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Objectives Decompressive craniectomy (DC) is a last-tier therapy in the treatment of raised intracranial pressure after traumatic brain injury (TBI). We report the association of comparative radiographic factors in predicting functional outcomes after DC in patients with severe TBI. Methods A retrospective analysis of a prospectively maintained database of cases between 2015 and 2018 at an academic tertiary care hospital was carried out. Univariate and multivariable regression analyses were performed for an array of comparative radiographic variables (pre- and post-DC) in relationship to functional outcome according to Glasgow Outcome Scale Extended (GOSE) at 180 days. GOSE was further dichotomized into favorable (GOSE:5–8) and unfavorable (GOSE:0–4) functional outcomes. All associations were reported as odds ratio (OR) with 95% confidence interval (CI). Results Statistical analysis included a cohort of 43 patients with a median age of 30.5 years (range: 18–62 years). The median GOSE at 180 days was 7. Multivariable regression analysis after adjusting for confounding variables (age, sex, comorbidities, site of surgery and size of decompression) showed that comparative radiographic findings of midline shift (MLS) > 10 mm (OR 3.2 (95% CI 1.25–8.04); P = 0.01); external cerebral herniation (ECH) > 2.5 cm (OR 2.5 [95% CI 1.18–5.2]; P = 0.02); and effacement of basal cisterns (OR 3.9 [95%CI 1.1–13.9]; P = 0.03), were significant independent predictors of poor functional outcome at 180 days after DC for severe TBI. However, the presence of infarction (OR 2.7 [95%CI 0.43–17.2]; P = 0.28) and absence of gray-white matter differentiation (OR 0.18 [95%CI 0.03–1.2]; P = 0.07) did not reach statistical significance. Conclusions The comparative radiographic findings that include MLS > 10mm, ECH > 2.5cm, and effacement of basal cisterns are predictive of poor functional outcome in severe TBI.

Objective Decompressive craniectomy (DC) has been advocated as a lifesaving procedure in management of patients with raised intracranial pressure due to malignant ischemic stroke (MIS). The aim of this study was to identify comparative radiologic parameters after DC to predict functional outcome at 6 months in patients with MIS. Methods A retrospective analysis (2015–2018) of patients (median age 54 years; range, 29–80 years) with MIS who underwent postoperative computed tomography within 24 hours of DC was performed. Multivariate regression analysis was computed to predict clinical outcome at 6 months based on the Glasgow Coma Outcome Scale Extended. Results With median National Institutes of Health Stroke Scale score of 20 (range, 3–33), mean preoperative stroke volume was 250 ± 75 cm3. Median Glasgow Coma Outcome Scale Extended score at 6 months was 4. Multivariate regression analysis showed that the comparative radiographic characteristics of absence of effacement of cortical sulci (odds ratio 2.88; 95% confidence interval, 1.22–20.71; P = 0.02), absence of hemorrhagic transformation (odds ratio 1.09; 95% confidence interval, 1.99–12.89; P = 0.03), and absence of compression of lateral ventricles (odds ratio 3.75; 95% confidence interval, 1.28–22.4; P = 0.05) on postoperative computed tomography scan were significant independent predictors of good functional outcome (Glasgow Coma Outcome Scale Extended score 5–8). Conclusions The comparative radiographic characteristics of absence of effacement of cortical sulci, hemorrhagic transformation, and compression of the lateral ventricles after DC in patients with MIS bore a significant relationship to predicting clinical outcome at 6 months.

