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Objectives: The aim was to explore the correlations between Jumping to Conclusions (JtC) tendency and neuropsychiatric features in patients with early Parkinson's disease (PD). Background: According to few reports, PD patients with impulsive–compulsive behaviors (ICBs) are prone to working memory difficulties including JtC bias. The correlation of psychotic features and JtC tendency remains still unclear. Methods: Healthy controls and patients within 3 years of PD onset were recruited. Participants were examined for psychotic symptoms using a 10 question PD-specific psychosis severity scale. JtC was measured by a probalistic reasoning scenario (beads task). In PD group, medication use, motor and non-motor symptoms were documented. Impulsivity was evaluated using the Questionnaire for Impulsive–Compulsive Disorders in PD (QUIP). Results: The prevalence of JtC bias was 9% (6/70) in healthy individuals, compared to 32% (22/68) of PD group [p = 0.001]. No association was detected between the presence of JtC tendency and PD-associated psychosis (p = 0.216). Patients with JtC had shorter duration of PD, more tremor-dominant PD subtype and higher QUIP scores, regardless of the dopaminergic therapy (p = 0.043, p = 0.015, p = 0.007, respectively). A trend towards attention and inhibition control deficit was noticed in JtC patients. Conclusions: We found a high prevalence of JtC bias in early, cognitively intact PD population and a potential link between subthreshold ICBs and poor performance on beads task. Additional studies are needed to confirm our results and elaborate on the mechanisms that correlate impulsivity with JtC tendency, which are likely to be different from those mediating psychotic features in early PD. [ABSTRACT FROM AUTHOR]

Background: Some reports suggest that psychotic features may occur in the early stages of Parkinson's disease (PD), but sensitive tools have not been utilized. Objective: The aim was to evaluate the presence of psychotic symptoms using detailed scales and to assess the association with clinical characteristics. Methods: Healthy controls and patients within three years of PD onset were recruited. Participants were examined for psychotic symptoms using two different instruments: the Comprehensive Assessment of At-Risk Mental States (CAARMS) and a 10 question PD specific psychosis severity scale (10PDQ). In the PD group, medication use, motor and non-motor symptoms were documented. Results: Based on CAARMS and 10PDQ scales, psychotic features were present in 39% (27/70) of patients and 4% (3/74) of controls. The prevalence of passage hallucinations and illusions was significantly higher in PD compared to the control group. The presence of PD-associated psychotic features was not significantly affected by medication, motor severity or global cognitive status. Higher prevalence of overall non-motor manifestations, REM sleep behavior disorder (RBD) and depressive symptoms was significantly associated with the manifestation of psychotic features in PD [(adjusted OR:1.3; 95% CI:1.1-1.6; p = 0.003), (adjusted OR:1.3; 95% CI:1.0-1.6; p = 0.023), and (adjusted OR:1.2; 95% CI:1.0-1.4;p = 0.026)]. Conclusions: Psychotic phenomena mainly of minor nature are highly common in early PD. Cumulative non-motor symptoms, RBD and depressive features are associated with the presence of psychotic symptoms in this non-demented, early-stage PD population. More studies are needed to clarify the mechanisms that contribute to the onset of psychotic features in early PD. [ABSTRACT FROM AUTHOR]

Antibodies to glutamic acid decarboxylase (GAD) have been predominantly associated with stiff-person syndrome (SPS), which is often accompanied by organ-specific autoimmune diseases, such as late-onset type 1 diabetes. Autoimmune retinal pathology in SPS has recently been suggested to coexist in patients suffering from this disease; however, evidence reporting potential treatment options for the neurological and visual symptoms these patients experience remains scarce. We provide a review of the relevant literature, presenting a rare case of a middle-aged woman with autoimmune retinopathy (AIR) followed by stiff-leg syndrome who responded to intravenous immune globulin treatment (IVIg). Our report adds to previously reported data supporting the efficacy of IVIg in SPS spectrum disorders while also proposing the potential effect of IVIg in treating SPS spectrum patients with coexisting AIR. [ABSTRACT FROM AUTHOR]

Progressive multifocal leukoencephalopathy (PML) is a potentially life-threatening complication among Multiple Sclerosis (MS) patients under natalizumab treatment, with serum anti-JCV antibody titers being used for stratification risk. Given the critical role of interferon (IFN)/B-cell activating factor (BAFF) axis in humoral immune responses against viruses, we explored whether it is involved in the generation of serum anti-JCV antibodies among these patients. 162 consecutive patients with relapsing-remitting MS under natalizumab treatment were included. Serum anti-JCV antibodies were measured at baseline, as well as 12 and 24 months after treatment initiation. Type I and II IFN-inducible genes and BAFF expression were quantitated in peripheral blood by qRT-PCR. Moreover, BAFF rs9514828, rs1041569, and rs9514827 gene variants were assessed by RFLP-PCR. While type I and II IFN inducible gene expression were not associated with anti-JCV serum titers, the latter were significantly correlated with BAFF gene expression. Of interest, the TTT haplotype of the studied BAFF variants was more frequently detected in male, but not female anti-JCV (+) MS patients compared to anti-JCV (−) counterparts at baseline, as well as at 12 months and 24 months of natalizumab treatment. Measures of clinical validity/utility for the BAFF TTT haplotype showed 88% specificity, 45%, positive predictive value, and sensitivity of 70% for the discrimination of anti-JCV (+) male MS patients after 24 months of treatment. Our study suggests an implication of the BAFF axis in the production of serum anti-JCV antibodies. Additionally, the BAFF TTT haplotype derived from the rs9514828, rs1041569, and rs9514827 variants may represent a novel risk factor for anti-JCV seropositivity and indirectly for PML development among male MS patients treated with natalizumab. • Peripheral blood BAFF gene expression significantly correlates with anti-JCV serum titers in MS patients. • The BAFF TTT haplotype significantly associates with anti-JCV seropositivity in male MS patients treated with natalizumab. • The BAFF TTT haplotype may represent a novel risk factor for JCV seropositivity and, consequently, PML in male MS patients. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to evaluate extraocular muscle (EOM) atrophy and fatty replacement in ocular myasthenia gravis (OMG) and generalized myasthenia gravis (GMG) patients with chronic and untreated ocular symptoms or with inadequate response to immunotherapy and unprovoked ocular exacerbations despite chronic immunotherapy. Methods: Nineteen patients with either OMG or GMG and 19 healthy age-matched controls underwent an orbital MRI. Visually obvious muscle atrophy and muscle fatty replacement were evaluated by two raters independently. Maximum thickness of EOM was measured. Measurements of the muscles of each participant were added up, in order to calculate the total thickness. Results: Eleven patients suffered from AChR-positive GMG, and 8 patients from OMG. All patients had chronic ocular symptoms or inadequate response to corticosteroids and unprovoked ocular exacerbations in spite of immunotherapy. Fatty replacement was reported in 6/19 (31.6%) patients and 0/19 (0%) controls (p = 0.02). Obvious atrophy in at least one muscle was reported in 8/19 (42.1%) patients and 1/19 (5.3%) controls (p = 0.019). Statistically significant differences between the two groups were also found in the mean total thickness, as well as in the thickness of superior recti, levator palpebrae, inferior recti, and superior oblique muscles. Conclusion: EOM atrophy and fatty replacement were seen frequently in our series of MG patients with treatment difficulties and frequent relapses of ocular involvement. [ABSTRACT FROM AUTHOR]

