Learned Helplessness and Cluster Headache – A Case Report

Spontaneous coronary artery dissection (SCAD) has long been recognized as a cause of acute coronary syndromes (ACS) with very low prevalence (3% in most cohorts). It predominantly occurs in young to middle-aged women. SCAD patients have fewer traditional cardiovascular risk factors for ischaemic heart disease than patients with atherosclerotic coronary artery disease, however, many patients do have some risk factors for ischaemic heart disease including hypertension, smoking, and dyslipidaemia, although there is no evidence these contribute directly to the risk of SCAD. We report in this case an observation of spontaneous coronary dissection, in order to discuss its pathogenesis, diagnosis and management

Space education in Europe: status and prospects

The space education landscape in Europe continues to evolve as the demand for a skilled workforce with interdisciplinary and multidisciplinary backgrounds, grows. This study aims to map the higher education landscape in Europe and understand trends and patterns among the higher education programmes within the European space sector. Indeed, the space sector is changing constantly as new technologies, challenges, and actors emerge, and the educational background must meet this demand for highly specialised and competent professionals. This analysis stems from the consolidation of a database of all higher educational space study programmes across all ESA and EU Member States within Europe, as well as a comprehensive view from students and young professionals entering the space sector. Further analysis groups the study programmes across Europe into so-called “macro-areas”, which support an in-depth analysis of the fields of study available for students in Europe, as well as their distribution across the continent. Overall, the study demonstrates key trends at the national level, both in terms of study programmes available and government strategies and initiatives influencing the space education landscape per country. European-wide trends are also identified. The study contributes to a better understanding of the space sector overall and allows for the identification of key trends among European higher education in space-related study fields. Additional key messages can be gleaned from an increased understanding of how the space sector is perceived by students and young professionals, complementing the analysis conducted of the space education landscape at the university leve

Prior information for brain parcellation

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2005.Includes bibliographical references (p. 171-184).To better understand brain disease, many neuroscientists study anatomical differences between normal and diseased subjects. Frequently, they analyze medical images to locate brain structures influenced by disease. Many of these structures have weakly visible boundaries so that standard image analysis algorithms perform poorly. Instead, neuroscientists rely on manual procedures, which are time consuming and increase risks related to inter- and intra-observer reliability [53]. In order to automate this task, we develop an algorithm that robustly segments brain structures. We model the segmentation problem in a Bayesian framework, which is applicable to a variety of problems. This framework employs anatomical prior information in order to simplify the detection process. In this thesis, we experiment with different types of prior information such as spatial priors, shape models, and trees describing hierarchical anatomical relationships. We pose a maximum a posteriori probability estimation problem to find the optimal solution within our framework. From the estimation problem we derive an instance of the Expectation Maximization algorithm, which uses an initial imperfect estimate to converge to a good approximation.(cont.) The resulting implementation is tested on a variety of studies, ranging from the segmentation of the brain into the three major brain tissue classes, to the parcellation of anatomical structures with weakly visible boundaries such as the thalamus or superior temporal gyrus. In general, our new method performs significantly better than other :standard automatic segmentation techniques. The improvement is due primarily to the seamless integration of medical image artifact correction, alignment of the prior information to the subject, detection of the shape of anatomical structures, and representation of the anatomical relationships in a hierarchical tree.by Kilian Maria Pohl.Ph.D

Study of the Higgs-boson decays into WW and ZZ at the Photon Collider

Production of the Standard Model Higgs-boson at the Photon Collider at TESLA is studied for the Higgs-boson masses above 150 GeV. Simulation of signal and background processes takes into account realistic luminosity spectra and detector effects. In the considered mass range, large interference effects are expected in the W+W- decay channel. By reconstructing W+W- and ZZ final states, not only the h->gamma gamma partial width can be measured, but also the relative phase of the scattering amplitude. This opens a new window for the precise determination of the Higgs-boson couplings. Models with heavy, fourth-generation fermions and with enlarged Higgs sector (2HDM (II)) are considered.Comment: 19 pages, 18 figures; updated version with improved precision of estimate

