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OBJECTIVE Skull base meningiomas (SBMs) involving the cavernous sinus encase the internal carotid artery (ICA) and may lead to stenosis of the vessel. Although ischemic stroke has been reported in the literature, there are to the authors’ knowledge no reported studies quantifying the risk of stroke in these patients. The authors aimed to determine the frequency of arterial stenosis in patients with SBMs that encase the cavernous ICA and to estimate the risk of ischemic stroke in these patients. METHODS Records of all patients with SBM encasing the ICA whose cases were managed by the skull base multidisciplinary team at Salford Royal Hospital between 2011 and 2017 were reviewed using a two-stage approach: 1) clinical and radiological strokes were identified from electronic patient records, and 2) cases were reviewed to examine the correlation between ICA stenosis associated with SBM encasement and anatomically related stroke. Strokes that were caused by another pathology or did not occur in the perfusion territory were excluded. RESULTS In the review of patient records the authors identified 118 patients with SBMs encasing the ICA. Of these, 62 SBMs caused stenosis. The median age at diagnosis was 70 (IQR 24) years, and 70% of the patients were female. The median follow-up was 97 (IQR 101) months. A total of 13 strokes were identified in these patients; however, only 1 case of stroke was associated with SBM encasement, which occurred in the perfusion territory of a patient without stenosis. Risk of acute stroke during the follow-up period for the entire cohort was 0.85%. CONCLUSIONS Acute stroke in patients with ICA encasement by SBMs is rare despite the propensity of these tumors to stenose the ICA. Patients with ICA stenosis secondary to their SBM did not have a higher incidence of stroke than those with ICA encasement without stenosis. The results of this study demonstrate that prophylactic intervention to prevent stroke is not necessary in ICA stenosis secondary to SBM.

OBJECTIVE Spinal deformity surgery is associated with significant blood loss, often requiring the transfusion of blood and/or blood products. For patients declining blood or blood products, even in the face of life-threatening blood loss, spinal deformity surgery has been associated with high rates of morbidity and mortality. For these reasons, patients for whom blood transfusion is not an option have historically been denied spinal deformity surgery. METHODS The authors retrospectively reviewed a prospectively collected data set. All patients declining blood transfusion who underwent spinal deformity surgery at a single institution between January 2002 and September 2021 were identified. Demographics collected included age, sex, diagnosis, details of any prior surgery, and medical comorbidities. Perioperative variables included levels decompressed and instrumented, estimated blood loss, blood conservation techniques used, length of surgery, length of hospital stay, and complications from surgery. Radiographic measurements included, where appropriate, sagittal vertical axis correction, Cobb angle correction, and regional angular correction. RESULTS Spinal deformity surgery was performed in 31 patients (18 male, 13 female) over 37 admissions. The median age at surgery was 41.2 years (range 10.9–70.1 years), and 64.5% had significant medical comorbidities. A median of 9 levels (range 5–16 levels) were instrumented per surgery, and the median estimated blood loss was 800 mL (range 200–3000 mL). Posterior column osteotomies were performed in all surgeries, and pedicle subtraction osteotomies in 6 cases. Multiple blood conservation techniques were used in all patients. Preoperative erythropoietin was administered prior to 23 surgeries, intraoperative cell salvage was used in all, acute normovolemic hemodilution was performed in 20, and perioperative administration of antifibrinolytic agents was performed in 28 surgeries. No allogenic blood transfusions were administered. Surgery was staged intentionally in 5 cases, and there was 1 unintended staging due to intraoperative blood loss from a vascular injury. There was 1 readmission for a pulmonary embolus. There were 2 minor postoperative complications. The median length of stay was 6 days (range 3–28 days). Deformity correction and the goals of surgery were achieved in all patients. Two patients underwent revision surgery during the follow-up period: one for pseudarthrosis and the other for proximal junctional kyphosis. CONCLUSIONS With proper preoperative planning and judicious use of blood conservation techniques, spinal deformity surgery may be performed safely in patients for whom blood transfusion is not an option. The same techniques can be applied widely to the general population in order to minimize blood loss and the need for allogeneic blood transfusion.

OBJECTIVE Preoperative differentiation of facial nerve schwannoma (FNS) from vestibular schwannoma (VS) can be challenging, and failure to differentiate between these two pathologies can result in potentially avoidable facial nerve injury. This study presents the combined experience of two high-volume centers in the management of intraoperatively diagnosed FNSs. The authors highlight clinical and imaging features that can distinguish FNS from VS and provide an algorithm to help manage intraoperatively diagnosed FNS. METHODS Operative records of 1484 presumed sporadic VS resections between January 2012 and December 2021 were reviewed, and patients with intraoperatively diagnosed FNSs were identified. Clinical data and preoperative imaging were retrospectively reviewed for features suggestive of FNS, and factors associated with good postoperative facial nerve function (House-Brackmann [HB] grade ≤ 2) were identified. A preoperative imaging protocol for suspected VS and recommendations for surgical decision-making following an intraoperative FNS diagnosis were created. RESULTS Nineteen patients (1.3%) with FNSs were identified. All patients had normal facial motor function preoperatively. In 12 patients (63%), preoperative imaging demonstrated no features suggestive of FNS, with the remainder showing subtle enhancement of the geniculate/labyrinthine facial segment, widening/erosion of the fallopian canal, or multiple tumor nodules in retrospect. Eleven (57.9%) of the 19 patients underwent a retrosigmoid craniotomy, and in the remaining patients, a translabyrinthine (n = 6) or transotic (n = 2) approach was used. Following FNS diagnosis, 6 (32%) of the tumors underwent gross-total resection (GTR) and cable nerve grafting, 6 (32%) underwent subtotal resection (STR) and bony decompression of the meatal facial nerve segment, and 7 (36%) underwent bony decompression only. All patients undergoing subtotal debulking or bony decompression exhibited normal postoperative facial function (HB grade I). At the last clinical follow-up, patients who underwent GTR with a facial nerve graft had HB grade III (3 of 6 patients) or IV facial function. Tumor recurrence/regrowth occurred in 3 patients (16%), all of whom had been treated with either bony decompression or STR. CONCLUSIONS Intraoperative diagnosis of an FNS during a presumed VS resection is rare, but its incidence can be reduced further by maintaining a high index of suspicion and undertaking further imaging in patients with atypical clinical or imaging features. If an intraoperative diagnosis does occur, conservative surgical management with bony decompression of the facial nerve only is recommended, unless there is significant mass effect on surrounding structures.

