation of disease, the management of minor illness and trauma, the recurrence of disease, the follow up and support of some chronic conditions, and the delivery of preventive health care. Planning for ophthalmic primary care needs to take service requirements of these categories of disease into account. Primary care research is abundant in ophthalmology but needs to be more structured and targeted. Ophthalmic primary care itself is urgently in need of recognition and formal adoption by the profession.

Novel poly (vinyl chloride) matrix membrane electrodes for the determination of phenolic pollutants in waste water.

The construction and electrochemical response characteristics of poly (vinyl chloride) matrix membrane sensors for seven phenolic compounds (phenol, o-cresol, p-cresol, p-chlorophenol, o-nitrophenol, alpha-naphthol and beta-naphthol) are described. The membranes incorporate ion association complexes of these seven phenolic anions with phenanthroline-iron(II) as electroactive materials. These sensors show linear response for phenol, o-cresol, p-cresol, p-chlorophenol, o-nitrophenol, alpha-naphthol, and beta-naphthol over wide concentration ranges, with an average anionic slope 54.3 mV per concentration decade. The suggested sensors exhibit fast response time (1 min), low determination limits (1 x 10(-5)M), good stability (2-3 weeks), reasonable selectivity to phenolic compounds in the presence of other water pollutants. The average percentage recovery was 99.78+/-0.088 for individual phenolates and 99.61+/-0.198 for phenolates in mixtures. The investigated sensors were successfully used for direct potentiometric determination of traces of these phenolic compounds in wastewater samples. Results with mean accuracy of 99.74+/-0.29%, 99.82+/-0.36%, 99.65+/-0.47%, 99.73+/-0.37%, 99.77+/-0.30%, 99.86+/-0.31% and 99.91+/-0.22% was obtained for the seven sensors, respectively. These results were compared with data obtained using the British pharamacopial method (The British Pharmacopoeia, Her Majesty's Stationary Office, London, 1993) and others (Clarke's Isolation and Identification of Drugs in Pharmaceuticals Body Fluids and Post-mortem Materials, 2nd Edition, The Pharmaceutical Press, London, 1998).

Environmental stress and genetic damage in aquatic organisms.

This work was planned to investigate the effect of pollution upon the genetic material of aquatic organisms. In order to achieve such a purpose, Tilapia nilotica and Tilapia zillii were chosen and caught from two regions varying in their environmental stress; the first is River Nile and the second is a closed drain which receives domestic sewage. Mitotic activity, chromosomal aberrations and in vivo induction of sister chromatid exchanges were examined in gills as well as in kidneys. The results obtained revealed that the environmental stress was proven to be capable of causing inhibition of cell proliferation; clastogenic effect and primary DNA damage in gills and kidneys of both species with differential effect.

High T2 signal in primary lateral sclerosis supports the topographic distribution of fibers in the corpus callosum: assessing disease in the primary motor segment.

PLS is a disease of the UMN, distinguished from ALS in prognosis and absence of LMN signs. We present, to our knowledge, the first conventional MR imaging visualization of the callosal motor segment, a concept previously supported by primate models, electrophysiologic studies, and postmortem examinations. Modification of the Witelson topographic scheme of the CC is supported by MR tractography. On the basis of 2 cases of PLS, we present conventional imaging confirmation of the revised topographic scheme of fiber distribution across the CC.

Apparent diffusion coefficient of glial neoplasms: correlation with fluorodeoxyglucose-positron-emission tomography and gadolinium-enhanced MR imaging.

BACKGROUND AND PURPOSE: Gd-enhancement provides essential information in the assessment of brain tumors. However, enhancement does not always correlate with histology or disease activity, especially in the setting of current therapies. Our aim was to compare FDG-PET scans to ADC maps and Gd-enhanced MR images in patients with glial neoplasms to assess whether DWI might offer information not available on routine MR imaging sequences and whether such findings have prognostic significance. MATERIALS AND METHODS: Institutional review board approval was obtained for this retrospective review, which was conducted in full compliance with HIPAA regulations. Twenty-one patients (11 men and 10 women) with glial tumors underwent FDG-PET and MR imaging, including ADC and Gd- enhancement. Subjectively, regions of interest were drawn around the following areas: 1) increased FDG uptake, 2) decreased signal intensity on ADC maps, and 3) Gd-enhancement. Objectively, FDG-PET and MR images were co-registered, and pixel-by-pixel comparison of ADC to PET values was made for all regions of interest. Correlation coefficients (r values) were calculated for each region of interest. Percentage overlap between regions of interest was calculated for each case. RESULTS: Subjective evaluation showed 60% of patients with excellent or good correlation between ADC maps and FDG-PET. Pixel-by-pixel comparison demonstrated r values that ranged from -0.72 to -0.21. There was significantly greater overlap between decreased ADC and increased FDG-PET uptake (67.1 +/- 15.5%) versus overlap between Gd-enhancement and increased FDG-PET uptake (54.4 +/- 27.5%) (P < .05). ADC overlap was greater with increased FDG-PET than with Gd-enhancement in 8/9 cases. Survival data revealed that the presence of restricted diffusion on ADC correlated with patient survival (P < .0001). CONCLUSIONS: ADC maps in patients with brain tumors provide unique information that is analogous to FDG-PET. There is a greater overlap between ADC and FDG-PET compared with Gd-enhancement. ADC maps can serve to approximate tumor grade and predict survival.