Background : Evaluation of cervicovaginal fetal fibronectin was considered as one of the most predictive factor for preterm labor when it is 50 ng/ml. Also, Salivary estriol (E3) has the same predictive factor for preterm labor when it is over 2.1ng/ml. The last factor in this study was measurement of cervical length. Objective: Assessing cervicovaginal fetal fibronectin and maternal Salivary estriol (E3) as biochemical markers, as well as transvaginal ultrasound in the prediction of preterm labor. Patients and Methods: The study included 150 pregnant women at gestational ages between 24 weeks and 34 weeks confirmed by sure history of last menstrual period and first trimestric ultrasound examination.The patients in this study were fulfilling the inclusion criteria, and were enlisted in a prospective clinical trial. As regard cervicovaginal fetal fibronectin, measure of it as Dacron swab was rotated in posterior fornix of the vagina or ectocervix and sent for assay of fetal fibronectin. Salivary estriol (E3) was collected from mouth after washing it, and stored till time of assay. Cervical length was evaluated by transvaginal ultrasound. Results: There was a highly significant difference between women with positive and negative fibronectin regarding gestational age at delivery. Salivary estriol (E3) showed a highly significant difference between women with positive and negative E3 regarding gestational age at delivery. Also, cervical length showed a highly significant difference between women with short and normal cervical length regarding gestational age at delivery. There was no significant effect for age, parity, presence of uterine contractions and uterine anomalies on the outcome of pregnancy . Conclusion: Cervicovaginal fetal fibronectin, salivary estriol E3 and measurement of cervical length were more helpful in prediction of preterm labor.

International audience; Domestic species such as cattle (Bos taurus taurus and B. t. indicus) represent attractive biological models to characterize the genetic basis of short term evolutionary response to climate pressure induced by their post-domestication history. Here, using newly generated dense SNP genotyping data, we assessed the structuring of genetic diversity of 21 autochtonous cattle breeds from the whole Mediterranean basin and performed genome-wide association analyses with covariables discriminating the different Mediterranean climate sub-types. This provided insights into both the demographic and adaptive histories of Mediterranean cattle. In particular, a detailed functional annotation of genes surrounding variants associated with climate variations highlighted several biological functions involved in Mediterranean climate adaptation such as thermotolerance, UV protection, pathogen resistance or metabolism with strong candidate genes identified (e.g. NDUFB3, FBN1, METTL3, LEF1, ANTXR2 and TCF7). Accordingly, our results suggest that main selective pressures affecting cattle in Mediterranean area may have been related to variation in heat and UV exposure, in food resources availability and in exposure to pathogens, such as anthrax bacteria (Bacillus anthracis). Furthermore, the observed contribution of the three main bovine ancestries (indicine, European and African taurine) in these different populations suggested that adaptation to local climate conditions may have either relied, on standing genomic variation of taurine origin or adaptive introgression from indicine origin, depending on the local breed origins. Taken together, our results highlight the genetic uniqueness of local Mediterranean cattle breeds and strongly support conservation of these populations

A 66 year old Indian gentleman presented with a 3 days history of headache and gradual progressive loss of vision in his eft eye, ophthalmological assessment showed no light perception in his left eye with papilledema and afferent papillary defect. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) were done and showed an expanding lesion in the left anterior clinoid process encroaching upon the left orbital apex and optic nerve with features suggestive of a mucocele. Patient was started on dexamethasone, and urgent craniotomy was undertaken, where marsupialization and resection of left anterior clinoid mucocele was done, and histopathologic examination of the operative specimen was consistent with a mucocele. Post-operatively, patient was kept on dexamethasone for few days, with uneventful outcome, and his follow up at 6 months showed complete recovery of his vision from no light perception to 6/12 in the affected eye., Highlights • Anterior clinoid mucocele should be considered as one the differential diagnosis for optic neuropathy. • CT/MRI should be done as part of workup in patients presenting with acute onset optic neuropathy. • Surgical decompression is recommended over medical management with antibiotics and/or steroids. • The timely radiological diagnosis and immediate surgical decompression was crucial to achieve for full recovery of vision.

Previous and more recent work of analyzing structural changes in the brain suggest that certain brain regions such as the frontal lobe are among the brain regions profoundly affected by the aging process across males and females. Also, a unified model of structural changes in a normally aging brain is still lacking. The present study investigated age-related structural brain changes in gray matter from young to early middle-age adulthood for males and females. Magnetic resonance images of 215 normal and healthy participants between the ages of 21–45 years were acquired. Changes in gray matter were assessed using voxel-based morphometry and gray matter volumetric analysis. The results showed significant decrease in gray matter volume between the youngest and oldest groups in the following brain regions: frontal, temporal, and parietal lobes. Grey matter loss in the frontal lobe was among the most widespread of all brain regions across the comparison groups that showed significant age-related changes in grey matter for both males and females. This work provides a unique pattern of age-related decline of normal and healthy adult males and females that can aid in the future development of a unified model of normal brain aging.