The Brain Computer Interface (BCI) has a great impact on mankind. Many researchers have been trying to employ different classifiers to figure out the human brain's thoughts accurately. In order to overcome the poor performance of a single classifier, some researchers used a combined classifier. Others delete redundant information in some channels before applying the classifier as they thought it might reduce the accuracy of the classifier. BCI helps clinicians to learn more about brain problems and disabilities such as stroke to use in recovery. The main objective of this paper is to propose an optimized High-Performance Support Vector Machines (SVM) based classifier (HPSVM-BCI) using the SelectKBest (SKB). In the proposed HPSVM-BCI, the SKB algorithm is used to select the features of the BCI competition III Dataset IVa subjects. Then, to classify the prepared data from the previous phase, SVM with Quadratic kernel (QSVM) were used in the second phase. As well as enhancing the mean accuracy of the dataset, HPSVM-BCI reduces the computational cost and computational time. A major objective of this research is to improve the classification of the BCI dataset. Furthermore, decreased feature count translates to fewer electrodes, a factor that reduces the risk to the human brain. Comparative studies have been conducted with recent models using the same dataset. The results obtained from the study show that HPSVM-BCI has the highest average accuracy, with 99.24% for each subject with 40 channels only.

Morse taper junction tribocorrosion is recognized as an important failure mode in total hip arthroplasty. Although taper junctions are used in almost all shoulder arthroplasty systems currently available in the United States, with large variation in design, limited literature has described comparable analyses of taper damage in these implants. In this study, taper junction damage in retrieved reverse total shoulder arthroplasty (RTSA) implants was assessed and analyzed.Fifty-seven retrieved RTSAs with paired baseplate and glenosphere components with Morse taper junctions were identified via database query; 19 of these also included paired humeral stems and trays or spacers with taper junctions. Components were graded for standard damage modes and for fretting and corrosion with a modified Goldberg-Cusick classification system. Medical records and preoperative radiographs were reviewed. Comparative analyses were performed assessing the impact of various implant, radiographic, and patient factors on taper damage.Standard damage modes were commonly found at the evaluated trunnion junctions, with scratching and edge deformation damage on 76% and 46% of all components, respectively. Fretting and corrosion damage was also common, observed on 86% and 72% of baseplates, respectively, and 23% and 40% of glenospheres, respectively. Baseplates showed greater moderate to severe (grade ≥ 3) fretting (43%) and corrosion (27%) damage than matched glenospheres (fretting, 9%; corrosion, 13%). Humeral stems showed moderate to severe fretting and corrosion on 28% and 30% of implants, respectively; matched humeral trays or spacers showed both less fretting (14%) and less corrosion (17%). On subgroup analysis, large-tapered implants had significantly lower summed fretting and corrosion grades than small-tapered implants (P .001 for both) on glenospheres; paired baseplate corrosion grades were also significantly lower (P = .031) on large-tapered implants. Factorial analysis showed that bolt reinforcement of the taper junction was also associated with less fretting and corrosion damage on both baseplates and glenospheres. Summed fretting and corrosion grades on glenospheres with trunnions (male) were significantly greater than on glenospheres with bores (female) (P .001 for both).Damage to the taper junction is commonly found in retrieved RTSAs and can occur after only months of being implanted. In this study, tribocorrosion predominantly occurred on the taper surface of the baseplate (vs. glenosphere) and on the humeral stem (vs. tray or spacer), which may relate to the flexural rigidity difference between the titanium and cobalt-chrome components. Bolt reinforcement and the use of large-diameter trunnions led to less tribocorrosion of the taper junction. The findings of this study provide evidence for the improved design of RTSA prostheses to decrease tribocorrosion.

Ticagrelor or prasugrel are recommended to reduce ischemic events in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). However, in clinical practice, patients are often switched from a potent P2Y12 inhibitor to clopidogrel prior to or at discharge ('de-escalation'). We sought to assess the incidence and predictors of de-escalation.Consecutive patients who received either a ticagrelor or prasugrel loading dose for AMI PCI at two tertiary centers between Jan 2015-Mar 2019 who survived to discharge were included. Data were obtained from the electronic health record and institutional NCDR CathPCI data. Patients who were de-escalated to clopidogrel were compared with those who remained on potent P2Y12 inhibitors through the time of discharge.Of the1818 patients in the cohort, 1146 (63%) were de-escalated. Patients in the de-escalation group were older, more often Black, had lower prevalence of co-morbidities, less often had private insurance, and had less complex PCI. After adjustment, older age remained positively associated (OR 1.2, CI 1.08-1.34, p = .001) and Caucasian race (OR 0.5, CI 0.33-0.77, p = .002), prior MI (OR 0.7, CI 0.5-0.97, p = .032), bifurcation lesion (OR 0.71, CI 0.53-0.95, p = .019), and greater number of stents (OR 0.82, CI 0.75-0.91, p = .0001) were negatively associated with de-escalation. In de-escalated patients, the rationale was not documented in 75.9% of cases.De-escalation occurred frequently in patients with AMI and was associated with both non-clinical and clinical factors. Medical decision making was poorly documented and represent an area for improvement.

This study was carried out at three locations (Laboratory of Plant Tissue Culture, Fields of the College of Agriculture, University of Diyala and one of the private nursery at the city of Baqubah. The applied experiments included two separate experiments on the scion Mandarin Clementine micro grafted on Sour orange rootstock. The first micro grafting experiment aimed to develop a method of vegetative propagation of Clementine and transferring the micro grafts from a laboratory to the field and comparing grafting dates (spring, early autumn, late autumn) with the laboratory grafting after treating grafting region with different concentrations of gibberellin (0, 0.3 or 0.4 mg. L-1). The effect of grafting dates on the percentages of success of grafted plants after one month of acclimatization. The experiment was carried out according to completely randomized design (CRD) as a factorial experiment with two factors and three replications for the first one, and as a single factor experiment with three replicates for the second experiment. Results showed a decline in the percentage of success of the grafting and a slight success correlated with increased gibberellin concentration in the aforementioned experiment at early fall grafting. A second field experiment, was conducted with the aim of studying the success of maintained micro propagated plants during summer season and the effect of foliar spray with salicylic acid (0, 200 or 400 mg. L-1) and marine algae extract (0, 5 or 10 g. L-1) on some characteristics of vegetative growth and some chemical characteristics. The experiment was carried out according to the Randomized Complete Block Design (RCBD), as a factorial experiment with two factors and three replications. No significant effect for both factors was recorded in most vegetative characteristics, while chemical composition was significantly affected caused by the two factors.

In order to help State to ensure food security of the populations, technologies for substituting wheat flour with flour from local food resources such as rice are used in bread making. The aim of this study was to determine the rheological behavior of pastes obtained by incorporating parboiled and non-parboiled rice flour in the bread-making process. The results obtained revealed that parboiling improves the tenacity of the mixed wheat (85%) and rice (15%) paste. Indeed, the parboiled Sahel 328 and Sahel 329 rice varieties would give a tougher mixed paste (P/L = 1.24±0.030; 1.28±0.020 respectively) and closer to that of 100% wheat (P/L= 1.13±0.050). The incorporation of parboiled Sahel 329 rice flour resulted in a paste with a swelling index closest to that of the control (WS). The results also indicated that all the parboiled rice studied composite flours had satisfactory baking strength. Of all studied varieties, Sahel 329 when parboiled, gave the closest rheological properties to the control (100% wheat). In addition, we can consider from this study, the alternative use of rice in bread-making supports the idea that rice would be a better vehicle than the soft wheat flour used for iron and folic acid fortification in Senegal.

