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Introduction: Intracranial aneurysm (IA) rupture accounts for 3% of strokes and is associated with a concerning mortality rate. Subarachnoid hemorrhage with cerebral hematoma (CSAH) often results in a higher mortality rate; however, the optimal treatment approach remains unclear. This study aims to identify factors predicting poor outcomes and mortality in cases of CSAH due to ruptured aneurysms in the anterior cerebral circulation., Methods: This study retrospectively included 102 patients with anterior circulation aneurysm ruptures, treated between 2017 and 2019. A multidisciplinary team determined the treatment strategies. Statistical analyses were performed to assess outcomes., Results: In the bivariate analysis of CSAH related to anterior circulation aneurysm rupture, significant factors associated with morbidity (mRS >2 at one year follow-up) and mortality were: WFNS score severity, mydriasis, Tako-Tsubo, and the presence of hydrocephalus. In the multivariate analysis, significant factors for mortality were hydrocephalus (p < 0.01) and Tako-Tsubo (p < 0.001), while significant factors for morbidity were hydrocephalus (p < 0.01) and hematoma volume (p = 0.012)., Conclusion: Our study analyzed a series of cases involving CSAH from anterior circulation aneurysms. We emphasize the importance of prompt treatment for hydrocephalus and suggest that the diagnosis of Tako-Tsubo should delay but not prevent treatment. Depending on local ethical standards, treatment abstention could be considered in patients with severe WFNS scores, the presence of mydriasis, hematoma >45 mL, and hydrocephalus. Our findings indicate that life-threatening hematomas are best managed surgically, while smaller, non-life-threatening cases may benefit from endovascular treatment, though further randomized trials are needed for validation., Competing Interests: Declaration of competing interest Informed consent was obtained from all individual participants included in the study., (Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

The Bostwick consistometer and the International Dysphagia Diet Standardization Initiative (IDDSI) Flow Test are both proposed methods to measure and categorize thickened liquids for dysphagia management. The objectives were to: (a) compare the Bostwick consistometer reference values used in clinical settings and the IDDSI reference values of thickened liquids suggested for nutrition care plans in the management of dysphagia when measuring commercially available preprepared thickened liquids; (b) explore the relationship between the two methods; (c) assess the interchangeability; (d) document the intra-rater reliability. Preprepared thickened liquids (n = 32) were measured twice with the Bostwick consistometer and 3 times with the IDDSI Flow Test, using a rigorous methodology. A registered dietitian nutritionist and a registered nutrition and dietetic technician performed the measurements. The Pearson's correlation coefficient was calculated to explore the relationship between the two methods. Using a linear regression equation, back-calculations of the IDDSI Flow Test values were done, based on the experimental Bostwick results. Interchangeability was assessed by documenting the level of agreement between the results with a Bland and Altman graphical analysis. Intraclass correlation coefficients calculation and a Bland and Altman graphical analysis were performed to assess reliability. The strong correlation (r = -.93, p < .001) between the IDDSI Flow Test and the Bostwick consistometer measurements suggests that they measure flow rate in a similar manner, but not exactly the same, as confirmed with the Bland and Altman graphical analysis. Thus, they produced results that are not interchangeable. However, both tests show excellent intra-rater reliability (ICC ≥ 0.99) when using a rigorous methodology. PRACTICAL APPLICATIONS: Thickened liquids are used to manage oropharyngeal dysphagia. Clinicians need to provide quality assurance/quality control (QA/QC) support in the selection or production of thickened liquids as well as staff training or patient education regarding these products. Methods and classification have been proposed to measure and categorize thickened liquids for dysphagia management, such as the line spread test, the Bostwick consistometer method, and the IDDSI Flow Test. Although empirical, these methods are more accessible to clinicians than viscometer or rheometer assessments. Clinicians need to understand the limitations of these techniques as neither appear to capture the full extent of consistency for potential beverages available on the market or produced in-house. In this article, we compare the Bostwick consistometer and the IDDSI Flow Test methods and classifications and propose a standard operating procedure in order to maximize the quality of results. We point out the large variations in consistency levels of commercial preprepared thickened liquids in light of the absence of evidence of clinical outcomes associated with either proposed methods or consistency classifications., (© 2018 Wiley Periodicals, Inc.)

Nonvertebral fractures account for 80% of all fractures and their accompanying morbidity and mortality. Despite this, the effect of drug therapy on cortical morphology has received limited attention, partly because cortical bone is believed to remodel less and decrease less with age than trabecular bone. However, the haversian canals traversing the cortex provide a surface for remodeling that produces bone loss, porosity, and cortical fragility. We developed a new method of 3D micro-computed tomography (microCT) to quantify intracortical porosity and the effects of treatment. Women with osteoporosis randomized to risedronate (5 mg/day, n = 28) or placebo (n = 21) had paired transiliac biopsies at baseline and 5 years imaged using 3D microCT. Pores determined from 8 to 12 slices were stratified by their minor axis length into those 25 to 100 microm (closing cone of haversian canals), 100 to 300 microm (cutting cone of haversian canals), and >300 microm (coalescent cavities). Porosity was analyzed as pore area (percent bone area) and pore density (pore number/mm(2)). Medians are reported. Risedronate reduced pore area in the 25 to 100, 100 to 300, and 300 to 500 microm ranges over 5 years (p = .0008, .04, NS, respectively) corresponding to an 18% to 25% reduction. In the placebo group, pore area was unchanged. At 5 years, pore area and pore number/mm(2) in the 25 to 100 microm range were each 17% lower in the risedronate group than in the placebo group (p = .02 and .04, respectively). Risedronate is likely to maintain bone strength and reduce nonvertebral fracture risk in part by reducing remodeling and therefore the number and size of intracortical cavities., (2010 American Society for Bone and Mineral Research)