We compute the phase diagram of the simplest holographic bottom-up model of conformal interfaces. The model consists of a thin domain wall between three-dimensional Anti-de Sitter (AdS) vacua, anchored on a boundary circle. We distinguish five phases depending on the existence of a black hole, the intersection of its horizon with the wall, and the fate of inertial observers. We show that, like the Hawking-Page phase transition, the capture of the wall by the horizon is also a first order transition and comment on its field-theory interpretation. The static solutions of the domain-wall equations include gravitational avatars of the Faraday cage, black holes with negative specific heat, and an intriguing phenomenon of suspended vacuum bubbles corresponding to an exotic interface/anti-interface fusion. Part of our analysis overlaps with recent work by Simidzija and Van Raamsdonk but the interpretation is different. [ABSTRACT FROM AUTHOR]

• A rare case of a seronegative relapse of neurobrucellosis is reported. • Seronegative neurobrucellosis represents a diagnostic challenge. • Oligoclonal bands and a cerebrospinal fluid agglutination test proved essential in diagnosis. • Neurobrucellosis diagnostic criteria should be established. Neurobrucellosis presents in various clinical forms and should always be considered in neurological patients in highly endemic areas such as the Mediterranean basin. Establishing a diagnosis can be challenging since serological testing can sometimes yield negative results. We present a rare case of a seronegative relapse of neurobrucellosis in a patient who had been successfully treated for systemic brucellosis. Oligoclonal bands, an agglutination test, and 16S rRNA sequencing of cerebrospinal fluid proved essential in unmasking a confined central nervous system relapse. This case reinforces the need for establishing diagnostic criteria for neurobrucellosis, which could potentially include oligoclonal bands and an agglutination test on the cerebrospinal fluid. [ABSTRACT FROM AUTHOR]

Although B cells and B cell activating factor (BAFF) have been previously implicated in MS pathogenesis, data regarding the genetic influence of BAFF polymorphisms on MS susceptibility are limited. Here we aim to explore whether BAFF polymorphisms could contribute to MS susceptibility. 156 RRMS patients fulfilling the revised McDonald criteria for MS diagnosis and 220 HCs were enrolled. Clinical, laboratory, and imaging characteristics were recorded. BAFF rs9514827, rs1041569, and rs9514828 polymorphisms were assessed by RFLP-PCR in DNA samples extracted from whole peripheral blood. The BAFF rs1041569 TT genotype along with the CTT and TTC haplotypes were associated with significantly increased risk for MS development in female MS patients compared to healthy female counterparts. These findings were not confirmed in males. The rs1041569 BAFF variant together with the CTT and TTC BAFF haplotypes derived from the BAFF rs9514827, rs1041569, and rs9514828 polymorphisms may represent novel genetic contributors to the development of MS in females. • The BAFF rs1041569 TT genotype confers increased risk for MS in females. • The CTT and TTC haplotypes derived from the BAFF gene variants rs9514827, rs1041569, and rs9514828 are associated with increased risk for MS in females. • BAFF gene variants may represent novel genetic contributors to the development of MS in females. [ABSTRACT FROM AUTHOR]

Two successive cruises in the Cretan Sea and Cretan Passage (West Levantine basin) during April and June 2016 surveyed the physical characteristics of the water masses in these large Eastern Mediterranean basins. Data confirm that the hydrographical status is far different from that of the Eastern Mediterranean Transient (EMT) period; however, the basins have not yet returned to the pre-EMT status. In the Cretan Sea, intermediate water masses of both Cretan and Levantine origins are detected. The stagnating bottom waters of this basin still hold high salinity, density, and dissolved oxygen values, remnant of the EMT deep water formation episodes. Characterised by low salinity and oxygen values, transitional waters of Mediterranean origin are present between intermediate and bottom layers throughout the Cretan Sea. Intermittent weak outflow of warm and saline masses of Cretan origin towards the Eastern Mediterranean is observed at the bottom of both east and west Cretan Straits. In the Cretan Passage, there is no sign of the Ierapetra anticyclonic gyre, possibly related to the seasonality of the gyre or linked to larger scale Eastern Mediterranean circulation variability. The observed surface circulation in this area is comprised of a series of smaller gyres between the Cretan Cyclone and the Rhodes Gyre. The bottom waters of the Cretan Passage present a west-to-east gradient of increasing salinity and decreasing oxygen related to the propagation of new Adriatic Deep Water from the Ionian Sea towards the Levantine basin. [ABSTRACT FROM AUTHOR]

