Enhancement of Subjective Quality of Life Following Surgical Intervention in Patients With Drug-Resistant Epilepsy: A Depressive Symptom-Independent Outcome.

PURPOSE: To evaluate the impact of depressive symptoms on the subjective perception of quality of life in patients with drug-resistant epilepsy (DRE) after surgical treatment for seizures.  Methods: A case-control study with DRE patients who received surgical treatment (n=19) and matched non-operated patients (n=23). We assessed the quality of life using the Subjective Handicap of Epilepsy (SHE) scale, alongside measuring depressive symptoms using the Beck Depression Inventory (BDI). RESULTS: The mean age of the participants was 45 years, with females constituting 52.4% of the patients. A majority (73.8%) had been diagnosed with temporal lobe epilepsy. Those who had undergone surgical intervention showed significantly enhanced performance across all quality-of-life domains on the SHE scale independently of depressive symptoms. The domains of "Work and Activity," "Physical Health," and "Self-Perception" displayed the greatest improvements, with the surgical group's averages outperforming the control group by factors of 1.87, 2.53, and 2.81, respectively. Influential differences impacting the quality-of-life scores included seizure frequency, the quantity of antiepileptic drugs utilized, and the incidence of convulsive seizures. CONCLUSION: The findings suggest that surgical control of seizures in drug-resistant focal epilepsy is associated with improvement in quality of life across various domains, independently of the depressive symptoms of the patients.

Unveiling Trichosporon austroamericanum sp. nov.: A Novel Emerging Opportunistic Basidiomycetous Yeast Species.

During an epidemiological survey, a potential novel species within the basidiomycetous yeast genus Trichosporon was observed. The clinical strain was obtained from a urine sample taken from a Brazilian kidney transplant recipient. The strain was molecularly identified using the intergenic spacer (IGS1) ribosomal DNA locus and a subsequent phylogenetic analysis showed that multiple strains that were previously reported by other studies shared an identical IGS1-genotype most closely related to that of Trichosporon inkin. However, none of these studies provided an in-depth characterization of the involved strains to describe it as a new taxon. Here, we present the novel clinically relevant yeast for which we propose the name Trichosporon austroamericanum sp. nov. (holotype CBS H-24937). T. austroamericanum can be distinguished from other siblings in the genus Trichosporon using morphological, physiological, and phylogenetic characters.

Granulomatous meningoencephalitis and blindness associated with Mycobacterium tuberculosis complex infection in a senile female chimpanzee (Pan troglodytes).

A 40-year old female chimpanzee (Pan troglodytes) developed hyporexia, weight loss, followed by progressive and complete blindness. Tomography demonstrated an intracranial mass in the rostroventral brain involving the optic chiasm, with a presumptive diagnosis of neoplasm. However, histopathology revealed a granulomatous meningoencephalitis, and tissue samples tested positive for Mycobacterium tuberculosis.

Blue-green infrastructure in view of Integrated Urban Water Management: A novel assessment of an effectiveness index.

Addressing urban water management challenges requires a holistic view. Sustainable approaches such as blue-green infrastructure (BGI) provide several benefits, but assessing their effectiveness demands a systemic approach. Challenges are magnified in informal areas, leading to the combination of integrated urban water management (IUWM) with BGI as a proposed solution by this research. We employed the Urban Water Use (UWU) model to assess the effectiveness index (EI) of BGI measures in view of IUWM after stakeholder consultation. The procedure in this novel assessment includes expert meetings for scenario building and resident interviews to capture the community's vision. To assess the impact of IUWM on the effectiveness of BGI measures, we proposed a simulation with BGI only and then three simulations with improvements to the water and sewage systems. The results of the EI analysis reveal a substantial improvement in the effectiveness of BGI measures through IUWM combination. Moreover, we offer insights into developing strategies for UWU model application in informal settlements, transferrable to diverse urban areas. The findings hold relevance for policymakers and urban planners, aiding informed decisions in urban water management.

Heavy metals bioaccumulation in free-ranging South American rattlesnakes (Crotalus durissus) in Southeastern Brazil.

