bluuebunny/crossref_metadata_2025 huggingface dataset:
Urban heritages: How history and housing finance matter to housing form and homeownership rates
Authors: Blackwell Timothy , Kohl Sebastian
Published: March 2018

Contemporary Western cities are not uniform, but display a variety of different housing forms and tenures, both between and within countries. We distinguish three general city types in this paper: low-rise, single-family dwelling cities where owner-occupation is the most prevalent tenure form; multi-dwelling building cities where tenants comprise the majority; and multi-dwelling building cities where owner-occupation is the principal tenure form. We argue that historical developments beginning in the 19th century are crucial to understanding this diversity in urban form and tenure composition across Western cities. Our path-dependent argument is twofold. First, we claim that different housing finance institutions engendered different forms of urban development during the late 19th century and had helped to establish the difference between single-family dwelling cities and multi-dwelling building cities by 1914. Second, rather than stemming from countries’ welfare systems or ‘variety of capitalism’, we argue that these historical distinctions have a significant and enduring impact on today’s urban housing forms and tenures. Our argument is supported by a unique collection of data of 1095 historical cities across 27 countries.
Pentagon Ju-Jitsu – reshaping the field of propaganda
Authors: Briant Emma L.
Published: March 2018

This article presents qualitative research examining adaptation to global asymmetric threats and a modern media environment of US Government propaganda systems by planners following 9-11, which proceeded largely unhindered by public debate. It draws on interviews with US elite sources including foreign policy, defense and intelligence personnel and documentary sources to explore how dissent was contained. A ‘merging’ of Psychological Operations and Public Affairs has been identified as a point of concern elsewhere and is argued to have facilitated the extension of US hegemony. It will present an account of the struggles between 2005 and 2009 when planners sought to alter ‘foreign’ and ‘domestic’ audience targeting norms that emerged in an old-media system of sovereign states with more stable populations. It focuses on a key example of transformation: the pressing through of internet policy changes for military Psychological Operations and Public Affairs, against resistance. Policies were brought in to coordinate and overcome discordance in foreign-domestic messaging by Psychological Operations and Information Operations personnel. Viewed as operational necessity for Psychological Operations, these resulted in a ‘terf war’ with Public Affairs who constructed a defense using discourses of legitimacy and credibility with domestic audiences. This article will show how concerns raised by Public Affairs were met by the reduction of their planning role, until a culture change and new orthodoxy emerged. Challenges raised by evolving media demand a reappraisal of propaganda governance and governments must allow greater transparency for public debate, legal judgement and independent academic enquiry to occur.
Feasibility study of a turbocharger rotor supported by air foil bearings with diameter of 17 mm focusing on rotordynamic performance
Authors: Yan Jiajia , Liu Zhansheng , Zhang Guanghui , Yu Xiangyu , Xu Liang
Published: March 2018

This paper presents the feasibility study of an oil-free turbocharger with journal bearing diameter of 17 mm. Rotordynamic performance of a turbocharger rotor, supported by two identical bump-type foil journal bearings and a pair of foil thrust bearings, is predicted and tested. High-pressure cold nitrogen is adopted to drive the turbocharger rotor. In rotordynamic analysis, the critical speeds and logarithmic decrement of the turbocharger rotor are predicted by employing the finite element method, in which the stiffness and damping coefficients of foil journal bearings and aerodynamic cross-coupled stiffness of the turbine are taken into account. Compared with experimental results, the accuracy of the prediction for rotordynamic analysis is verified for 7.82% marginal error of the critical speed. During the experiment, three foil journal bearings with different nominal clearances are manufactured and tested. The maximum stable operating speed reaches 105,000 r/min for this 17-mm-diameter oil-free turbocharger rotor system. Test results indicate the nominal clearance has a negative influence on threshold speed of sub-synchronous motions. When the nominal clearance is relatively small, the foil journal bearing could not lift off due to a large starting torque, while sub-synchronous motions would emerge under a large nominal clearance because of the reduced stiffness and damping coefficients of foil journal bearings.
Robust adaptive fractional order proportional integral derivative controller design for uncertain fractional order nonlinear systems using sliding mode control
Authors: Yaghooti Bahram , Salarieh Hassan
Published: March 2018

This article presents a robust adaptive fractional order proportional integral derivative controller for a class of uncertain fractional order nonlinear systems using fractional order sliding mode control. The goal is to achieve closed-loop control system robustness against the system uncertainty and external disturbance. The fractional order proportional integral derivative controller gains are adjustable and will be updated using the gradient method from a proper sliding surface. A supervisory controller is used to guarantee the stability of the closed-loop fractional order proportional integral derivative control system. Finally, fractional order Duffing–Holmes system is used to verify the proposed method.
Organizational Values: Positive, Ambivalent and Negative Interrelations in Work Organizations
Authors: Gibb Stephen , Burns Calvin
Published: March 2018