Recent reports of warming trends in the Red Sea raise concerns about the response of the basin's fragile ecosystem under an increasingly warming climate. Using a variety of available Sea Surface Temperature (SST) data sets, we investigate the evolution of Red Sea SST in relation to natural climate variability. Analysis of long‐term SST data sets reveals a sequence of alternating positive and negative trends, with similar amplitudes and a periodicity of nearly 70 years associated with the Atlantic Multidecadal Oscillation. High warming rates reported recently appear to be a combined effect of global warming and a positive phase of natural SST oscillations. Over the next decades, the SST trend in the Red Sea purely related to global warming is expected to be counteracted by the cooling Atlantic Multidecadal Oscillation phase. Regardless of the current positive trends, projections incorporating long‐term natural oscillations suggest a possible decreasing effect on SST in the near future. Plain Language Summary: The recent warming trend of the Red Sea SST is critical for the fragile basin's ecosystem, especially for its precious coral reef community. Several studies based on satellite‐era data sets recently reported warming rates that can rapidly alter the environmental status of the Red Sea in the near future. We show that the long‐term variation of the SST over the Red Sea is influenced by a natural oscillation related to the Atlantic Multidecadal Oscillation. Satellite‐era data sets coincide with a positive phase of this oscillation and the associated SST trend is overstated compared to the real, long term trend. As Atlantic Multidecadal Oscillation currently shifts from positive to negative phase, the Red Sea SST is expected to shift into a cooling phase during the next decades. Key Points: The Red Sea SST exhibits long‐term oscillations related to the Atlantic Multidecadal OscillationHigh warming trends for the period 1980 to 2010 are dominated by a positive phase of the natural SST oscillationSST over the Red Sea is expected to shift to a cooling phase during the next few decades [ABSTRACT FROM AUTHOR]

The exceptionally cold December 2016 over the Aegean Sea-one of the most important dense water formation areas of the eastern Mediterranean Sea-resulted in winter heat loss comparable to the peak Eastern Mediterranean Transient winters (1992-1993). Hydrological data sampled in March/April 2017 showed that newly produced dense waters ventilated the North Aegean deep basins up to density horizons of σ θ ~ 29.35 kg/m3. The water column ventilation was unable to reach the bottom as the present upper thermohaline circulation of the eastern Mediterranean does not favor the salinity preconditioning of the Aegean Sea. In the southwest Aegean, the Myrtoan basin was ventilated by dense waters traceable farther south to the West Cretan Straits. Export of these masses from the Aegean Sea can potentially have a broader impact on the thermohaline circulation of the eastern Mediterranean. [ABSTRACT FROM AUTHOR]

Objective: Pre- or early-pregnancy obesity carries significant health implications. This retrospective cohort study investigates the association between pre- or early-pregnancy body mass index (BMI) and the risk of fetal and neonatal death in pregnancies implicated by obesity in a Mediterranean country. Study design: Data on pregnancies delivered during 2003-2008 at a University hospital was linked to data from regional registry. Logistic regression models were used to determine the odds ratios of a spontaneous fetal death and perinatal death among overweight, obese, and morbid obese women. Results: Independent predictors of fetal death were maternal prepregnancy BMI over 25, maternal age, maternal co-morbidities, and maternal residence in an island. Perinatal mortality was independently correlated to neonatal birthweight, maternal age, maternal residence in towns and villages, and maternal BMI over 40. Overall, maternal residence in an island, maternal autoimmune disease, and maternal prepregnancy BMI (over 25) were independent risk factors predicting offspring death (both intrauterine and perinatal). Conclusions: Maternal obesity is correlated to offspring's mortality during fetal and/or perinatal period. This is one of the very few studies in a Mediterranean country. This study underlines the need for public health interventions to prevent obesity in young women. [ABSTRACT FROM AUTHOR]

The impacts of various climate modes on the Red Sea surface heat exchange are investigated using the MERRA reanalysis and the OAFlux satellite reanalysis datasets. Seasonality in the atmospheric forcing is also explored. Mode impacts peak during boreal winter [December-February (DJF)] with average anomalies of 12-18 W m−2 to be found in the northern Red Sea. The North Atlantic Oscillation (NAO), the east Atlantic-west Russia (EAWR) pattern, and the Indian monsoon index (IMI) exhibit the strongest influence on the air-sea heat exchange during the winter. In this season, the largest negative anomalies of about −30 W m−2 are associated with the EAWR pattern over the central part of the Red Sea. In other seasons, mode-related anomalies are considerably lower, especially during spring when the mode impacts are negligible. The mode impacts are strongest over the northern half of the Red Sea during winter and autumn. In summer, the southern half of the basin is strongly influenced by the multivariate ENSO index (MEI). The winter mode-related anomalies are determined mostly by the latent heat flux component, while in summer the shortwave flux is also important. The influence of the modes on the Red Sea is found to be generally weaker than on the neighboring Mediterranean basin. [ABSTRACT FROM AUTHOR]

The impacts of nutrient and other chemical inputs released by a submarine groundwater discharge (SGD) on the marine environment of an oligotrophic Mediterranean coastal area (Messiniakos Gulf, SE Ionian Sea) are investigated through a multidisciplinary approach. Nutrients and organic pollutants associated with the SGD are presented to study the chemical characteristics of the SGD and to investigate its effect on the marine ecosystem in comparison to freshwater discharges of the water bodies of Messinia Prefecture. Nutrient and organic pollutant fluxes were calculated from 214Bi-based SGD estimates. An average of 22×103 mol of silicate per month and 8×103 mol of nitrate per month were released via the SGD. Nutrient concentrations at the mouth of the SGD were three times higher than in Messiniakos Gulf, and NO3 − was the primary Dissolved Inorganic Nitrogen form discharged by SGD. Organic pollutant concentrations associated with agricultural activities were low at the SGD. The implementation of a Eutrophication Index (E.I.) showed that the water column at the SGD site corresponds to Moderate/Bad ecological quality, whereas the status switches rapidly to Good at a small distance from the SGD. Coastal areas influenced by river or sewage discharge correspond to a Moderate/Good ecological status. The BENTIX index used for the classification of the ecological quality status of the benthic macroinvertebrate communities showed that the SGD has a minor influence compared to the other freshwater discharges in Messiniakos Gulf. Though the SGD has a considerable outflow, morphology and hydrodynamics of the area favor the rapid dispersion of the upwelling water and degrades the SGD's effect even on a regional scale. [ABSTRACT FROM AUTHOR]

