ure

Bilateral trigeminal neuralgia refractory to medical therapy is a rare occurrence and it is mandatory to choose therapeutic procedures minimizing possible bilateral sensitive deficit due to the employment of bilateral mininvasive ablative techniques.  A patient affected by bilateral trigeminal neuralgia refractory to medical therapy secondary to multiple sclerosis is presented. Multiple therapeutic tools were employed in this challenging pathology. The second and third left trigeminal divisions were involved by the neuralgia, while the third division was involved in the right facial side. Controlled radiofrequency thermocoagulation was employed for the isolated right third division, then radiosurgery was conducted for the left hemifacial side.  After one month, because of the persistence of pain attacks of the left second trigeminal division, peripheral authorizations were performed. Control of pain, with the withdrawal of medical therapy (BNI scale class I), was achieved in this patient with a multi-therapeutic approach. Radiofrequency thermorizotomy was performed for the right third division because neuralgia was very acute, and immediate pain relief was achieved. Pain in the left third trigeminal division regressed after radiosurgery, while pain in the left second division continued after radiosurgery, then peripheral alcoholization was performed with pain control.Bilateral trigeminal neuralgia refractory to medical therapy should be treated by the dedicated neurosurgeon, avoiding bilateral ablative techniques for the same division and using neurosurgical techniques according to the trigeminal division interested by the neuralgia and according to the intensity of pain.

Post-transplant malignancy is one of the contentious and feared consequences of Solid Organ Transplantation (SOT), which might detrimentally alter the outcome of transplantation. Risk factors are manifold, principally related to a suppressed immune system with intercurrent immunosuppressant medications commonly used in the context of SOT. Opportunistic viral infections encountered in SOT are crucial promoters of mitogenic proliferation in several common tumors. Lastly, immune suppressant therapy might trigger mitogenic changes directly.In this paper, we are discussing post-SOT malignancies, elaborating on the different phases of its pathogenesis, and elucidating on the different aspects that linger in its risk factors, preventive strategies, and management.

Stroke is a clinically defined syndrome of acute focal neurological deficit attributed to vascular injury (infarction, hemorrhage) of the central nervous system. Stroke is the second leading cause of death and disability worldwide. Stroke is not a single disease but can be caused by a wide range of risk factors, disease processes and mechanisms. Approximately 15% of strokes worldwide are the result of intracerebral hemorrhage, which can be deep (basal ganglia, brainstem), cerebellar or lobar. A minority (about 20%) of intracerebral hemorrhages are caused by macrovascular lesions (vascular malformations, aneurysms, cavernomas), venous sinus thrombosis or rarer causes.

Background: Sickle cell anaemia (SCA) in children demonstrates a broad range of clinical manifestations and serious complications. Assessment of disease severity in specific populations is necessary to plan services and optimise care. Aim: To describe the clinical severity of SCA and associated sociodemographic and clinical factors in children in Gambia.Methods: The presence of lifetime complications was confirmed by history and review of medical charts. We determined clinical severity using a validated scoring system and related the severity to sociodemographic and clinical factors.Results: In 130 study participants, ages ranged from 5 to 15 years with a mean (SD) age of 9.74 (2.81) years. Eleven (8.5%) children had had acute chest syndrome, 7 (5.4%) avascular necrosis of the femoral head, 6 (4.6%) gallstones, 5 (3.8%) stroke and 1 (0.8%) priapism over their lifetime. Disease severity was classified as mild in 108 (83.1%) children, moderate in 17 (13.1%) and severe in 5 (3.8%). Age, age at diagnosis, sex, ethnicity, social class, and treatment with hydroxyurea was not significantly correlated with SCA clinical severity (P values 0.10-0.84).Conclusion: The high proportion of children with mild disease may be due to the high prevalence of Senegalese β-haemoglobin haplotype in the Senegambia subregion. However, the presence of moderate or severe disease in almost 1 in 5 children calls for concerted efforts in SCD care in this region.