The espousal of organizational values with an expectation of primarily positive consequences in leadership, employee performance and organizational change has often been recognized as overly simplistic, but giving a more complete and critical account of the interrelations between values and behaviour has proven challenging. This article describes a balanced and integrated positive, ambivalent and negative (PAN) approach. The use of this PAN approach is described in the case of a health care organization. Evidence is given from a survey of 96 staff perceptions of their current organizational values, staff evaluations of their colleagues’ demonstration of the organization’s espoused values and content analysis of 35 ‘memorable moments’ regarding what staff had experienced. Using the PAN framework in this case suggests a picture of staff reporting experiences as 50–30–20, respectively, for the PAN approach. The implications of this framework for leadership, employee performance and organizational change are discussed.
Tunable isolator based on magnetorheological elastomer in coupling shear–squeeze mixed mode
Authors: Leng Dingxin , Wu Tongtong , Liu Guijie , Wang Xiaojie , Sun Lingyu
Published: March 2018

In this article, the systematic design, construction, and testing of a novel tunable isolator based on magnetorheological elastomers in coupling shear–squeeze mixed mode have been studied. The influence of magnetic particle volume fraction on field-induced properties of magnetorheological elastomer isolator is studied, and the performance of vibration mitigation of magnetorheological elastomer isolator is evaluated experimentally. The results show that the frequency-shift property of magnetorheological elastomer isolator is linearly proportional to the magnetic particle volume fraction and applied current, and vibration mitigation capacity of magnetorheological elastomer isolator is remarkably enhanced by increasing the applied current. The design of magnetorheological elastomer isolator in coupling mixed mode may provide a new insight for using magnetorheological elastomers in vibration reduction applications.
The Intergroup Foundations of Policy Influence
Authors: Hinkle Rachael K. , Nelson Michael J.
Published: March 2018

Most decisions about policy adoption require preference aggregation, which makes it difficult to determine how and when an individual can influence policy change. Examining how frequently a judge is cited offers insight into this question. Drawing upon the psychological concept of social identity, we suggest that shared group memberships can account for differences in policy influence. We investigate this possibility using the demographic and professional group memberships of federal circuit court judges and an original dataset of citations among all published search and seizure cases from federal circuit courts from 1990 to 2010. The results indicate that shared professional characteristics do tend to lead to ingroup favoritism in citation decisions while only partial evidence of such a pattern emerges for demographic group memberships. There is evidence of ingroup favoritism among female and minority judges but none for male or white judges. Overall, judges appear to generally have greater influence on judges with shared characteristics. The findings have vital implications for our understanding of the diversification of policy-making institutions.
Opioid Consumption Following Foot and Ankle Surgery
Authors: Merrill Haley M. , Dean Daniel M. , Mottla Jay L. , Neufeld Steven K. , Cuttica Daniel J. , Buchanan Matthew M.
Published: March 2018

Background

Orthopedic surgeons frequently prescribe pain medications during the postoperative period. The efficacy of these medications at alleviating pain after foot/ankle surgery and the quantity of medication required (and conversely, leftover) are unknown.

Methods:

Patients undergoing foot/ankle surgery during a 3-month period who met inclusion criteria were surveyed at their first postoperative visit. Information collected included gender, number of prescribed pills remaining, satisfaction with pain control, and willingness to surrender leftover opioids to a Drug Enforcement Administration (DEA) disposal center. Additional data, including utilization of a perioperative nerve block and type (bony versus nonbony) and anatomic region of procedure, were collected through review of the medical record. All data were analyzed in a retrospective fashion. A total of 171 patients with a mean age of 53.1 ± 15.5 years (range, 18-81 years) were included in the study.

Results:

The mean number of opioids taken was 27.2 ± 17.5 pills (range, 0-70). The mean number of short-acting opioids and long-acting opioids taken was 21.4 ± 14.8 and 9.2 ± 5.0 pills, respectively. Most (73.5%) patients were satisfied with their pain control. Patients who underwent ankle/hindfoot surgery took more long-acting opioids on average than others ( P = .047). There was not a significant difference in opioid usage between bony and nonbony procedures. Of those with leftover opioids, 63% were willing to surrender them to a DEA disposal center. Patients willing to surrender leftover medications had both more short-acting ( P < .001) and long-acting ( P = .015) opioids leftover than those not willing to surrender them.

Conclusion:

Most patients undergoing foot/ankle surgery had opioids leftover at the first postoperative visit, and most were willing to surrender them. We can adequately treat patients’ pain and decrease the number of opioid pills available in the community by decreasing the number of pills prescribed and encouraging disposal of leftovers.

Level of Evidence:

Level IV, retrospective case series.
Infiltration and extravasation in pediatric patients: A prevalence study in a children’s hospital
Authors: Özalp Gerçeker Gülçin , Kahraman Ayşe , Yardimci Figen , Bilsin Elif , Binay Şeyda , Çevik Özdemir Hamide Nur , Karakul Atiye , Zengin Dilek , Ardahan Sevgili Seda , Gümüş Merve , Başbakkal Zümrüt , Akpınar Selma
Published: March 2018

Purpose:

The aim of this study is to determine the prevalence of infiltration and extravasation among children staying in a children’s hospital and the interventions carried out when infiltration or extravasation occurred.