The influence of the atmospheric circulation on the winter air-sea heat fluxes over the northern Red Sea is investigated during the period 1985-2011. The analysis based on daily heat flux values reveals that most of the net surface heat exchange variability depends on the behavior of the turbulent components of the surface flux (the sum of the latent and sensible heat). The large-scale composite sea level pressure (SLP) maps corresponding to turbulent flux minima and maxima show distinct atmospheric circulation patterns associated with each case. In general, extreme heat loss (with turbulent flux lower than −400 W m−2) over the northern Red Sea is observed when anticyclonic conditions prevail over an area extending from the Mediterranean Sea to eastern Asia along with a recession of the equatorial African lows system. Subcenters of high pressure associated with this pattern generate the required steep SLP gradient that enhances the wind magnitude and transfers cold and dry air masses from higher latitudes. Conversely, turbulent flux maxima (heat loss minimization with values from −100 to −50 W m−2) are associated with prevailing low pressures over the eastern Mediterranean and an extended equatorial African low that reaches the southern part of the Red Sea. In this case, a smooth SLP field over the northern Red Sea results in weak winds over the area that in turn reduce the surface heat loss. At the same time, southerlies blowing along the main axis of the Red Sea transfer warm and humid air northward, favoring heat flux maxima. [ABSTRACT FROM AUTHOR]

Atmospheric circulation patterns that are conducive to extreme ocean heat loss are investigated at four sites of special interest in the Mediterranean Sea. The Gulf of Lions, the South Adriatic Sea, the Cretan Sea, and the Levantine Sea are areas where anomalously high winter heat loss may lead to deep- or intermediate-water formation. At each of the above sites, the atmospheric circulation during such events is derived by averaging the sea level pressure (SLP) fields during the lower decile of the wintertime series of the net heat exchange. A relatively simple SLP pattern dominated by an anticyclone over northwestern Europe with a weaker cyclone to the southeast is found to be associated with strong heat loss in the selected sites with minor variations in pattern structure depending on the site. The SLP composite pattern reflects the combined effect of different atmospheric modes of variability and the authors consider the impacts on heat loss of a number of these modes (North Atlantic Oscillation, east Atlantic pattern, east Atlantic-west Russia pattern, and Scandinavian pattern), together with the North Sea-Caspian pattern and the Mediterranean index. The extremes in heat loss are strongly connected with the intensity and the positions of the poles of these patterns that modulate, through the necessary SLP gradient and associated northerlies, the transfer of cold and dry air over the areas of dense-water formation. Analysis of air-sea temperature difference, specific humidity, and evaporation anomalies indicates that the extremes of the net heat fluxes are primarily due to the latent and sensible heat flux components. [ABSTRACT FROM AUTHOR]

The authors examine the impact of low-frequency atmospheric forcings on the air-sea heat fluxes over the Aegean Sea. The correlation between the air-sea heat flux components and three established [North Atlantic Oscillation (NAO), east Atlantic-western Russian pattern (EAWR), and North Sea-Caspian pattern (NCP)] and two testing climatic indices of potential effect over the eastern Mediterranean Sea region underlines significant discrepancies between the radiative (shortwave and longwave radiation) and the turbulent (sensible and latent heat) components. The NAO index affects the air-sea heat fluxes over the Aegean Sea region much less than the two innovative indices, the 'Mediterranean index' and the 'Eastern Europe index,' which play more effective roles. Moreover, the influence of the sea level atmospheric pressure (SLP) variability over an extended area (Europe and North Africa) on surface fluxes regime is investigated. The SLP anomalies are corroborated as a prominent regulating factor of the air-sea heat fluxes over the Aegean Sea region, especially during the cold season of the year. The analysis of the extreme values in the heat exchange anomalies for the period 1958-2001 highlights the role of SLP field on determining the air-sea heat fluxes regime, mainly during winter, when, occasionally, large amounts of heat loss from the sea surface trigger the mechanism of intermediate- and deep-water formation. It is suggested that wind regime and turbulent components are the modulators of the net air-sea heat flux anomalies throughout the year. [ABSTRACT FROM AUTHOR]

Introduction: Primary intestinal tuberculosis is a rare variant of tuberculosis. The preferred treatment is usually pharmaceutical, but surgery may be required for complicated cases.Case Presentation: We report two cases of primary intestinal tuberculosis where the initial diagnosis was wrong, with colonic cancer suggested in the first case and a Crohn's disease complication in the second. Both of our patients were Caucasians of Greek nationality. In the first case (a 60-year-old man), a right hemicolectomy was performed. In the second case (a 26-year-old man), excision was impossible due to the local conditions and peritoneal implantations. Histopathology revealed an inflammatory mass of tuberculous origin in the first case. In the second, cell culture and polymerase chain reaction tests revealed Mycobacterium tuberculosis. Both patients were given anti-tuberculosis therapy and their post-operative follow-up was uneventful.Conclusions: Gastrointestinal tuberculosis still appears sporadically and should be considered in the differential diagnosis along with other conditions of the bowel. The use of immunosuppressants and new pharmaceutical agents can change the prevalence of tuberculosis. [ABSTRACT FROM AUTHOR]

Abstract: Hemangiomas of the umbilical cord are extremely rare benign vascular tumors, not always detected prenatally. They have been associated with increased alpha-fetoprotein (AFP), hydramnios, congenital anomalies, and increased perinatal mortality. Impaired umbilical circulation has been proposed as the predisposing factor for fetal compromise. We report a case of an antenatally detected umbilical cord hemangioma with one artery crossing the tumor, and we reviewed the literature. Close surveillance with Doppler flow studies of the umbilical vessels were carried out throughout the pregnancy. All indices were normal, except from the intra-tumoral part of the umbilical artery under discussion that showed increasing resistance from 32 weeks onwards. Our review confirmed the reported association with increased AFP and hydramnios. The placental end of the cord was the preferred site of location, and the umbilical artery the commonest vessel of origin. Association with cutaneous vascular malformations, and single umbilical artery were assessed. [Copyright &y& Elsevier]

