Insight into brain sex differences of typically developed infants and brain pathologies: A systematic review.

The continually advancing landscape of neuroscientific and imaging research has broadened our comprehension of sex differences encoded in the human brain, expanding from the hypothalamus and sexual behaviour to encompass the entire brain, including its diverse lobes, structures, and functions. However, less is known about sex differences in the brains of neonates and infants, despite their relevance to various sex-linked diseases that develop early in life. In this review, we provide a synopsis of the literature evidence on sex differences in the brains of neonates and infants at the morphological, structural and network levels. We also briefly overview the present evidence on the sex bias in some brain disorders affecting infants and neonates.

Prognostic factors for visual recovery after successful large macular hole surgery using the inverted flap technique.

PURPOSE: The goal of our study is to describe the functional results and preoperative factors predicting visual recovery after successful inverted flap technique and closure of large full-thickness macular holes (FTMH) and to evaluate the correlations between microstructural foveal changes and final visual acuity. METHODS: Retrospective, descriptive, analytical study including 80 eyes of 78 patients with large FTMH; operated by inverted flap technique with successful closure of the macular hole after surgery. All eyes underwent a full preoperative ophthalmic examination and macular B-scan SD-OCT. We performed the classic inverted flap technique for all patients. Postoperatively, all patients were examined at 7 days, 1, 3, 6, 9 and 12 months after surgery. SD-OCT was performed for all patients on each follow-up. Preoperatively, best-corrected visual acuity (BCVA), FTMH size and basal hole diameter were the main outcome measures. Postoperatively, BCVA, macular thickness, integrity of the external limiting membrane (ELM) and ellipsoid zone (EZ) were recorded. RESULTS: Mean age was 62±8.42 years with female predominance. Mean size of the FTMH was 692.59µm, and mean basal hole diameter was 1436.06µm. Mean BCVA improved from 1.06±0.491 LogMAR preoperatively to 0.52±0.32 at 9 months following surgery (P<0.001). At 9 months, the ELM was absent, partial or fully restored in 6.67, 10 and 83.33% respectively. The EZ was absent, partial or fully restored in 6.67, 33 and 63.33% respectively. ELM regeneration always preceded EZ regeneration at every point of follow-up. Final BCVA was statistically correlated with initial hole size (P=0.006, OR=1.056; CI [1.016-1.098]) and mean symptom duration prior to surgery (P=0.001. OR=0.987; CI [0.976-0.998]). Analysis of the ROC curve demonstrated that a hole diameter>478.5µm and symptom duration>5 weeks were correlated with non-improvement of visual acuity, with 81.3% sensibility and 18.7% specificity. CONCLUSION: We report tomographic microstructural foveal changes and functional results following successful large idiopathic FTMH surgery using the classic inverted flap technique. Preoperative parameters such as initial FTMH diameter and mean symptom duration prior to surgery are crucial prognostic factors influencing final visual results.

Knowledge and Attitude of General People Towards Symptoms of Heart Attack and the Impact of Delay Time in Riyadh, Saudi Arabia.

BACKGROUND: Cardiovascular disease is prevalent worldwide. The goal of this research is to evaluate the knowledge of Riyadh, Saudi Arabia, population about heart attack symptoms and risk factors. METHODOLOGY: A one-year cross-sectional study was carried out. The study was conducted on 385 individuals in Riyadh, Saudi Arabia. We used the Acute Coronary Syndrome Response Index, with additional questions added, such as risk factors of heart attack and physical activity time. An anonymous self-administered online questionnaire was used to collect the data. RESULTS: We collected data from 440 participants, but only 385 were included in the analysis. Males represented 41.4% of the participants. In terms of participant knowledge of heart attack symptoms, we found that chest pain or pressure was the most common (80.5%), followed by shortness of breath (77%) and weakness and fatigue (72.0%). In addition, 90.2% and 90.7% of the participants knew that smoking and obesity were risk factors for heart attacks. Furthermore, 46% of participants said they "would not be at all certain" of identifying the symptoms and indicators of a heart attack in another person and 45.7% "in themselves." We found that males were more likely than females to have low knowledge (RR: 1.84, 95% CI: 1.24:2.72, P = 0.002). CONCLUSION: Our findings suggest that there is a lack of awareness of the heart attack warning signs and symptoms. We propose that future local campaigns focus on increasing awareness and recognition of heart attack symptoms.