Methods:

A prospective and descriptive research design was used in the study, conducted between September 2015 and February 2016, and determined the prevalence of infiltration and extravasation and their characteristics. The study sample consisted of 297 peripheral catheters in 173 pediatric patients.

Results:

Of 297 peripheral catheters, 50.8% were located on the right and 30.6% were inserted in the dorsal metacarpal vein. Infiltration and extravasation occurred in 2.9% and 2.3% of the patients, respectively. The prevalence of infiltration and extravasation was 5.5 and 4.4 per 1000 patient-days, respectively. The applied interventions after infiltration or extravasation included covering with a gauze dressing or alcohol-soaked cotton, cold application, irrigation with physiological saline, and elevation.

Conclusion:

The infiltration and extravasation prevalence were found to be high, but the interventions to address them were inadequate. Training and implementation strategies should be planned for pediatric nurses to prevent infiltration and extravasation.
The relationship between resilience and quality of life in patients with a drainage enterostomy
Authors: Temprado Albalat María Dolores , García Martínez Pedro , Ballester Arnal Rafa , Collado-Boira Eladio J
Published: March 2018

Impact and adjustment to a drainage enterostomy are measured mainly through health indicators. To investigate the relationship between resilience and adaptation to the placement of a drainage enterostomy. Prospective observational study with a sample of 125 patients (64 men/36 women) with a temporary or permanent drainage enterostomy and a mean age of 66.72 years. High quality of life (mean, 80.5) and resilience (mean, 79.57) scores and a positive relationship between both were found. There seems to be a positive relationship with general quality of life and health-related quality of life. The logistic regression model shows that the main predictor as regards health-related quality of life is resilience.
Support node construction error analysis of a cable-strut tensile structure based on the reliability theory
Authors: Chen Lian-Meng , Hu Dong , Gao Wei-Feng , Dong Shi-Lin , Zhou Yi-Yi , Zhang Fu-Bo
Published: March 2018

A support node construction error sensitivity analysis was conducted, and the allowable value of node error was determined in this study based on the reliability theory and using the ANSYS software. First, the node construction error sensitivity analysis method was proposed based on Latin hypercube sampling, and detailed procedures were described. Then, a method for determining an allowable error value with a reliability index not less than 1.5, an internal force deviation of the cable not greater than 10%, and a normal serviceability limit state was presented. An exemplary tensile structure with different error distribution and error values was employed to verify the proposed method. Finally, a cable-strut tensile structure model with a diameter of 5.0 m was designed and fabricated. The research showed that different directions of the node construction error had different error sensitivities, and that each direction of the node error had different error sensitivities for different elements. The allowable node construction error can be obtained using a linear searching method with a reliability index not less than 1.5, an internal force deviation of the cable not greater than 10%, and a normal serviceability limit state. The theoretical results were generally consistent with the experimental results, which indicated that the proposed error sensitivity analysis method was accurate. Thus, this study has value for both theoretical research and engineering applications.
Determination of critical loads for global buckling of axially loaded pultruded fiber-reinforced polymer members with doubly symmetric cross sections
Authors: Zhan Yang , Wu Gang
Published: March 2018

This article proposes a new closed-form equation to determine the reduction factor for global buckling of concentrically loaded pultruded fiber-reinforced polymer struts based on the Ayrton–Perry formula and observed initial out-of-straightness of pultruded fiber-reinforced polymer members measured by other researchers, which makes the original solution recommended by Eurocode 3 easy to be used to predict the global buckling loads of doubly symmetric pultruded fiber-reinforced polymer members subjected to axial compression. The influence of the geometric imperfections of pultruded fiber-reinforced polymer profiles is considered in this new closed-form equation. Validation of the solution including the parameter of the reduction factor for global buckling of pultruded fiber-reinforced polymer columns is performed by comparison with published experimental evidence. In addition, compared with the five closed-form solutions available in the literature, this solution exhibits higher accuracy in predicting the global buckling capacity of concentrically loaded pultruded fiber-reinforced polymer struts with doubly symmetric cross sections. The solution implemented into the new reduction factor equation for global buckling of pultruded fiber-reinforced polymer members can be conveniently used by structural engineers at the preliminary engineering design stage for accurately assessing the reliability and safety of composite structures under concentric compressive loading.
Cultural values matter
Authors: Kim Soyeon , Mori Izumi , Rahim Abd Rahman Abdul
Published: March 2018

As the economic footprint of developing countries increases, talent management grows in importance for foreign multinational companies in emerging markets. Multinational companies, however, face fierce competition for local talent, and competitive recruiting calls for practical knowledge about the personal traits of job applicants. The present study applies a cross-cultural perspective to this issue, exploring how individually held cultural values influence the attractiveness of Japanese companies in Malaysia. Drawing on similarity-attraction theory and person–organization fit theory, the study quantitatively analyses data from a paper-based survey of 245 prospective jobseekers. The findings indicate that an individual cultural value fit with the foreign company’s country of origin is significant predictors of employer attractiveness. Specifically, the study finds that potential Malaysian jobseekers who are lower in power distance and higher in risk aversion and long-term orientation view Japanese companies as attractive future employers and have higher job-pursuit behavior. Based on this finding, the study discusses theoretical and practical contributions to corporate employment strategies.
High-resolution nerve ultrasound and magnetic resonance neurography as complementary neuroimaging tools for chronic inflammatory demyelinating polyneuropathy
Authors: Pitarokoili Kalliopi , Kronlage Moritz , Bäumer Philip , Schwarz Daniel , Gold Ralf , Bendszus Martin , Yoon Min-Suk
Published: March 2018

Background:

We present a clinical, electrophysiological, sonographical and magnetic resonance neurography (MRN) study examining the complementary role of two neuroimaging methods of the peripheral nervous system for patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Furthermore, we explore the significance of cross-sectional area (CSA) increase through correlations with MRN markers of nerve integrity.