Abstract: Objectives: To verify the effect of vibroacoustic stimulation on biophysical profile score, with a prospective randomised study. Study design: All women with singleton pregnancy, gestational age ≥30 weeks, intact membranes and biophysical profile score ≤8/10 entered the study, after giving written consent, and were randomised to two groups. In group A, a 3-s stimulus with an artificial larynx was applied; if biophysical profile remained abnormal for 30 min, a second stimulus was applied and it was assessed again. In group B, the observation time was extended for 60 min to match the time periods of group A. Pregnancies were managed by final test score and patients delivering more than 24 h apart from last examination were disregarded from the study. Outcome criteria were intrauterine deaths, caesarean sections for fetal distress, Apgar score <7 at 5 min postpartum, meconium-stained amniotic fluid and neonatal intensive care unit admissions. Our null hypothesis was that application of vibroacoustic stimulation does not alter test''s statistical parameters. Results: 1349 patients were randomised in group A and 1484 in group B (2833 in total). When comparing group A to B, application of vibroacoustic stimulation significantly decreased the number of positive tests (4.74% vs. 6.67%, p <0.05) and increased the prevalence of outcome criteria in this subgroup (positive likelihood ratio: 24.1 95% CI: 11.12–52.46 vs. 7.52 95% CI: 4.93–11.46), without altering perinatal outcome. Furthermore, specificity, positive predictive value and test accuracy were significantly improved, as well as negative predictive value for intrauterine death. Conclusion: Vibroacoustic stimulation improves the efficiency of biophysical profile score by decreasing false positive tests and improving test accuracy and should be considered as a means of a more thorough fetal evaluation when fetal compromise is suspected. [Copyright &y& Elsevier]

Gerstmann's syndrome is a syndrome caused by lesions of the dominant parietal lobe. It has historically been a subject of dispute as it is often accompanied by other neuropsychological deficits such as aphasia. Novel neuropsychological tests and neuroimaging techniques have lately changed the perspective allowing to decode a conjunction of symptoms like Gerstmann's. In our case, we present Diffusion Tensor Imaging Tractography findings of a patient who acutely exhibited Gerstmann's tetrad. Using advanced structural neuroimaging we tested a hypothesis that up until recently could only be challenged post mortem. Our study offers much needed patient neuroimaging data helping to establish Gerstmann's as a disconnection syndrome. More reports of Gerstmann's syndrome patients including high resolution tractography and fMRI data are needed. • Tractography imaging identified loss of connectivity that caused Gerstmann's tetrad and aphasia. • Superior longitudinal fasciculus and intraparietal u-fiber interruptions were unveiled. • Patient neuroimaging data supporting Gerstmann's syndrome as a disconnection syndrome. [ABSTRACT FROM AUTHOR]

During the last decades, the coastal areas of the Kingdom of Saudi Arabia, on the Red Sea and the Arabian Gulf, have been subjected to intense economic and industrial growth. As a result, it may be expected that the overall environmental status of Saudi Arabian coastal marine waters has been affected by human activities. As a consequence, adequate management of the Saudi Arabian coastal zone requires an assessment of how the various pressures within this zone impact the quality of seawater and sediments. To this end, environmental surveys were conducted over 15 hotspot areas (areas subject to environmental pressures) in the Saudi Arabian coastal zone of the Red Sea and over three hotspot areas in the Saudi Arabian waters of the Arabian Gulf. The survey in the Red Sea, conducted in June/July 2021, acquired measurements from hotspot areas spanning most of the Saudi coastline, extending from near the Saudi–Jordanian border in the north to Al Shuqaiq and Jizan Economic City (close to the Saudi–Yemen border) in the south. The survey in the Arabian Gulf, carried out in September 2021, included the areas of Al Khobar, Dammam and Ras Al Khair. The main objective of both cruises was to record the physical and biogeochemical parameters along the coastal waters of the kingdom, tracing the dispersion of contaminants related to specific pressures. Taken together, these cruises constitute the first multidisciplinary and geographically comprehensive study of contaminants within the Saudi Arabian coastal waters and sediments. The measurements acquired revealed the influence of various anthropogenic pressures on the coastal marine environment of Saudi Arabia and also highlighted a strong influence of hydrographic conditions on the distribution of biochemical properties in the Red Sea and the Arabian Gulf. The data can be accessed at SEANOE 10.17882/96463 (Abualnaja et al., 2023), whereas the details of the sampling stations are available at https://mcep.kaust.edu.sa/cruise-postings (last access: 25 March 2024). The dataset includes the parameters shown in Tables 1a, b and 2a. [ABSTRACT FROM AUTHOR]

We find stationary thin-brane geometries that are dual to far-from-equilibrium steady states of two-dimensional holographic interfaces. The flow of heat at the boundary agrees with the result of CFT and the known energy-transport coefficients of the thin-brane model. We argue that by entangling outgoing excitations the interface produces thermodynamic entropy at a maximal rate, and point out similarities and differences with double-sided black funnels. The non-compact, non-Killing and far-from-equilibrium event horizon of our solutions coincides with the local (apparent) horizon on the colder side, but lies behind it on the hotter side of the interface. We also show that the thermal conductivity of a pair of interfaces jumps at the Hawking-Page phase transition from a regime described by classical scatterers to a quantum regime in which heat flows unobstructed. [ABSTRACT FROM AUTHOR]

During the last decades, the coastal areas of the Kingdom of Saudi Arabia, on the Red Sea and the Arabian Gulf, have been subjected to intense economic and industrial growth. As a result, it may be expected that the overall environmental status of Saudi Arabian coastal marine waters has been affected by human activities. As a consequence, adequate management of the Saudi Arabian coastal zone requires an assessment of how the various pressures within this zone impact the quality of seawater and sediments. To this end, environmental surveys were conducted over fifteen hotspot areas (areas subject to environmental pressures) in the Saudi Arabian coastal zone of the Red Sea and over three hotspot areas in the Saudi Arabian waters of the Arabian Gulf. The survey in the Red Sea, conducted in June/July 2021, acquired measurements from hotspot areas spanning most of the Saudi coastline, extending from near the Saudi-Jordanian border in the north to Al Shuqaiq and Jizan Economic City (close to the Saudi-Yemen border) in the south. The survey in the Arabian Gulf, carried out in September 2021, included the areas of Al Khobar, Dammam, and Ras Al Khair. The main objective of both cruises was to record the physical and biogeochemical parameters along the coastal waters of the Kingdom, tracing the dispersion of contaminants related to specific pressures. Taken together, these cruises constitute the first multidisciplinary and geographically comprehensive study of contaminants within the Saudi Arabian coastal waters and sediments. The measurements acquired revealed the influence of various anthropogenic pressures on the coastal marine environment of Saudi Arabia and also highlighted a strong influence of hydrographic conditions on the distribution of biochemical properties in the Red Sea and the Arabian Gulf. The data can be accessed at: SEANOE. https://doi.org/10.17882/96463 (Abualnaja et al., 2023), whereas the details of the sampling stations at https://mcep.kaust.edu.sa/cruise-postings. The dataset includes the parameters shown in Tables 1(a,b) and 2(a). [ABSTRACT FROM AUTHOR]

The article presents a review study that explores the importance of intertwin estimated fetal weight (EFW) and crown rump length (CRL) discordance for predicting the adverse perinatal outcome in monochorionic and dichorionic diamniotic gestations. Topics covered include the occurrence of discordant twin growth, the unique aspects of monochorionic twins, and the estimated fetal weight discordance and perinatal outcome. It also discusses crown-rump length discordance and perinatal outcome.