The present study was undertaken to study the effect of apigenin and luteolin on physiological and histological changes in rats treated with cytarabine drugs. Thirty-five albino healthy male adult rats with equal age weighing 250 -300g were enrolled. Rats were randomly divided into seven groups according to the treatment. Group “1” was treated with normal saline and served as the control group. Groups “2,3 and 4” received cytarabine, apigenin, and luteolin respectively, while groups 5, 6, and 7 received a combination of “apigenin + cytarabine”, “luteolin + cytarabine”, and “apigenin + luteolin + cytarabine”, respectively. After one week of treatment, all seven groups of rats were sacrificed for histological finding, and blood samples were collected from each rat for biochemical parameters analysis. The results of this study showed that cytarabine increased the activity of GPT, GOT, and cholesterol levels in rats after one week of intraperitoneal injection in comparison to the control. There was no significant difference in GPT and GOT when apigenin and luteolin were administrated orally compared to the control group. When apigenin and luteolin are combined with cytarabine, they have a protective effect on leakage of liver enzymes GPT and GOT in serum. Apigenin and luteolin histologically protect liver cells from cytarabine damage when administered alone. These findings conclude that apigenin and luteolin have a protective effect on cytarabine side effects on the liver and its function in rats.

The widespread availability and use of brain magnetic resonance imaging and computed tomography has led to an increase in the frequency of incidental meningioma diagnoses. Most incidental meningioma are small, demonstrate indolent behavior during follow-up, and do not require intervention. Occasionally, meningioma growth causes neurological deficits or seizures prompting surgical or radiation treatment. They may cause anxiety to the patient and present a management dilemma for the clinician. The questions for both patient and clinician are "will the meningioma grow and cause symptoms such that it will require treatment within my lifetime?" and "will deferment of treatment result in greater treatment-related risks and lower chance of cure?." International consensus guidelines recommend regular imaging and clinical follow-up, but the duration is not specified. Upfront treatment with surgery or stereotactic radiosurgery/radiotherapy may be recommended but this is potentially an overtreatment, and its benefits must be balanced against the risk of related adverse events. Ideally, treatment should be stratified based on patient and tumor characteristics, but this is presently hindered by low-quality supporting evidence. This review discusses risk factors for meningioma growth, proposed management strategies, and ongoing research in the field.

This Policy Brief provides an analysis of the narratives of (potential) migrants of Gambian and Afghan origin. This brief focuses on how locally held narratives relate to the messages of EU-funded information campaigns, which usually aim at deterring irregular migration. The research is based on data gathered in interviews and focus groups with Gambians in The Gambia and Afghans in Turkey. The narratives on Europe and migration in both settings are positive, albeit slightly more nuanced and critical in the Gambian context. According to the dominant narratives, there are few or hardly any opportunities in their countries of origin and/or transit. The irregular journey to Europe is dangerous; however, this risk can hardly be avoided given a lack of legal migration opportunities and their current situation. Life in Europe brings opportunities for a positive life change. The migrants’ narratives tend to differ strongly from the messages communicated in the EU-funded information campaigns, with the partial exception of the message emphasizing the dangers of an irregular migration route. Overall, the findings demonstrate that the messages of EU-funded information campaigns often compete with locally held narratives on migration and Europe. When the messages of information campaigns appear irrelevant or at odds with the life conditions of (potential) migrants, they tend to be discarded in favor of local narratives that better express these realities. As a matter of fact, it is relevant not to overestimate the capacity of migration information campaigns and carefully reflect upon their objectives.

This work is carried out to objectively establish a new method to detect harmonics and measure the total harmonic distortion (THD) in a remote source, such as a high voltage transformer. The proposed approach utilized embedded design techniques to construct an embedded processor system with Ethernet intellectual property core to acquire data from a remote harmonics source. The designed system has several notable merits, namely, it is portable that can be applied in the work field, and it avoids workers from being subject to a hazard high voltage shock as well as its simplicity and high accuracy. The harmonics detection and analysis are achieved by inserting a microcontroller system near the high voltage transformer to acquire the necessary data and transmit it to a remote embedded processor system that is used to detect and analyze the harmonics. The microcontroller and the processor systems are connected by a wide-area network (WAN) through Ethernet and transmission control protocol/internet protocol (TCP/IP) protocols. The processor system is accommodated to perform 128 points fast Fourier transform for harmonics detection. Matlab simulations are used to validate the results. It is found that the results match very accurately the simulation results with an error of less than 0.02%.

This BRIDGES report studies the migration narratives of (potential) migrants in the Gambia as well as Afghan (transit) migrants in Istanbul. A particular emphasis has been placed on the question of how individually held narratives on migration, Europe, and the irregular migration journey interrelate with EU-promoted messages put forward in migration information campaigns. The locally held narratives highlight the opportunities for a positive life change enabled by migration to Europe. Migrants who made it to Europe are perceived as successful individuals who are now safe (in the Afghan case) and/or able to improve the situation of their families and communities (primarily in the Gambian case). In the absence of legal migration opportunities, the narratives on migration in both countries primarily concern irregular migration. Regarding the narratives on Europe, those of potential migrants in the Gambia are more nuanced than those in Turkey. While Europe is still seen as a place of opportunity in the Gambia, informants also put forward more critical statements on Europe, for instance regarding the colonial past. The narratives on migration and Europe promoted in EU migration campaigns strongly differ from those of (potential) migrants in the Gambia and those in transit in Turkey. EU-funded information campaigns mostly portray (irregular) migration to and life in Europe in a negative light. However, there is a match between the locally dominant and EU-promoted narratives regarding the issue of risks during the migratory journey. Independently of or alongside migration information campaigns, there has been an intensifying public and private discourse about people suffering or dying on the road. Compared to those from the Gambia, Afghan migrants (in transit) in Istanbul pose fewer questions about whether to accept the risk of irregular migration as, for them, there seems to be no alternative. They increasingly perceive that they are unwanted in Turkey. Onward migration is narrated as a solution to a difficult or even life-threatening situation in Turkey, due to the risk of being deported back to Afghanistan. The narrative of Afghans in Turkey is one of forced migration. Overall, the study demonstrates that the messages of EU migration information campaigns compete with locally dominant narratives. Information and knowledge about migration constitute just one of the many drivers of migration that interrelate with others.&nbsp

This report of the BRIDGES project investigates as to how locally dominant and EU-promoted narratives related to migration, interact and influence the decision-making of potential migrants in the Gambia. The study is based on focus groups and in-depth interviews with 60 Gambian youngsters who think about migrating abroad. The report starts by outlining the dominant - or Master - narratives on migration and Europe in the Gambia. These narratives put to the forefront the opportunities for a positive life change enabled by a person migrating to Europe. Europe is associated with (professional or educational) opportunities and a probability of getting high(er) living standards and achieving social mobility. Practically every participant tended to see a positive cost-benefit calculus in favour of migration, yet some considered the risks to outweigh the benefits of irregular migration. The research shows that the messages promoted in EU-funded information campaigns struggle to unfold an influence in view of the dominant Master narratives on migration and Europe. Aggregately speaking, potential migrants in the Gambia rely little on the information of EU-funded campaigns when making decisions. The exception are potential migrants who are already sensitive about the risks of the journey. The campaigns are able to reinforce existing doubts, thereby tipping the overall calculus in some cases. That said, information is only one factor among others influencing migratory decision-making. More relevant ones are the actual livelihood opportunities or a lack of prospects in the Gambia as well as the social prestige that can be gained through migration.