Anthropogenic activities are the main sources of soil, air, and water pollution by metals, including cadmium (Cd), lead (Pb), chromium (Cr), the metalloid arsenic (As), magnesium (Mg), zinc (Zn), and copper (Cu). The goal of this study was to assess the presence and concentration of toxic (As, Cd, Pb, and Cr) and essential metals (Mg, Zn, and Cu) in the liver and kidneys from 96 free-ranging rattlesnakes (Crotalus durissus) from Minas Gerais (Brazil). Bioaccumulation of Cd and Pb were significantly higher in males and heavier rattlesnakes (those with body weight above the average of the study population). Average ± standard deviations of Cd, Pb, Cr, Cu, Mg, Zn, and As in the general population (n = 96) were 3.19 ± 2.52; 5.98 ± 8.49; 0.66 ± 1.97; 3.27 ± 2.85; 776.14 ± 2982.92; 27.44 ± 29.55; and 0.32 ± 1.46; respectively. Bioaccumulation of some metals correlated positively with changes in hematologic and serum biochemical parameters. Results of this study were contrasted with previous studies assessing metal bioaccumulation in other species of terrestrial or aquatic snakes. Considering their position in the food chain and the broad range of bioaccumulation of both toxic and essential metals observed in this study, rattlesnakes may function as highly relevant biological sentinels for environmental pollution.

Management of lumbar spondylolisthesis: A retrospective analysis of posterior lumbar interbody fusion versus transforaminal lumbar interbody fusion.

Background: One of the most frequent etiologies for spinal surgery is unstable lumbar spondylolisthesis (ULS). To decompress affected structures while maintaining or restoring stability through fusion, surgeons utilize a variety of procedures. When paired with interbody fusion, posterior fusion is most applied, resulting in greater fusion rates. The two most popular techniques for implementing spinal fusion are posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF). As a result, these two procedures have been assessed formally. Methodology: A retrospective analysis of patients who underwent interbody fusion for lumbar stenosis through PLIF and minimally invasive (MI)-TLIF was performed. The patients were followed up for 24 months and fusion rates, Visual Analog Score (VAS), and Oswestry Disability Index (ODI) alongside the MacNab clinical outcome score, were assessed. The Bridwell interbody fusion grading system was used to evaluate fusion rates in computed tomography (CT). Results: Operations were performed in 60 cases where patients suffered from ULS. PLIF was performed on 33 patients (55%) (14 males and 19 females) and 27 patients (45%) (11 males and 16 females) who underwent MI-TLIF. In 87% of our respective cohort, either the L4-5 or the L5-S1 level was operated on. Overall fusion rates were comparable between the two groups; however, the TLIF group improved more in terms of VAS, ODI, and MacNab scores. On average, MI-TLIF surgery was longer and resulted in reduced blood loss. MI-TLIF patients were more mobile than PLIF patients postoperatively. Conclusion: With well-established adequate results in the literature, TLIF offers benefits over other methods used for interbody lumbar fusion in ULS or other diseases of the spine. However, MI-TLIF may procure more advantageous for patients if MI methods are implemented. In this instance, TLIF outperformed PLIF due to shorter operating times, less blood loss, faster ODI recovery, better MacNab scores, and a greater decline in VAS pain ratings.

Occurrence of parasites in waters used for crops irrigation and vegetables from the Savannah of Bogotá, Colombia.

The World Health Organization (WHO) has established as a criterion of parasitological quality for irrigation water, ≤ 1 helminth egg/liter, which guarantees the safety in agricultural products. In this study, the presence of parasites in surface water used for irrigation of crops (n = 96) and vegetables (celery and lettuce) (n = 120), from the Former La Ramada irrigation district, was evaluated using conventional and molecular parasitological methods. Our findings showed contamination of irrigation systems in the study area with domestic wastewater, demonstrated by the presence of Ancylostomatidae eggs, Ascaris spp., Hymenolepis spp., Trichuris spp., Capillaria spp., Giardia spp. cysts, and oocysts of Toxoplasma gondii and Cryptosporidium spp. A prevalence of 33% and 23.3% was calculated for helminths and protozoa, respectively in vegetables, representing a possible risk to human and animal health in relation to these parasites. These findings show the need for continuous monitoring of the water quality used for crop irrigation, as well as the safety of food, taking into account the values established in national and international regulations.

Pathogenic potential of an environmental Aspergillus fumigatus strain recovered from soil of Pygoscelis papua (Gentoo penguins) colony in Antarctica.

Aspergillus fumigatus is a common opportunistic pathogen in different animals, including birds such as penguins. For the first time, a fungal strain identified as A. fumigatus was isolated from soil in the nests of gentoo penguins, Pygoscelis papua, on Livingston Island, South Shetland Islands (maritime Antarctica). This isolate (A. fumigatus UFMGCB 11829) displayed a series of potentially pathogenic characteristics in vitro. We evaluated its detailed molecular taxonomy and submitted the A. fumigatus UFMGCB 11829 Antarctic strain to in vivo pathogenic modelling. The isolate was confirmed to represent A. fumigatus morphological and phylogenetic analysis showed that it was closely related to A. fumigatus sequences reported from animals, immunosuppressed humans, storage grains, plants and soils. The strain displayed the best mycelial growth and conidia production at 37 ºC; however, it was also able to grow and produce conidia at 15º, demonstrating its capability to survive and colonize penguin nest at least in the summer season in maritime Antarctica. In pathogenicity tests, healthy mice did not showed symptoms of infection; however, 50% lethality was observed in immunosuppressed mice that were inoculated with 106 and 107 spores. Lethality increased to 100% when inoculated with 108 spores. Our data highlight the potential pathogenicity of opportunistic A. fumigatus that may be present in the Antarctic, and the risks of both their further transfer within Antarctica and outwards to other continents, risks which may be exacerbated due global climatic changes.

