Diffuse axonal injury on magnetic resonance imaging and its relation to neurological outcomes in pediatric traumatic brain injury.

OBJECTIVE: Diffuse axonal injury (DAI), a frequent consequence of pediatric traumatic brain injury (TBI), presents challenges in predicting long-term recovery. This study investigates the relationship between the severity of DAI and neurological outcomes in children. METHODS: We conducted a retrospective analysis of 51 pediatric TBI patients diagnosed with DAI using Adam's classification. Neurological function was assessed at 2, 3, and 6 weeks, and 12 months post-injury using the Pediatric Glasgow Outcome Scale-Extended (PGOSE). RESULTS: PGOSE scores significantly improved over time across all DAI grades, suggesting substantial recovery potential even in initially severe cases. Despite indicating extensive injury, patients with DAI grades II and III demonstrated significant improvement, achieving a good recovery by 12 months. Although the initial Glasgow Coma Scale (GCS) score did not show a statistically significant association with long-term outcomes in our limited sample, these findings suggest that the severity of DAI alone may not fully predict eventual recovery. CONCLUSIONS: Our study highlights the potential for significant neurological recovery in pediatric patients with DAI, emphasizing the importance of long-term follow-up and individualized rehabilitation programs. Further research with larger cohorts and extended follow-up periods is crucial to refine our understanding of the complex relationships between DAI severity, injury mechanisms, and long-term neurological outcomes in children.

Assessment of heavy metals at mangrove ecosystem, applying multiple approaches using in-situ and remote sensing techniques, Red Sea, Egypt.

Mangrove areas are considered the most retention zone for heavy metal pollution as it work as an edge that aggregates land and sea sediments. This study aims to examine if the heavy metals' existence in the mangrove sediment is related to contamination or natural resources. In addition, it gives an interpretation of the origin of these metals along the Egyptian Red Sea coast. Twenty-two samples of mangrove sediments were collected and then, analyzed for metals (Mn, Ni, Cu, Fe, Cd, Ag, and Pb) using inductively coupled plasma mass spectroscopy (ICP-MS). Integration between the in-situ data, contamination indices, and remote sensing and geographical information science (GIS), and multivariate statistical analysis techniques (PCA) were analyzed to assess and clarify the spatial origin of heavy metals in sediment at a regional scale. The average concentration of heavy metals from mangrove sediments were shown to be substantially lower than the referenced value, ranging from moderate to significant except the levels of Ag were very high. The heavy metals concentrations were expected to be naturally origin rather than anthropogenic and that be confirmed by mapping of Red Sea alteration zones spots. These alteration zones are parallel to mangrove sites and rich by several mineralization types including heavy metals that are carried by flooding to the coastline. Remote sensing and GIS techniques successfully contributed to interpreting the pattern of the origin of heavy metals and discharging systems that control the heavy metals concentration along the Red Sea coast.

Modified Capsulorrhaphy Technique in Open Reduction of Developmental Dysplasia of the Hip.

BACKGROUND: Neglected patients with developmental dysplasia of the hip (DDH) are not uncommon. Various treatment modalities have been used. Capsulorrhaphy is one of the most critical steps during the process of open reduction of DDH. Inadequate capsulorrhaphy technique can increase the failure rate of open reduction procedures. This study presented the clinical and radiographic results of using a new capsulorrhaphy technique. METHODS: Between November 2005 and March 2018, 540 DDH in 462 patients were retrospectively reviewed. The mean age at surgery was 31 months. All patients underwent a modified capsulorrhaphy technique developed by the main author (with or without additional pelvic or femoral procedures). Postoperative patient assessment during the follow-up period was performed both clinically and radiologically. RESULTS: Follow-up period ranged between 36 months and 12 years. Based on the modified McKay score, good and excellent outcomes were obtained in 90.3%. Functional results were better in younger age (less than 39 mo). Both acetabular index and lateral center edge angle showed significant improvement at 3 years follow-ups. Proximal femoral growth disturbance (PFGD) was encountered in 92 hips. Classes 2 and 3 did not affect the functional results, whereas patients with PFGD classes 4 and 5 had fair to poor functional outcomes. There were 12 hips with redislocation. Revision was done using the same capsulorrhaphy technique. CONCLUSION: Using the index technique of capsulorrhaphy in DDH surgery is safe, reliable, and yields good functional and radiologic outcomes with a relatively low complication rate. LEVEL OF EVIDENCE: Level IV-therapeutic retrospective case series.

Acute Correction and Plate Fixation for the Management of Severe Infantile Blount's Disease: Short-term Results.