Exploration of robustness indicators using adaptive responses to short-term feed restriction in suckling primiparous beef cows.

Animal robustness is a complex trait of importance for livestock production systems and genetic selection. Phenotyping is essential for evaluation of the adaptation of different genotypes to changing environments. This study tested an experimental framework to induce marked deviations in the adaptive responses of suckling beef cows and to identify relevant indicators of responses to characterise individual differences in the robustness of cows. The production and metabolic responses of primiparous suckling Charolais cows to two periods of feed restriction (FR, 50% of their net energy requirements) of different durations were monitored. After calving, 13 cows (aged 39 ±â€¯2 months, BW of 680 ±â€¯42 kg at calving) had ad libitum access to a diet composed of hay and supplemented with concentrate to meet their energy and protein requirements. Starting at 54 ±â€¯6 days postcalving, the cows underwent two periods of FR: 4 days of FR (FR4), which was followed by 17 days of ad libitum intake to study the recovery from FR4, and 10 days of FR (FR10), which was followed by 18 days of ad libitum intake to study the recovery from FR10. The milk yield (MY), BW, body condition score and plasma non-esterified fatty acid (NEFA), ß-hydroxybutyrate, glucose and urea concentrations were measured before, during and after each FR. Among all measured variables, the MY and NEFA concentrations showed the most significant changes in response to FR. A functional data analysis approach was applied to the MY and NEFA data to model the adaptive responses and extract quantifiable indicators of deviation and recovery. Linear correlations (P < 0.03-0.07) between FR4 and FR10 were found for some indicators describing MY and NEFA levels before and after FR. The overall repeatability of MY and NEFA responses between both FR accounted for 46% based on quartile analysis performed on average responses. Moreover, the variance in both the MY and NEFA variables did not differ significantly between FR4 and FR10, despite a trend for higher variances in FR10. Altogether, (1) the calculated variables derived from the functional data analysis of the time patterns of the MY and NEFA accounted for the differences in the cow responses to FR, and (2) the animal responses appeared to show concordance between FR4 and FR10. In conclusion, short-term FR is a relevant framework for studying productive and metabolic adaptive responses in suckling cows and allows the identification of potential robustness indicators.

Epidemiology and prognostic factors of open globe injuries in a Tunisian pediatric population.

INTRODUCTION: Childhood ocular trauma is a preventable cause of visual impairment and blindness worldwide. The purpose of our study was to determine demographic, etiologic, and clinical characteristics, visual outcome, and factors affecting visual prognosis in children with open globe injuries (OGI) and to analyze the predictive value of ocular trauma scoring systems for OGI in children. METHODS: We conducted a retrospective study enrolling 120 pediatric patients hospitalized for OGI from January 2010 to March 2017. Age, gender, date of trauma, time between trauma and presentation, place and circumstances of injury, etiology, visual acuity (VA), wound location and type of injury based on the Birmingham Eye Trauma Terminology, and the clinical signs were recorded. We recorded the number of surgical procedures performed, complications and visual outcomes. RESULTS: The mean age was 7.38 years. In all, 62.5% of the patients were male, and 37.5% were female. The gender ratio was observed to decrease with increasing age. The mean time interval between injury and consultation was 22.80±42.68hours. Injuries usually occurred at home (80%) followed by playgrounds and sports venues (8.3%), the street (6.7%) and school (5%). All of the OGI's were accidental, and the main context was play (70%). The most common traumas were penetrating injury (60.8%) and metal (30%) objects. Penetrating trauma accounted for 68.3% of cases, followed by rupture (27.5%) and intraocular foreign body (IOFB) (7.5%). Initial VA was<1/10 in 59.2% of cases, and the point of entry was the cornea in 65.8% of cases. Final VA was<1/10 in 39.69% of all cases. FVA was significantly correlated with BCVA prior to the surgery, mechanism of the trauma, wound location and size, and other associated lesions. The Ocular Trauma Score (OTS) and the Pediatric Ocular Trauma Score (POTS) were significantly correlated with final VA. CONCLUSION: OGI's in children occurs most frequently in school-age boys. Prognosis is determined by presenting visual acuity, trauma score, and wound severity and location.

