Classification and imaging of ankle impingement syndromes.

Learning Objectives: To review the classification of ankle impingement syndromes. To describe and illustrate the spectrum of appearance of ankle impingement syndromes using conventional radiography (CR), multidetector computed tomography (MDCT), ultrasonography (US), magnetic resonance imaging (MRI), and MR arthrography (MRA). Background: Ankle impingement syndromes are a spectrum of diseases common in both athletic and general population and depend on many causes that can be distinguished by the type of tissue which determines the conflict (bone, fibrous, synovial). In general, classification of ankle impingement syndromes takes into account the anatomical site relative to the tibio-tarsal joint, and thus they may be classified as anterior, antero-medial, antero-lateral, posterior and postero-medial. Imaging findings: CR alone already suffices to demonstrate a bone impingement in most cases, while there is necessity to use MDCT where the site of impingement is in an anatomical site not clearly demonstrable by CR because of the presence of superimposed structures. US has the ability to recognize the presence of an anterior impingement and it may assess tendon disorders (stenosing tenosynovitis) which may be an associate sign of an impingement syndrome. MRI is the method of choice to assess synovial or fibrous impingement syndromes thanks to its excellent contrast resolution. MRA is used when there is capsular thickening that could not be detected by simple MRI. Conclusion: Diagnostic imaging has a very important role in the recognition of the cause of impingement and of the anatomical site where such a conflict takes place, thus allowing a correct therapeutic management

On the completeness of impulsive gravitational wave space-times

We consider a class of impulsive gravitational wave space-times, which generalize impulsive pp-waves. They are of the form $M=N\times\mathbb{R}^2_1$, where $(N,h)$ is a Riemannian manifold of arbitrary dimension and $M$ carries the line element $ds^2=dh^2+ 2dudv+f(x)\delta(u)du^2$ with $dh^2$ the line element of $N$ and $\delta$ the Dirac measure. We prove a completeness result for such space-times $M$ with complete Riemannian part $N$.Comment: 13 pages, minor changes suggested by the referee

Social Determinants of Health and Distance Learning in Italy in the Era of the SARS-CoV-2 Pandemic

Objectives: To investigate the experiences by distance learning (DL) method during the first wave of the SARS-CoV-2 pandemic in Italy, and to search for correlations with purported experiences and respective levels of social determinants of health (SDH). Study design and methods: Cross-sectional online survey, investigating various SDH and parents’ attitude towards DL, proposed 6 months after the beginning of the pandemic to a sample population of parents with school-aged children throughout Italy. Results: A total of 3791 questionnaires were analyzed. Non-Italian parents complained more frequently of difficulties in providing support to their children in DL due to poor digital skills (p = 0.01), lack of good-quality digital equipment (p = 0.01), problems with the Italian language (p < 0.001), and a lower level of education (p < 0.001). When parents lived apart, greater difficulties in concentration in children using DL (p = 0.05) and a lower parental capacity to support DL (p = 0.002) were reported. Adequate digital structures appeared related to living in owned compared to rented property, higher levels of parental education, and better familial financial situations. Conclusions: Students from families with financial difficulties and low levels of parental education, or even those living in houses for rent or having separated parents, may be disadvantaged in an educational context since the introduction of DL

The impact of controlled ovarian stimulation hormones on the metabolic state and endocannabinoid system of human cumulus cells

Different Follicle Stimulating Hormone (FSH) formulation and Luteinizing Hormone (LH) are used in Assisted Reproductive Technology (ART) to induce follicles development and oocytes maturation, but it is still under debate which protocol is to be preferred. In the present study, the different effects on cumulus cells (CCs) of three controlled ovarian stimulation (COS) protocols, based on urinary FSH, recombinant FSH, or human Menopausal Gonadotropin (hMG) administration, were assessed. CCs were obtained from 42 normal-responders women undergoing COS, randomly divided into three groups according to the used gonadotropin formulation. Differences were found in the expression of genes belonging to the endocannabinoid system (the receptors CNR1, CNR2 and TRPV1, and the enzymes involved in the metabolisms of anandamide, NAPE-PLD and FAAH, and 2-acylglycerol, DAGL and MAGL); consistently, changes in lipid (PPARα, and FASN) and carbohydrate (GLUT1 and GLUT9) metabolisms, in CCs’ macromolecules composition (highlighted by Fourier Transform Infrared Microspectroscopy, FTIRM), and in the number of retrieved oocytes were found. For the first time, statistically significant evidence on the differences related to each COS protocol on the endocannabinoid system, metabolism and macromolecular composition of CCs was found, representing a proof of concept to be further confirmed in a larger cohort of patients

Palacio de los Deportes

This building was specially built for the Mexico Olympic Games, and was the site for the basketball competition. But during the design stage it was foreseen that it could be later adapted to various other uses, such as boxing matches, ice skating displays, theatre, circus, shows, etc. It has 19.834 seats for spectators. Its circular planform has a 180 m diameter, and there are three levels of organisation. — on the lower level there is accommodation for the competitors, the press and the organisers of the Olympic Competitions; — the main level houses the entrance halls, the stairs, and access to the lower and middle spectator stands; — the top level has the washrooms for the public, the special stands and access to the middle and top stands. The outstanding feature of this sports palace is its general structure, which from the outset was regarded as the dominant element of the design, and also defined its plastic and spatial quality.Este edificio, construido para los Juegos Olímpicos de México, fue destinado a los juegos de baloncesto, pero al proyectarlo se previó que posteriormente pudiera servir para múltiples usos: celebración de combates de boxeo, espectáculos sobre hielo, teatro, circo, etc. Tiene capacidad para 19.824 espectadores sentados. Su planta es circular, con un diámetro total de 180 m, y está organizada en tres niveles: — en el nivel inferior se alojan: los servicios para deportistas, prensa y organización del Certamen Olímpico; —el nivel principal alberga: los vestíbulos, escaleras y accesos a gradería baja y media; — y en el nivel superior se distribuyen: los servicios para público, palcos y accesos a gradería media y alta. En este Palacio de los Deportes destaca su estructura general que fue considerada, desde la fase del proyecto, como el elemento dominante de la composición, y el determinante de su sentido plástico y espacial