Methods:

A total of 108 nerve segments on the median, ulnar, radial, tibial and fibular nerve, as well as the lumbar and cervical plexus of 18 CIDP patients were examined with high-resonance nerve ultrasound (HRUS) and MRN additionally to the nerve conduction studies.

Results:

We observed a fair degree of correlation of the CSA values for all nerves/nerve segments between the two methods, with a low random error in Bland–Altman analysis (bias = HRUS-CSA − MRN-CSA, −0.61 to −3.26 mm). CSA in HRUS correlated with the nerve T2-weighted (nT2) signal increase as well as with diffusion tensor imaging parameters such as fractional anisotropy, a marker of microstructural integrity. HRUS-CSA of the interscalene brachial plexus correlated significantly with the MRN-CSA and nT2 signal of the L5 and S1 roots of the lumbar plexus.

Conclusions:

HRUS allows for reliable CSA imaging of all peripheral nerves and the cervical plexus, and CSA correlates with markers of nerve integrity. Imaging of proximal segments as well as the estimation of nerve integrity require MRN as a complementary method.
Pembrolizumab and its role in relapsed/refractory classical Hodgkin’s lymphoma: evidence to date and clinical utility
Authors: Shindiapina Polina , Alinari Lapo
Published: March 2018

Immune evasion is a critical mechanism of malignant cell survival, and relies in part on molecular signaling through the programmed cell death 1 (PD-1)/PD-1 ligand (PD-L1) axis that contributes to T cell exhaustion. Immune modulatory therapy with monoclonal antibodies against PD-1 designed to enhance antitumor immune response have shown promise in the treatment of advanced solid tumors and hematologic malignancies. Classical Hodgkin’s lymphoma (cHL), a unique B cell malignancy characterized by an extensive but ineffective immune cell infiltrate surrounding a small number of tumor cells, has shown significant response to anti-PD-1 directed therapy. The anti-PD-1 monoclonal antibodies nivolumab and pembrolizumab have shown similarly remarkable activity in relapsed/refractory cHL and have been approved by the Food and Drug Administration for treatment of this disease. In this article we review the rationale of targeting the PD-1/PD-L1 axis in cHL and the pharmacology of pembrolizumab, and summarize the data on activity and safety profile of this agent in the treatment of relapsed/refractory cHL. We also discuss the potential benefits and pitfalls of using PD-1 blockade in the setting of allogeneic stem-cell transplantation, and summarize ongoing prospective trials of single-agent pembrolizumab and combination strategies as well as future directions.
Psychiatric manifestations in Wilson’s disease: possibilities and difficulties for treatment
Authors: Litwin Tomasz , Dusek Petr , Szafrański Tomasz , Dzieżyc Karolina , Członkowska Anna , Rybakowski Janusz K.
Published: March 2018

Wilson’s disease (WD) is an inherited metabolic disorder related to disturbances of copper metabolism, and predominantly presents with liver and neuropsychiatric symptoms. In most cases it can be successfully treated with anti-copper agents, and both liver function and neuropsychiatric symptoms typically improve. Treatment guidelines for WD include recommendations for anti-copper treatment as well as for the treatment of liver failure symptoms. Recently, recommendations for treatment of the neurological symptoms of WD have also been proposed. Although most WD patients present with psychiatric symptoms at some stage of the disease, currently there are no guidelines for the treatment of the psychiatric manifestations. Treatment of the psychiatric symptoms of WD is often guided by general psychiatric experience, which typically glosses over the specificity of WD, and can result in severe neurological and/or hepatic complications. Here we review and discuss the possible treatments available for the mood disturbances, psychosis, behavioral and cognitive disorders that can occur in WD, as well as their efficacy.
Atypical Left Ventricular Myxoma: Unusual Echocardiographic and Histopathological Features
Authors: Azad Sushil , Dutta Nilanjan , Roy Chowdhuri Kuntal , Ramman Tarun Raina , Chandra Nishit , Radhakrishnan Sitaraman , Iyer Krishna Subramony
Published: March 2018

