N,N′-Bis[4-(trifluoro­meth­yl)phen­yl]pyridine-2,6-dicarboxamide

In the title mol­ecule, C21H13F6N3O2, the pyridine ring forms dihedral angles of 1.7 (1) and 5.2 (1)° with the two benzene rings. In the crystal structure, inter­molecular N—H⋯O hydrogen bonds and π⋯π inter­actions [centroid–centroid distance of 3.628 (3) Å between aromatic rings] link mol­ecules into stacks along the c axis. The two trifluoro­methyl groups are each rotationally disordered between two orientations, with occupancy ratios of 0.58 (1):0.42 (1) and 0.55 (1):0.45 (1)

(Dimeth­oxy­phosphor­yl)(furan-2-yl)methyl 2-(2,4-dichloro­phen­oxy)acetate

In the title compound, C15H15Cl2O7P, the benzene and furan rings form a dihedral angle of 73.54 (1)°. In the crystal, weak inter­molecular C—H⋯O hydrogen bonds link the mol­ecules into layers parallel to (100)

2-[(4-Chloro­phen­yl)(hy­droxy)meth­yl]-5,5-dimethyl-1,3,2-dioxaphosphinan-2-one

In the title compound, C12H16ClO4P, the phospho­nate ring adopts a chair conformation. In the crystal, intermolecular O—H⋯O hydrogen bonds link the molecules into chains propagating along the b axis

(S)-2-[1-(4-Bromo­phen­yl)-1-hy­droxy­ethyl]-5,5-dimethyl-1,3,2-dioxaphos­phinane 2-oxide

In the crystal structure of the title mol­ecule, C13H18BrO4P, the phospho­nate ring adopts a chair conformation. Mol­ecules are linked by an O—H⋯O hydrogen bond [O⋯O = 2.780 (3) Å] to form chains parallel to the c axis. Two C—H⋯O inter­actions help to stabilize the crystal structure

(S)-2-[(2,4-Dichloro­phen­yl)(hy­droxy)meth­yl]-5,5-dimethyl-1,3,2-dioxa­phosphinane 2-oxide

In the title mol­ecule, C12H15Cl2O4P, the cyclic dioxaphosphinane ring adopts a chair conformation. In the crystal, inter­molecular O—H⋯O hydrogen bonds link the mol­ecules into chains propagating along the b axis

The Head AIS 4+ Injury Thresholds for the Elderly Vulnerable Road User Based on Detailed Accident Reconstructions

Compared with the young, the elderly (age greater than or equal to 60 years old) vulnerable road users (VRUs) face a greater risk of injury or death in a traffic accident. A contributing vulnerability is the aging processes that affect their brain structure. The purpose of this study was to investigate the injury mechanisms and establish head AIS 4+ injury tolerances for the elderly VRUs based on various head injury criteria. A total of 30 elderly VRUs accidents with detailed injury records and video information were selected and the VRUs’ kinematics and head injuries were reconstructed by combining a multi-body system model (PC-Crash and MADYMO) and the THUMS (Ver. 4.0.2) FE models. Four head kinematic-based injury predictors (linear acceleration, angular velocity, angular acceleration, and head injury criteria) and three brain tissue injury criteria (coup pressure, maximum principal strain, and cumulative strain damage measure) were studied. The correlation between injury predictors and injury risk was developed using logistical regression models for each criterion. The results show that the calculated thresholds for head injury for the kinematic criteria were lower than those reported in previous literature studies. For the brain tissue level criteria, the thresholds calculated in this study were generally similar to those of previous studies except for the coup pressure. The models had higher (>0.8) area under curve values for receiver operator characteristics, indicating good predictive power. This study could provide additional support for understanding brain injury thresholds in elderly people

The Head AIS 4+ Injury Thresholds for the Elderly Vulnerable Road User Based on Detailed Accident Reconstructions

Compared with the young, the elderly (age greater than or equal to 60 years old) vulnerable road users (VRUs) face a greater risk of injury or death in a traffic accident. A contributing vulnerability is the aging processes that affect their brain structure. The purpose of this study was to investigate the injury mechanisms and establish head AIS 4+ injury tolerances for the elderly VRUs based on various head injury criteria. A total of 30 elderly VRUs accidents with detailed injury records and video information were selected and the VRUs’ kinematics and head injuries were reconstructed by combining a multi-body system model (PC-Crash and MADYMO) and the THUMS (Ver. 4.0.2) FE models. Four head kinematic-based injury predictors (linear acceleration, angular velocity, angular acceleration, and head injury criteria) and three brain tissue injury criteria (coup pressure, maximum principal strain, and cumulative strain damage measure) were studied. The correlation between injury predictors and injury risk was developed using logistical regression models for each criterion. The results show that the calculated thresholds for head injury for the kinematic criteria were lower than those reported in previous literature studies. For the brain tissue level criteria, the thresholds calculated in this study were generally similar to those of previous studies except for the coup pressure. The models had higher (>0.8) area under curve values for receiver operator characteristics, indicating good predictive power. This study could provide additional support for understanding brain injury thresholds in elderly people

