Case Report of Schwannomas: Benign Tumour of the Peripheral Nerve Sheath

Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumours arising from the Schwann cells surrounding the nerve. Incidence of peripheral nerve sheath benign tumours occurring in the lower extremities is rare (1–10%). The authors present two cases with solitary schwannomas from the peripheral nerves. In one case, the schwannoma arose from the sural nerve and in the other, from the tibial nerve. They were successfully surgically removed with the aid of a surgical microscope, with no intraoperative or postoperative complications.

Dispositional Positive Emotions and Employee Engagement in University Teachers: Mediating Role of Appreciative Inquiry

Dispositional Positive Emotions and Employee Engagement in University Teachers: Mediating Role of Appreciative Inquiry

Iraqi EFL Learners' Ability In Figuring Out Inferring Questions In Literary Texts

The Status of Coastal Benthic Ecosystems in the Mediterranean Sea: Evidence From Ecological Indicators

The Mediterranean Sea is subject to multiple human pressures increasingly threatening its unique biodiversity. Spatially explicit information on the ecological status of marine ecosystems is therefore key to an effective maritime spatial planning and management, and to help the achievement of environmental targets. Here, we summarized scientific data on the ecological status of a selection of marine ecosystems based on a set of ecological indicators in more than 700 sites of the Mediterranean Sea. For Posidonia oceanica seagrass beds, rocky intertidal fringe, and coastal soft bottoms, more than 70% of investigated sites exhibited good to high ecological conditions. In contrast, about two-thirds of sites for subtidal rocky reefs were classified to be in moderate to bad conditions, stressing the need for prioritizing conservation initiatives on these productive and diverse environments. Very little quantitative information was available for the southern Mediterranean Sea, thus monitoring programs and assessments in this area are essential for a representative assessment of the health of marine coastal ecosystems in the whole basin. This overview represents a first step to implement a baseline that, through georeferenced data on ecological status, could help identifying information gaps, directing future research priorities, and supporting improvements to spatial models of expected cumulative impacts on marine ecosystems.

Antimicrobial Efficacy of Aqueous Ozone and Ozone–Lactic Acid Blend on Salmonella-Contaminated Chicken Drumsticks Using Multiple Sequential Soaking and Spraying Approaches

Ozone (O 3 ) is an attractive alternative antimicrobial in the poultry processing industry. The optimal operational conditions of O 3 for improving food safety concerns are poorly understood. The main objective of this study was therefore to characterize the microbial killing capacity of aqueous O 3 and O 3 –lactic acid blend (O 3 –LA) at different operational conditions on chicken drumsticks contaminated with high Salmonella load using sequential soaking and spraying approaches. Four hundred forty-eight chicken drumsticks (280–310 g) were soaked into two-strain Salmonella cocktail, and the initial load on the surface of the skin was 6.9-log 10 cell forming unit (CFU)/cm 2 [95% confidence interval (CI), 6.8–7.0]. The contaminated drumsticks were then sequentially (10×) soaked and sprayed with aqueous O 3 (8 ppm) and O 3 –LA. Following O 3 exposure, quantitative bacterial cultures were performed on the post-soaking and post-spraying water, skin surface, and subcutaneous (SC) of each drumstick using 3M TM Petrifilm TM Rapid Aerobic Count Plate (RAC) and plate reader. The average killing capacity of aqueous O 3 /cycle on the skin surface was 1.6-log 10 /cm 2 (95% CI, 1.5–1.8-log 10 /cm 2 ) and 1.2-log 10 /cm 2 (95% CI, 1.0–1.4-log 10 /cm 2 ), and it was 1.1-log 10 /cm 2 (95% CI, 0.9–1.3-log 10 /cm 2 ) and 0.9-log 10 /cm 2 (95% CI, 0.7–1.1-log 10 /cm 2 ) in SC for soaking and spraying approaches, respectively. Six sequential soaking and seven sequential spraying cycles with ozonated water of 8 ppm reduced the heavy Salmonella load below the detectable limit on the skin surface and SC of drumsticks, respectively. Addition of LA seems to increase the microbial killing capacity of aqueous O 3 with average differences of 0.3-log 10 /cm 2 ( P = 0.08) and 0.2-log 10 /cm 2 ( P = 0.12) on the skin surface using soaking and spraying approaches, respectively. Aqueous O 3 did not cause any significant changes in the drumstick skin color. The Salmonella load of < 4.5-log 10 /cm 2 was a strong predictor for the reduction rate ( P < 0.001, R 2 = 0.64). These results provide important information that helps the poultry processing facilities for selecting the optimal operational strategy of O 3 as an effective antimicrobial.