Cardiac myxomas are the most common primary cardiac tumors and are typically attached to the interatrial septum. Left ventricular myxomas are exceedingly rare and presentation in children is all the more uncommon. We report a case of left ventricular myxoma with very atypical cystic appearance raising an initial suspicion of a hydatid cyst. Subsequently, cardiac magnetic resonance imaging was done, which ruled out the diagnosis of hydatid cyst. Complete surgical excision was done through transaortic and transmitral route. Histopathological examination revealed it to be a cardiac myxoma with vascular proliferation, which on echocardiography had appeared as a polycystic lesion. This is a very unusual histopathological presentation of cardiac myxoma.
Purulent Pericarditis Due to Paronychia in a 16-Month-Old Child: A Nail-Biting Story
Authors: Bansal Neha , Walters Henry L. , Kobayashi Daisuke
Published: March 2018

Purulent pericarditis is a rare infectious disease with significant mortality, even in the modern antibiotic era. The presenting signs can often be subtle and patients can deteriorate rapidly with cardiac tamponade. We report a previously healthy 16-month-old female who developed purulent pericarditis associated with paronychia and sepsis caused by methicillin-sensitive Staphylococcus aureus. In addition to antibiotic treatment, she required emergent pericardiocentesis for cardiac tamponade, followed by two surgical interventions including full median sternotomy incision and partial pericardiectomy. At 4-month follow-up, she did well with no evidence of constrictive pericarditis on echocardiogram.
The Impact of an Aging Population in the Workplace
Authors: White Mercedia Stevenson , Burns Candace , Conlon Helen Acree
Published: March 2018

According to the Centers for Disease Control and Prevention, the number of people 65 years of age or older living in the United States is projected to double by 2030 to 72 million adults, representing 20% of the total U.S. population. Evidence suggests that older Americans are working longer and spending more time on the job than their peers did in previous years. The increased number of older adults working longer is observed not only in the Unites States but also worldwide. There are numerous ramifications associated with the changing demographics and the expanding prevalence of an aging population in the workforce. Dynamics that arise include stereotyping and discrimination, longevity and on-site expert knowledge, variances in workplace behavior, a multigenerational employee pool, chronic disease management, occupational safety, and the application of adaptive strategies to reduce injury occurrences. Occupational health nurses play a pivotal role in implementing best practices for an aging-friendly workplace.
Contours of Cinema Theatres and Bombay City
Authors: Sadhana Paroma
Published: March 2018

Bombay cannot be divorced from Bollywood, its medusa-like industry. While the relationship between the city of Bombay and the cinema it produces has been much talked about, this article seeks to look at the history of single-screen cinema theatres that are testimony to the urban history of Bombay. They are the receptacle in which cinema meets its audience. Within the darkened space of the theatre, a heterogeneous audience meets for a homogenous activity—to consume cinema. On the outside, their façades bear the marks of a city’s growth—be it Art-Deco theatres like Liberty, or warehouse structures like Chandan. Their unique style also becomes a geographical marker for the city’s public to navigate their way—countless bus stops and lanes are named after theatres, and a quick chat with the city’s slightly older residents will reveal how they identify neighbourhoods with theatres. This article traces the history of theatres and entertainment in Bombay (from the 1850s) vis-à-vis the city’s urban history. The contention is that as the city grew upwards from its southern tip, expanding in girth, so did the cinema theatres multiply situating themselves along the south-north running railway lines. Thus, to understand the urban growth of Bombay, a unique lens is exploring the history of cinema theatres. In understanding this, the article will highlight the importance of single-screen cinema theatres, and the reason why their sites and spaces need to be preserved.
Identification of morphologies of gas hydrate distribution based on amplitude variation with angle analysis
Authors: Liu Tao , Liu Xuewei
Published: March 2018

There are two basic distribution morphologies of gas hydrates in nature: pore filling and fracture filling. Identification of gas hydrate morphologies is essential for improved resource evaluation and exploitation. Improper exploitation may cause seafloor instability, lead to atmospheric venting, and exacerbate the greenhouse effect. To identify gas hydrate morphologies, we combine rock-physics modeling and amplitude variation with angle (AVA) analysis to study the theoretical AVA patterns of the bottom simulating reflector (BSR) beneath the pore-filling and fracture-filling gas hydrate bearing sediments (GHBS), respectively. The theoretical results indicate completely different AVA patterns between these two morphologies. The AVA of the BSR beneath the pore-filling GHBS shows a class III anomaly with negative intercept and gradient. However, the AVA of the BSR beneath the fracture-filling GHBS exhibits a class IV anomaly with a negative intercept and positive gradient. In addition, the theoretical AVA intercept and gradient are affected by the fracture orientation, manifesting an anisotropic signature varying with the fracture dip and azimuth. The processed prestack data at well sites 08 and 16 in the northern South China Sea are selected for testing our method. The AVA analysis of the actual BSRs beneath the pore-filling and fracture-filling GHBS at these sites shows class III and IV responses, respectively, in agreement with our theoretical results. The gas hydrate saturations are also estimated by comparing the theoretical AVA with the actual AVA patterns. The estimations at site 08 are close to those estimated from the pore-water freshening.
Implementing National Institute for Health and Care Excellence smoke-free guidance in a secure facility: an evaluation of the prescribing costs in clozapine users
Authors: Noblett Stephen , Beenstock Jane , Noblett James , Ireland Joanne , Ormiston Sarah
Published: March 2018

Aims and method

The increased rates of smoking in people with mental illness is well documented, and establishing smoke-free mental health environments has been emphasised over recent years. This article examines the financial costs of implementing smoke free guidance and assesses the cost associated with patients who were prescribed clozapine and who committed to stopping smoking cigarettes for the duration of the study period.