Fold-Over Oversampling Effects in the Measurements of Cerebral Cerebrospinal Fluid and Blood Flows with 2D Cine Phase-Contrast MRI.

This prospective study investigated the effects of fold-over oversampling on phase-offset background errors with 2D-Cine phase contrast (Cine-PC) magnetic resonance imaging (MRI). It was performed on brain MRI and compared to conventional Full-field of view FOV coverage and it was tested with two different velocity encoding (Venc) values. We chose Venc = 100 mm/s to encode cerebrospinal fluid (CSF) flows in the aqueduct and 600 mm/s to encode blood flow in the carotid artery. Cine-PC was carried out on 10 healthy adult volunteers followed simultaneously by an acquisition on static agar-gel phantom to measure the phase-offset background errors. Pixel-wise correction of both the CSF and the blood flows was calculated through 32 points of the cardiac-cycle. We compared the velocity-to-noise ratio, the section area, the absolute and the corrected velocity (peak; mean and minimum), the net flow, and the stroke volume before and after correction. We performed the statistical T-test to compare Full-FOV and fold-over and Bland-Altman plots to analyze their differences. Our results showed that following phase-offset error correction, the blood stroke-volume was significantly higher with Full-FOV compared to fold-over. We observed a significantly higher CSF mean velocity and net flow values in the fold-over option. Compared to Full-FOV, fold-over provides a significantly larger section area and significantly lower peak velocity-offset in the aqueduct. No significant difference between the two coverages was reported before and after phase-offset in blood flow measurements. In conclusion, fold-over oversampling can be chosen as an alternative to increase spatial resolution and accurate cerebral flow quantification in Cine-PC.

Melatonin mends adverse temporal effects of bright light at night partially independent of its effect on stress responses in captive birds.

Ecological artificial light at night (ALAN) has been increasingly associated with negative effects on the behavior and ecology of wild birds. However, the impacts of short-term bright ALAN on the temporal biology of companion animals and the underlying mediating mechanism are unknown. We evaluated impacts of 1X60-min/middle night ALAN (200 lux, λDominant = 460 nm) nightly with or without melatonin administration on growth performance, reproductive capacity, food and water intake, and stress responses in Australian budgerigars (Melopsittacus undulatus) under captivity. 36 birds were housed in pairs under natural photoperiod and were equally divided into three groups: control, natural conditions; ALAN, control + ALAN; and melatonin, ALAN + melatonin in the drinking water during the dark period. Birds were regularly monitored for body mass, egg production, and hatchability over four months. Food intake, water consumption, and daily rhythm of fecal corticosterone were also evaluated. ALAN increased mass gain, food intake, water consumption, and drastically decreased reproductive capacity, whereas stress responses were markedly augmented. Melatonin restored food and water intake to control levels but partly reversed mass gain. Melatonin failed to ameliorate the impaired reproductive capacity despite reducing the stress responses to basal levels. These results suggest that the ALAN-induced negative impacts cannot be attributed solely to direct effects of melatonin suppression or/and exacerbated stress responses and the involvement of other photoperiodic pathway components warrant further studies. Finally, the results of our study may be of importance for improving the housing conditions of companion animals at least as concern bright ALAN exposures.

Total cerebrovascular blood flow and whole brain perfusion in children sedated using propofol with or without ketamine at induction: An investigation with 2D-Cine PC and ASL.