STEPS-T Program Improves Endovascular Treatment Outcomes of Acute Ischemic Stroke; A 6-Year Study

Background: Early endovascular recanalization of occluded vessels in acute ischemic stroke (AIS) is a major contributor to good clinical outcome. We report the analysis of all AIS patients throughout a 6-year experience following the deployment of a quality initiative aiming at improving care, speed and maintaining quality for AIS treatment. Methods: Using a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2017, workflow/outcomes were recorded. There were no exclusion criteria. During the first year, a quality program employing “digital-object” technology, staff education, and workflow improvement was implemented to reduce time-to-treatment. Using electronic recording, workflow times were collected for onset (T O ), CT (T CT ), door (T D ), angiography-suite (T A ), groin puncture (T G ), DSA (T DSA ), and recanalization (T R ). Recanalization time (T G -T R ) and workflow intervals were compared at Year 1 and 6. Results: Analysis of 382 patients (aged 71.3 ± 12.9) undergoing mechanical thrombectomy for AIS (206 male and 176 female) was performed. Recanalization time was significantly reduced from 82 min in 2012 to 34 min by 2017 (IQR 52–117 min and 23–49 min), a 59% reduction ( P < 0.001). Further, consistent year-over-year reductions in setup time (T A -T G ) (44% improvement) and T CT to T A times were observed. During the same period, clinical outcome significantly improved year-over-year as measured with the modified Rankin Scale 0–2 (33, 37, 38, 41, 53, and 58%). Conclusions: Significant improvements were observed following the deployment of a quality initiative enabling iterative evidence-based process improvements, thereby sustaining significant reductions in time-to-treat and improved clinical outcomes for AIS patients.

Initial Experience With the Next-Generation Resolute Onyx Zotarolimus-Eluting Stent in Symptomatic Intracranial Atherosclerotic Disease

Background and Purpose: Intracranial atherosclerotic disease (ICAD) is a common cause of stroke worldwide. Although there are different endovascular options for the treatment of symptomatic ICAD (sICAD), it is still controversial. Herein, we aim to study the safety and efficacy of a new generation of drug-eluting balloon-mounted stent (DES); Resolute (R) onyx DES in the treatment of sICAD. Methods: A prospectively maintained neuroendovascular procedures database in a high-volume comprehensive stroke center was reviewed from October 2019 through January 2020. Patients were included if they had sICAD (≥70% stenosis), failed medical management, and underwent intracranial stenting with R-onyx DES. Technical success was defined as the ability to deploy the device at the desired location and achievement of <30% residual stenosis. The primary outcome was the occurrence of complications within 72 h of the procedure (strokes, ischemic or hemorrhagic; and mortality). Secondary outcomes included rates of symptomatic and angiographic recurrence within 6 months of the procedure. Results: A total of 18 consecutive patients (mean age, 66.6 years; 44.4% were females and 94.4% were Hispanic) were eligible for the analysis. Indication for treatment was recurrent strokes in 13 and recurrent transient ischemic attack (TIA) in 5. A total of 22 symptomatic lesions with a mean baseline stenosis percent (84.9 ± 9.6) were treated using 23 R-onyx DES in 19 procedures. All procedures were done under general anesthesia with 100% technical success, and no reported periprocedural strokes or death. Among 13 patients who had clinical follow-up, 1 (7.7%) patient had TIA. There were no reported ischemic or hemorrhagic strokes. Angiographic follow-up for 9 (50%) patients showed no in-stent restenosis. Conclusion: The use of R-onyx DES in the treatment of sICAD is safe with high technical success rates. Large prospective multicenter trials with long-term follow-up are warranted.

A Framework for Adapting Deep Brain Stimulation Using Parkinsonian State Estimates

The mechanisms underlying the beneficial effects of deep brain stimulation (DBS) for Parkinson's disease (PD) remain poorly understood and are still under debate. This has hindered the development of adaptive DBS (aDBS). For further progress in aDBS, more insight into the dynamics of PD is needed, which can be obtained using machine learning models. This study presents an approach that uses generative and discriminative machine learning models to more accurately estimate the symptom severity of patients and adjust therapy accordingly. A support vector machine is used as the representative algorithm for discriminative machine learning models, and the Gaussian mixture model is used for the generative models. Therapy is effected using the state estimates obtained from the machine learning models together with a fuzzy controller in a critic-actor control approach. Both machine learning model configurations achieve PD suppression to desired state in 7 out of 9 cases; most of which settle in under 2 s.

Laterality Influences Central Integration of Baroreceptor Afferent Input in Male and Female Sprague Dawley Rats

We explored the effects of baroreceptor afferents laterality and sexual dimorphism on the expression of cardiovascular reflex responses to baroreflex activation in Sprague Dawley (SD) rats. Under urethane anesthesia, rats of either sex (total n = 18) were instrumented for left, right and bilateral aortic depressor nerve (ADN) stimulation (1–40 Hz, 0.2 ms, 0.4 mA for 20 s) and measurement of mean arterial pressure (MAP), heart rate (HR) and mesenteric (MVR) and femoral (FVR) vascular resistance. Female rats were matched for the diestrus phase of the estrus cycle. Left, right and bilateral ADN stimulation evoked frequency-dependent drops in MAP, HR, and MVR, and increases in FVR. Irrespective of sex, left and bilateral ADN stimulation as compared to right-sided stimulation mediated greater reflex reductions in MAP, HR, and MVR but not in FVR. In males, reflex bradycardic responses were greater in response to bilateral stimulation relative to both left- and right-sided stimulation. In females, left ADN stimulation evoked the largest increase in FVR. Left and bilateral ADN stimulations evoked greater reductions in MAP and MVR while left-sided stimulation produced larger increases in FVR in females compared with males. All other reflex responses to ADN stimulation were relatively comparable between males and females. These results show a differential baroreflex processing of afferent neurotransmission promoted by left versus right baroreceptor afferent inputs and sexual dimorphism in the expression of baroreflex responses in rats of either sex. Collectively, these data add to our understanding of physiological mechanisms pertaining to baroreflex control in both males and females.