This document has been translated from Spanish into English using ChatGPT. While efforts have been made to ensure accuracy and maintain the original meaning, some nuances or interpretations may differ from the source text. For any clarification, please refer to the original document or contact the author.This brief article addresses the concern arising from the accelerated whirlwind of changes of all kinds experienced by our social systems, some of which have a significant evolutionary impact, largely driven by advances in science and technology. Particular interest has emerged in connecting certain properties inherent to the behavior of complex systems far from equilibrium—such as social systems—under the framework of properties currently studied in Complexity Sciences. The article outlines this concern, which is, for now, merely the beginning of what could develop into a groundbreaking investigation. It references laboratory simulation work aimed at understanding the evolutionary horizons of Chile’s social system. The text includes an example of some graphs that illustrate a potential method for detecting and anticipating possible evolutionary horizons of the social system, based on the role played by certain “attractor variables” within the system. However, the research is still exploratory, and this article serves merely as a general description of the initial concern.

This study investigates the impact of socio-political disruptions on air quality in Khartoum, Sudan, focusing on key pollutants: Aerosol Optical Depth (AOD), Carbon Monoxide (CO), Nitrogen Dioxide (NO₂), and Sulfur Dioxide (SO₂). Using Sentinel-5P satellite data (2020–2024) processed in Google Earth Engine (GEE), spatial and temporal variations in pollutant levels were analyzed before and after a significant war event in April 2023. The methodology included data acquisition, preprocessing (e.g., cloud masking, spatial filtering), monthly averages computation, visualization, and statistical analysis using Google Earth Engine (GEE), ArcGIS Pro, and Microsoft Excel. Results showed a marked post-war increase in AOD levels, attributed to infrastructure destruction, fires, and diminished industrial oversight, alongside spatially consistent pollution patterns in some regions. CO concentrations exhibited an overall decline due to reduced industrial activities and transportation, though localized anomalies were linked to concentrated emissions. Similarly, NO₂ levels dropped significantly, reflecting reduced vehicular and industrial activities, while sporadic increases suggested localized emissions like generator use. SO₂ demonstrated mixed trends, with reduced mean levels but increased variability, indicating sporadic high-emission events linked to emergency fuel use or conflict-related disruptions. This study uniquely combines high-resolution satellite data with advanced spatial and temporal analysis techniques to reveal the nuanced and multi-pollutant impact of socio-political conflicts on air quality in Khartoum, providing novel insights into the environmental repercussions of armed conflicts. These findings highlight the profound impact of socio-political events on atmospheric pollution dynamics, underscoring the need for robust urban planning, targeted environmental monitoring, and policies to mitigate air quality deterioration and address public health concerns in conflict-prone regions. The study emphasizes the importance of satellite-based monitoring to provide critical insights into the environmental repercussions of socio-political upheavals.

The spin of a physical object is a vector which is held by the self-rotation axis of the object. Spin measures the intensity of the self-rotation of the object around its axis. The sudden and forceful, but direct contact of two bodies is known as collision. The collision is supposed to be perfectly elastic. Newton stated the law of universal attraction. The formula of Biot & Savart is unavoidable if we are interested by electromagnetism; this formula led to the famous equations of Maxwell. Curiously, this formula includes a vector product which may seem quite unusual. An electric current, which flows in an electric wire, creates, by induction, another current of small particles, all around the wire. The colors are intensities of reflections, due to the self-rotation of atoms of the colored objects. The stars novas are due to sudden appearance of storms of space winds, which strike the stars, and which make them self-rotate faster and then it became brighter.

Double-Positive Patients (DPPs), characterized by the simultaneous presence of Anti-Neutrophil Cytoplasmic Antibody (ANCA) and anti-Glomerular Basement Membrane (anti-GBM) antibodies, represent a rare subset in systemic vasculitis. We present two cases of DPPs with renal involvement and review the existing literature to elucidate the clinical characteristics, histopathological findings, management strategies, and prognostic outcomes associated with this condition. Both cases exhibited renal involvement with rapidly progressive glomerulonephritis, requiring renal replacement therapy. Renal biopsies confirmed crescentic glomerulonephritis with features of both anti-GBM disease and ANCA-associated vasculitis. Management included high-dose glucocorticoids, cyclophosphamide, and consideration of plasma exchanges. Double-positive ANCA and anti-GBM vasculitis pose challenges in management and prognosis. Further research is essential to improve therapeutic strategies for this rare and heterogeneous condition.

