Revascularization of vertebrobasilar tandem occlusions: a meta-analysis.

PURPOSE: To investigate the difference in mechanical thrombectomy (MT) outcomes between vertebrobasilar tandem occlusion (VBTO) and isolated basilar artery (BA) occlusion (non-VBTO) and the difference in rates of successful recanalization between the clean-road and dirty-road pathways, in VBTO. METHODS: We conducted a meta-analysis after searching PubMed, EMBASE, and Google Scholar databases as of April 2021. We only included adult patients who underwent MT to treat acute ischemic stroke (AIS) due to VBTO, and the following outcomes should be reported: successful recanalization, functional outcome at 90 days, and symptomatic intracerebral hemorrhage (sICH). The main effect size measures were odds ratio and risk difference, and the software used was RevMan 5.4. RESULTS: The analysis included 81 VBTO and 324 non-VBTO patients (seven studies). We found no significant difference regarding 3 m functional independence [4 studies: OR = 1.71 (95% CI, 0.54, 5.43), I2 = 75%], 3 m mortality [4 studies: OR = 1.62 (95% CI, 0.62, 4.25), I2 = 66%], sICH [4 studies: OR = 1.71 (95% CI, 0.67, 4.39), I2 = 0%], and successful recanalization [3 studies: OR = 0.81 (95% CI, 0.12, 5.57), I2 = 80%]. A subgroup analysis of 118 VBTO patients (five studies) showed no significant difference in successful recanalization between clean-road and dirty-road pathways [RD = 0.07 (95% CI, - 0.09, 0.24), I2 = 40%]. CONCLUSION: The results of this meta-analysis support the use of MT for AIS patients with VBTO. In VBTO patients, none of the clean-road or dirty-road pathways proved to be superior to the other.

Mycobacterium tuberculosis Complex Lineage 3 as Causative Agent of Pulmonary Tuberculosis, Eastern Sudan1.

Pathogen-based factors associated with tuberculosis (TB) in eastern Sudan are not well defined. We investigated genetic diversity, drug resistance, and possible transmission clusters of Mycobacterium tuberculosis complex (MTBC) strains by using a genomic epidemiology approach. We collected 383 sputum specimens at 3 hospitals in 2014 and 2016 from patients with symptoms suggestive of TB; of these, 171 grew MTBC strains. Whole-genome sequencing could be performed on 166 MTBC strains; phylogenetic classification revealed that most (73.4%; n = 122) belonged to lineage 3 (L3). Genome-based cluster analysis showed that 76 strains (45.9%) were grouped into 29 molecular clusters, comprising 2-8 strains/patients. Of the strains investigated, 9.0% (15/166) were multidrug resistant (MDR); 10 MDR MTBC strains were linked to 1 large MDR transmission network. Our findings indicate that L3 strains are the main causative agent of TB in eastern Sudan; MDR TB is caused mainly by transmission of MDR L3 strains.

Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan.

BACKGROUND: In Sudan, tuberculosis diagnosis largely relies on clinical symptoms and smear microscopy as in many other low- and middle-income countries. The aim of this study was to investigate the positive predictive value of a positive sputum smear in patients investigated for pulmonary tuberculosis in Eastern Sudan. METHODS: Two sputum samples from patients presenting with symptoms suggestive of tuberculosis were investigated using direct Ziehl-Neelsen (ZN) staining and light microscopy between June to October 2014 and January to July 2016. If one of the samples was smear positive, both samples were pooled, stored at -20°C, and sent to the National Reference Laboratory (NRL), Germany. Following decontamination, samples underwent repeat microscopy and culture. Culture negative/contaminated samples were investigated using polymerase chain reaction (PCR). RESULTS: A total of 383 samples were investigated. Repeat microscopy categorized 123 (32.1%) as negative, among which 31 were culture positive. This increased to 80 when PCR and culture results were considered together. A total of 196 samples were culture positive, of which 171 (87.3%), 14 (7.1%), and 11 (5.6%) were M. tuberculosis, M. intracellulare, and mixed species. Overall, 15.6% (57/365) of the samples had no evidence of M. tuberculosis, resulting in a positive predictive value of 84.4%. CONCLUSIONS: There was a discordance between the results of smear microscopy performed at local laboratories in the Sudan and at the NRL, Germany; besides, a considerable number of samples had no evidence of M. tuberculosis. Improved quality control for smear microscopy and more specific diagnostics are crucial to avoid possible overtreatment.

Prediction of Hydrophobic Reagent for Flotation Process Using Molecular Modeling.