Study curried out to evolution response growth and biochemical of Ocimum basilicum L. under drought conditions. Plant grown under treatment conditions (24 hours with - 54°C, 21°C, 55-70% RH) and plant were transferred to growth chamber for 6 weeks. The results showed that the rate of increase in chlorophyll a and b was significant with an increase rate of 1.7 and 0.6 compared to control after three days of treatment. The results also showed that H2O2 content was increased and reached to 1.3, 2.8 and 3.5X compared to the control after three, six and nine days of treatment respectively. One the other hand the levels of the enzyme APX activity, Lipid peroxidation and protein which was conducted on the tissue of basil leaves, increase compared with control after three days of treatment.

Background This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic.

The depth conversion process is a significant task in seismic interpretation to establish the link between the seismic data in the time domain and the drilled wells in the depth domain. To promote the exploration and development of the Subba oilfield, more accurate depth conversion is required. In this paper, three approaches of depth conversions: Models 1, 2, and 3 are applied from the simplest to the most complex on Nahr Umr Reservoir in Suba oilfield. This is to obtain the best approach, giving less mistakes with the actual depth at well locations and good inter/extrapolation between or away from well controls. The results of these approaches, together with the uncertainty analysis provide a reliable velocity model and more accurate predicted depth that reduced the ambiguity of the subsurface. The uncertainty analysis reveals that Model 3 is considered a more practical and most accurate approach because it gives a minimized standard deviation value of 14 with less residual and error values. The uncertainty of the depth conversion and the standard deviation values is raised towards the eastern part of the field due to an increase in the dipping depth in this region that affects the depth conversion results.

Migration was prominently set on West African political agendas with Europe’s increasing pressure for cooperation since the 2000s. Notwithstanding, we have hardly any insights about how politicized migration is in that region, how West African policymakers frame migration and why. Relying on newspaper data, we analyse the politicization and framing of migration in the Gambia from 2009 to 2020. This small West African state with very high emigration to Europe is a good case study to verify the so-called ‘regime effect’ in migration policymaking because it underwent a democratic transition in 2016. The analysis shows that the transition to democracy did not lead so much to a policy change, but to a change of migration politics on the most salient sub-issue: cooperation on forced return with migrant-receiving states. We show that democratization led to a clear multiplication of national and international claims-makers on this topic, polarizing policy positions for and against cooperation, and a diversification of justification frames. The paper shows how democratic policymakers in the Global South, differently from autocracies or Western democratic states, struggle with creative and diversifying justification frames to cater the needs of both international donors and electorates.

The capacity to deal with digital transformation is a valuable asset for established organizations, and employees play a crucial role in this process. This study contributes to the understanding of employees’ sensemaking of digital transformation in the tour operating industry. Using prior digital transformation research, construal-level theory (CLT), and dynamic change perspectives, our scholarly work focuses on the complexities of organizational change in a digital transformation context. Although employees generally support digital transformation, our findings show that their perceptions change over time across a range of specific challenges experienced during the employee change journey. Our findings stress the importance of adopting a social exchange lens in digital transformation knowledge as this represents deep structure change that might cause well-designed transformation processes to fail. Implications for hospitality and tourism management are discussed.

Vestibular schwannomas are benign nerve sheath tumours that arise on the vestibulocochlear nerves. Vestibular schwannomas are known to occur in the context of tumour predisposition syndromes NF2-related and LZTR1-related schwannomatosis. However, the majority of vestibular schwannomas present sporadically without identification of germline pathogenic variants.To identify novel genetic associations with risk of vestibular schwannoma development, we conducted a genome-wide association study in a cohort of 911 sporadic vestibular schwannoma cases collated from the neurofibromatosis type 2 genetic testing service in the north-west of England, UK and 5500 control samples from the UK Biobank resource. One risk locus reached genome-wide significance in our association analysis (9p21.3, rs1556516, P = 1.47 × 10−13, odds ratio = 0.67, allele frequency = 0.52).9p21.3 is a genome-wide association study association hotspot, and a number of genes are localized to this region, notably CDKN2B-AS1 and CDKN2A/B, also referred to as the INK4 locus. Dysregulation of gene products within the INK4 locus have been associated with multiple pathologies and the genes in this region have been observed to directly impact the expression of one another. Recurrent associations of the INK4 locus with components of well-described oncogenic pathways provides compelling evidence that the 9p21.3 region is truly associated with risk of vestibular schwannoma tumorigenesis.

Purpose There is no compelling outcome data or clear guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using low molecular weight heparin (chemoprophylaxis) in patients undergoing pituitary surgery. Here we describe our experience of early chemoprophylaxis (post-operative day 1) following trans-sphenoidal pituitary surgery. Methods Single-centre review of a prospective surgical database and VTE records. Adults undergoing first time trans-sphenoidal pituitary surgery were included (2009–2018). VTE was defined as either deep vein thrombosis and/or pulmonary embolism within 3 months of surgery. Postoperative haematomas were those associated with a clinical deterioration together with radiological evidence. Results 651 Patients included with a median age of 55 years (range 16–86 years). Most (99%) patients underwent trans-sphenoidal surgery using a standard endoscopic single nostril or bi-nostril trans-sphenoidal technique. More than three quarters had pituitary adenomas (n = 520, 80%). Postoperative chemoprophylaxis to prevent VTE was administered in 478 patients (73%). Chemoprophylaxis was initiated at a median of 1 day post-procedure (range 1–5 days postoperatively; 92% on postoperative day 1). Tinzaparin was used in 465/478 patients (97%) and enoxaparin was used in 14/478 (3%). There were no cases of VTE, even in 78 ACTH-dependent Cushing’s disease patients. Six patients (1%) developed postoperative haematomas. Chemoprophylaxis was not associated with a significantly higher rate of postoperative haematoma formation (Fisher’s Exact, p = 0.99) or epistaxis (Fisher’s Exact, p > 0.99). Conclusions Chemoprophylaxis after trans-sphenoidal pituitary surgery on post-operative day 1 is a safe strategy to reduce the risk of VTE without significantly increasing the risk of postoperative bleeding events.