The 1.5° lat. x 3.5° lon. Levantine area south of Crete was surveyed for the first time in April 2016 with a combination of direct current measurements comprised by CTD-LADCP (Lowered Acoustic Doppler Current Profiler) grid casts and ship-track ADCP measurements in the upper 500 m, while a mooring was launched at the end of the continental slope and provided yearly current records at 700 m and 30 m off the bottom depth of 4300 m. Horizontal flow structures are mapped in the upper 1000 m via objective analysis of the direct current measurements depicting the Cretan Cyclone at the west, the Rhodes Gyre at the east and anticyclonic circulation in the middle due to Modified Atlantic Water in the upper 80 m and a thick, saline, warm mass extending from ~100 m to ~1500 m, possibly of Cretan origin. The bottom kinetic energy spectra have higher density values than those at 700 m. In the two-month energetic period of end/Jan.-to-end/Mar. 2017, topographic Rossby waves (TRW) with wavelength of ~42 km exist in the window of ~34-19 days with significant coherence between the near-bottom and the 700-m records. At the TRW spectral window, the motions are transverse and the direction of maximum velocity variance veers from nearly along isobaths ~20° (north-northeast) to ~45° (northeast) with decreasing period. The presence of TRWs in the specific time period within 2017 appears to be related to the lateral shifts of the Ierapetra Anticyclone over the sloping bottom of the continental margin. [ABSTRACT FROM AUTHOR]

Even though the Red Sea is characterized by unique oceanographic conditions, only few studies have addressed the ecology of its deep-sea benthos. This work discusses some traits of the Saudi deep waters of the Red Sea between 23°N and 28°N. Macrobenthic samples were collected using a box corer (0.1 m 2 surface area) from 59 stations at depths ranging between 220 m and 1678 m. The stations were categorized into four depth zones (≤500 m, 501–750 m, 751–1000 m and >1000 m) and two latitudinal areas (northern and central) for data analysis. A total of 186 species have been identified including polychaetes (135), crustaceans (27), molluscs (18), echinoderms (3), echiuroid (1), sipunculoid (1), and oligochaete (1). While 114 species were present in only 1–3 stations, only 30 species were found to be widely distributed, being recorded in all depth zones from northern and central areas. The trophic structure analysis indicated high functional diversity with the presence of seven feeding levels represented mainly by surface deposit feeders, facultative detritivores, and benthic carnivores. In general, the density and biomass of the deep sea macrobenthic community studied herein are lower than those reported in other seas with similar depth zones. This is most likely due to the particular environmental factors of the Red Sea, represented mainly by its oligotrophic nature, high temperature, high salinity, and low food availability in the form of organic matter. It is worth noting that some ecological parameters considered showed a general decreasing pattern (density: 10–1666 ind. m −2 ; biomass: 0.02 – 10.98 g m −2 ; species richness S: 1–59; Shannon-Wiener diversity index H' : 0 – 5.1) in relation with the increasing depth in northern and central areas. The bathymetric trends of the macrobenthic communities were also demonstrated with findings of multivariate analyses. The distribution of benthic communities at all depth zones appeared to be controlled by the availability of organic matter and abiotic factors such as temperature and salinity. Pronounced latitudinal and longitudinal trends in the macrobenthic communities are not evident, most likely due to the limited latitudinal and longitudinal variation of the sampling stations of this study. No spatial variations were found with the feeding types, species evenness index, and species dominance index. Considering the scarcity of published data on the deep benthic community from the Red Sea, this study provides some useful baseline information on this topic and contributes to decrease the knowledge gap on the diversity of macrobenthic communities in this region. [ABSTRACT FROM AUTHOR]

ABSTRACT: The Red Sea convergence zone (RSCZ) is formed by opposite surface winds blowing from northwest to southeast directions at around 18°–19°N between October and January. A reverse‐oriented, low‐level monsoon trough at 850 hPa, known as the Red Sea trough (RST), transfers moisture from the southern Red Sea to RSCZ. The positions of the RSCZ and RST and the intensity of the RST have been identified as important factors in modulating weather and climatic conditions across the Middle East. Here, we investigate the influence of the El Niño southern oscillation (ENSO) on the interannual variability of RSCZ, RST, and regional rainfall during winter months. Our results indicate that El Niño (warm ENSO phase) favours a shift of the RSCZ to the north and a strengthening of the RST in the same direction. Conversely, during November and December of La Niña periods (cold ENSO phase), the RSCZ shift to the south and the RST strengthens in the same direction. During El Niño periods, southeasterly wind speeds increase (20–30%) over the southern Red Sea and northwesterly wind speeds decrease (10–15%) over the northern Red Sea. Noticeable increases in the number of rainy days and the intensity of rain events are observed during El Niño phases. These increases are associated with colder than normal air intrusion at lower levels from the north combined with warm air intrusion from the south over the RSCZ. Our analysis suggests that during El Niño winters, warmer sea surface temperatures and higher convective instability over the Red Sea favour local storms conditions and increase rainfall over the Red Sea and adjoining regions. [ABSTRACT FROM AUTHOR]

