“Tennis leg”: gastrocnemius injury is a far more common cause than plantaris rupture

AbstractWe report a typical case of “tennis leg”, in which the main finding was a fluid collection between the medial head of the gastrocnemius and soleus muscles. Since the first clinical description of this entity in 1883, the injury has been attributed to rupture of the plantaris tendon. However, recent studies of this condition with sonography and magnetic resonance imaging have shown that most of these cases are actually due to injury to the gastrocnemius and/or soleus muscles, and up to 10% are due to deep venous thrombosis masquerading as muscle injury. The plantaris muscle and tendon are only rarely involved in this injury

Advection and eddy mixing in the Mediterranean salt tongue

Lagrangian trajectories from the SOFAR float Mediterranean outflow experiment are used to estimate the low frequency variability and mixing in the vicinity of the Mediterranean salt tongue. Two dominant patterns of Lagrangian variability are observed, (1) nearly zonal low frequency motions and (2) wave-like oscillations with northwest to southeast orientation. The zonal motions are found near the core of the salt tongue in the Canary Basin while the oscillations are generally found to the south and east. It is suggested that the zonal motions are the result of baroclinic instability of the large-scale flow. They have zonally enhanced low frequency variability (periods greater than 200 days) and nearly isotropic mesoscale variability (periods 50 to 200 days). The wave motions are believed to be the signature of radiating baroclinic Rossby waves generated to the south at the Cape Verde Frontal Zone. They are strongly peaked at the mesoscale band and have an essentially isotropic low frequency component. Integral time scales for the zonal motions are relatively long (23 and 13 days for the zonal and meridional directions) while for the wave motions they are short (7.7 and 5.0 days). The resulting eddy diffusivities are found to be non-isotropic and non-homogeneous with (Kxx, Kyy) = (21 and 8.4 × 106 cm2 s−1) in the core of the salt tongue (mainly zonal motions) and (Kxx, Kyy) = (4.3 and 3.5 × 106 cm2 s−1) to the south of the core (mainly wave-like motions). A simple scale analysis indicates that these time dependent motions play the dominant role in the spread of the Mediterranean salt tongue in both the zonal and meridional directions

Imaging Findings in Two Cases of Fluoroquinolone-Induced Achilles Tendinopathy

AbstractTendonitis and tendon rupture are rare but recognized complications of fluoroquinolone therapy. Most reports of this problem have appeared in the rheumatology and pharmacology literature, and this topic has received little attention in the radiologic literature. We report two cases of fluoroquinolone-induced tendinopathy and describe their magnetic resonance (MR) and sonographic findings. Although Achilles tendinopathy is generally the result of repetitive injury, it is useful to keep other causes in mind. MR or sonographic findings of Achilles tendinopathy in a patient without history of antecedent trauma should prompt the radiologist to consider fluoroquinolone treatment as a possible causative agent

Land Use Implications of Expanding Biofuel Demand

The Renewable Fuel Standard mandates in the Energy Independence and Security Act of 2007 will require 36 billion gallons of ethanol to be produced in 2022. The mandates require that 16 of the 36 billion gallons must be produced from cellulosic feedstocks. The potential land use implications resulting from these mandates were examined using two methods, the POLYSYS model and a general equilibrium model. Results of the POLYSYS analysis indicated that 72.1 million tons of corn stover, 23.5 million tons of wheat straw, and 24.7 million acres would be used to produce 109 million tons of switchgrass in 2025 to meet the mandate. Results of the CGE analysis indicated that 10.9 billion bushels of corn grain, 71 million tons of corn stover, and 56,200 tons of switchgrass is needed to meet the mandate.cellulosic ethanol, corn stover, grain ethanol, renewable fuel standard, switchgrass, Crop Production/Industries, Demand and Price Analysis, Environmental Economics and Policy, Land Economics/Use, Resource /Energy Economics and Policy, Q15, Q42,

LOCATION OF A MIXALCO PRODUCTION FACILITY WITH RESPECT TO ECONOMIC VIABILITY

Monte-Carlo simulation modeling is used to perform a feasibility study of alternative locations for a MixAlco production facility. Net present value distributions will be ranked within feasible risk aversion boundaries. If MixAlco is a profitable investment, it would have a major impact on the fuel oxygenate and gasoline markets.Resource /Energy Economics and Policy,