Results

Patients (38) who were prescribed clozapine were included in the study. A moderate reduction in dose was noted with a moderate reduction in prescribing costs. The total increase in cost for the whole group, however, was £17 624, largely due to the use of nicotine replacement therapy and an increase in the number of clozapine assay tests.

Clinical implications

Further studies on implementing this important policy change are needed. The positive effects must be balanced with increased financial pressure on Mental Health Trusts.

Declarations of interest

None.
Communicating about Mental Illness and Violence: Balancing Stigma and Increased Support for Services
Authors: McGinty Emma E. , Goldman Howard H. , Pescosolido Bernice A. , Barry Colleen L.
Published: March 2018

In the ongoing national policy debate about how to best address serious mental illness (SMI), a major controversy among mental health advocates is whether drawing public attention to an apparent link between SMI and violence, shown to elevate stigma, is the optimal strategy for increasing public support for investing in mental health services or whether nonstigmatizing messages can be equally effective. We conducted a randomized experiment to examine this question. Participants in a nationally representative online panel (N = 1,326) were randomized to a control arm or to read one of three brief narratives about SMI emphasizing violence, systemic barriers to treatment, or successful treatment and recovery. Narratives, or stories about individuals, are a common communication strategy used by policy makers, advocates, and the news media. Study results showed that narratives emphasizing violence or barriers to treatment were equally effective in increasing the public's willingness to pay additional taxes to improve the mental health system (55 percent and 52 percent, vs. 42 percent in the control arm). Only the narrative emphasizing the link between SMI and violence increased stigma. For mental health advocates dedicated to improving the public mental health system, these findings offer an alternative to stigmatizing messages linking mental illness and violence.
Plasma Metabolite Profiles in Response to Chronic Exercise
Authors: BRENNAN ANDREA M. , BENSON MARK , MORNINGSTAR JORDAN , HERZIG MATTHEW , ROBBINS JEREMY , GERSZTEN ROBERT E. , ROSS ROBERT
Published: March 2018

Purpose

High-throughput profiling of metabolic status (metabolomics) allows for the assessment of small-molecule metabolites that may participate in exercise-induced biochemical pathways and corresponding cardiometabolic risk modification. We sought to describe the changes in a diverse set of plasma metabolite profiles in patients undergoing chronic exercise training and assess the relationship between metabolites and cardiometabolic response to exercise.

Methods

A secondary analysis was performed in 216 middle-age abdominally obese men and women (mean ± SD, 52.4 ± 8.0 yr) randomized into one of four groups varying in exercise amount and intensity for 6-month duration: high amount high intensity, high amount low intensity, low amount low intensity, and control. One hundred forty-seven metabolites were profiled by liquid chromatography-tandem mass spectrometry.

Results

No significant differences in metabolite changes between specific exercise groups were observed; therefore, subsequent analyses were collapsed across exercise groups. There were no significant differences in metabolite changes between the exercise and control groups after 24 wk at a Bonferroni-adjusted statistical significance (P < 3.0 × 10−4). Seven metabolites changed in the exercise group compared with the control group at P < 0.05. Changes in several metabolites from distinct metabolic pathways were associated with change in cardiometabolic risk traits, and three baseline metabolite levels predicted changes in cardiometabolic risk traits.

Conclusions

Metabolomic profiling revealed no significant plasma metabolite changes between exercise and control after 24 wk at Bonferroni significance. However, we identified circulating biomarkers that were predictive or reflective of improvements in cardiometabolic traits in the exercise group.
Sonography and Magnetic Resonance Imaging Characteristics of Testicular Adrenal Rest Tumors
Authors: Yılmaz Ravza , Şahin Dilek , Aghayev Ayaz , Erol Oğuz Bülent , Poyrazoğlu Şükran , Saka Nurçin , Yekeler Ensar
Published: March 2018

Background: The aim of this study was to describe the gray-scale and color Doppler ultrasonography (US) and magnetic resonance (MR) imaging features of testicular adrenal rest tumors (TART) in patients with congenital adrenal hyperplasia.

Material/Methods: Forty-one patients with congenital adrenal hyperplasia were evaluated by gray-scale and color Doppler ultrasonography. Totally eighteen adrenal rest tumors in 9 patients were diagnosed TART on US and MR imaging. Gray-scale and color Doppler US and MR findings of the patients were documented.

Results: A total of eighteen masses were evaluated in nine patients. The mean age of these patients was 14.3±4.5 (range 10.1–23.3) years. US revealed hypoechoic lesions around the mediastinum testis with hypervascularity dispersing in ten patients and hypovascularity in two patients. In six patients, the lesions were hyperechoic with poor vascularity. Lesions exhibited homogeneous (n=8) and heterogeneous (n=10). Testicular microlithiasis was present in 4 of 9 patients with TART. Doppler ultrasound showed normal testicular vessels passing through the mass which were undisturbed, not displaced and not change in caliber. MRI features were the following: all lesions were hypointense on T2- and hyperintense (n=12) and isointense (n=6) on T1-weighted images. All masses revealed homogeneous contrast enhancement on postcontrast T1-weighted images.