Retracing the evolution of Mineralocorticoid Receptors (MR) obliges us to take an instructive as well as fascinating leap back in time. This journey teaches us that the relationship between MRs and what we consider their natural ligand, aldosterone, has not always been an exclusive one. MRs operated for a very long time in the oceans and, in any case, in an aquatic environment, stimulated by ligands other than aldosterone, and exercising functions that we still do not know well but which were certainly different from those they currently perform in terrestrial vertebrates, where they maintain normal sodium and body fluids. The history of MRs was initially intertwined with that of female sexual hormones, in particular with progesterone, which was one of the first agonists for MRs, before becoming, with the transition to the terrestrial environment, an important antagonist. This initial intertwining could be the cause of the sexual dimorphism that can be glimpsed when these receptors are overstimulated, as emerges from many experimental studies and some clinical data and/or when antagonistic drugs for these receptors are studied. This must be taken into account in the planning of clinical studies, especially randomized controlled trials, in which the presence of the two sexes must always be well balanced and in the interpretation of the results which must always be performed being well aware of the gender of participants. This does not always happen, however.

Introduction: Behçet’s disease is a rare, systemic, inflammatory condition that primarily affects young adults. It is characterized by a variety of clinical manifestations. However, neurological and cardiac presentations remain uncommon and often delayed in diagnosis. This disease can lead to severe complications, such as ischemic strokes and myocarditis, highlighting the systemic and complex nature of the condition.Case presentation: A 27-year-old patient was hospitalized after experiencing an ischemic stroke and myocarditis, which revealed Behçet’s disease. He had a history of oral and cutaneous ulcers, without a prior diagnosis of Behçet. Upon admission, brain imaging confirmed an ischemic stroke, and echocardiography and cardiac MRI showed acute myocarditis. Biological tests confirmed elevated systemic inflammation, which guided the treatment plan. The initial treatment included corticosteroids, immunosuppressors (azathioprine), and cardioprotective therapy. The patient showed significant clinical improvements, although mild deficits persist.Discussion: Myocarditis in Behçet’s disease is a rare but severe manifestation resulting from inflammation of the heart walls, often associated with other systemic vascular involvement. Although less common than oral or cutaneous ulcers, myocarditis can lead to acute heart dysfunction and even heart failure if not treated promptly. It is generally caused by an excessive inflammatory response, often associated with immune system activation, which affects the coronary circulation and damages the cardiac muscle. Treatment for myocarditis in this context relies on high-dose corticosteroids to control inflammation, followed by long-term immunosuppressive medications like azathioprine. While the initial treatment often leads to a rapid improvement in cardiac function, the risk of long-term complications, such as dilated cardiomyopathy or heart failure, remains high. Close follow-up is therefore essential to prevent these complications and optimize the long-term cardiac prognosis of patients with this rare disease.Conclusion: The progression of myocarditis in Behçet’s disease can be favorable if diagnosed and treated early, with significant improvement in cardiac function achieved through the use of corticosteroids and immunosuppressive therapy. However, the long-term prognosis remains uncertain due to the risk of chronic cardiac complications, such as dilated cardiomyopathy or heart failure.

This review underscores the transformative impact of Computer-Aided Engineering (CAE) on modern engineering, emphasizing its role in advancing sustainable and efficient technological solutions. The CAE industry is further analyzed, focusing on market trends and future directions. The CAE market is projected to grow significantly in the next five years in industries like automotive, aerospace, and energy, especially with the rapid advancements in High-Performance Computing (HPC), Artificial Intelligence (AI), Internet of Things (IoT), and Digital Twin technologies that enhance real-time optimization and predictive capabilities, thus fostering innovation in sustainable product design and performance. Lastly, this review presents KYAMOS Software and its state-of-the-art CAE solutions for tackling high-demand engineering problems, mainly concerning green technologies.