PURPOSE: The purpose of this study is to evaluate the short-term results of lateral closing wedge osteotomy with medial hemiplateau elevation for the management of severe infantile Blount's disease. MATERIALS AND METHODS: In this prospective study, 11 cases of severe Blount's disease (Langenskiold stages five and six) were managed in the period between January 2017 and January 2020. Double osteotomy technique was applied, namely a metaphyseal closing wedge and a medial hemiplateau elevation, through a single midline incision. Fixation was achieved by a medial anatomical locked plate. Patients were evaluated clinically according to a modified version of paediatric outcomes data collection Instrument (PODCI) and radiologically by measuring the angle between the tibial and the femoral shaft, the mechanical axis deviation (MAD) and the angle of the medial tibial plateau (MTP) depression. RESULTS: The average follow-up period was 2 years. Healing of the osteotomies was achieved in all cases after the index operation within an average of 3 months. Based on our modification of the PODCI score, five cases had an excellent outcome, five were good, and one case ended with a fair outcome. No major complications were encountered in this study. CONCLUSION: The management of severe Blount's disease by acute correction using the aforementioned technique has been proven to achieve acceptable clinical and radiological outcomes without significant complications. LEVEL OF EVIDENCE: Level IV case series study. HOW TO CITE THIS ARTICLE: Nada AA, Hammad ME, Eltanahy AF, et al. Acute Correction and Plate Fixation for the Management of Severe Infantile Blount's Disease: Short-term Results. Strategies Trauma Limb Reconstr 2021;16(2):78-85.

Weyl Semimetal Path to Valley Filtering in Graphene.

We propose a device in which a sheet of graphene is coupled to a Weyl semimetal, allowing for the physical access to the study of tunneling from two- to three-dimensional massless Dirac fermions. Because of the reconstructed band structure, we find that this device acts as a robust valley filter for electrons in the graphene sheet. We show that, by appropriate alignment, the Weyl semimetal draws away current in one of the two graphene valleys, while allowing current in the other to pass unimpeded. In contrast to other proposed valley filters, the mechanism of our proposed device occurs in the bulk of the graphene sheet, obviating the need for carefully shaped edges or dimensions.

Profiling Inflammatory Cytokines in a Cohort Study of Egyptian Patients with COVID-19 Infection.

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic is an international public health emergency with major disruptions and devastating health consequences resulting from the associated cytokine storm syndrome. The aim of our research was to assess the inflammatory biomarkers and risk factors associated with severity of (COVID-19) patients. METHODS: A cross-sectional study was conducted and included 150 Egyptian patients with COVID-19. Patients were classified into mild, moderate, and severe according to the clinical and CT chest findings. Blood samples were collected from patients for laboratory assessment of inflammatory biomarkers. RESULTS: Our results showed significant negative correlation between oxygen saturation percent and serum levels of inflammatory markers. The correlations were statistically significant with IL-6, CRP, ferritin, LDH, and D-dimer which can be used as sensitive biomarkers for assessment of the risk of severity of infection in COVID 19 patients. CONCLUSIONS: The study revealed that the risk factors associated with severity of COVID 19 infection included older age, male gender, presence of underlying chronic disease, and increased levels of inflammatory biomarkers: CRP, LDH, ferritin, IL-6, and D-dimer.

Microsporidia infection in patients with autoimmune diseases.

Purpose: Microsporidium is a spore-forming intracellular parasite that affects a wide range of hosts including humans. The tumor necrosis factor alpha (TNF-α) plays a key role in the immunity to infection with microsporidia. Recently, the TNF-α antagonists have proven successful in treating variable autoimmune diseases. In the current study, we aimed to investigate the impact of using TNF-α antagonists as a therapeutic regimen in the prevalence of infections with microsporidia. Materials and Methods: Diarrheal patients with distinct autoimmune diseases (n = 100) were assigned to the study. Patients taking anti-TNF-α medications (n = 60) were allocated to Group 1A and those undergoing non-TNF-α inhibitor treatment (n = 40) to Group 1B. Furthermore, patients with diarrhea without autoimmune disorders (n = 20) were allocated as controls. Stool specimens, 3 per patient, were collected and microscopically examined for microsporidia spores. A microsporidia-specific stool polymerase chain reaction was used to confirm the microscopic findings. Results: Microsporidia infection was identified in 28.3% (17/60), 10% (4/40), and in 5% (1/20) of patients in Group 1A, Group 1B, and in the control group, respectively. Overall, infection was significantly high in cases compared to the controls and in patients receiving TNF-α antagonists compared to patients not given TNF-α inhibitors (P < 0.05). Finally, infection was significantly higher in cases treated with TNF-α antagonists for ≥2 months compared to cases treated for <2 months of duration (P < 0.05). Conclusion: There was a significant increase in microsporidia infection in autoimmune disease patients undergoing treatment with TNF-α antagonists, and the duration of treatment is one of the risk factors. The study highlights the importance of microsporidia testing in immunocompromised patients, particularly those undergoing treatment with anti-TNF-α drugs and emphasises the need for awareness among clinicians regarding this opportunistic parasite.