Conclusions: Ultrasonography and MRI are good methods for detecting and monitoring TART. US is the first preferable modality because it is quick and cheap than MRI. Bilateral mostly hypoechoic lesions depicted around the mediastinum testis with no mass effect is highly suggestive for the diagnosis of testicular adrenal rest tissues on ultrasonography. Normal testicular vessels coursing through the lesions undisturbed and not change in caliber is described specific for this kind of tumors.
Application of Intravoxel Incoherent Motion (IVIM) Model for Differentiation Between Metastatic and Non-Metastatic Head and Neck Lymph Nodes
Authors: Hejduk Beata , Bobek-Billewicz Barbara , Rutkowski Tomasz , Hebda Anna , Zawadzka Agata , Jurkowski Marek K.
Published: March 2018

Background: Application of intravoxel incoherent motion (IVIM) model parameters, including: true diffusion (D), pseudodiffusion (D*), and perfusion fraction (Fp), for differentiation between metastatic and non- metastatic head and neck lymph nodes.

Material/Methods: Diffusion-weighted images/apparent diffusion coefficient (DWI/ADC) images of 86 lymph nodes from 31 cancer patients were analyzed. DWI images were obtained with a 1.5T MRI scanner (Magnetom Avanto); b=0,50, 150, 300, 500, 750, 1000, 1200 s/mm2.

Results: In the study group, there were 32 (37%) and 54 (67%) metastatic and non-metastatic lymph nodes, respectively. The mean values of D, D*, and Fp did not differ significantly between metastatic and non-metastatic lymph nodes.

Conclusions: IVIM parameters are not useful for differentiation between metastatic and non-metastatic head and neck lymph nodes.
Magnetic Resonance (MR) Imaging Assessment for Glossopharyngeal Neuralgia: Value of Three-Dimensional T2-Reversed MR Imaging (3D-T2R) in Conjunction with Other Modes of 3D MR Imaging
Authors: Nishihara Masashi , Noguchi Tomoyuki , Kawashima Masatou , Azama Shinya , Matsushima Ken , Irie Hiroyuki
Published: March 2018

Background: To retrospectively examine the usefulness of gray-scale reversal imaging of T2-weighted images (3D-T2R) in conjunction with other modes of 3D MRI for preoperative assessments in patients with glossopharyngeal neuralgia (GPN) due to neurovascular compression.

Material/Methods: Imaging findings on 3D-T2R, constructive interference in steady state (CISS), and MRA were analyzed with reference to operative charts in 10 patients with GPN.

Results: Offending vessels were associated with the posterior inferior cerebellar artery (PICA) in 9 of 10 patients (90%). Eight of the 10 patients (80%) had offending vessels located at the supraolivary fossette. Of those eight patients, six (75%) had a shift of the ipsilateral vertebral artery to the affected side. Five (42%) and seven (48%) contact points were associated with the root entry/exit zone and the peripheral nerve system segment, respectively. In six of nine contact points (67%), 3D-T2R demonstrated the pathomorphological features at the contact points better than CISS.

Conclusions: The offending vessels were mostly associated with posterior inferior cerebellar arteries, were frequently located at the supraolivary fossette, and had attachments at the root entry/exit zone and at the peripheral segment of the glossopharyngeal nerve, which was well demonstrated on 3D-T2R.
Unilateral Primary Adrenal B-Cell Lymphoma Clinically Mimicking Chronic Gastritis
Authors: Altaiar Ahmad , Aslan Ahmet , Gündüz Nesrin , Alimoğlu Orhan , Ayaz Ercan
Published: March 2018

Background: Primary adrenal lymphomas are a very rare type of extranodal lymphoma, and they usually are found bilaterally. Symptoms of the disease are variable and depend on the type of lymphoma and/ or presence of adrenal insufficiency. Magnetic resonance imaging is the best radiologic modality for differentiating lymphomas from other adrenal malignancies; however, histopathology is considered as the gold standard method for diagnosing extranodal lymphomas.

Case Report: We present a case of unilateral adrenal lymphoma that was initially diagnosed as an infectious disease and chronic gastritis, based on clinical and laboratory findings. Ultrasonography detected an adrenal mass, and magnetic resonance imaging excluded common lesions of the adrenal gland and showed lymphadenopathy around the major vessels of the abdomen. A percutaneous biopsy of the mass and bone marrow biopsy confirmed the diagnosis of primary adrenal lymphoma without bone marrow metastasis.