The results of the study of the texture of thin films of aluminum nitride obtained by magnetron sputtering are presented. The dependence of the sizes and degree of preferential orientation of crystallites on the conditions of formation of thin films (pressure, discharge power, composition of the plasma-forming gas) is investigated.

Antioxidants are groups of compounds that neutralize free radicals and Reactive Oxygen Species (ROS) in the cell [1]. Antioxidant activity in food and beverages has become one of the most interesting features in the science community. These antioxidants provide protection against damage caused by free radicals played important roles in the development of many chronic diseases including cardiovascular diseases, aging, heart disease, anemia, cancer, and inflammation [2].

Stroke and acute myocardial infarction are primary global causes of mortality. Statistical studies have shown that acute myocardial infarction is responsible for around 9 million deaths each year. Ischemic stroke and myocardial infarction have a significant role in global adult physical disabilities. While reperfusion is vital for tissue recovery, it may paradoxically, inadvertently increase damage through oxidative stress, inflammation, and cell death. Early reperfusion procedures are currently the sole therapy to reduce infarct size. There are many mysteries about heart biology. It is not known the source of energy for myocardial tissues. The heart-beating force (120 mm Hg) cannot explain how erythrocytes are impelled through almost 95,000 km of capillaries in less than 5 minutes. A better knowledge of how the heart is oxygenated should allow the development of new therapies.

Mitochondria are essential intracellular organelles that significantly influence various cellular processes, including metabolism, stress response, and cell fate. Their precise regulation is crucial for maintaining both organelle and cellular homeostasis. Wound healing is a complex, multifactorial process that relies on the coordinated actions of multiple cell types and numerous cellular mechanisms. Dysregulation in this process can lead to chronic wounds, which pose substantial challenges for healthcare systems and present limited treatment options due to their intricate pathogenesis. Recent research has increasingly focused on the role of mitochondria in wound healing, revealing their involvement in critical processes such as metabolism, apoptosis, and redox signaling. Mitochondrial dynamics play a vital role in wound healing by adapting to cellular demands and environmental cues. Moreover, mitophagy, the selective degradation of damaged mitochondria, is crucial for maintaining mitochondrial integrity and function during the healing process. Mitochondria are not only pivotal in energy production but also in calcium homeostasis and the generation of mitochondrial reactive oxygen species, which are essential for signaling during wound repair. As wound healing progresses through distinct yet overlapping stages mitochondria facilitate the energy demands of repair and contribute to cytoskeletal remodeling necessary for wound closure. Understanding the multifaceted roles of mitochondria in wound healing could lead to novel therapeutic approaches for chronic wounds. Future research should prioritize investigating mitochondrial dynamics and functions in human tissues to develop targeted strategies for enhancing wound healing outcomes.

Blood cell production through hematopoiesis within the bone marrow serves both to maintain blood equilibrium and to respond to tissue injury and infectious demands. Hematopoietic stem cell (HSC) therapy developments have revolutionized medical treatment approaches for anemia leukemia and bone marrow failure caused by chemotherapy or radiation exposure. The therapeutic compounds present in medicinal plants have traditionally supported blood health and researchers now understand these plants could help regenerate bone marrow tissue. The analysis investigates how phytochemicals affect HSC proliferation and differentiation while supporting HSC survival. The medicinal plants Panax ginseng, Astragalus membranaceus, and Curcuma longa receive special attention for their documented ability to enhance hematopoiesis in preclinical and clinical settings. This review examines the challenges that include standardization issues, toxicity concerns, and regulatory barriers alongside future perspectives about combining plant-based therapies with traditional treatments to improve bone marrow recovery and health results. 