Background\ud \ud Genetic studies support the scenario that Bos taurus domestication occurred in the Near East during the Neolithic transition about 10 thousand years (ky) ago, with the likely exception of a minor secondary event in Italy. However, despite the proven effectiveness of whole mitochondrial genome data in providing valuable information concerning the origin of taurine cattle, until now no population surveys have been carried out at the level of mitogenomes in local breeds from the Near East or surrounding areas. Egypt is in close geographic and cultural proximity to the Near East, in particular the Nile Delta region, and was one of the first neighboring areas to adopt the Neolithic package. Thus, a survey of mitogenome variation of autochthonous taurine breeds from the Nile Delta region might provide new insights on the early spread of cattle rearing outside the Near East.\ud \ud \ud Methodology\ud Using Illumina high-throughput sequencing we characterized the mitogenomes from two cattle breeds, Menofi (N = 17) and Domiaty (N = 14), from the Nile Delta region. Phylogenetic and Bayesian analyses were subsequently performed.\ud \ud \ud Conclusions\ud Phylogenetic analyses of the 31 mitogenomes confirmed the prevalence of haplogroup T1, similar to most African cattle breeds, but showed also high frequencies for haplogroups T2, T3 and Q1, and an extremely high haplotype diversity, while Bayesian skyline plots pointed to a main episode of population growth ~12.5 ky ago. Comparisons of Nile Delta mitogenomes with those from other geographic areas revealed that (i) most Egyptian mtDNAs are probably direct local derivatives from the founder domestic herds which first arrived from the Near East and the extent of gene flow from and towards the Nile Delta region was limited after the initial founding event(s); (ii) haplogroup Q1 was among these founders, thus proving that it underwent domestication in the Near East together with the founders of the T clades.

Lymph node metastasis in head and neck cancer isa significant prognostic indicator that has a major impactboth on treatment planning and patient survival [1]. Becauseaggressive treatment for primary malignancy has becomemore advanced, patients often live long enough to experienceeither recurrence or distant metastasis. Nodal disease and,particularly, its presence on first presentation is the mostreliable predictor for both of these phenomena [2e5]. Withregard to the natural history of this head and neck cancer, themost common sites of metastasis from positive cervicallymph nodes are the lungs, bones, and liver [6].The rate of metastasis varies among different areas of theaerodigestive tract. For instance, T3/T4 carcinomas of theoral cavity, oropharynx, hypopharynx, and supraglotticlarynx exhibit ipsilateral nodal metastasis at a rate of higherthan 50% [7]. The rate of either bilateral or contralateralnodal metastasis ranges from 2%-35% [8,9]. Radiologicidentification of nodal disease thus is critical to guidesurgical decision making regarding neck dissection becauseimaging has been shown to identify metastasis in 7.5%-19%of clinically silent nodes [2,3,9].The identification of nodal disease is important withregard to both the pre- and posttreatment stages. Pretreat-ment imaging has been shown to identify areas of involve-ment in the retropharyngeal, high level II, low level IV, lowlevel V, and level VI/VII nodes [7]. As a result, pretreatmentcomputed tomography (CT) or magnetic resonance imaging(MRI) has become a mainstay of the care plan for patientswith head and neck cancer. The wide acceptance of theradiologic definition of nodal levels has expedited thistransition. Diseased lymph nodes are identified radiologi-cally by their clustering, roundness (shape), inhomogeneity,size, and periphery (extracapsular spread). In addition,the radiologist should be familiar with the most probablesentinel nodes for a given malignancy. For this reason, wepropose the acronym ‘‘CRISPS’’ (clustering, rounded shape,inhomogeneity, size, periphery, sentinel location) asa comprehensive and easy-to-remember mnemonic to aid theradiologist in identifying nodal involvement in patients withhead and neck cancer.Contrast-enhanced CT represents the ideal modalityfor the assessment of metastatic lymphadenopathy, followedclosely by magnetic resonance (MR) pulse sequences(unenhanced T1 or T2 with fat saturation) [10]. Positronemission tomographyeCT possesses the advantage ofmetabolic correlation, which can aid both in the setting ofequivocal findings and distant disease. However, challenges