BACKGROUND: Multiple sedation regimes may be used to facilitate pediatric MRI scans. These regimes might affect cerebral blood flow and hemodynamics to varying degrees, particularly in children who may be vulnerable to anesthetic side effects. PURPOSE: To compare the effects of propofol monosedation solely (Pm group) vs. a combination of propofol and ketamine (KP group) on brain hemodynamics and perfusion. STUDY TYPE: Prospective double-blind randomized trial. FIELD STRENGTH/SEQUENCES: 1.5T and 3T. 2D-Cine phase contrast (2D-Cine PC) and pseudocontinuous arterial spin labeling (ASL). POPULATION: Children aged from 3 months to 10 years referred for MRI with deep sedation were randomized into either the KP or the Pm group. Perfusion images were acquired with ASL followed by single-slice 2D-Cine PC acquired between the cervical vertebra C2 and C3. ASSESSMENT: Average whole-brain perfusion (WBP ml.min-1 .100 ml-1 ) was extracted from the ASL perfusion maps and total cerebrovascular blood flow (CVF) was quantified by bilaterally summing the flow in the vertebral and the internal carotid arteries. The CVF values were converted to units of ml.min-1 .100 g-1 to calculate the tissue CVF100g (ml.min-1 .100 g-1 ). Images were assessed by a neuroradiologist and data from n = 81 (ASL) and n = 55 (PC) cases with no apparent pathology were entered into the analysis. STATISTICAL TESTS: Multivariate analysis of covariance was performed to compare drug sedation effects on WBP, CVF, and CVF100g . RESULTS: No significant difference in arterial flow was observed (P = 0.57), but the KP group showed significantly higher WBP than the Pm group, covarying for scanner and age (P = 0.003). A correlation analysis showed a significant positive correlation between mean WBP (ml.min-1 .100 g-1 ) and mean CVF100g . DATA CONCLUSION: The KP group showed higher perfusion but no significant difference in vascular flow compared with the Pm group. WBP and CVF100g correlated significantly, but ASL appeared to have more susceptibility to perfusion differences arising from the different sedation regimes. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2019;50:1433-1440.

Early assessment of lateralization and sex influences on the microstructure of the white matter corticospinal tract in healthy term neonates.

We assessed the sex and the lateralization differences in the corticospinal tract (CST) during the early postnatal period. Twenty-five healthy term neonates (13 girls, aged 39.2 ± 1.2 weeks, and 12 boys aged 38.6 ± 3.0 weeks) underwent Diffusion Tensor Imaging (DTI). Fiber tracking was performed to extract bilaterally the CST pathways and to quantify the parallel (E1 ) and perpendicular (E23 ) diffusions, the apparent diffusion coefficient (ADC), and fractional anisotropy (FA). The measurements were performed on the entire CST fibers and on four segments: base of the pons (CST-Po), cerebral peduncles (CST-CP), posterior limb of the internal capsule (CST-PLIC), and corona-radiata (CST-CR). Significantly higher E1 , lower E23, and higher FA in the right compared to the left were noted in the CST-PLIC of the girls. Significantly lower E23 and lower ADC with higher FA in the right compared to left were observed in the CST-CP of the boys. Moreover, the CST-PLIC of the boys had significantly higher E1 in the right compared to the left. There was a significant increase in left CST E1 of boys when compared with girls. Girls had a significantly lower E1 , lower E23 and, lower ADC in the left CST-CP compared with boys. In addition, girls had a significantly lower E23 and higher FA in the right CST-PLIC compared with boys. Sex differences and lateralization in structure-based segments of the CST were found in healthy term infants during early postnatal period. These findings are vital to understanding motor development of healthy term born neonates to better interpret newborn infants with abnormal neurodevelopment.

Vascular occlusion following application of subcutaneous anterior pelvic fixation (INFIX) technique.