Public-Private Partnership (PPP) road projects are being promoted worldwide to encourage road investments; however, research on the appropriate rate of return for these projects is insufficient. This is likely because the return on investment for PPP road projects is determined through negotiations between the government and the private sector, a process that remains confidential. The rate of return for PPP road projects is not only a key indicator for evaluating project performance but also a potential driver for future government financial subsidies. Therefore, research on the appropriate rate of return for PPP road projects is necessary for the sustainability of these projects.This study, based on the concept that both the government and the private sector share the anticipated risks of the project, quantifies six types of risks and proposes a model for predicting the appropriate rate of return. The model is able to explain approximately 68% of the cases in South Korea’s PPP road projects. The risk with the greatest influence on the rate of return was found to be an economic risk, while the least influential was regulation change risk.Due to the confidentiality of data related to PPP road projects, this study only utilized 54 cases from South Korea. It is hoped that a wider range of data will be collected and further research on the appropriate rate of return will continue to enhance the sustainability of PPP road projects.

Amyloidosis-associated kidney disease commonly manifests with chronic glomerular symptoms including heavy proteinuria predominantly albuminuria. Clinical presentation ranges from full-blown nephrotic syndrome, hematuria, and hypertension to renal failure. In India patients with chronic kidney disease are mainly attributed to hypertension and diabetes but an underlying etiology such as amyloidosis needs to be unearthed and shouldn’t be ignored as an etiology. We report a case of a 60-year-old man with hypertension and hypothyroidism who presented with frothy urine for several years, b/l pedal edema for 15 days. Over the past 3 months, there was a serial increase in creatinine. As per CKD-EPI equation, the patient was CKD-4. As the patient was suspected to be rapidly progressive renal failure; a renal biopsy was planned. Biopsy reports were suggestive of Amyloidosis. Glomerular, vascular, and tubulointerstitial deposition of amyloid was seen. Based on renal biopsy and IHC staining; the patient’s diagnosis was AA-associated secondary renal amyloidosis. Thus in this case renal amyloidosis was an unearthed etiology.

Quantum fluctuations, usually arising from the inherent uncertainty in the quantum fields, are pivotal in understanding the universe at both the small and large scales. Even though fluctuations are usually unobservable and rather small, they give significant observable effects during specific epochs under specific conditions. During the early epochs of the universe, the fluctuations were scaled, resulting in the primordial density perturbations that gave rise to the large-scale structure of the universe and the observed inhomogenities. In this paper, we study the basic origin, structure, evolution, and imprints of fluctuations during the inflationary period resulting in large-scale structure formation. We use the Mukhanov-sasaki formalism to model scalar perturbations, embedding the theoretical results into observations. Theoretical predictions show an almost scale-invariant power spectrum with stringent constraints on the inflationary parameters. It further states that in the very early universe, the inflatons that are quanta of the primordial field were highly filled in the degenerate quantum state. This carries large potential energy that results in an exponential expansion of the universe. During post post-inflationary period the inflaton dominated the Universe’s energy density; they interact among themselves and due to non-linear effects, these inhomogeneities grow which amalgamate into spatially distinguishable patches in our observable universe. Our understanding projects us towards the fact that fluctuations play a pivotal role in understanding the structure formation at micro, macro, and far-macro scales. This study also addresses the significance of quantum fluctuations in cosmic evolution and manifests the enduring relevance in addressing some of the profound mysteries of our universe.

Pulmonary Embolism (PE) can present with symptoms resembling pneumonia, creating a diagnostic challenge, particularly in patients with comorbidities. We report the case of a 67-year-old male who presented with cough, hemoptysis, shortness of breath, fever, and pedal edema. Initially diagnosed with consolidation based on chest X-ray findings, he was treated with antibiotics. However, persistent symptoms prompted further evaluation, leading to the diagnosis of PE with pulmonary infarction and deep vein thrombosis on computed tomography pulmonary angiography and Doppler ultrasound. This case highlights the need to consider PE in the differential diagnosis of consolidation, particularly in high-risk individuals, to avoid delays in appropriate management.