PURPOSE: To assess and compare outcome of surgical management of non-functioning pituitary adenohypophyseal tumours in patients under 65-years, and 65-years and older at tertiary neurosurgical referral centre.METHODS: Data was retrospectively analysed from pituitary database. Forty-four patients aged 65 or older (Group 1) and 93 patients under 65 (Group 2) underwent endoscopic trans-sphenoidal surgery (ETSS) between January 2017 and July 2019. The surgical, endocrinological, ophthalmological and radiological outcomes were compared.RESULTS: 6.8% of Group 1 patients had peri-operative surgical complications compared to 12.9% in Group 2 (p = 0.29). Improved visual fields and acuity were seen in 65.2% and 82.8% of Group 1 and Group 2 respectively (p = 0.124), although there were pre-existing ocular problems in 15.9% of Group 1. New hormone deficiencies were observed in 31.8% of Group 1 patients, and 24.7% of Group 2 (p = 0.555). Tumour regrowth/recurrence was seen in 2.3% of Group 1 (p = 0.553). The rate of repeat surgery was 6.8% in the Group 1 and 12.9% in Group 2 (p = 0.28). There was no significant relationship between extent of resection, complications or hormonal deficiency. The mean duration of follow-up was 10.5 ± 13.0 months for Group 1 patients and 13.0 ± 16.0 months for Group 2 patients (p = 0.526).CONCLUSIONS: ETSS for non-functioning pituitary adenohypophyseal tumours is safe and well tolerated in the patients aged 65 and older. Advanced age by itself should not be a contra-indication for ETSS. It is however highly recommended that the care of such patients to be offered at a high volume, dedicated pituitary surgical units.

Objectives Determine the rate of positive extremity ultrasound exams for DVT in patients with COVID-19 and assess for differences in laboratory values in patients with and without DVT, which could be used as a surrogate to decide the need for further evaluation with ultrasound. Methods Retrospective case control study with 1:2 matching of cases (COVID-19+ patients) to controls (COVID-19- patients) based on age, gender, and race. Laboratory values assessed were serum D-dimer, fibrinogen, prothrombin time, international normalized ratio, and C-reactive protein. Demographic variables, comorbidities, and clinical variables including final disposition were also evaluated. P-values for categorical variables were calculated with the chi-square test or Fisher's exact test. P-values for continuous variables were compared with the use of a two-tailed unpaired t-test. Results The rate of extremity ultrasound exams positive for DVT were similar in patients with (14.7%) and without (19.3%) COVID-19 (P = .423). No significant difference was observed in laboratory values including the D-dimer level in COVID-19 patients without (mean 9523.9 ng/mL (range 339 to >60,000)) or with DVT (mean 13,663.7 ng/mL (range 1193->60,000)) (P = .475). No differences were found in demographic variabilities or co-morbidities among COVID-19 patients with and without extremity DVT. Conclusions We found no statistically significant difference in rate of positive DVT studies between COVID-19+ and COVID-19- patients. D-dimer levels are elevated, in some cases markedly, in COVID-19 patients with and without DVTs and therefore these data do not support their use as a surrogate when assessing the need for ultrasound evaluation.

Objectives In developing countries, the pneumococcal conjugate vaccine (PCV) has not been incorporated into the national immunization schedule, and the vaccination rate is low. This study aimed to examine parental knowledge, attitudes, and barriers to children receiving the PCV in Jordan. Methods This was a questionnaire-based cross-sectional study. The online survey was written in Arabic and consisted of three main sections. The questionnaire was distributed via social media platforms, such as Facebook, Twitter, and WhatsApp. Results In total, 720 responses were analyzed. Only 149 (20.7%) of the parents’ children were vaccinated with the PCV. However, almost half 356 (49.4%) of the respondents were willing to vaccinate their children. Most (563, 78.1%) parents stated that the vaccine would protect their children from pneumococcal disease. More than two thirds (516, 71.6%) of them strongly agreed or agreed that the cost of the PCV is high. Parents who had vaccinated their children had a higher monthly income than parents who had not vaccinated their children. Conclusions This study shows a lack of knowledge regarding pneumococcal infection and the PCV among Jordanian parents. This is the main barrier to vaccinating children. Therefore, improving parental knowledge would increase the rate of vaccination among Jordanian children.

Background: Most primary Health Care Centers (PHCCs) in Iraq have a referral system records; however, this mechanism does not function well because of the lack of other requirements for an efficient referral system. Objective: To assess the practice & opinion of doctors in PHCs toward the referral system, and to determine the doctors in PHC's commitment to referral system instructions and guidelines. Subjects and methods: A cross-sectional study with analytic elements was conducted in nine health directorates in Iraq, from the 1st October 2018 – 30th June 2019.One PHC was selected randomly form each sector in every governorate, A questionnaire was used to collect the required information. SPSS version 24 analysis was used for the statistical analysis. Results: sixty-three doctors were working in PHCs had participated in the current study, the mean age (40.03 ±10.24), 58.7%were female, 46% were general practitioner, 30.2% of the participated doctors had 300 and less patient/month; 31.7% of doctors had ≤10 Patients referred/month, emergencies was the main cause for referral (46.03%), and 37(58.37%) of doctors announced that the referred-form not retrained to the PHC, and ever retrained-forms had no feedback 29(46%), 28(44%)of the participated doctors agreed that the current referral-system was effective and seven of them strongly agreed, 59(93.7%) believe in the importance of hospital-feedback, with a significant relationship between their attitude about the effective-current-referral system & Refer cases Percentage, while no significant-relation with their Patients examined/month. Loaded crowded and hospital doctors shortage as possible causes and suggest to referral-system activation especially the hospital -part". Conclusions: there was inadequate knowledge of referral-policies and lack of coordination or/and clear feedback-expectations and PHCs-hospitals collaboration and lack of referral-system integrated within an electronic-health-record.

Introduction: Food handlers play an important role in ensuring food safety throughoutthe chain of production, processing, storage and preparation of food. Good knowledge,positive attitude and good practice of food handlers are important for prevention offood borne diseases. Aim of work: To assess knowledge, attitude and practice (KAP)of food handlers towards food safety at Mansoura University Hospitals and find outpersonal and work-related factors associated with different KAP levels. Materialsand Methods: A descriptive observational cross-sectional study was conducted fromDecember 2016 to September 2017. It included all food handlers working at MansouraUniversity hospitals᾿ kitchens who were on duty and fulfilling legibility criteria. Thedata were collected using a questionnaire about demographic data, occupational history,food safety knowledge and attitude. Observational checklist was used to assess theworkers practice. Results: Only one quarter of food handlers had good knowledgetowards food safety and hygiene, on contrary, most of them had a good attitude level(61.0%) and a good hygienic practice level (59.0%). High KAP scores were notedamong females and university certified workers. The highest KAP scores were notedamong veterinarians and cooks. There is a significant strong positive correlationbetween knowledge and attitude (r = 0.78), and moderate positive correlation betweenknowledge and practice (r = 0.46). Conclusion: Limited number of food handlers hadenough knowledge regarding food safety. Practice had a positive correlation with bothknowledge and attitude. KAP scores of food handlers differ significantly regardinggender, educational level and type of work. It should be mandatory for food handlersto undergo a supervised food safety training courses prior to renewal of their license toensure their efficacy.