Background and aim: Cancer cachexia is a metabolic syndrome related with poor outcome. Cytokines play a key role in the pathophysiology of that syndrome. The aim of this study was to investigate the potential correlations between nutritional status, systemic inflammation, and psychological distress in cancer patients. The prognostic significance of the recorded parameters was also assessed. Patients and methods: Patients with metastatic lung cancer were eligible. Mini Nutritional Assessment (MNA) was used for the evaluation of nutritional status, Glasgow Prognostic Score (GPS) for the estimation of systemic inflammation, and Hospital Anxiety and Depression Scale (HADS) for psychological assessment. Results: Totally, 122 patients were enrolled (71.3% with NSCLC and 28.7% with SCLC). The following correlations were observed: MNA and GPS ( r = 0.289, p = 0.001), MNA and HADS (depression scale) ( r = 0.275, p = 0.002), GPS and HADS (depression scale) ( r = 0.256, p = 0.004), and GPS and HADS (anxiety scale) ( r = 0.194, p = 0.033). In univariate analysis, GPS ( p = 0.002) and MNA ( p = 0.010) emerged as significant predictors of survival. In multivariate analysis, both MNA ( p = 0.032) and GPS ( p = 0.020) retained their importance. Conclusions: This study highlights the associations between nutritional status, systemic inflammation, and psychological distress, supporting their common underlying pathophysiological mechanisms and further suggesting the necessity of a holistic anti-cachectic approach. [ABSTRACT FROM AUTHOR]

Abstract: In-situ underwater gamma-ray spectrometer KATERINA was used for continuous measurements of radon progenies (214Pb, 214Bi), thoron progeny (208Tl) and 40K in submarine groundwater discharge (SGD) sites at Kalogria Bay, SW Peloponnesus (Greece). The spectrometer was deployed attached on measuring platform along with two conductivity - temperature data loggers while underwater battery packs supplied the system for acquisition periods up to 25 days. The radionuclide time series together with salinity data were obtained for spring (wet) and summer (dry) seasons. The 40K activity concentrations correlated well with salinity of the emanating groundwater. Although the 214Bi and 208Tl activities showed usually similar trends anticorrelating with salinity, in some cases 208Tl did not follow the 214Bi record due to changes in the dynamics of the groundwater aquifer. As the half-life of 220Rn is very short (55.6 s), its concentration in SGD may depend on the distance from its origin to the monitoring point. The observed temporal variations of 214Bi and 208Tl confirmed advantages of continuous in-situ monitoring of SGD in coastal areas. [Copyright &y& Elsevier]

The aim of this study was to evaluate indices of respiratory failure in terms of their ability to predict respiratory impairment and need for ventilatory support in late-preterm neonates with respiratory distress. Arterial blood gas data during the first 12 postnatal hours or until intubation were recorded in 155 neonates with gestational age 34-36 weeks admitted in the NICU with respiratory distress between January 2006 and June 2008. Alveolar-arterial oxygen tension difference (A-aDO), arterial to alveolar oxygen tension ratio (a/A ratio), and partial arterial oxygen tension to inspired oxygen fraction ratio (PaO/FiO) were calculated. Considering the worst single value of each parameter, receiver operating characteristic curve analyses and area under the curve (AUC) comparisons were used to evaluate their predictive performance. Fifty-five neonates (35.5%) required mechanical ventilation. The predictive performances of the maximum A-aDO (AUC 0.97), minimum a/A ratio (AUC 0.95), and minimum PaO/FiO (AUC 0.95) were similar. The A-aDO at a threshold of >200 mmHg proved to be more effective than the other parameters, having excellent positive and negative likelihood ratios of 24.5 and 0.02, respectively. This threshold was achieved by 98.25% of the neonates who developed respiratory failure at a median of 3 h before the ventilatory support to be definitely decided. Composite indices, such as A-aDO, a/A ratio, and PaO/FiO, can reasonably predict respiratory failure in late-preterm neonates with respiratory distress, allowing for closer monitoring, early medical intervention, or transfer to a level III neonatal unit. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess the effect of selected maternal medical conditions and complications of pregnancy on the risk for morbidity among late preterm neonates. Design: Prospective cohort study. Material and methods: A total of 548 late preterm neonates (340/7 to 366/7 weeks'' gestation) delivered from August 2006 to July 2009, were included. Information regarding demographics, gestational age, mode of delivery, maternal age and parity, pre-existing medical conditions and complications of pregnancy were obtained and associated with neonatal morbidity, both independently and as joint exposures. Newborn morbidity was defined by combining specific diagnoses, length of hospital stay, and transfer to the Neonatal Intensive Care Unit. Results: Overall, 165 (30.1%) of the late preterm infants suffered from morbidity. The morbidity rates were 16.8% at 36weeks'' gestation, and then approximately doubled from 38.2% at 35weeks to 59.7% at 34weeks. The joint effect of gestational age (OR 8.43 for 34weeks and 3.60 for 35weeks'' gestation), small for gestational age (SGA) (OR 4.18), multiple gestation (OR 3.68) and lack of antenatal steroid administration (OR 4.03), was greater than the independent effect of each of these factors, and greater than additive. Emergency caesarean section (OR 1.43) and antepartum haemorrhage (OR 3.07) were also associated with a significant impact on neonatal morbidity. Conclusions: The risk for morbidity among late preterm infants, changes with each passing week of gestation. This risk seems to be intensified, when other exposures such as SGA, multiple gestation, emergency caesarean section, lack of antenatal steroid administration and antepartum haemorrhage, are also present. [Copyright &y& Elsevier]

Theoretical and experimental studies have shown that stone columns can be used for accelerating the consolidation rate of soft soils by providing a drainage path, reducing foundation settlements, improving the bearing capacity of the soil, and limiting the risk of liquefaction due to seismic activity. This paper studies the influence of the main controlling parameters in the design of stone columns through a series of laboratory experiments. The effects of (a) the drainage conditions, (b) the grain size of the stone column material, (c) the confining pressure of the soil, and (d) the rate of deformation are investigated. Triaxial compression tests are performed on composite soil specimens of soft kaolin clay, reconstituted from a slurry with a central compacted reinforcement column. Two cases of reinforcement material are studied: sand and gravel. The behaviour of the reinforced soil compared with that of the unreinforced soil under the same loading and drainage conditions is analysed. The experimental results show the beneficial effect of this ground improvement technique on the strength characteristics of the foundation soil, even with a relatively low replacement factor compared with that used in practice. As the confining pressure increases, the improvement in the specimen with the sand column is more pronounced. [ABSTRACT FROM AUTHOR]