Pharmacological intestinal obstruction because of calcium polystyrene sulfonate administration.

Cation exchange resins are commonly used as treatment for hyperkalaemia in patients with chronic renal disease. There is a relation between cation exchange resins and the development of gastrointestinal adverse effects. A case of an intestinal obstruction at the terminal ileum is presented that underwent an ileocolic resection because of a critical stenosis of the intestine. The pathologist revealed abundant inflammatory cells together with deposits of calcium polystyrene crystals responsible of the intestinal obstruction. A rare cause of intestinal obstruction to bear in mind in chronically medicated patients with cation exchange resins.

Optimizing the Release Pattern of Telenomus podisi for Effective Biological Control of Euschistus heros in Soybean.

An augmentative biological control program using the egg parasitoid Telenomus podisi Ashmead (Hymenoptera: Platygastridae) is a promising tool for the management of the brown stink bug, Euschistus heros (Fabricius) (Hemiptera: Pentatomidae) in soybeans. The T. podisi are released as adults or pupae within lab-reared E. heros eggs. Because of the small size of the parasitoid and potentially limited dispersal ability, determining the optimal release pattern is critical for biological control of the target pest. This study used sentinel E. heros eggs to investigate T. podisi dispersal within soybean crops during two distinct phenological stages: the beginning of flowering (Vn-R1) and the grain-filling phase (R5-R6). Data were analyzed using semi-variograms and kriging maps. The results indicate significant differences in parasitism rates between the two plant growth stages and among different matrices. The maximum dispersal range for T. podisi was calculated at 39.0 m in the Vn-R1 stage with a maximum parasitism rate of 42%, while in the R5-R6 stage, the maximum dispersal range was calculated to be 30.9 m with a maximum parasitism of 73%. Therefore, it is recommended that release points for T. podisi be spaced no further than 30 m apart. These results provide valuable insights for future research and applications in biological control strategies, including adjustment of the logistics and release technique depending upon the crop phenological stage.

[Ethics and artificial intelligence]. / Ethik und künstliche Intelligenz.

The introduction of artificial intelligence (AI) into radiology promises to enhance efficiency and improve diagnostic accuracy, yet it also raises manifold ethical questions. These include data protection issues, the future role of radiologists, liability when using AI systems, and the avoidance of bias. To prevent data bias, the datasets need to be compiled carefully and to be representative of the target population. Accordingly, the upcoming European Union AI act sets particularly high requirements for the datasets used in training medical AI systems. Cognitive bias occurs when radiologists place too much trust in the results provided by AI systems (overreliance). So far, diagnostic AI systems are used almost exclusively as "second look" systems. If diagnostic AI systems are to be used in the future as "first look" systems or even as autonomous AI systems in order to enhance efficiency in radiology, the question of liability needs to be addressed, comparable to liability for autonomous driving. Such use of AI would also significantly change the role of radiologists.

An electrochemical genomagnetic assay for detection of SARS-CoV-2 and Influenza A viruses in saliva.

Viral respiratory infections represent a major threat to the population's health globally. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 disease and in some cases the symptoms can be confused with Influenza disease caused by the Influenza A viruses. A simple, fast, and selective assay capable of identifying the etiological agent and differentiating the diseases is essential to provide the correct clinical management to the patient. Herein, we described the development of a genomagnetic assay for the selective capture of viral RNA from SARS-CoV-2 and Influenza A viruses in saliva samples and employing a simple disposable electrochemical device for gene detection and quantification. The proposed method showed excellent performance detecting RNA of SARS-CoV-2 and Influenza A viruses, with a limit of detection (LoD) and limit of quantification (LoQ) of 5.0 fmol L-1 and 8.6 fmol L-1 for SARS-CoV-2, and 1.0 fmol L-1 and 108.9 fmol L-1 for Influenza, respectively. The genomagnetic assay was employed to evaluate the presence of the viruses in 36 saliva samples and the results presented similar responses to those obtained by the real-time reverse transcription-polymerase chain reaction (RT-PCR), demonstrating the reliability and capability of a method as an alternative for the diagnosis of COVID-19 and Influenza with point-of-care capabilities.