Objective The study aimed to determine long-term outcomes in patients with intraoperative electrical conduction block in an anatomically intact facial nerve (FN). Methods Single center retrospective review of prospectively collected database of all vestibular schwannoma surgeries between January 1, 2008 and August 25, 2015. Operative notes were reviewed and patients with anatomically intact FNs, but complete conduction block at the end of surgery were included for analysis. Results In total, 371 patients had vestibular schwannoma surgery of which 18 met inclusion criteria. Mean follow-up was 34.28 months and average tumor size was 28.00 mm. Seventeen patients had House-Brackmann Grade VI facial palsy immediately postoperatively and one patient was grade V. At 1 year, three patients remained grade VI (17%), two improved to grade V (11%), seven to grade IV (39%), six to grade III (33%), and one patient to grade II (6%). On extended follow-up, five patients (28%) had additional 1 to 2 score improvement in facial function. Subset analysis revealed no correlation of tumor size, vascularity, adherence to nerve, operative approach, extent of resection, splaying of FN, and recurrent tumor or sporadic tumors to the extent of FN recovery. Conclusion Intraoperative conduction block does not condemn a patient to permanent FN palsy. There is potential for a degree of recovery comparable with those undergoing nerve grafting. Our data do not clearly support a policy of same-surgery or early-postoperative primary nerve grafting in the event of a complete conduction block, and instead we favor monitoring for recovery in an anatomically intact nerve.

Las investigaciones arqueológicas en el centro de la provincia de Corrientes han sido escasas y discontinuas. Con el objetivo de revertir este panorama se iniciaron trabajos de campo en el sector sur y sursureste del macrosistema Iberá (Reserva Provincial Iberá y Parque Nacional Iberá). En este trabajo se presentan los resultados de las actividades de prospección y excavación desarrolladas. Como resultado de las mismas, se identificaron 11 áreas en las que los materiales arqueológicos se presentan en densidades variables y asociados a una matriz sedimentaria con alta proporción de conchillas. En líneas generales, estas se caracterizan por la presencia de material cerámico, lítico, restos óseos humanos y faunísticos, ornamentos, entre otros. A esta información, se integran y discuten los antecedentes para el sector, confirmando el alto potencial arqueológico del área. La evaluación de la red de permeabilidad del sector permitió identificar tres formas posibles de desplazamiento práctico entre la totalidad de los sitios hasta ahora identificados (n= 33).

Baclofen has a central acting effect, so clinicians have been utilized it chiefly for treating the spasticity of spinal origin. Nowadays, off-labeling use of baclofen with high doses is frequently increased. Despite of the extensive research studies on the effectiveness of baclofen, the reports on its histological effects on testes and on sperm parameters we insufficient. This work aims to assess the histological influences of baclofen on rats' testes and on several sperm characteristics after administration for 8 weeks. Twenty-two male rats at age of peripuberty (8weks) that were categorized into two groups. Group I (control group) includes 10 rats which were gavaged with 1 ml/day of distilled water daily. Group II (baclofen's group) includes 12 rats which were received baclofen 14.5 mg/kg for 8 weeks via gavage. At the end of the designed work, euthenization was done and the testes were excised from each rat, the epididymis samples were obtained and prepared for examination under light microscope. This study revealed that rats that were administered with 14.5mg/kg/day of baclofen for 8 weeks showed changes in the sperms parameters with several testicular histological alterations in their sections in comparison with those of controls. The percentage of the live sperms of rats (baclofen's group was lower than that of control group). Features of sloughing inside seminiferous tubules' lumen are frequently seen among these sections with mild decrease in the diameter of seminiferous tubules. Evidence of decreased Johnsen's scores (spermatogenic index -SI) was noticed in some sections, and decreasing of the frequency of seminiferous tubules that possess spermatozoa was obviously noticed. Moreover, disorganization of seminiferous tubules is shown in these sections. In addition, sections of rats of baclofen group revealed features of necrosis of seminiferous tubules, presence of degenerated spermatogenic layer, features of apoptosis, and presence of gaps in the seminiferous epithelium of degenerated tubules. Different alterations of sertoli cells as vacuolation, and detachment sertoli cells are noticed in sections of rats that were administered with baclofen. The chronic administration of rats with 14.5 mg/kg with baclofen induced effects on sperm parameters and testicular histology. however, the testicular histological alterations were more obvious. Further works are needed to clarify mechanism that stands behind these effects.

The Android operating system ranks first in the market share due to the system’s smooth handling and many other features that it provides to Android users, which has attracted cyber criminals. Traditional Android malware detection methods, such as signature-based methods or methods monitoring battery consumption, may fail to detect recent malware. Therefore, we present a novel method for detecting malware in Android applications using Gated Recurrent Unit (GRU), which is a type of Recurrent Neural Network (RNN). We extract two static features, namely, Application Programming Interface (API) calls and Permissions from Android applications. We train and test our approach using CICAndMal2017 dataset. The experimental results show that our deep learning method outperforms several methods with accuracy of 98.2%.

Meningiomas are the most common primary brain tumor and their incidence and prevalence is increasing. This review summarizes current evidence regarding the embryogenesis of the human meninges in the context of meningioma pathogenesis and anatomical distribution. Though not mutually exclusive, chromosomal instability and pathogenic variants affecting the long arm of chromosome 22 (22q) result in meningiomas in neural-crest cell-derived meninges, while variants affecting Hedgehog signaling, PI3K signaling,TRAF7,KLF4, andPOLR2Aresult in meningiomas in the mesodermal-derived meninges of the midline and paramedian anterior, central, and ventral posterior skull base. Current evidence regarding the common pathways for genetic pathogenesis and the anatomical distribution of meningiomas is presented alongside existing understanding of the embryological origins for the meninges prior to proposing next steps for this work.

The combination antimalarial therapy of artemisinin-naphthoquine (ART-NQ) was developed as a single-dose therapy, aiming to improve adherence relative to the multiday schedules of other artemisinin combination therapies. The pharmacokinetics of ART-NQ has not been well characterized, especially in children. A pharmacokinetic study was conducted in adults and children over 5 years of age (6 to 10, 11 to 17, and >/=18 years of age) with uncomplicated malaria in Tanzania. The median weights for the three age groups were 20, 37.5, and 55 kg, respectively. Twenty-nine patients received single doses of 20 mg/kg of body weight for artemisinin and 8 mg/kg for naphthoquine, and plasma drug concentrations were assessed at 13 time points over 42 days from treatment. We used nonlinear mixed-effects modeling to interpret the data, and allometric scaling was employed to adjust for the effect of body size. The pharmacokinetics of artemisinin was best described by one-compartment model and that of naphthoquine by a two-compartment disposition model. Clearance values for a typical patient (55-kg body weight and 44.3-kg fat-free mass) were estimated as 66.7 L/h (95% confidence interval [CI], 57.3 to 78.5 L/h) for artemisinin and 44.2 L/h (95% CI, 37.9 to 50.6 L/h) for naphthoquine. Nevertheless, we show via simulation that patients weighing >/=70 kg achieve on average a 30% lower day 7 concentration compared to a 48-kg reference patient at the doses tested, suggesting dose increases may be warranted to ensure adequate exposure. (This study has been registered at ClinicalTrials.gov under identifier NCT01930331.).

