Adolescent Boys are at Risk for Body Image Dissatisfaction and Muscle Dysmorphia

Background and Purpose: Muscle Dysmorphia (MD) is characterized by extreme body dissatisfaction and a drive for muscularity that leads to compulsive behaviors to attain an ideal body shape. The primary purpose of this study was to assess the level of body image dissatisfaction (BID) among male adolescents (N = 149, mean age = 15.01 + 1.85 y and mean BMI = 23.26 + 5.01 kg/m2 ) and whether or not BID was correlated with behaviors associated with MD. A secondary purpose was to examine if a difference exists between athletes and non-athletes. Methods: The Eating Attitude Survey (EAS) was used to assess attitudes toward body weight and shape while the Muscle Dysmorphia Inventory (MDI) was used to assess the behavioral and psychological characteristics of MD. Results: This sample of male adolescents indicate some level of BID, which is also associated with overall higher scores for all subscales of the MDI, but especially the subscales relating to muscularity. Athletes in particular showed higher levels of BID and higher scores on the MDI. Conclusion: Individuals who work with adolescent boys should be aware that they can develop body dissatisfaction and may participate in compensatory behaviors that may be harmful to their overall health and development

Bíborsügérek (Hemichromis guttatus Günther, 1862) a Hévízi-tó termálvizében = Jewel cichlids (Hemichromis guttatus Günther, 1862) in thermal water of Lake Hévíz (Western Hungary)

Abstract—We contend that repeatability of execution times is crucial to the validity of testing of real-time systems. However, computer architecture designs fail to deliver repeatable timing, a consequence of aggressive techniques that improve averagecase performance. This paper introduces the Precision-Timed ARM (PTARM), a precision-timed (PRET) microarchitecture implementation that exhibits repeatable execution times without sacrificing performance. The PTARM employs a repeatable thread-interleaved pipeline with an exposed memory hierarchy, including a repeatable DRAM controller. Our benchmarks show an improved throughput compared to a single-threaded in-order five-stage pipeline, given sufficient parallelism in the software. I

New role of ventricular assist devices as bridge to transplantation: European perspective.

PURPOSE OF REVIEW Progress of ventricular assist devices (VAD) technology led to improved survival and apparently low morbidity. However, from the European perspective, updated analysis of EUROMACS reveals a somewhat less impressive picture with respect to mortality and morbidity. RECENT FINDINGS We describe the great demand of cardiac allografts versus the lack of donors, which is larger in Europe than in the United States. Technical progress of VADs made it possible to work out a modern algorithm of bridge-to-transplant, which is tailored to the need of the particular patient. We analyze the burden of patients undergoing bridge-to-transplant therapy. They are condemned to an intermediate step, coupled with additional major surgery and potential adverse events during heart transplantation. SUMMARY Based on current registry data, we do have to question the increasingly popular opinion, that the concept of heart transplantation is futureless, which seems to be for someone who treats and compares both patients (VAD and heart transplantation) in daily practice, questionable. Up to now, left ventricular assist device therapy remains a bridge to a better future, which means a bridge to technical innovations or to overcome the dramatic lack of donors in Europe

Valve-in-valve TAVI and risk of coronary obstruction: Validation of the VIVID classification.

BACKGROUND The Valve-in-Valve International Data (VIVID) registry proposed a simplified classification to assess the risk of coronary obstruction during valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) based on preprocedural multi-detector computed tomography (MDCT). We investigated the validity of the VIVID classification in patients undergoing ViV-TAVI for degenerated bioprostheses. METHODS Patients undergoing ViV-TAVI for degenerated bioprostheses were prospectively included in this study. The risk of coronary obstruction among patients treated with stented valves was retrospectively evaluated based on anatomical assessment on pre-procedural MDCT. RESULTS Among a total of 137 patients that underwent ViV-TAVI between August 2007 and June 2021, 109 patients had stented, sutureless, or transcatheter degenerated bioprosthesis of which 96 (88%) had adequate MDCT data for risk assessment. High-risk anatomy for coronary obstruction (VIVID type IIB, IIIB, or IIIC) in either the left or right coronary artery was observed in 30 patients (31.3%). Of the 30 patients with high-risk anatomy, coronary protection using wire protection or BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) was performed in 3 patients (10.0%). Three patients treated with stentless valves and one patient treated with a stented valve with externally mounted leaflets had coronary obstruction. None of the patients with high risk anatomy according to MDCT had coronary obstruction even without coronary protection. CONCLUSIONS Coronary obstruction occurred in none of the patients classified as high-risk patients according to the VIVID classification despite the absence of coronary protection. Refined tools are required to assess the risk of coronary obstruction. CLINICAL TRIAL REGISTRATION https://www. CLINICALTRIALS gov. NCT01368250

What makes the difference between the natural course of a remaining type B dissection after type A repair and a primary type B aortic dissection?†