Potential of Dual-Energy CT-Based Collagen Maps for the Assessment of Disk Degeneration in the Lumbar Spine.

RATIONALE AND OBJECTIVES: Lumbar disk degeneration is a common condition contributing significantly to back pain. The objective of the study was to evaluate the potential of dual-energy CT (DECT)-derived collagen maps for the assessment of lumbar disk degeneration. PATIENTS AND METHODS: We conducted a retrospective analysis of 127 patients who underwent dual-source DECT and MRI of the lumbar spine between 07/2019 and 10/2022. The level of lumbar disk degeneration was categorized by three radiologists as follows: no/mild (Pfirrmann 1&2), moderate (Pfirrmann 3&4), and severe (Pfirrmann 5). Recall (sensitivity) and accuracy of DECT collagen maps were calculated. Intraclass correlation coefficient (ICC) was used to evaluate inter-reader reliability. Subjective evaluations were performed using 5-point Likert scales for diagnostic confidence and image quality. RESULTS: We evaluated a total of 762 intervertebral disks from 127 patients (median age, 69.7 (range, 23.0-93.7), female, 56). MRI identified 230 non/mildly degenerated disks (30.2%), 484 moderately degenerated disks (63.5%), and 48 severely degenerated disks (6.3%). DECT collagen maps yielded an overall accuracy of 85.5% (1955/2286). Recall (sensitivity) was 79.3% (547/690) for the detection of no/mild lumbar disk degeneration, 88.7% (1288/1452) for the detection of moderate disk degeneration, and 83.3% (120/144) for the detection of severe disk degeneration (ICC=0.9). Subjective evaluations of DECT collagen maps showed high diagnostic confidence (median 4) and good image quality (median 4). CONCLUSION: The use of DECT collagen maps to distinguish different stages of lumbar disk degeneration may have clinical significance in the early diagnosis of disk-related pathologies in patients with contraindications for MRI or in cases of unavailability of MRI.

Parent training for disruptive behavior symptoms in attention deficit hyperactivity disorder: a randomized clinical trial.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) affects 5% of children and 2.5% of adults worldwide. Comorbidities are frequent, and Oppositional Defiant Disorder (ODD) reaches 50%. Family environment is crucial for the severity of behaviors and for prognosis. In middle-income countries, access to treatment is challenging, with more untreated children than those under treatment. Face-to-face behavioral parent training (PT) is a well-established intervention to improve child behavior and parenting. Method: A clinical trial was designed to compare PT-online and face-to-face effects to a waiting list group. Outcomes were the ADHD and ODD symptoms, parental stress and styles, and quality of life. Families were allocated into three groups: standard treatment (ST), ST + PT online, and ST + Face-to-Face PT. We used repeated measures ANOVA for pre × post treatment analysis corrected for multiple comparisons. Results and discussion: Parent training was effective in reducing symptoms of ADHD (p = 0.030) and ODD (p = 0.026) irrespective of modality (p = 1.000). The combination of ST and PT was also associated with better quality of life in the physical domain for patients (p = 0.009) and their parents (p = 0.050). In addition to preliminary data, online intervention seems effective for parenting and improving social acceptance of children. The potential to reach many by an online strategy with a self-directed platform may imply effectiveness with a low cost for public health to support parents' symptoms management.

Cranial and postcranial anatomy of a juvenile baurusuchid (Notosuchia, Crocodylomorpha) and the taxonomical implications of ontogeny.

Baurusuchidae comprises a clade of top-tier terrestrial predators and are among the most abundant crocodyliforms found in the Adamantina Formation, Bauru Basin, Brazil (Campanian-Maastrichtian). Here, we provide a detailed description of the cranial and postcranial osteology and myology of the most complete juvenile baurusuchid found to date. Although the preservation of juvenile individuals is somewhat rare, previously reported occurrences of baurusuchid egg clutches, a yearling individual, and larger, but skeletally immature specimens, comprise a unique opportunity to track anatomical changes throughout their ontogenetic series. Its cranial anatomy was resolved with the aid of a three-dimensional model generated by the acquisition of computed tomography data, and its inferred adductor mandibular musculature was compared to that of mature specimens in order to assess possible ontogenetic shifts. A subsequent phylogenetic analysis included the scoring of Gondwanasuchus scabrosus, the smallest baurusuchid species known to date, to evaluate its phylogenetic relations relative to a known juvenile. We find considerable differences between juveniles and adults concerning skull ornamentation and muscle development, which might indicate ontogenetic niche partitioning, and also anatomical and phylogenetic evidence that G. scabrosus corresponds to a young semaphoront lacking mature cranial features.