MRI signal intensity differentiation of brainstem encephalitis induced by Enterovirus 71: a classification approach for acute and convalescence stages

Additional file 3. After tick the segment region, Medflovan show the segmentation region of lesion

New Findings, Classification and Long-Term Follow-Up Study Based on MRI Characterization of Brainstem Encephalitis Induced by Enterovirus 71

Background To report the diversity of MRI features of brainstem encephalitis (BE) induced by Enterovirus 71. This is supported by implementation and testing of our new classification scheme in order to improve the diagnostic level on this specific disease. Methods Neuroimaging of 91 pediatric patients who got EV71 related BE were hospitalized between March, 2010 to October, 2012, were analyzed retrospectively. All patients underwent pre- and post-contrast MRI scan. Thereafter, 31 patients were randomly called back for follow-up MRI study during December 2013 to August 2014. The MRI signal patterns of BE primary lesion were analyzed and classified according to MR signal alteration at various disease stages. Findings in fatal and non-fatal cases were compared, and according to the MRI scan time point during the course of this disease, the patients’ conditions were classified as 1) acute stage, 2) convalescence stage, 3) post mortem stage, and 4) long term follow-up study. Results 103 patients were identified. 11 patients did not undergo MRI, as they died within 48 hours. One patient died on 14th day without MR imaging. 2 patients had postmortem MRI. Medical records and imaging were reviewed in the 91 patients, aged 4 months to 12 years, and two cadavers who have had MRI scan. At acute stage: the most frequent pattern (40 patients) was foci of prolonged T1 and T2 signal, with (15) or without (25) contrast enhancement. We observed a novel pattern in 4 patients having foci of low signal intensity on T2WI, with contrast enhancement. Another pattern in 10 patients having foci of contrast enhancement without abnormalities in T1WI or T2WI weighted images. Based on 2 cases, the entire medulla and pons had prolonged T1 and T2 signal, and 2 of our postmortem cases demonstrated the same pattern. At convalescence stage, the pattern observed in 4 patients was foci of prolonged T1 and T2 signal without contrast enhancement. Follow-up MR study of 31 cases showed normal in 26 cases, and demonstrated foci of prolonged T1 and T2 signal with hyper-intensity on FLAIR in 3 cases, or of prolonged T1 and T2 signal with hypo-intensity on FLAIR in 2 cases. Most importantly, MR findings of each case were thoroughly investigated and classified according to phases and MRI signal alteration. Conclusions This study has provided enhanced and useful information for the MRI features of BE induced by EV71, apart from common practice established by previous reports. In addition, a classification scheme that summarizes all types of features based on the MRI signal at the four different stages of the disease would be helpful to improve the diagnostic level

Clinical and Immunopathological Features of Moyamoya Disease

Background: Moyamoya disease (MMD) is a cerebrovascular disease characterized by progressive stenosis or occlusion of the terminal portion of internal carotid arteries and the formation of a vascular network at the base of the brain. The pathogenesis of MMD is still unclear. Methodology/Principal Findings: We retrospectively analyzed clinical data for 65 consecutive patients with MMD in our institutions and evaluated the histopathological and immunohistochemical findings of intracranial vessels from 3 patients. The onset age distribution was found to have 1 peak at 40–49 year-old age group, no significant difference was observed in the female-to-male ratio (F/M = 1.2). Intracranial hemorrhage was the predominant disease type (75%). Positive family history was observed in 4.6 % of patients. Histopathological findings were a narrowed lumen due to intimal fibrous thickening without significant inflammatory cell infiltration, and the internal elastic lamina was markedly tortuous and stratified. All 3 autopsy cases showed vacuolar degeneration in the cerebrovascular smooth muscle cells. Immunohistochemical study showed the migration of smooth muscle cells in the thickened intima, and aberrant expression of IgG and S100A4 protein in vascular smooth muscle cells. The Complement C3 immunoreactivity was negative. Conclusion/Significance: This study indicated that aberrant expression of IgG and S100A4 protein in intracranial vascular wall of MMD patients, which suggested that immune-related factors may be involved in the functional and morphologica