Interrater agreement in headache diagnoses

Background: Diagnosing headache disorders comprises the collection and interpretation of information. This study estimates agreement and bias in the latter. Methods: Physicians and medical students diagnosed eight patients’ headaches using the International Classification of Headache Disorders. We calculated Cohen’s Kappa for all participants and subgroups (board-certified neurologists, physicians working in a neurology department). Moreover, we asked how sure they felt about their diagnoses. Finally, participants estimated the number of different headache diagnoses a patient receives when consulting many physicians for the same headache and indicated the highest acceptable number. Results: The data of 63 participants entered the analysis, of whom 18 were neurologists (18/63, 28.6%), and 41 were currently working at a neurology clinic (41/63, 66.7%). Cohen’s Kappa decreased (0.706, 0.566, and 0.408) with increasing levels of the classification hierarchy. Interrater agreement was highest among neurologists. Physicians not working in a neurology clinic tended to diagnose secondary headaches more often were less confident about their diagnoses. Conclusions: Physicians with less experience in headache disorders struggle more to diagnose headaches than neurologists do; they suspect secondary headaches, disagree, and feel insecure more often. Thus, interpreting a headache history is prone to error and bias

The Loneliness of Migraine Scale: A Development and Validation Study

Patients with migraine often isolate themselves during their attacks. This disease-related loneliness seems to reverberate interictal, as some patients report failing relationships, losing jobs, or suffering from reduced social contacts. We developed a 10-item self-report questionnaire, the loneliness of migraine scale (LMS), and conducted an online survey. The questionnaire comprised diagnostic questions for migraine, the loneliness of migraine scale, the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), and the Headache Attributed Lost Time Index (HALT-90). We computed item statistics, the psychometric properties of the LMS and assessed correlations between loneliness, migraine days, anxiety, and depression. We included 223 participants with (probable) migraine, reporting 8 ± 6 headache days with a disease duration of 11 ± 11 years. The mean scores of the HALT were 88 ± 52, of the GAD-7 10 ± 5, for PHQ-8 11 ± 6, and of the LMS 28.79 ± 9.72. Cronbach’s alpha for all ten items was 0.929. The loneliness scale correlated with the GAD-7 (r = 0.713, p < 0.001), with the PHQ-8 scale (r = 0.777, p < 0.001) and with migraine days (r = 0.338, p < 0.001). The LMS is a reliable and valid questionnaire measuring the loneliness of migraine patients. Feelings of loneliness were common and correlated highly with migraine days, anxiety, and depression

Osteomimicry of mammary adenocarcinoma cells in vitro; increased expression of bone matrix proteins and proliferation within a 3D collagen environment.

Bone is the most common site of metastasis for breast cancer, however the reasons for this remain unclear. We hypothesise that under certain conditions mammary cells possess osteomimetic capabilities that may allow them to adapt to, and flourish within, the bone microenvironment. Mammary cells are known to calcify within breast tissue and we have recently reported a novel in vitro model of mammary mineralization using murine mammary adenocarcinoma 4T1 cells. In this study, the osteomimetic properties of the mammary adenocarcinoma cell line and the conditions required to induce mineralization were characterized extensively. It was found that exogenous organic phosphate and inorganic phosphate induce mineralization in a dose dependent manner in 4T1 cells. Ascorbic acid and dexamethasone alone have no effect. 4T1 cells also show enhanced mineralization in response to bone morphogenetic protein 2 in the presence of phosphate supplemented media. The expression of several bone matrix proteins were monitored throughout the process of mineralization and increased expression of collagen type 1 and bone sialoprotein were detected, as determined by real-time RT-PCR. In addition, we have shown for the first time that 3D collagen glycosaminoglycan scaffolds, bioengineered to represent the bone microenvironment, are capable of supporting the growth and mineralization of 4T1 adenocarcinoma cells. These 3D scaffolds represent a novel model system for the study of mammary mineralization and bone metastasis. This work demonstrates that mammary cells are capable of osteomimicry, which may ultimately contribute to their ability to preferentially metastasize to, survive within and colonize the bone microenvironment