Howardheller9778

The hypotensive action of the vlPAG observed in anaesthetised animals has been attributed to inhibition of pre-sympathetic neurones originating in the rostral ventrolateral medulla. We therefore used an un-anaesthetised, decerebrate SH rat preparation to investigate whether activation of vlPAG neurons produced sympatho-inhibition that might be below the threshold at which a peripheral vascular response could be observed. Only sympatho-excitatory responses to electrical and excitatory amino acid microinjections were observed, and these were evoked from both the dorsal and ventral PAG; no responses were evoked from the vlPAG. We conclude that the vlPAG is not a reliable antihypertensive locus in the awake SH rat. We discuss the potential importance of the state-dependency of the hypotensive response that can be evoked from the vlPAG, which has important implications for translating to humans.

Delineation of the seizure onset zone (SOZ) is required in children with drug resistant epilepsy (DRE) undergoing neurosurgery. Intracranial EEG (icEEG) serves as gold standard but has limitations. Here, we examine the utility of virtual implantation with electrical source imaging (ESI) on ictal scalp EEG for mapping the SOZ and predict surgical outcome.

We retrospectively analyzed EEG data from 35 children with DRE who underwent surgery and dichotomized into seizure-free (SF) and non-seizure-free (NSF). We estimated virtual sensors (VSs) at brain locations that matched icEEG implantation and compared ictal patterns at VSs vs icEEG. We calculated the agreement between VSs SOZ and clinically defined SOZ and built receiver operating characteristic (ROC) curves to test whether it predicted outcome.

Twenty-one patients were SF after surgery. Moderate agreement between virtual and icEEG patterns was observed (kappa=0.45, p<0.001). Virtual SOZ agreement with clinically defined SOZ was higher in SF vs NSF patients (66.6% vs 41.6%, p=0.01). Anatomical concordance of virtual SOZ with clinically defined SOZ predicted outcome (AUC=0.73; 95% CI 0.57-0.89; sensitivity=66.7%; specificity=78.6%; accuracy=71.4%).

Virtual implantation on ictal scalp EEG can approximate the SOZ and predict outcome.

SOZ mapping with VSs may contribute to tailoring icEEG implantation and predict outcome.

SOZ mapping with VSs may contribute to tailoring icEEG implantation and predict outcome.Using a Straussian grounded theory methodology, we explored the meaning women attribute to body image and how they understand their breast cancer experience as influencing their body image to develop a grounded theory of body image for women diagnosed with breast cancer. Interviews were conducted with 27 women who had completed treatment for breast cancer in Canada. Data were analyzed through a process of open, axial, and selective coding using constant comparison techniques and memo-writing. A grounded theory of body image for women diagnosed with breast cancer was developed around the core category of body image what it means to women, which was underpinned by six themes and 17 subthemes. This theory explains how women diagnosed with breast cancer define body image and illustrates intrapersonal and interpersonal factors that can undermine or support their body image, along with strategies they used to manage their body image. This theory can guide research and practice aimed at enhancing body image and minimizing its consequences for women diagnosed with breast cancer.Does dieting intensify during Spring? Previous research suggests that body dissatisfaction is seasonal and peaks during Summer. Extending these findings to seasonal dieting, we contend that individuals' apprehensions about heightened Summertime body dissatisfaction motivate Springtime dieting. To detect seasonal dieting, we examined the seasonal frequencies of 69 dieting hashtags within a database of 564 million tweets originating from the United States and spanning eight calendar years (2012-19). In total, we detected 628,355 dieting hashtags. Of these, 30% occurred during Spring, 20% during Autumn/Fall, and 25% during each of Summer and Winter. During Spring, there were ~64,000 additional dieting hashtags compared with Autumn/Fall, and ~32,000 additional hashtags compared with Summer and Winter. Of the nine most common dieting hashtags that together accounted for 96% of the total, all nine peaked during Spring (ps less then 0.0001). This Spring-centric pattern was apparent for both appearance-oriented diets (e.g., "atkins" and "weightwatchers") and ostensibly non-appearance-oriented diets (e.g., "vegan" and "glutenfree"), suggesting that non-appearance-oriented diets might nonetheless be co-opted for appearance-oriented purposes. In conclusion, we found credible evidence that dieting intensifies during Spring. Future research should examine whether eating disorders and muscle dysmorphia also intensify during Spring because dieting is intrinsic to both these conditions.

Comminution is a significant aspect of periprosthetic distal femoral fracture characterization and may influence post-surgical outcomes. Existing classification systems that guide treatment decisions do not take into account comminution and current literature is unclear on which surgical approach is optimal. We hypothesize that fractures with comminution will have poorer quality post-reduction alignment, especially with a lateral approach.