NEOM (short for Neo-Mustaqbal) is a $500 billion coastal city megaproject, currently under construction in the northwestern part of the Red Sea, off the coast of Tabuk province in Saudi Arabia, and its success will rely on the preservation of biodiverse marine ecosystems. Monitoring the variability of ecological indicators, such as phytoplankton, in relation to regional environmental conditions, is the foundation for such a goal. We provide a detailed description of the phytoplankton seasonal cycle of surface waters surrounding NEOM using satellite-derived chlorophyll-a (Chl-a) observations, based on a regionally-tuned product of the European Space Agency's Ocean Colour Climate Change Initiative, at 1 km resolution, from 1997 to 2018. The analysis is also supported with in situ cruise datasets and outputs of a state-of-the-art high-resolution hydrodynamic model. The open waters of NEOM follow the oligotrophic character of the Northern Red Sea (NRS), with a peak during late winter and a minimum during late summer. Coral reef-bound regions, such as Sindala and Sharma, are characterised by higher Chl-a concentrations that peak during late summer. Most of the open waters around NEOM are influenced by the general cyclonic circulation of the NRS and local circulation features, while shallow reef-bound regions are more isolated. Our analysis provides the first description of the phytoplankton seasonality and the oceanographic conditions in NEOM, which may support the development of a regional marine conservation strategy. [ABSTRACT FROM AUTHOR]

The Red Sea Project (RSP) is based on a coastal lagoon with over 90 pristine islands. The project intends to transform the Red Sea coast into a world-class tourist destination. To better understand the regional dynamics and water exchange scenarios in the lagoon, a high-resolution numerical model is implemented. The general and tidal circulation dynamics are then investigated with a particular focus on the response of the lagoon to strong wind jets. Significant variations in winter and summer circulation patterns are identified. The tidal amplitude inside the lagoon is greater than that outside, with strong tidal currents passing over its surrounding coral reef banks. The lagoon rapidly responds to the strong easterly wind jets that occur mainly in winter; it develops a reverse flow at greater depths, and the coastal water elevation is instantly affected. Lagrangian particle simulations are conducted to study the residence time of water in the lagoon. The results suggest that water renewal is slow in winter. Analysis of the Lagrangian coherent structures (LCS) reveals that water renewal is largely linked to the circulation patterns in the lagoon. In winter, the water becomes restricted in the central lagoon with only moderate exchange, whereas in summer, more circulation is observed with a higher degree of interaction between the central lagoon and external water. The results of LCS also highlight the tidal contribution to stirring and mixing while identifying the hotspots of the phenomenon. Our analysis demonstrates an effective approach for studying regional water mixing and connectivity, which could support coastal management in data-limited regions. • The RSP lagoon dynamics are governed by larger-scale circulation and tidal currents. • Episodes of easterly winds modulate the lagoonal circulation, particularly in winter. • The seasonally varying circulation controls the residence time in the RSP lagoon. [ABSTRACT FROM AUTHOR]

The article focuses on the changes in intra-abdominal pressure (IAP) after inguinal hernia repair. It discusses a study to quantify the changes of IAP during the first 24 postoperative hours after voluminous primary inguinal hernia (PIH) repair. It notes the benefits of IAP elevation such as easy and rapid mobilization after PIH repair. It states that premature infants and elderly patients have to be considered separately when studying the influence of any alteration in IAP.

Introduction: Splenic vein thrombosis results in localized portal hypertension called sinistral portal hypertension, which may also lead to massive upper gastrointestinal bleeding. Symptomatic sinistral portal hypertension is usually best treated by splenectomy, but interventional radiological techniques are safe and effective alternatives in the management of a massive hemorrhage, particularly in cases that have a high surgical risk.Case Presentation: We describe a 23-year-old Greek man with acute massive gastric variceal bleeding caused by splenic vein thrombosis due to a missing von Leiden factor, which was successfully managed with splenic arterial embolization.Conclusions: Interventional radiological techniques are attractive alternatives for patients with a high surgical risk or in cases when the immediate surgical excision of the spleen is technically difficult. Additionally, surgery is not always successful because of the presence of numerous portal collaterals and adhesion. Splenic artery embolization is now emerging as a safe and effective alternative to surgery in the management of massive hemorrhage from gastric varices due to splenic vein thrombosis, which often occurs in patients with hypercoagulability. [ABSTRACT FROM AUTHOR]

Background: Listeria monocytogenes is an opportunistic pathogen of the central nervous system commonly associated with impaired cell-mediated immunity. We hereby present a case of adult neurolisteriosis where the only immunological feature persistently present was serum IgM deficiency, suggesting that non-specific humoral immunity may also play a central role in the control of neuroinvasion by Listeria monocytogenes.Case Presentation: A 62-year-old male who had never experienced severe infections presented with headache, nuchal rigidity and confusion. Neuroimaging was normal and lumbar puncture revealed pleiocytosis (760 leukocytes/mm3) and hypoglycorrhachia (34 mg/dL). The patient was treated empirically for bacterial meningitis. Indeed, further analysis of the CSF showed infection by Listeria monocytogenes, which was accompanied by reduced serum IgM levels that persisted well beyond the period of acute bacterial infection. Levels of IgG and IgA isotypes, along with peripheral blood counts of major leukocyte subsets, were at the same time largely preserved. Intriguingly, the absence of membrane-bound IgM on B cells was essentially complete in the acute post-infection period leading to a remarkable recovery after 12 months, suggesting that mechanisms other than defective membrane expression are underlying serum deficiency.Conclusions: As far as we know, this is the first reported case of neurolisteriosis associated with IgM deficiency in an adult individual without a history of severe infections or other underlying conditions. A possible role of circulating IgM against invasive disease caused by Listeria monocytogenes, particularly in the early course of host-pathogen interaction, is discussed. [ABSTRACT FROM AUTHOR]

The article presents several case studies of endometriosis infiltrating the round ligament. The initial diagnosis of the three conditions was irreducible hernia due to the rare nosologic entity, which causes unusual preoperative symptoms. In connection, the authors recommended that surgery is the treatment of choice and is curative such as laparoscopy.