The interaction or nonbonded energies of base organic ions and water molecules during the flotation process of minerals have important meanings for organizing hydrophobic and stable collectors. Furthermore, the interaction, cross-term, and valence energies of optimized structures are important for understanding the properties and structures of selective collectors. The simulation of pure scheelite mineral (PSM) surfaces with four different negative ions, using an adsorption locator module is demonstrated. The interaction energies for base organic ions and water molecules were resolved and detected by shaping the best hydrophobic interaction and the most stable suspension over the PSM surface (112) and (101). The adsorption locator results for base organic ions and water molecules on PSM surfaces (112) and (101) using buffer width 0.5 Å and temperature range from 318.15 to 283.15 K confirmed the results obtain from Forcite calculations. The results have demonstrated that the possibilities of using consistent valence force field implemented by Forcite and adsorption locator modules in the selection of flotation reagents are cost saving. Furthermore, hydrophobicity of the main negative ions in soaps were solved by the simulation methods and results are in a good agreement with the experimental methods that proved that mustard soap is more selective on the mineral surfaces than sunflower soap when used as a collector. Increasing the molecular weight of negative ions increases the interaction energy between base collector ions and PSM surfaces (112) and (101) significantly.

Recognition of protozoan parasites from microscopic images: Eimeria species in chickens and rabbits as a case study.

Automated diagnosis and identification of diseases and conditions such as parasites from microscopic images have been mainly carried out by utilizing the object morphological characteristics. The extraction of morphometric features needs the use of highly complex techniques that require computational power. Therefore, in order to reduce this complexity, this paper presents an automated identification based on analyzing three groups of pixel-based feature sets: column features (CF), row features (RF), and the third one (CRF) obtained by merging CF and RF together. For the classification task, K-Nearest Neighbor (KNN) and Artificial Neural Networks (ANN) have been applied. The classification results have been evaluated by adapting a 5-fold cross validation. Additionally, a robust sub-set of the features has been selected by Relieff feature selection method to prevent overfitting, which in turn has improved the final results. Two microscopic image slide databases of a type of protozoan parasites genus called Eimeria in fowls and rabbits have been examined in order to assess the robustness of the proposed methods. The highest accuracy rates obtained when the entire features were used are 85.55% (±0.39%) and 96.6% (±0.82%) from grey-scale level and color images, respectively. These results have been increased by 5% when the feature size is reduced by two thirds when Relieff was utilized. The feature sets have yielded highly accurate results and are expected to make the automatic identification simpler than the analysis of morphological features.

Histomorphometric parameters of normal full term placenta of Sudanese women.

The aim of the study was to provide values for morphometric parameters of histological components of normally delivered full term placentas of Sudanese women and compare them with reported parameters for other ethnic groups. A total of 200 histological sections, stained with hematoxylin and eosin and trichrome stains were used to give a final sample of 1000 fields saved as PowerPoint images for histomorphometry. A systematic random sampling procedure was adopted to ensure the optimum sample size that keeps the percentage error below 5% for the volume estimates. Standard stereological methods of point-counting and intersection-counting were applied to the microscopic fields to determine the volumes of placental components and surface area of fetal-maternal interface. The morphometric parameters showed no variations either between the placentas or between central and peripheral regions. The placental villi and the intervillus space occupied 65% and 35% of placental volume respectively with mean absolute values of 318 cm(3) and 169 cm(3). The mean absolute volume of the intervillus space was less than that of other ethnic groups by 8.67% but was significantly larger than that of the fetal capillaries which measured 41.2 cm(3). The ratio of the absolute volume of the intervillus space to the volume of the fetal blood capillaries was 4:1 in both Sudanese and other ethnic groups. In the placental villi the fetal connective tissue together with the contained blood vessels larger than capillaries occupied 88% of the villus volume. The mean surface area of the fetal-maternal interface of the placental villi (syncytiotrophoblast) was 12.59 M(2).

Prevalence of bluetongue virus infection and associated risk factors among cattle in North Kordufan State, Western Sudan.

BACKGROUND: Bluetongue virus causes febrile disease in sheep and a fatal hemorrhagic infection in North American White-tailed deer. However, in cattle the disease is typically asymptomatic and no clinical overt disease is associated with bluetongue infection. Bluetongue virus activity has been detected in Khartoum, Sennar and South Darfur states of the Sudan. Currently, no information is available in regard to previous exposure of livestock to Bluetongue virus in North Kordufan State, the largest livestock producing region in the country. The present study was conducted to determine the prevalence of bluetongue antibodies and to identify the potential risk factors associated with the presence of bluetongue antibodies among cattle in North Kordufan State, Sudan. A total of 299 bovine blood samples were collected randomly from six localities in North Kordufan State and were tested by enzyme-linked immunosorbent assay (ELISA) for detection of BTV-specific immunoglobulin G (IgG) antibodies. RESULTS: The serological evidence of Bluetongue virus infection was observed in 58 out of 299 cows, accounting for a 19.4% prevalence rate among cattle in North Kordufan State. Older cattle (>2 years of age) had four times the odds to be infected with BTV compared to young cattle (OR = 4.309, CI = 1.941-9.567, p-value = 0.01). Application of preventive measures, such as spraying or dipping with insecticide protects cattle against Bluetongue infection. Application of vector control measures decreased the odds for bluetongue seropositivity by 7 times (OR = 7.408, CI = 3.111-17.637, p-value = 0.01). CONCLUSIONS: The results of this study indicated that age and application of routine insecticides are influential risk factors for seroprevalence of Bluetongue in cattle. Surveillance of Bluetongue virus should be extended to include other susceptible animals and to study the distribution of the insect vectors in the region to better predict and respond to BTV outbreak in the State of North Kordufan, Sudan.