37 study patients were identified with billing codes designating a distal femoral periprosthetic fracture. A retrospective chart review was performed to categorize fractures by absence or presence of comminution and medial parapatellar versus lateral surgical approach. These patients underwent an imaging evaluation for the primary outcome of reduction quality including the anatomic lateral distal femoral angle (LDFA) and the posterior distal femoral angle (PDFA). Differences in radiographic outcomes were analyzed with Wilcoxon/Kruskal-Wallis tests, and analysis by appron systems and treatment guidelines for periprosthetic distal femoral fractures do not adequately address several issues that may influence treatment outcomes, especially comminution. Comminuted fractures had greater post-reduction extension malalignment, falling outside the recommended PDFA range of 87-90°, especially with a lateral approach. Consideration should be given to surgical approach and techniques to reduce excessive extension when treating comminuted periprosthetic distal femoral fractures.

The treatment of symptomatic partial anterior cruciate ligament (ACL) tears remains controversial. This study investigated the clinical and functional outcome of patients undergoing selective posterolateral (PLB) or anteromedial (AMB) bundle reconstruction.

55 consecutive patients underwent partial bundle reconstruction, of which 45 (AMB=17, PLB=28) were included in the current analysis (62% male, mean age of 29.1years). Patients were assessed at 12 and 24months with patient-reported outcome measures (PROMs), graft laxity (KT-1000), knee extensor and flexor torque and a 4-hop battery. Limb Symmetry Indices (LSIs) were calculated. Return to sport (RTS) rates, re-operations and re-injuries were evaluated.

High scoring PROMs were evident, with 62% and 84% of patients participating in pivoting sports at 12 and 24months, respectively. Overall, 98% of patients demonstrated 'normal' knee laxity at 24months. Mean LSIs for all hop tests were≥90% at 12 and 24months, with 76-87% of patients demonstrating LSIs≥90% on the four hop tests employed at 12months, which was 89-93% of patients at 24months. A mean knee extensor torque LSI of 89% and 97% was observed at 12 and 24months. Two ipsilateral re-tears (2/55, 3.6%, AMB=1, PLB=1) were observed over the 24-month period, with no contralateral ACL tears.

High levels of physical function and RTS were observed in patients following partial bundle reconstruction, higher than that reported in the literature in patients undergoing ACLR, without evidence of instability and a low re-injury rate.

High levels of physical function and RTS were observed in patients following partial bundle reconstruction, higher than that reported in the literature in patients undergoing ACLR, without evidence of instability and a low re-injury rate.Reversed-phase high performance thin-layer chromatography (RP-HPTLC) on C18 bonded silica gel was combined with desorption electrospray ionization (DESI) and high resolution time of flight mass spectrometry (HRToFMS) to detect, characterize and image (MSI) phytoecdysteroids (plant-derived insect moulting hormones) in ethanolic extracts of members of the Silene plant family. As seen previously for silica gel, DESI provided a simple and convenient method for recovering polar polyhydoxysteroids from RP-HPTLC plates for the purposes of both the MS and MSI of extracts obtained from three species of the Silene family (Silene otites, S. nutans and S. viridiflora). Using RP-HPTLC/DESI/MSI/HRToFMS a number of ecdysteroids, including 20-hydroxyecdysone, polypodine-B, 2-deoxy-20-hydroxyecdysone and 2-deoxyecdysone were identified in these extracts. Differences were noted in the mass spectra obtained depending upon both the stationary phase on which they were separated, and the temperatures used in the heated transfer line used for introduction into the ion source. Ecdysteroids detected after chromatography on C18 bonded silica showed increased fragmentation due to water loss compared to those imaged from silica. In addition, the benefits of the additional resolution provided by 2-dimensional TLC for increasing spectral quality compared to a 1-dimensional separation are demonstrated.Keratoconus is an eye condition caused by localized thinning of the corneal tissue, which leads to a characteristic cone-shaped protrusion of the cornea. We investigate the mechanical behavior of keratoconus and suspect keratoconus corneas versus healthy corneas by using patient-specific finite element models. Patient-specific geometries of the corneas are obtained from diagnostic images provided by corneal topographer, transformed into solid models, and discretized in hexahedral elements. For the diseased corneas, a suitable reduction of the stiffness is applied within a limited region of the cornea around the conus. After the identification of the stress-free configuration, the models are used to simulate pressurization tests up to 40 mmHg. The material parameters have been estimated within the stress-free configuration identification procedure. As expected, numerical results reveal a more compliant behavior for the diseased corneas in terms of apex displacement plots as a function of the intraocular pressure, with diseased corneas experiencing up to 44% increase in apex displacement compared to healthy corneas. The maps of the stress confirm, for the diseased corneas, a marked increase of the maximum tensile stress, on both anterior and posterior surfaces, to be ascribed mainly to the reduction of the corneal thickness. Stress maps also show, for keratoconus corneas, a marked increase of the ratio between posterior and anterior tensile stress in the conus. selleck compound Numerical analyses are used to construct the refractive power maps, revealing clearly that the maximum dioptric power in keratoconus corneas is at the center of the cone-shape rather than at the apex.