We report a case of bilateral external iliac artery compression after application of subcutaneous anterior pelvic fixation (INFIX) technique in a 51-year-old male with an unstable pelvic fracture sustained following a motor vehicle accident. This has not been previously reported in the literature. The management of this complication is discussed in detail, along with key precautions and technical steps to consider while utilizing the 'INFIX' technique for pelvic fractures.

Regional differences in interhemispheric structural fibers in healthy, term infants.

Using fiber tracking we investigated the early interhemispheric to cortical development by segmenting the corpus callosum (CC) in five substructures, genu, rostrum, body, isthmus, and splenium, and to examine gender differences in healthy, term neonates. Twenty neonates (11 boys aged 39 ± 2 days, nine girls aged 39 ± 1 days) were scanned in natural sleep with diffusion tensor imging and 35 gradient directions. Fiber tracking was performed using the FACT algorithm. The CC was segments in five substructures on midsagittal imaging. The fiber axial and radial diffusion were measured along with apparent diffusion coefficient and fractional anisotropy. Volume measures were performed for each of these substructures using high-resolution isotropic 3D T1-weighted images. Radial and mean diffusivity in all measured interhemispheric connections were significantly higher in male newborn infants than in female. Second, a gender-dependent regional difference of the measured interhemispheric connections exists. There was no volume difference between boys and girls in any of the five studied sudsubstructures. In addition there was no association between macrostructural and microstructural differences either in boys or girls. The cytoarchitecture and the integrity of the interhemispheric fibers is more developed in female infants in all subdivisions of the CC, except for the isthmus. This might result from a larger axonal diameter, highly packed fibers, or more well-developed myelin sheath. © 2016 Wiley Periodicals, Inc.

Pathophysiological mechanisms of calcineurin inhibitor-induced nephrotoxicity and arterial hypertension.

Solid organ transplantation is an established treatment modality in patients with end-stage organ damage in cases where other therapeutic options fail. The long-term outcomes of solid organ transplant recipients have improved considerably since the introduction of the first calcineurin inhibitor (CNI) - cyclosporine. In 1984, the potent immunosuppressive properties of another CNI, tacrolimus, were discovered. The immunosuppressive effects of CNIs result from the inhibition of interleukin-2 synthesis and reduced proliferation of T cells due to calcineurin blockade. The considerable side effects that are associated with CNIs therapy include arterial hypertension and nephrotoxicity. The focus of this article was to review the available literature on the pathophysiological mechanisms of CNIs that induce chronic nephrotoxicity and arterial hypertension. CNIs lead to activation of the major vasoconstriction systems, such as the renin-angiotensin and endothelin systems, and increase sympathetic nerve activity. On the other hand, CNIs are known to inhibit NO synthesis and NO-mediated vasodilation and to increase free radical formation. Altogether, these processes cause endothelial dysfunction and contribute to the impairment of organ function. A better insight into the mechanisms underlying CNI nephrotoxicity could assist in developing more targeted therapies of arterial hypertension or preventing CNI nephrotoxicity in organ transplant recipients, including heart transplantation.

Can Leukocyte Telomere Length Predict Survival Time in Heart Transplant Recipients over a Minimal Follow-Up of 20 years?

In humans, leukocyte telomere length (LTL) reduces with age and is reported to be inversely associated with ageing-related diseases. We measured LTL in leukocyte DNA using a quantitative PCR-based method from 127 blood samples of heart recipients (107 males, 20 females, age 44.1 ± 10.5), followed for up to 30 years. Patients with coronary artery disease survived for a shorter time and also had shorter LTL (both P < 0.05 after adjustment for age and sex) than subjects with dilated cardiomyopathy. Patients with non-cardiac causes of death had shorter LTL than patients with cardiac causes (P < 0.05 after adjustment for age). An inverse correlation between LTL and age (P < 0.03) was observed in patients with non-cardiac causes of death only. Most importantly, LTL was not associated with general survival time in patients after heart transplantation. However, shorter LTL was a marker of non-cardiac causes of death. Different LTLs and survival times were determined in association with aetiology of heart failure (HF).