OBJECTIVES To analyse the outcome and need for intervention [surgery or thoracic endovascular aortic repair (TEVAR)] in patients after surgery for remaining type B dissection after type A repair and primary type B aortic dissection. METHODS Within a 10-year period, 247 patients with remaining type B after type A, and 112 patients with primary type B aortic dissection were analysed. We assessed the clinical outcome as well as the need for intervention (surgery or TEVAR) within the aortic arch and the thoracoabdominal aorta as well as risk factors. RESULTS The median follow-up was 23 months (interquartile range 5-52). There was a significant difference with regard to the status of the primary entry tear between patients after surgical repair of an acute type A aortic dissection and primary acute type B aortic dissection (patent vs. non-patent entry 35 vs. 83%, P<0.001). The overall need for any kind of intervention (surgery or TEVAR) was 19%. Multivariate Cox regression analysis revealed a patent primary entry tear in patients after surgery for acute type A aortic dissection as an independent predictor for intervention (surgery or TEVAR) during follow-up [odds ratio (OR) 6.4; confidence interval (CI) 1.39-29.81, P=0.017]. Multivariate Cox regression analysis did not reveal a patent primary entry tear in patients after acute type B aortic dissection as an independent predictor for intervention (surgery or TEVAR) during follow-up (OR 0.67; CI 0.27-1.69, P=0.671). Finally, the thrombosis status of the false lumen was not an independent predictor for intervention (surgery or TEVAR) either in patients after surgery for acute type A aortic dissection (OR 3.46; CI 0.79-15.16, P=0.100) or in patients after acute type B aortic dissection (OR 0.77; CI 0.31-1.93, P=0.580). CONCLUSIONS A remaining type B dissection after type A repair and a primary type B aortic dissection represent two distinct pathophysiological entities with regard to late outcome. The need for any kind of intervention in the thoracoabdominal aorta is significantly higher in primary type B aortic dissections. A remaining patent primary entry tear independently predicts the need for intervention (surgery or TEVAR) in patients after surgery for acute type A aortic dissection and, thereby, remains the main target of initial therapy. The thrombosis status of the false lumen seems to be of secondary importanc

Antegrade cerebral protection in thoracic aortic surgery: lessons from the past decade

Objective: Prolonged deep hypothermic circulatory arrest (DHCA) adversely affects outcome and quality of life in thoracic aortic surgery. Several techniques of antegrade cerebral perfusion are routinely used: bilateral selective antegrade cerebral protection (SACP) by introducing catheters in the innominate and left carotid artery, unilateral perfusion through the right axillary antegrade cerebral perfusion (RAACP) or a combination of right axillary perfusion with an additional catheter in the left carotid artery (RAACCP), resulting also in bilateral perfusion. The aim of the present study was to analyse the impact of the different approaches on the quality of life (QoL). Methods: The data of 292 patients who underwent surgery of the thoracic aorta using DHCA at our hospital between January 2004 and December 2007 have been analysed and a follow-up was performed focussing on QoL, assessed with the Short Form-36 Health Survey Questionnaire (SF-36). Results were analysed according to the type of cerebral perfusion and the duration of DHCA. Results: Patients' characteristics were similar in all groups. Of the total, 3.4% patients underwent DHCA (average 8.3±6.4min) without ACP, 45.9% underwent SACP (average DHCA of 15.6±7.1min), 40.4% had RAACP (average DHCA of 28.1±11.6min) and 9.4% bilateral perfusion (RAACCP) (average DHCA of 43.1±16.7min). The average follow-up was 23.2±15.1 months. QoL was preserved in all groups. For DHCA above 40min, bilateral ACP provides superior midterm QoL than unilateral RAACP (average SF-36 95.1±44.4 vs 87.6±31.3; p=0.072). Conclusions: When midterm QoL is assessed, bilateral SACP provides the best cerebral protection for prolonged DHCA (>40min

Spatting restricts ankle motion more effectively than taping during exercise

Ankle injuries, via plantarflexion (PF) and inversion, are commonplace today. To reduce ankle injuries, restrictive appliances such as taping and bracing have been employed. These appliances, however, have the disadvantage of potentially loosening considerably with mild activity. Spatting—applying tape over the shoe and sock—has been suggested as a viable alternative, yet its efficacy has not been researched widely. We examined the effects of taping or spatting the ankles on 17 men (age = 20.7 ± 2.1 years; height = 185.7 ± 5.7 cm; mass = 93.6 ± 16.2 kg) before, during, and after 60 minutes of exercise involving multi-directional activity. Active range of motion (ROM) for PF and inversion was measured via goniometry for each subject\u27s dominant leg to establish baseline values. ROM was measured after the appliances were applied, then following a five-minute warm-up period, and after each of three, 20-minute exercise periods. The subjects also completed a 5-item, 5-point Likert-type scale survey regarding their perceptions of each ankle appliance with respect to comfort, effectiveness, and protective ability. Separate, two-way ANOVAs with repeated measures were used to assess differences in PF and inversion ROM relative to time. A series of Wilcoxon tests were used to assess the Likert-type scale survey. In comparison to spatting, taping loosened by ~5° for PF at 40 minutes and by ~3° for inversion at 20 minutes (both significant interactions, p \u3c 0.01). Thus indicating that spatting is more restrictive than taping after 20 minutes of exercise. Interestingly, taping was perceived as more comfortable than spatting (Z = 2.03, p = 0.04); nonetheless, the perceived protection along with the perceived ability to move before, during, and after exercise was rated similarly between the appliances (p \u3e 0.05). Despite an advantage of restricting PF and inversion during exercise with spatting, it is not known if the loss of tape-skin contact underscores the potential benefits associated with the neuromuscular reactivity that have been reported with taping. Additional research is needed to clarify this issue