The author attempts a "Roazenesque" interpretation of Paul Roazen's life and work, and situates his career vis-á-vis that of other revisionist critics of Freud. To these ends, the essay charts the highs and lows of Roazen's long career as a biographer-historian of psychoanalysis. His career is divided into four phases, the first of which is arguably the most important. It was also the most controversial, producing classic books on Victor Tausk and on Freud's followers. Roazen's later work fares less well, even undermining his standing among scholars. If there is a commonality to the work of all four phases, it is Roazen's fairly constant recourse to interviews he conducted in the mid-1960s with many people intimate with Freud. On the good side, these interviews provided him unique access to details about Freud's everyday life and practice. Roazen thus became known as the historian of arcane detail. On the bad side, Roazen came to rely too heavily on these interviews and on his own singular role as interviewer. As a result his work became increasingly self-regarding and nostalgic, and thus less original, interesting, or discerning. His legacy is therefore mixed, although secure enough that future scholars will not easily ignore his contribution in a handful of good books.

The present article addresses the fundamental developmental differences between monolingualism and bilingualism, as outlined in the literature. It takes into account research using qualitative and quantitative methodologies and reviews the advantages and possible disadvantages of bilingualism in preschool children. It then moves on to biliteracies in early childhood education. The questions addressed are: Will the early learning of a second language delay a child's language development? What effect does bilingualism have on the development of phonemic awareness, and does that have an impact on reading development? Do bilingual children have an advantage over monolingual children? What happens when a child with language impairment is called upon to develop two languages? What are some challenges regarding the acquisition of biliteracies? The present article concludes with recommendations for physicians who counsel bilingual families regarding early childhood literacy promotion and development.

Objectives: Dysphagia affects 35% to 60% of the institutionalized elderly population. This study aimed at evaluating the nutrient intake of frail institutionalized elderly persons with dysphagia and to assess the impact of Sainte-Anne's Hospital Advanced Nutritional Care program on dietary intake and weight., Design: A 12-week intervention study., Subjects/setting: Ninety-three individuals residing in a Montreal, Canada, long-term care facility who were aged at least 65 years were evaluated. Seventeen subjects with a body mass index (BMI; calculated as kg/m(2)) <24 or weight loss >7.5% within 3 months and with dysphagia were included., Intervention: The treated group (n=8; aged 82.5+/-4.41 years, weight 55.9+/-12.1 kg, BMI 22.4+/-3.93) received Sainte-Anne's Hospital reshaped minced- or pureed-texture foods with thickened beverages where required. The control group (n=9; aged 84.6+/-3.81 years, weight 54.3+/-7.49 kg, BMI 21.2+/-2.31) maintained traditional nourishment., Main Outcome Measures: Macronutrient and micronutrient intake, weight, and BMI were measured at baseline, 6 weeks, and 12 weeks., Statistics: Student t tests were performed to evaluate change within and between groups., Results: The treatment and control groups were similar at baseline, having a mean age of 82.5+/-4.41 years vs 84.6+/-3.81 years and BMI of 22.4+/-3.93 vs 21.2+/-2.31, respectively. The average weight in the treated group increased compared to the control group (3.90+/-2.30 vs -0.79+/-4.18 kg; P=0.02). Similarly, the treated group presented an increased intake of energy, proteins, fats, total saturated fats, monounsaturated fats, potassium, magnesium, calcium, phosphorus, zinc, vitamin B-2, and vitamin D compared to control subjects (P<0.05)., Conclusion: Institutionalized elderly patients with dysphagia can eat better and increase body weight via a diversified, modified in texture, and appealing oral diet that meets their nutrition needs.

Improved methods for evaluation and quantification of the three-dimensional (3D) architecture of bone are needed in order to more fully understand the role of trabecular architecture in bone strength. Computed tomography (microCT) is capable of examining bone at resolutions below 30 microm (isotropic), with collection of a three-dimensional data set which can then be subjected to image analysis. In this paper, we discuss automated methods for important steps in this analysis, including methods for (1) segmenting the image into bone and background; (2) defining the volume of interest for determination of structural parameters; and (3) segmenting the bone into trabecular and cortical components. Evaluation of bone structure using these techniques provides new information about the 3D architecture of bone tissue, and may be useful for evaluation of structural changes in bone caused by aging, disease, or drug treatment.

This paper rescues Ernest Jones's largely-unknown book, 'The Elements of Figure Skating' (1931/1952), from relative obscurity and argues for its place in the psychoanalytic literature. In the first section, the authors situate Jones's passion for figure skating by turning to various historical and biographical sources, and to personal correspondence with Jones's son, Mervyn Jones. In the second section, they offer the first textual reading of Jones and skating within a psychoanalytic framework. This approach, they argue, is long overdue since Jones explicitly claimed that the 'Elements' was motivated by his interest in the 'psychological' problems of the beginning skater, and with the task of instruction therein. The authors rely heavily on passages from the 'Elements', in part because the book is out-of-print and unavailable to most readers, but also because Jones's own words are an exemplary instance of his intense transference to psychoanalytic theory during his extra-professional time as a skater. They conclude the paper by arguing that Jones ultimately advocates a position beyond psychology when he idealistically embraces 'exact knowledge' as the royal road to masterful skating.