Changing clinical and therapeutic trends in tentorial dural arteriovenous fistulas: a systematic review

BACKGROUND AND PURPOSE: Tentorial dural arteriovenous fistulas are characterized by a high hemorrhagic risk. We evaluated trends in outcomes and management of tentorial dural arteriovenous fistulas and performed a meta-analysis evaluating clinical and angiographic outcomes by treatment technique. MATERIALS AND METHODS: We performed a comprehensive literature search for studies on surgical and endovascular treatment of tentorial dural arteriovenous fistulas. We compared the proportion of patients undergoing endovascular, surgical, and combined endovascular/surgical management; the proportion of patients presenting with ruptured tentorial dural arteriovenous fistulas; and proportion of patients with good neurologic outcome across 3 time periods: 1980-1995, 1996-2005, and 2006-2014. We performed a random-effects meta-analysis, evaluating the rates of occlusion, long-term good neurologic outcome, perioperative morbidity, and resolution of symptoms for the 3 treatment modalities. RESULTS: Twenty-nine studies with 274 patients were included. The proportion of patients treated with surgical treatment alone decreased from 38.7% to 20.4% between 1980-1995 and 2006-2014. The proportion of patients treated with endovascular therapy alone increased from 16.1% to 48.0%. The proportion of patients presenting with ruptured tentorial dural arteriovenous fistulas decreased from 64.4% to 43.6%. The rate of good neurologic outcome increased from 80.7% to 92.9%. Complete occlusion rates were highest for patients receiving multimodality treatment (84.0%; 95% CI, 72.0%-91.0%) and lowest for endovascular treatment (71.0%; 95% CI, 56.0%-83.0%; P < .01). Long-term good neurologic outcome was highest in the endovascular group (89.0%; 95% CI, 80.0%-95.0%) and lowest for the surgical group (73.0%; 95% CI, 51.0%-87.0%; P < .03). CONCLUSIONS: Patients with tentorial dural arteriovenous fistulas are increasingly presenting with unruptured lesions, being treated endovascularly, and experiencing higher rates of good neurologic outcomes. Endovascular treatment was associated with superior neurologic outcomes but lower occlusion rate

Differences Between Two Commonly Measured \u27Suprailiac\u27 Skinfold Sites

Please see the pdf version of the abstract

Nonlinear modelling of the seismic response of masonry structures: Calibration strategies

In this paper, a simple and practitioners-friendly calibration strategy to consistently link target panel-scale mechanical properties (that can be found in national standards) to model material-scale mechanical properties is presented. Simple masonry panel geometries, with various boundary conditions, are utilized to test numerical models and calibrate their mechanical properties. The calibration is successfully conducted through five different numerical models (most of them available in commercial software packages) suitable for nonlinear modelling of masonry structures, using nonlinear static analyses. Firstly, the panel stiffness calibration is performed, focusing the attention to the shear stiffness. Secondly, the panel strength calibration is conducted for several axial load ratios by attempts using as reference the target panel strength deduced by well-known analytical strength criteria. The results in terms of panel strength for the five different models show that this calibration strategy appears effective in obtaining model properties coherent with Italian National Standard and Eurocode. Open issues remain for the calibration of the post-peak response of masonry panels, which still appears highly conventional in the standards

Promoting Awareness about Psychological Consequences of Living in a Community Oppressed by the Mafia: A Group-Analytic Intervention

The effects of the Mafia have been extensively studied from sociological, economic, and historical points of view. However, little research has investigated the influence of the Mafia on individuals and communities in terms of its psychological and social impact. In order to contribute to the advancement of our understanding of the psychological effects of the Mafia on individuals and communities and to promote a participative process of social change, a group analytic intervention was conducted within a Community Based Participatory Research carried out in Corleone, a small Sicilian town with a historically recognized role in the evolution of the Mafia, as well as in the fight against its control. Qualitative findings from the group intervention revealed the development of an awareness process that allowed participants to become aware of their social unconscious anxieties and defenses and to recognize and manage the strong emotional impact related to the Mafia\u2019s presence in their lives. Highlighting how psychological processes can have negative impacts on individual and collective capacity to pursuit transformation and resilience, this article provides important insight on how clinical psychology may operate in socio-cultural contexts to promote the reconstruction of the traumatic social dimensions in the community