Defect engineering in 1D Ti-W oxide nanotube arrays and their correlated photoelectrochemical performance.

Understanding the nature of interfacial defects of materials is a critical undertaking for the design of high-performance hybrid electrodes for photocatalysis applications. Theoretical and computational endeavors to achieve this have touched boundaries far ahead of their experimental counterparts. However, to achieve any industrial benefit out of such studies, experimental validation needs to be systematically undertaken. In this sense, we present herein experimental insights into the synergistic relationship between the lattice position and oxidation state of tungsten ions inside a TiO2 lattice, and the respective nature of the created defect states. Consequently, a roadmap to tune the defect states in anodically-fabricated, ultrathin-walled W-doped TiO2 nanotubes is proposed. Annealing the nanotubes in different gas streams enabled the engineering of defects in such structures, as confirmed by XRD and XPS measurements. While annealing under hydrogen stream resulted in the formation of abundant Wn+ (n < 6) ions at the interstitial sites of the TiO2 lattice, oxygen- and air-annealing induced W6+ ions at substitutional sites. EIS and Mott-Schottky analyses indicated the formation of deep-natured trap states in the hydrogen-annealed samples, and predominantly shallow donating defect states in the oxygen- and air-annealed samples. Consequently, the photocatalytic performance of the latter was significantly higher than those of the hydrogen-annealed counterparts. Upon increasing the W content, photoelectrochemical performance deteriorated due to the formation of WO3 crystallites that hindered charge transfer through the photoanode, as evident from the structural and chemical characterization. To this end, this study validates the previous theoretical predictions on the detrimental effect of interstitial W ions. In addition, it sheds light on the importance of defect states and their nature for tuning the photoelectrochemical performance of the investigated materials.

Thr136Ile polymorphism of human vesicular monoamine transporter-1 (SLC18A1 gene) influences its transport activity in vitro.

OBJECTIVES: Although single nucleotide polymorphisms of the human vesicular monoamine transporter 1 (hVMAT1) gene SLC18A1 have been associated with neuropsychiatric disorders, there is limited information on the function of naturally occurring hVMAT1 variant proteins. This study evaluated transport activity of full length hVMAT1 isoform-a (NP_003044.1) with a threonine (Thr) or isoleucine (Ile) at amino acid 136 and hVMAT1 isoform-b (NP_00135796.1) with a 136-Thr and deletion of 32 amino acids in the central region of the protein. Genetic studies have previously linked the 136-Thr to bipolar disorder. METHODS: Expression vectors with hVMAT1 DNA coding for isoform variants were transfected into COS-1 cells. Expression of immunoreactive proteins was assessed by Western blotting, and function was assayed by ATP-dependent transport of radiolabeled serotonin and concentration-dependent inhibition by reserpine. RESULTS: Immunoreactive isoform-a proteins were observed as a major doublet (68-71 Kd) and a minor 39 Kd protein. The major isoform-b protein was 47 Kd with minor 57 and 115 Kd proteins. Isoform-b had no detectable transport activity, despite a large amount of immunoreactive protein. Transport activity of isoform-a with 136-Thr was 20-50% lower than with 136-Ile in time course studies (2.5-5 min) and in additional 5 min assays repeated with 5-6 transfections per variant. Kinetic analyses indicated a lower transport Vmax of isoform-a with 136-Thr but no significant differences in the transport Km or reserpine IC50. CONCLUSIONS: Deletion of amino acids 307-338 in hVMAT1 isoform-b abolishes transport activity, and a 136-Thr partially reduces activity of isoform-a.

Improving near vision in presbyopic eyes by selective treatment of high-order aberrations.