Neuronal activation for semantically reversible sentences

Semantically reversible sentences are prone to misinterpretation and take longer for typically developing children and adults to comprehend; they are also particularly problematic for those with language difficulties such as aphasia or Specific Language Impairment. In our study, we used fMRI to compare the processing of semantically reversible and nonreversible sentences in 41 healthy participants to identify how semantic reversibility influences neuronal activation. By including several linguistic and nonlinguistic conditions within our paradigm, we were also able to test whether the processing of semantically reversible sentences places additional load on sentence-specific processing, such as syntactic processing and syntactic-semantic integration, or on phonological working memory. Our results identified increased activation for reversible sentences in a region on the left temporal–parietal boundary, which was also activated when the same group of participants carried out an articulation task which involved saying “one, three” repeatedly. We conclude that the processing of semantically reversible sentences places additional demands on the subarticulation component of phonological working memory

Differences in experiences of care between patients diagnosed with metastatic cancer of known and unknown primaries: mixed-method findings from the 2013 cancer patient experience survey in England.

OBJECTIVES: To explore differences in experiences of care reported in the Cancer Patient Experience Survey (CPES) between patients with cancer of unknown primary (CUP) and those with metastatic disease of known primary (non-CUP); to determine insights pertaining to the experiences of care for CUP respondents from free-text comments. DESIGN: Two separate, but related, studies, involving secondary analysis of existing data. Using frequency matching of CUP and non-CUP patients, statistical comparisons of responses to CPES questions were conducted. Free-text comments from CUP respondents were analysed thematically. SETTING AND PARTICIPANTS: The CPES questionnaire comprises 63 closed questions measuring 8 areas that relate to experience of care and 3 free-text questions. Questionnaires were mailed to all adult patients (aged ≥16 years) in England with cancer admitted to hospital between 1 September 2013 and 30 November 2013. RESULTS: Matched analysis of closed response items from 2992 patients found significant differences between CUP (n=1496) and non-CUP patients (n=1496): CUP patients were more likely to want more written information about their type of cancer and tests received, to receive their diagnosis from a general practitioner (GP) and have seen allied health professionals, but less likely to have understood explanations of their condition or had surgery. Freetext responses (n=3055) were coded into 17 categories and provided deeper insight regarding patient information and interactions with GPs. CPES data may include a preponderance of patients with favourable CUP subtypes and patients initially identified as CUP but whose primary was subsequently identified. CONCLUSIONS: These are the first large-scale studies to explore the experiences of care of CUP patients. The significant differences identified between the experiences of CUP and non-CUP patients suggest CUP patients require more psychosocial support and specific interventions to manage diagnostic uncertainty and the multiple investigations many CUP patients face. Substantial limitations were identified with the CPES data, emphasising the need for prospective studies

The ongoing effects of the COVID-19 pandemic on perceived physical activity, physical function and mood of older adults in the U.K:A follow-up study (March 2020-June 2021)

Coronavirus (COVID-19) and its variants, continue to spread globally more than two years after the discovery of the wild-type virus in Wuhan, China. Following the onset of COVID-19, fluctuating restrictions have likely impacted the daily lives of older adults living in the United Kingdom (UK). Subsequently, the longer term effects of COVID-19 on physical activity levels, perceived physical function and mood of older adults are unclear. Therefore, the present study aimed to follow a group of older adult's living in the UK for one year, to monitor physical activity levels, perceived physical function and mood. A longitudinal, mixed-methods, observational study was conducted using self-administered, online surveys at 3-month intervals between March 2020 and June 2021. A total of 100 participants (46 males [age: 76 ± 5 years] and 54 females [age:74 ± 4 years]) completed all surveys. Bayesian analysis allowed calculation of direct probabilities whilst incorporating our prior knowledge. Throughout this period, older adults maintained or increased their pre-lockdown physical activity levels despite a decrease in intensity of effort of physical activity tasks, whilst sitting time increased at two of the follow-up time-points. Furthermore, perceived physical function decreased (ps = 91.78%;>1.21 AU) and mood undu�lated in a pattern that reflected the tightening and easing of restrictions. Despite total physical activity being maintained, perceived physical function decreased by a small but clinically meaningful margin