Evaluation of the inion and asterion as neurosurgical landmarks for dural venous sinuses: osteological study on a sample of South African skull specimens

BACKGROUND : Sub-Saharan neurosurgeons most likely need to perform invasive procedures without the latest imaging and navigation technology in the operating room. Therefore, these surgeons need to utilize other methods such as superficial surface landmarks for neuro-navigation. Bony landmarks, including the inion and asterion, are commonly used during invasive procedures to pinpoint the location of the confluence of sinuses and transverse-sigmoid sinus junction, respectively. The purpose of this study was to investigate whether the inion and asterion can be used as superficial landmarks for the confluence of sinuses and the transverse-sigmoid sinus junction, respectively, in a South African population. METHODS : Fifty South African human skulls were used (25 male, 25 female). The micro-focus X-ray radiography and tomography facility (MIXRAD) at Necsa scanned and created three-dimensional virtual images of the skull specimens. Reference points were then inserted on the images and the relation between bony landmarks and venous sinuses was documented. RESULTS : The inion was directly related to the confluence of sinuses in 4% of the sample, whereas the asterion was directly related to the transverse-sigmoid sinus junction in 28% of the cases, on both the right and left sides. CONCLUSIONS : This study confirmed that neither the inion, nor the asterion, are directly related the confluence of sinuses and transverse-sigmoid sinus junction, respectively. These bony landmarks are more likely to be located either inferior, or not related at all, to the investigated dural venous sinuses.https://www.minervamedica.it/en/journals/neurosurgical-sciences2022-04-01hj2022Anatom

Research-informed gardening activism: steering the public food and land agenda

Drawing on the authors’ personal experience in the Edible Public Space project (Leeds, UK), this paper explores the “spheres of influence” and contradictions that shaped the project’s trajectory. We identify and analyse the dynamics and contradictions at play in the formation of an urban gardening group grown out of a coming together of scholarly and committed action ambitions and aim to capture learning elements for scholarly activism, political gardening and radical urbanism. We explore the action research intervention with a focus on the role of spatial interventions in fostering social innovation in the public food and land agenda. We structure our discussion in a threefold conceptual framework: (i) a discussion on shifting planning arenas and their understanding in social innovation; (ii) an overview of the role of political gardening practices, in particular of food commons/food sovereignty initiatives, in envisioning and implementing alternative urbanism and (iii) a discussion on the action research nexus, through a thick case study description in which we also unpack our own engagement and positionality. Doing so, we aim to contribute to the creation of an active memory of political gardening. The paper will speak in particular to a rising number of researcher–gardeners–environmentalists, and aims to problematise the links between research-informed strategic thinking and actions, and the vocation of critical urban theory to provide and make visible alternatives for social change

Fish Intake in Pregnancy and Child Growth A Pooled Analysis of 15 European and US Birth Cohorts

IMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. OBJECTIVE To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight and obesity. DESIGN, SETTING, AND PARTICIPANTS Multicenter, population-based birth cohort study of singleton deliveries from 1996 to 2011 in Belgium, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Spain, and Massachusetts. A total of 26 184 pregnant women and their children were followed up at 2-year intervals until the age of 6 years. EXPOSURES Consumption of fish during pregnancy. MAIN OUTCOMES AND MEASURES We estimated offspring body mass index percentile trajectories from 3 months after birth to 6 years of age. We defined rapid infant growth as a weight gain z score greater than 0.67 from birth to 2 years and childhood overweight/obesity at 4 and 6 years as body mass index in the 85th percentile or higher for age and sex. We calculated cohort-specific effect estimates and combined them by random-effects meta-analysis. RESULTS This multicenter, population-based birth cohort study included the 26 184 pregnant women and their children. The median fish intake during pregnancy ranged from 0.5 times/week in Belgium to 4.45 times/week in Spain. Women who ate fish more than 3 times/week during pregnancy gave birth to offspring with higher body mass index values from infancy through middle childhood compared with women with lower fish intake (3 times/week or less). High fish intake during pregnancy (>3 times/week) was associated with increased risk of rapid infant growth, with an adjusted odds ratio (aOR) of 1.22 (95% CI, 1.05-1.42) and increased risk of offspring overweight/obesity at 4 years (aOR, 1.14 [95% CI, 0.99-1.32]) and 6 years (aOR, 1.22 [95% CI, 1.01-1.47]) compared with an intake of once per week or less. Interaction analysis showed that the effect of high fish intake during pregnancy on rapid infant growth was greater among girls (aOR, 1.31 [95% CI, 1.08-1.59]) than among boys (aOR, 1.11 [95% CI, 0.92-1.34]; P = .02 for interaction). CONCLUSIONS AND RELEVANCE High maternal fish intake during pregnancy was associated with increased risk of rapid growth in infancy and childhood obesity. Our findings are in line with the fish intake limit proposed by the US Food and Drug Administration and Environmental Protection Agency

Fish intake in pregnancy and child growth: A pooled analysis of 15 European and US birth cohorts

IMPORTANCE Maternal fish intake in pregnancy has been shown to influence fetal growth. The extent to which fish intake affects childhood growth and obesity remains unclear. OBJECTIVE To examine whether fish intake in pregnancy is associated with offspring growth and the risk of childhood overweight and obesity. DESIGN, SETTING, AND PARTICIPANTS Multicenter, population-based birth cohort study of singleton deliveries from 1996 to 2011 in Belgium, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Spain, and Massachusetts. A total of 26 184 pregnant women and their children were followed up at 2-year intervals until the age of 6 years. EXPOSURES Consumption of fish during pregnancy. MAIN OUTCOMES AND MEASURES We estimated offspring body mass index percentile trajectories from 3 months after birth to 6 years of age.We defined rapid infant growth as a weight gain z score greater than 0.67 from birth to 2 years and childhood overweight/obesity at 4 and 6 years as body mass index in the 85th percentile or higher for age and sex.We calculated cohort-specific effect estimates and combined them by random-effects meta-analysis. RESULTS This multicenter, population-based birth cohort study included the 26 184 pregnant women and their children. The median fish intake during pregnancy ranged from 0.5 times/week in Belgium to 4.45 times/week in Spain.Women who ate fish more than 3 times/week during pregnancy gave birth to offspring with higher body mass index values from infancy through middle chil

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used