PURPOSE: Evaluation of improving near vision in presbyopic patients with low to moderate myopia with selective treatment of high-order aberrations (HOAs) using the ORK-CAM software aberrometer and a SCHWIND ESIRIS excimer laser. In this study, all HOAs except vertical coma were treated and the effect on near visual function was evaluated. SETTING: Horus Vision Correction Center, Alexandria, Egypt. METHODS: Twenty-six presbyopic patients (52 eyes) with low to moderate myopia were divided into two groups, A and B. The ORK-CAM software aberrometer was used in both groups to measure HOAs and design wavefront-guided treatment. All included eyes had total coma >0.2 µm. The Moria M2 mechanical microkeratome was used for flap making in both groups. Wavefront-guided laser-assisted in situ keratomileusis using ESIRIS laser was done for all eyes. In Group A (30 eyes) all HOAs were treated. In Group B (22 eyes) vertical coma was left untreated. Postoperative uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), uncorrected near acuity (UCNA), distance corrected near acuity (DCNA), best corrected near acuity with addition for near vision (BCNA), manifest refractive spherical equivalent (MRSE), HOAs, and contrast sensitivity for both groups were done preoperatively and at 3 months postoperatively. RESULTS: Mean age was 47.46 and 45.2 years for groups A and B, respectively. Mean preoperative MRSE was -2.37 and -2.87 D and mean preoperative total HOAs was 0.35 and 0.38 µm in groups A and B, respectively. There was no significant difference between groups regarding age, sex, preoperative MRSE, and preoperative total HOAs. After 3 months, there was no significant difference between groups in terms of UCVA, BCVA, MRSE, and contrast sensitivity. Analysis of postoperative HOAs showed significant difference in vertical coma between the two groups (P < 0.001). DCNA was significantly better in Group B (P < 0.01). CONCLUSION: Treating low to moderate myopia with wavefront-guided ablation including selective treatment of HOAs might be very useful for improving visual functions. Treating all HOAs but the vertical coma improved uncorrected near acuity in presbyopic patients.

Vesicular monoamine transporter-1 (VMAT-1) mRNA and immunoreactive proteins in mouse brain.

OBJECTIVE: Vesicular monoamine transporter 1 (VMAT-1) mRNA and protein were examined (1) to determine whether adult mouse brain expresses full-length VMAT-1 mRNA that can be translated to functional transporter protein and (2) to compare immunoreactive VMAT-1 proteins in brain and adrenal. METHODS: VMAT-1 mRNA was detected in mouse brain with RT-PCR. The cDNA was sequenced, cloned into an expression vector, transfected into COS-1 cells, and cell protein was assayed for VMAT-1 activity. Immunoreactive proteins were examined on western blots probed with four different antibodies to VMAT-1. RESULTS: Sequencing confirmed identity of the entire coding sequences of VMAT-1 cDNA from mouse medulla oblongata/pons and adrenal to a Gen-Bank reference sequence. Transfection of the brain cDNA into COS-1 cells resulted in transporter activity that was blocked by the VMAT inhibitor reserpine and a proton ionophore, but not by tetrabenazine, which has a high affinity for VMAT-2. Antibodies to either the C- or N- terminus of VMAT-1 detected two proteins (73 and 55 kD) in transfected COS-1 cells. The C-terminal antibodies detected both proteins in extracts of mouse medulla/pons, cortex, hypothalamus, and cerebellum but only the 73 kD protein and higher molecular weight immunoreactive proteins in mouse adrenal and rat PC12 cells, which are positive controls for rodent VMAT-1. CONCLUSIONS: These findings demonstrate that a functional VMAT-1 mRNA coding sequence is expressed in mouse brain and suggest processing of VMAT-1 protein differs in mouse adrenal and brain.

Expression of transient receptor potential vanilloid (TRPV) families 1, 2, 3 and 4 in the mouse olfactory epithelium.

We investigated the expression of transient receptor potential vanilloid (TRPV)-1-4 in the mouse olfactory epithelium (OE) in comparison to its expression in respiratory epithelium. CBA/J mice were used. The localization of TRPV-1, -2, -3 and -4 in the nasal mucosa was investigated using immunohistochemistry and a double staining study for TRPV-1 and -2 and SP was also carried out. TRPV-1-4, were expressed variably in the OE with a diffuse pattern in lamina propria, and were expressed in respiratory epithelium with strong positive expression in glandular cells of lamina propria. The double-staining study revealed coexpression of TRPV-1 and -2 and substance P (SP) in the trigeminal nerve fibers of the OE. Coexpression of TRPV-1 and SP was marked around the blood vessels and seromucinous gland of respiratory epithelium while TRPV-2 showed no co-localization. TRPV-1-4 were found to be localized in the mouse OE and respiratory epithelium. Our results suggest that TRPVs may play multiple roles in the OE, contributing to olfactory adaptation, olfactory/trigeminal interactions in nasal chemoreception and OE homeostasis; they may also be involved in olfactory transduction as well as olfactory dysfunction secondary to sinonasal inflammatory disease. TRPVs in respiratory mucosa may play a significant role in nasal nociception, ciliary movement and the regulation of mucous secretion.