Perinatal exposure to 5-metoxytryptamine, behavioural-stress reactivity and functional response of 5-HT1A receptors in the adolescent rat

Serotonin is involved in a wide range of physiological and patho-physiological mechanisms. In particular, 5-HT1A receptors are proposed to mediate stress-adaptation. The aim of this research was to investigate in adolescent rats: first, the consequences of perinatal exposure to 5- metoxytryptamine (5MT), a 5-HT1/5-HT2 serotonergic agonist, on behavioural-stress reactivity in elevated plus maze, open field and forced swim tests; secondly, whether the behavioural effects induced by perinatal exposure to 5MT on open field and forced swim tests were affected by the selective 5-HT1A receptor agonist LY 228729, a compound able to elicit a characteristic set of motor behaviours on these experimental models, and by the co-administration of the selective and silent 5-HT1A antagonist WAY 100635. Results indicate that a single daily injection of 5MT to, pregnant dams from gestational days 12 to 21 (1 mg/kg s.c.), and to the pups from postnatal days 2 to 18 (0.5 mg kg s.c.), induce in the adolescent rat offspring: an increase in the percentage of entries and time spent on the open arms in the elevated plus maze; a reduction in locomotor activity and rearing frequency, and an increase in the time spent on the central areas in the open field test; a decrease in immobility and an increase in swimming in the forced swim test. Acute administration of LY 228729 (1.5 mg/kg s.c.) strongly decreases rearing frequency and increases peripheral activity in the open field test, and decreases immobility and increases swimming in the forced swim test both in perinatally vehicle and 5MT-exposed offspring. Co-administration of WAY 100635 (0.25 mg/kg s.c.) abolishes the effects exerted by LY 228729. These results suggest that, in the adolescent rat, perinatal exposure to 5MT enhances the stress-related adaptive behavioural responses, presumably through a predominant action on presynaptic 5-HT1A receptors and does not deteriorate the functional response of 5-HT1A receptors to selective agonist and antagonist compounds

Study of a Semi Active Electromagnetic Regenerative Suspension

The main objective of this work is the theoretical and numerical study of a device that allows recovering energy from an automobile suspension. In place of the viscous damper, which dissipates the kinetic energy of the vehicle due to rough roads or more marked obstacles, an electromagnetic damper performs the functions of the viscous shock absorber with a recovery of electric energy. The damper has permanent magnets and its working is based on the electromagnetic induction. The used ferromagnetic material is the Supermendur, which has very good ferromagnetic properties, but is expensive and difficult to found, so that the choice of different material is useful to reduce the costs. The mathematical model describes the operation of the damper, restoring the values of the electrical and mechanical magnitudes versus the relative speed between the stem and the stator. Several finite element analyses, conducted in ANSYS Workbench Magnetostatic, confirm both the magnetic field and flux values obtained through the theoretical analysis. A calculation example of the energy recovery is done considering an electric minicar transiting on a bumpy road (IRI=3); the recovered power has a total value of 280W about; at last a comparison with similar devices proves the excellent quality of the design also if the comparison should be done with uniformity of the parameters