Intravascular lithotripsy (IVL) is a novel endovascular treatment for calcified common femoral artery disease (CFA). Data on midterm effectiveness for clinically driven target lesions revascularization (CD-TLR) is lacking. This study investigated CD-TLR during 18-month follow-up in patients requiring IVL for CFA disease treatment.In a single-center retrospective cohort study, electronic medical record of patients undergoing IVL for CFA disease from January 2018 to March 2020 were reviewed. Primary outcome was CD-TLR estimated by Kaplan-Meier method during 18-month follow-up. Univariate logistic regression was used to compare differences in CD-TLR by the type of adjunct therapy used.Among 54 CFA lesions in 50 patients, mean age (SD) was 75(8) years, gender and race were predominantly male (74%, n = 37) and white (94%, n = 47), respectively. Rutherford class III claudication was most common (70%, n = 35) with mean ABI of 0.66 (0.26) and mean angiographic stenosis of 77% (13%). Adjunct use of drug-coated balloon (DCB) angioplasty was 83% (n = 45) and atherectomy was 39% (n = 21). Residual angiographic stenosis was30% in all cases. Complications included dissection requiring stent placement (2%, n = 1). After 18-months, 18% (n = 9) died unrelated to procedural complications and 6% (n = 3) were lost to follow-up. 18-month cumulative freedom from CD-TLR was 80.6% (95% CI: 69.1%, 92%). Univariate logistic regression did not reveal a statistically significant difference in CD-TLR with type of adjunct therapy used (p0.05).IVL with adjunct use of DCB and/or atherectomy is safe and effective in treatment of calcified CFA disease. Randomized studies are required to confirm these findings.

Primary non-neuroendocrine tumours of the pituitary gland and sella are rare lesions often challenging to diagnose. We describe two cases of clinically aggressive primary glomus tumour of the pituitary gland. The lesions occurred in a 63-year-old male and a 30-year-old female who presented with headache, blurred vision and hypopituitarism. Neuroimaging demonstrated large sellar and suprasellar tumours invading the surrounding structures. Histologically, the lesions were characterised by angiocentric sheets and nests of atypical cells that expressed vimentin, smooth muscle actin and CD34. Perivascular deposition of collagen IV was also a feature. Case 2 expressed synaptophysin. INI-1 (SMARCB1) expression was preserved. Both lesions were mitotically active and demonstrated a Ki-67 labelling index of 30%. Next-generation sequencing performed in case 1 showed no mutations in the reading frame of 37 commonly mutated oncogenes, including BRAF and KRAS. Four pituitary glomus tumours have previously been reported, none of which showed features of malignant glomus tumour. Similar to our two patients, three previous examples displayed aggressive behaviour.

Introduction Vestibular schwannomas (VS) are histologically benign tumors arising from cranial nerve VIII. Far from a homogenous proliferation of Schwann cells, mounting evidence has highlighted the complex nature of the inflammatory microenvironment in these tumors. Methods A review of the literature pertaining to inflammation, inflammatory molecular pathways, and immune-related therapeutic targets in VS was performed. Relevant studies published up to June 2020 were identified based on a literature search in the PubMed and MEDLINE databases and the findings were synthesized into a concise narrative review of the topic. Results The VS microenvironment is characterized by a dense infiltrate of inflammatory cells, particularly macrophages. Significantly higher levels of immune cell infiltration are observed in growing versus static tumors, and there is a demonstrable interplay between inflammation and angiogenesis in growing VS. While further mechanistic studies are required to ascertain the exact role of inflammation in angiogenesis, tumor growth, and Schwann cell control, we are beginning to understand the key molecular pathways driving this inflammatory microenvironment, and how these processes can be monitored and targeted in vivo. Conclusion Observational research has revealed a complex and heterogeneous tumor microenvironment in VS. The functional landscape and roles of macrophages and other immune cells in the VS inflammatory infiltrate are, however, yet to be established. The antiangiogenic drug bevacizumab has shown the efficacy of targeted molecular therapies in VS and there is hope that agents targeting another major component of the VS microenvironment, inflammation, will also find a place in their future management.

Alchisme grossa is a treehopper species showing maternal care until at least the third nymphal instar. A secondary female treehopper has frequently been observed near a family (primary female guarding its egg clutch). Intraspecific brood parasitism, communal breeding or alloparental care may be suggested as possible mechanisms to explain secondary female presence. To distinguish between these phenomena, we performed relatedness analyses of genetic samples of groups including one A. grossa primary female, a secondary female and the associated offspring using polymorphic microsatellites. Furthermore, we characterized the behavioral interaction between both females during maternal care and the reproductive strategy (monandry or polyandry) of A. grossa females by estimating the number of male parents. We observed the presence of secondary females in 35.9% of monitored families. The behaviors characterized suggest the occurrence of brood parasitism in the interaction between both females. Nevertheless, all offspring within a family were descendants only of the primary female and a single male, thus showing that A. grossa females are monandrous. The results, taken together with data on the reproductive biology reported for other treehoppers, are consistent with the occurrence of brood parasitism in A. grossa.

The computer control plays important role in the solar cell design and development of dual axis solar tracker for the sun's position. The main goal of this paper is to maximize energy output to reduce panel temperature (cooling), to increase efficiency of the PV panel. Small-scale solar is developed through a complete hardware and software in order to function accurately. The main parts in this work are Arduino Uno R3, kit relay, LDR (Light Dependent Resistor), LM35 (temperature sensor), high-efficiency solar panel and satellite motor. The Protuse software is used with (Arduino Uno) as embedded computer control. The results show the effectiveness of the complete tracking system.