Determination of carmine food dye (E120) in foodstuffs by stripping voltammetry.

The behavior of the food colorant agent carmine (E120) was studied by square-wave adsorptive stripping voltammetry (SW-AdSV) at the hanging mercury drop electrode. It was observed that carmine gave a sensitive stripping voltammetric peak at -350 mV in pH 3 acetate buffer. The cyclic voltammetric technique was also used to characterize the electrochemical reduction process of carmine. The adsorptive voltammetric signal was evaluated with respect to various experimental conditions, and the optimized values were supporting electrolyte, acetate buffer; buffer acidity, pH 3; dye concentration, 3 x 10(-7) M; accumulation time, 150 s; accumulation potential, -0.2 V; scan rate, 300 mV/s; pulse amplitude, 185 mV; SW frequency, 20 Hz; working electrode area, 0.6 mm2; and convection rate, 2600 rpm. The SW-AdSV peak currents depended linearly on the concentration of carmine from 5 x 10(-8) to 1.25 x 10(-7) mol/L (r = 0.99). A detection limit of 1.43 x 10(-9) mol/L with an RSD of 2.2% and a mean recovery of 97.9% were obtained. Possible interferences by several substances usually present in food products such as food additive dyes (E102, E100, E123, E127, and E129), artificial sweeteners, preservatives, and antioxidants were also evaluated. The proposed electrochemical procedure was successfully applied to the determination of carmine food dye in spiked commercially available ice cream and soft drinks.

A single-tube RT-PCR for rapid detection and differentiation of some African isolates of palyam serogroup orbiviruses.

A single-tube nested reverse transcriptase (nRT) polymerase chain reaction (nRT-PCR) was developed and evaluated for detection of palyam serogroup orbiviruses ribonucleic acid (RNA) in cell cultures and clinical samples. A pair of outer primers (pal1 and pal2), designed from genome segment three of Chuzan virus of the palyam viruses serogroup, resulted in amplification of a primary 660-base pair (bp) PCR product. Using a pair of internal (nested) primers (pal3 and pal4), the nRT-PCR produced a 350-bp PCR product. The primary and the nested PCR products were amplified from RNA extracted from Sudanese and South African isolates of palyam viruses, propagated in cell cultures. Application of this nRT-PCR to clinical samples resulted in direct detection of palyam virus RNA in blood and serum samples from infected cattle and goats. The nested amplification increased the sensitivity of the assay by 1000-fold, and specific PCR products were detected from as little as 0.1fg of viral RNA. Amplification products were not detected when the nRT-PCR was applied to RNA from closely related orbiviruses including, bluetongue virus (BTV) serotypes 1, 2, 4, 6; epizootic hemorrhagic disease of deer virus prototype serotype 1 (EHDV-1); Sudanese isolates of EHDV-318; total nucleic acid extracts from non-infected Vero cells; and blood and sera from goats and calves from which virus was not isolated. This nRT-PCR provides a reliable, sensitive and specific assay for rapid detection and differentiation of palyam viruses from other related orbiviruses. In addition, the assay is recommended for inclusion in epidemiological surveys and during investigation of an epizootic of the disease among susceptible ruminants.

Serogrouping of United States and some African serotypes of bluetongue virus using RT-PCR.

The diagnostic potential of RT-PCR for detection of bluetongue virus (BTV) ribonucleic acid (RNA) sequence in cell culture and tissue samples from infected ruminants from United States, Sudan, South Africa and Senegal, was evaluated. The non structural protein 1 (NS1) gene of North American BTV serotype 11 was targeted for PCR amplification. The United States BTV serotypes 2, 10, 11, 13 and 17 and the Sudanese BTV serotypes 1, 2, 4 and 16 and BTV serotype 4 from South Africa and BTV serotype 2 from Senegal were studied. RNAs from all BTV field isolates used in this study, propagated in cell cultures, were detected by the described RT-PCR-based assay. The first specific 790bp BTV PCR products were amplified using a pair of outer primers (BTV1 and BTV2). Specificity of the PCR products was confirmed by a nested amplification of a 520bp PCR product using a pair of internal (nested) primers (BTV3 and BTV4). The BTV PCR products were visualized on ethidium bromide-stained agarose gels. Amplification products were not detected when the RT-PCR-based assay was applied to RNAs from closely related orbiviruses including, epizootic hemorrhagic disease virus (EHDV) prototypes serotypes 1, 2, 4; RNA from Sudanese isolate of palyam orbiviruses serogroup and total nucleic acid extracts from uninfected Vero cells. Application of the nested BTV RT-PCR to clinical samples resulted in amplification of BTV RNA from blood and serum samples from goats experimentally infected with BTV4 and from naturally infected sheep, goats, cattle and deer. The results of this study indicated that this RT-PCR assay could be applied for rapid detection of BTV, in cell culture and clinical samples from susceptible ruminants during an outbreak of the disease, in the United States and African.