Manipulation of the DA signal on the onset of relapse of ACD

It's widely known that all addictive drugs show analogous pathological behaviours consisting in compulsive drug seeking,loss of self –control and propensity to relapse. This evidence is suggestive of a common brain mechanism involving the Ventral Tegmental Area and Nucleus Accumbens whereby mesocorticolimbimc dopamine pathway. Dfferent and apparently anthitetic classes of drugs of abuse manage to increase DA release, in the aforementioned areas (Di Chiara, 1988; 1995). Reductions in activity of the mesolimbic dopamine system in the nucleus accumbes occur during drug withdrawal in animal studies (Weiss F et al. 1992; 1996). Experimental evidences have proven D2 receptor involvement in drug seeking and reinstatement behaviours. In that, according to the hypo-dopaminergic hypothesis of drug abuse, striatal D2-receptors significantly decrease during forced abstinence (Thanos, 2008). These premises suggest that D2 receptor manipulations might represent a valid strategy for alcohol dependence. Ropinirole, a D2-D3 receptors agonist, apparently acting on post-synaptical terminal and thus previously administered in methamphetamine withdrawal (Hoefer, 2006), could reduce drug intake in the reinstatement by means of its presumable properties in compensating DA reduction during abstinence. Acetaldehyde, alcohol first metabolite, is able to induce and maintain an operantdrinking behaviour, because of its addictive properties (Cacace, 2012). This research pointed at evaluating Ropinirole protective effect on ACD relapse as a possible therapeutic tool, together with a dose-response investigation. Rats were trained to self-administer ACD 3,2% solution along 30 days. Then, animals underwent three cycles, each one consisting of withdrawal (7days) followed by relapse phase (5 days). The first withdrawal-relapse cycle provided basal information of animal responses for ACD. During the second withdrawal phase, rats were treated i.p. daily with Ropinirole under the dosage of 0.03mg/kg. A third cycle of withdrawal and relapse was performed so as to correlate the drug potency to a higher dosage of 0.05mg/kg. Preliminary data convey that the aforementioned DA agonist is able to reduce animal responses for ACD also at the latter dosage, which is proved by a lower frequency of lever presses during the third relapse phase. An open field test was used to exclude a not specific Ropinirole effect on reducing locomotor activity and to assess dopaminergic activation by measuring the number of episodes of stereotypes, such as grooming and rearing. Our results indicated that this DA agonist, administered during withdrawal phase, is able to limit ACD reinstatement with responses dose-related. Such studies may be implemented in order to assess Ropinirole efficacy in other drug addictions, starting with alcoholism investigation

Design of an Electromagnetic Regenerative Damper and Energy Harvesting Assessment

Design of an electromagnetic regenerative shock absorber is proposed in this paper. In order to increase the efficiency of land vehicles the sources of energy losses have to be eliminated, or reduced. For this reason, several systems, recovering kinetic energy and converting it into electrical power, were studied and designed in the last years. This energy, converted into heat in traditional systems, is recovered to increase the autonomy of the vehicle. The proposed device is constituted by a stator part which coils are placed in an innovative disposition. The moving part is constituted by a rod made in stainless steel with alternated permanent magnets and spacers, so that the relative motion generates a great variation of the concatenated magnetic flux on the coils. A damper mathematical model is implementedin order to characterize the device operating. Several finite element analyses, conducted in ANSYS Workbench Magnetostatic, have confirmed the magnetic field and flux values obtained through the theoretical analysis

Serotonergic modulation of rat pineal gland activity: In vivo evidence for a 5-hydroxytryptamine(2c) receptor involvement

There are some suggestions that, in the pineal gland, serotonin acts not only as a precursor of melatonin but also plays a role in the modulation of the pineal biosynthetic activity. To corroborate this possible neuromodulatory role of 5-hydroxytryptamine (serotonin) (5-HT) on the pineal gland, the effects of two 5-HT2 receptor agonists meta-chlorophenylpiperazine (m-CPP) and 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane were assessed in vivo on pineal N-acetyltransferase (NAT) activity and melatonin content in rats. m-CPP potentiated the enhancement of NAT activity and pineal melatonin content induced by isoproterenol administration during daytime, whereas it did not affect the diurnal basal biosynthetic activity of the gland. At night, m-CPP and 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane enhanced significantly the physiological increases in both pineal NAT activity and melatonin content. This enhancement was prevented by pretreatment with N-(1-methyl-5-indolyl)-N'-(3-pyridyl) urea hydrochloride, an antagonist with higher affinity for 5-HT(2B/C) than for 5-HT(2A) receptor, as well as by pretreatment with 8-[5-(2,4-dimethoxy-5-(4-trifluoromethyl-phenylsulphonamido)-phenyl-5-oxopent hyl]-1,3,8-triazospiro[4,5]decane-2,4-dione, the most specific 5-HT(2C) receptor now available, but not by pretreatment with ketanserin, an antagonist with higher affinity for 5-HT(2A) than for 5-HT(2C) receptor. These results suggest that 5-HT(2C) receptors are likely involved in the mediation of the serotonergic modulation of pineal biosynthetic activity in rats