Our experience of controlling diabetes in the peri-operative period of patients who underwent cardiac surgery.

AIMS: We have different protocols applied in our cardiac center for control of blood glucose (BG), we like to see which protocol can achieve our goal. METHODS: From a prospective study of 120 diabetic patients randomly assigned to either simple sliding scale or Braithwaite protocol who underwent open heart surgical procedures between 2005 and 2008. The study group included 80 patients treated with Braithwaite protocol; the control group included 40 patients treated with simple sliding scale in an attempt to maintain BG level less than 200 mg/dl. RESULTS: In the study group all the patients were under 200 mg/dl at the end of 48 h postoperatively, which was not achieved in the control group (P<0.01). There was a significant reduction in hospital stay in the study group compared to the control group (mean in days 9.1+/-2.3/12.3+/-7.6) (P<0.001) and also there was no wound infection compared to the control group (0/5 cases). CONCLUSION: The study showed that control of DM in peri-operative period using Braithwaite regimen was of great benefit and safety.

Campylobacter-associated diarrhoea in Egyptian infants: epidemiology and clinical manifestations of disease and high frequency of concomitant infections.

A diarrhoeal disease survey in Alexandria, Egypt determined the prevalence, seasonality, and household risk factors for Campylobacter-associated diarrhoea in young children. The study population was 880 children (mean age = 9.8 months) presenting with diarrhoea at one of two hospitals. A control group consisted of 1,079 healthy children (mean age = 8.8 months) attending two nearby vaccination clinics. The overall isolation frequencies for Campylobacter spp. were 16.8% for cases and 6.4% for the comparison group (p = 1 x 10(-8)). Other enteropathogens detected in diarrhoeal stools were: rotavirus (28.6%), Giardia lamblia trophozoites (21.3%), enterotoxigenic Escherichia coli (8.7%), Entamoeba histolytica (3.9%), Salmonella spp. (2.7%), and Shigella spp. (1.8%). There were few or no isolates of Aeromonas spp., Vibrio spp., Yersinia spp., or Plesiomonas spp. Comparisons among cases showed that Campylobacter spp. isolations were more prevalent during the rainy season (p = 0.001) and positively associated with keeping fowl in the home (p = 0.003) or having an outdoor source of drinking water (p = 0.029). Among Campylobacter-positive diarrhoeal patients, 69.0% had faecal leukocytes present and 16.3% had bloody stools. Patients with Campylobacter-positive diarrhoeal stools were frequently co-infected with rotavirus (28.6%) or G. lamblia (24.5%).

Evaluation of some direct diagnostic methods in intestinal parasitic infections.

Stool specimens of 100 cases attending the outpatient clinic of Cairo Medical Center Hospital suffering from gastro-intestinal disturbances were examined for intestinal parasites by direct smear, trichrome stained smear and formol ethyl acetate concentration methods. Although formol ethyl acetate concentration method gave the best results (45%), followed by trichrome stain (37%) then direct smear (32%) yet, for a reliable diagnosis a combination of several techniques is required.

A second controlled field trial of a serogroup A meningococcal polysaccharide vaccine in Alexandria.

The encouraging results of an earlier controlled field trial of the serogroup A meningococcal polysaccharide vaccine in the prevention of clinical disease prompted this study, the aim of which was to evaluate further the effectiveness of another lot of this type of vaccine, the duration of immunity, and the effectiveness against meningococcal carriage. A controlled field trial was carried out in early 1973 on 176 646 schoolchildren 6-15 years of age, of whom half received the serogroup A polysaccharide vaccine and the other half tetanus toxoid as a control. The incidence of cerebrospinal meningitis caused by serogroup A meningococci was 89% lower in the immunized group than in the controls for one year only. With regard to its effect on carriage, the vaccine was found to reduce to less than half the rate of new acquisition of serogroup A meningococci during the period immediately following immunization. The duration of the carrier state was also shortened in the immunized group.