Infinitesimal and local convexity of a hypersurface in a semi-Riemannian manifold

Given a Riemannian manifold M and a hypersurface H in M, it is well known that infinitesimal convexity on a neighborhood of a point in H implies local convexity. We show in this note that the same result holds in a semi-Riemannian manifold. We make some remarks for the case when only timelike, null or spacelike geodesics are involved. The notion of geometric convexity is also reviewed and some applications to geodesic connectedness of an open subset of a Lorentzian manifold are given.Comment: 14 pages, AMSLaTex, 2 figures. v2: typos fixed, added one reference and several comments, statement of last proposition correcte

Interaction Between Dietary Lipid Level and Seasonal Temperature Changes in Gilthead Sea Bream Sparus aurata: Effects on Growth, Fat Deposition, Plasma Biochemistry, Digestive Enzyme Activity, and Gut Bacterial Community

A 121-day feeding trial was undertaken to test the effects of two dietary lipid levels (16 and 21% L16, L21) in triplicated gilthead sea bream groups (initial weight: 67.5 g) reared at two different water temperatures (high, H 23°C and low, L 17°C) in the same recirculation system but exposed to a switch in temperature after 58 days. Fish kept at H were transferred to L (HL transition, autumn shift), and the fish kept at L were exposed to H (LH transition, summer shift), while continuing to receive the same diet to apparent satiation in each group. At the end of the trial, no significant diet effect on specific growth rate (SGR), feed intake (FI), and feed conversion rate (FCR) were detected in fish exposed to HL transition compared with those exposed to LH transition, while gross lipid efficiency (GLE) and lipid efficiency ratio (LER) were higher in L16. After temperature changes, L16 displayed higher SGR, FI, GLE, and LER, while mesenteric fat index was reduced. After temperature changes, the combined effects of low lipid diet and low temperature conditions resulted in higher pepsin activity, while trypsin, chymotrypsin, and lipase activities were generally higher at high lipid content. The combined effect of diet and temperature did not alter the metabolic plasma profile, except for the observed final higher aspartate aminotransferase (AST) and alkaline phosphatase (ALP) values when combining high dietary lipid (L21) and temperature changes. Different diets showed a significantly different gut microbiome layout, only at high temperature with L16 diet resulting in a higher load of Lactobacillus. On the contrary, no dietary impact on ecosystem diversity was observed, independently from the temperature. In addition, L16 diet in the HL transition favored an increase in Weissella and Bradyrhizobium genera in the gut microbiome, while in the final condition of LH transition, L21 diet favored a significant increase in Streptococcus and Bacillus. According to the results, the utilization of 16% dietary lipid levels in gilthead sea bream should be preferred during seasonal temperature changes in order to optimize feed utilization and gut health

Effects of increasing dietary level of organic acids and nature-identical compounds on growth, intestinal cytokine gene expression and gut microbiota of rainbow trout (Oncorhynchus mykiss) reared at normal and high temperature

Organic acids (OA) and nature-identical compounds (NIC) such as monoterpenes and aldehydes are well-known growth and health promoters in terrestrial livestock while their application for fish production is recent and their mechanisms of action require further study. Hence, this study tested the increasing dietary level (D0, D250, D500, D1000; 0, 250, 500 and 1000 mg kg feed−1 respectively) of a microencapsulated blend containing citric and sorbic acid, thymol and vanillin over 82 days on rainbow trout to assess the effects on growth, feed utilization, intestine cytokine gene expression and gut microbiota (GM). Furthermore, the effects on intestinal cytokine gene expression and GM were also explored after one week at high water temperature (23 °C). OA and NIC improved specific growth rate (SGR) and feed conversion rate (FCR) during the second half (day 40–82) of the feeding trial, while at the end of the trial protein (PER) and lipid efficiency (LER) increased with increasing dietary level. GM diversity and composition and cytokine gene expression analysis showed no significant differences in fish fed with increasing doses of OA and NIC (82 days) demonstrating the absence of inflammatory activity in the intestinal mucosa. Although there were no statistical differences, GM structure showed a tendency in clustering D0 group separately from the other dietary groups and a trend towards reduction of Streptococcus spp. was observed in the D250 and D1000 groups. After exposure to high water temperature, lower GM diversity and increased gene expression of inflammatory intestinal cytokines were observed for both inclusions (D0 vs. D1000) compared to groups in standard condition. However, the gene up-regulation involved a limited number of cytokines showing the absence of a substantial inflammation process able to compromise the functional activity of the intestine. Despite further study should be conducted to fully clarify this mechanism, cytokines up-regulation seems to be concomitant to the reduction of the GM diversity and, particularly, to the reduction of specific lactic acid bacteria such as Leuconostoc. The application of the microencapsulate blend tested can be a useful strategy to improve growth and feed utilization in rainbow trout under normal temperature conditions. According to the results organic acids and nature-identical compounds did not revert the effects triggered by the increased temperature of water