Soft-sediment deformation structures, like convolute lamination and pseudonodules, are common in deep-marine turbidites, but details of their origin and timing of formation remain a source of debate. Deep-marine basin-floor deposits of the Neoproterozoic Upper Kaza Group (Windermere Supergroup) crop out superbly in the Castle Creek study area and provide an ideal laboratory to investigate these aspects in convolute-laminated pseudonodules, and also how that deformation influenced later diagenesis. Pseudonodules consist of well-sorted, matrix-poor, upper medium- to coarse-grained, planar-stratified or cross-stratified sandstone that are underlain and overlain by comparatively more poorly sorted, matrix-rich, graded sandstone of similar grain size. Deposition of the stratified pseudonodules is interpreted to have occurred during the same event that deposited the graded sandstone, albeit during a period of general transport bypass, whereby isolated, shallow, seafloor depressions became filled with well-sorted, stratified sand. As stratified sand accumulated the depressions slowly subsided until a critical thickness had built up and exceeded the load-bearing capacity of the substrate composed of graded sand. This destabilized the surface separating the two layers and resulted in the stratified unit foundering, and in some cases becoming completely enveloped by, the upward-displaced lower-density substrate. Surprisingly, despite the deformed macroscopic character of the stratified sediment, primary grain fabric, including intergranular porosity up to 40%, was preserved and influenced early diagenesis, which, owing to dispersed phosphate cement and depleted carbon isotope composition of the pervasive carbonate cement, would have begun very near the sediment–water interface. Importantly also, pseudonodules are common in basin-floor deposits but comparatively rare in continental-slope strata. Expanding flow conditions over the basin floor would have promoted grain settling, and in turn development of a more stably (density) stratified flow structure. Ultimately this resulted in higher local rates of sedimentation on the basin floor and the accumulation of a substrate more prone to later liquidization.

Due to the importance of petroleum exploration and production in the oil industry and developments. Therefore, this study targets one of the more important reservoir rocks in Iraq, which it Yamama Formation in the Majnoon oilfield, southern Iraq. The facies distribution showed that the formation was deposited on a ramp platform. Seven main carbonate facies were distinguished in the studied area. Based on these facies, Yamama Formation was represented to deposit on a ramp setting, that consist of different sedimentary environments. The main depositional environments represented by the shoal, middle - outer ramp and deep outer ramp environments. Eventually, the Yamama Formation is divided into two main sequences. The lower part of the formation was a regression phase that deposited highstand system tracts, named Yamama sequence one. The upper was a transgression phase deposited transgressive system tracts named Yamama sequence two. The diagenetic processes showed that the early and late dissolution and cementation are important that affected the reservoir characteristics. Dolomitization is not an active process in the formation. Petrophysical properties represented by primary and as well as secondary porosity were studied and processed to evaluate the reservoir characteristics. The data were obtained from wireline logs and core data from plugs and thin sections. Good reservoir property units were located in a high-energy shoal environment and found in other environments depending on secondary porosity and dissolution processes activity. According to porosity cut-off, the formation was divided into five units that have porosity more than the lower limit of the worthy values.

Objective: The current study assessed the success of infiltration anesthesia versus inferior alveolar nerve block (IANB) anesthesia during (mobile and non-vital) teeth extraction in posterior mandible. Materials and methods: In a prospective study, 120 patients were included to extract one tooth for each patient in the posterior mandible under local anesthesia either by local infiltration = 60 (18 males, 42 females); or IANB = 60 (32 males, 28 females). Comparing anesthetic success rate of the two techniques and time until onset of anesthetic action (min). Results: IANB was successful in 100% of the patients, where infiltration anesthesia succeeded in 85%. In addition, duration until onset of action was found to be equal with p =(0.7) Conclusion: Infiltration technique offers a simpler substitute with less complication compared to IANB in establishing effective anesthesia for mandibular mobile and non-vital posterior teeth during intra-alveolar dental extractions.

PURPOSE: To evaluate the incidence of mosaicism in de novo neurofibromatosis 2 (NF2).METHODS: Patients fulfilling NF2 criteria, but with no known affected family member from a previous generation (n = 1055), were tested for NF2 variants in lymphocyte DNA and where available tumor DNA. The proportion of individuals with a proven or presumed mosaic NF2 variant was assessed and allele frequencies of identified variants evaluated using next-generation sequencing.RESULTS: The rate of proven/presumed mosaicism was 232/1055 (22.0%). However, nonmosaic heterozygous pathogenic variants were only identified in 387/1055 (36.7%). When variant detection rates in second generation nonmosaics were applied to de novo cases, we assessed the overall probable mosaicism rate to be 59.7%. This rate differed by age from 21.7% in those presenting with bilateral vestibular schwannoma CONCLUSION: This study has identified a very high probable mosaicism rate in de novo NF2, probably making NF2 the condition with the highest expressed rate of mosaicism in de novo dominant disease that is nonlethal in heterozygote form. Risks to offspring are small and probably correlate with variant allele frequency detected in blood.

Radiology reports are a rich resource for advancing deep learning applications for medical images, facilitating the generation of large-scale annotated image databases. Although the ambiguity and subtlety of natural language poses a significant challenge to information extraction from radiology reports. Thyroid Imaging Reporting and Data Systems (TI-RADS) has been proposed as a system to standardize ultrasound imaging reports for thyroid cancer screening and diagnosis, through the implementation of structured templates and a standardized thyroid nodule malignancy risk scoring system; however there remains significant variation in radiologist practice when it comes to diagnostic thyroid ultrasound interpretation and reporting. In this work, we propose a computerized approach using a contextual embedding and fusion strategy for the large-scale inference of TI-RADS final assessment categories from narrative ultrasound (US) reports. The proposed model has achieved high accuracy on an internal data set, and high performance scores on an external validation dataset.

Hypoxic zones are spreading worldwide in marine environments affecting many organisms. Shrimp and other marine crustaceans can withstand environmental hypoxia using several strategies, including the regulation of energy producing metabolic pathways. Pyruvate carboxylase (PC) catalyzes the first reaction of gluconeogenesis to produce oxaloacetate from pyruvate. In mammals, PC also participates in lipogenesis, insulin secretion and other processes, but this enzyme has been scarcely studied in marine invertebrates. In this work, we characterized the gene encoding PC in the white shrimp Litopenaeus vannamei, modelled the protein structure and evaluated its gene expression in hepatopancreas during hypoxia, as well as glucose and lactate concentrations. The PC gene codes for a mitochondrial protein and has 21 coding exons and 4 non-coding exons that generate three transcript variants with differences only in the 5'-UTR. Total PC expression is more abundant in hepatopancreas compared to gills or muscle, indicating tissue-specific expression. Under hypoxic conditions of 1.53 mg/L dissolved oxygen, PC expression is maintained in hepatopancreas, indicating its key role even in energy-limited conditions. Finally, both glucose and lactate concentrations were maintained under hypoxia for 24-48 h in hepatopancreas.

Information campaigns aim at discouraging potential migrants from leaving their countries irregularly. This paper systematically reviews academic research on these campaigns and presents some avenues for further research. It is shown that (EU-funded) information campaigns have gained importance andbecome more diversified in terms of communication tools and actors involved. Future research projects may focus more on how information campaigns relate to the narratives and information landscape that influence the decision-making of potential migrants, the role of local actors in implementing thesecampaigns and the way narratives and frames are actually built up in countries of origin and transit. To better understand the effects of information campaigns, we need to understand and compare alternative and counter-narratives taken up or even produced by potential migrants.