Conclusions: Extranodal lymphomas can occur in almost every organ, and if nonspecific clinical findings are combined with the presence of a solid organ mass, lymphoma should be included in the differential diagnosis.
Magnetic Resonance Imaging (MRI) of Snapping Scapula in a 10-Year-Old Boy
Authors: Gunes Altan , Fırat Tuzun , Uzumcugil Akın , Aydingoz Ustun
Published: March 2018

Background:  Snapping scapula syndrome, also known as scapulothoracic crepitus or bursitis, is a manifestation of a mechanical abnormality of the scapulothoracic joint. In addition to characteristic findings on physical examination, magnetic resonance imaging (MRI) exquisitely reveals soft tissue changes such as muscle edema and scapulothoracic bursitis.

Case Report: We present a case of a 10-year-old boy who had snapping scapula syndrome of the right scapula that was associated with edema of the serratus anterior muscle at the scapulothoracic interface and with scapulothoracic, specifically supraserratus, bursitis on MRI.

Conclusions: MRI in snapping scapula syndrome, which is a clinical diagnosis, exquisitely reveals soft tissue changes such as muscle edema and scapulothoracic bursitis. Such soft tissue findings of snapping scapula syndrome need to be kept in mind while evaluating routine shoulder and/or scapular region MRI, especially in the absence of relevant clinical information at the time of the imaging study.
Assessment of the Pancreas with Strain Elastography in Healthy Children: Correlates and Clinical Implications
Authors: Öztürk Mehmet , Citil Serdal , Menzilcioglu Mehmet Sait
Published: March 2018

Background: To determine strain index (SI) values at various locations in the pancreas and to investigate the relationship between age, gender, body weight, height, body mass index (BMI), and elasticity values of the pancreas in healthy children.

Material/Methods: This cross-sectional trial was performed in 147 healthy children who underwent transabdominal ultrasonography for strain elastography of the pancreas. A convex, 3.5–5-MHz probe was used to obtain the images. Baseline descriptive data including age (months), body weight (kg), height (cm), and BMI (kg/m2) were noted. Strain index values were calculated for the head, body, and tail of the pancreas, and a mean value was obtained. The relationship between demographic variables and SI values was assessed. Correlation between variables with normal distribution was evaluated with Pearson’s correlation coefficient and Spearman’s rho.

Results: The average SI values in girls and boys were 1.30±0.34 and 1.32±0.22, respectively. There was no significant difference between SI values measured in the head, trunk, and tail of the pancreas (p=0.594). The average SI value did not differ between girls and boys (p=0.751). Correlation analysis revealed that SI was positively associated with age (p=0.005), body weight (p=0.004), height (p=0.003), and BMI (p=0.005).

Conclusions: This study determined normal elasticity values of the pancreas in healthy children. SI values of pancreas change with age, body weight, height, and BMI in the pediatric population. Information obtained from healthy children can serve as a baseline against which pancreatic diseases can be examined.
Evaluation of Imaging Parameters of Ultrasound Scanners: Baseline for Future Testing
Authors: Fabiszewska Ewa , Pasicz Katarzyna , Grabska Iwona , Skrzyński Witold , Ślusarczyk-Kacprzyk Wioletta , Bulski Wojciech
Published: March 2018

Background: Regular quality control is required in Poland only for those methods of medical imaging which involve the use of ionizing radiation but not for ultrasonography. It is known that the quality of ultrasound images may be affected by the wearing down or malfunctioning of equipment.

Material/Methods: An evaluation of image quality was carried out for 22 ultrasound scanners equipped with 46 transducers. The CIRS Phantom model 040GSE was used. A set of tests was established which could be carried out with the phantom, including: depth of penetration, dead zone, distance measurement accuracy, resolution, uniformity, and visibility of structures.

Results: While the dead zone was 0 mm for 89% of transducers, it was 3 mm for the oldest transducer. The distances measured agreed with the actual distances by 1 mm or less in most cases, with the largest difference of 2.6 mm. The resolution in the axial direction for linear transducers did not exceed 1 mm, but it reached even 5 mm for some of the convex and sector transducers, especially at higher depths and in the lateral direction. For 29% of transducers, some distortions of anechoic structures were observed. Artifacts were detected for several transducers.

Conclusions: The results will serve as a baseline for future testing. Several cases of suboptimal image quality were identified along with differences in performance between similar transducers. The results could be used to decide on the applicability of a given scanner or transducer for a particular kind of examination.
Radiologist as a Leader in the Diagnostic Process in Patients with Prostate Cancer
Authors: Sklinda Katarzyna
Published: March 2018

Multiparametric MRI of the prostate gland is a relatively new diagnostic modality which is gathering a growing interest among urologists and radiologists. The second version of the PI-RADS guidelines enabled standardized imaging, evaluation and reporting of prostatic lesions. Nonetheless, since 2015 – when the PI-RADS v.2 was published, numerous questions regarding imaging of the prostate gland have appeared.
Phylogeny of Zehneria (Cucurbitaceae) with special focus on Asia
Authors: Dwivedi Mayank D. , Barfield Siobhan , Pandey Arun K. , Schaefer Hanno
Published: March 2018

Zehneria is a genus of small creepers and climbers from the Old–World Tropics and Subtropics. In its broadest circumscription, it comprises up to 94 species and its centre of diversity is Southeast Asia. Zehneria has been split into several smaller genera but this remained controversial mainly due to morphological plasticity of the species groups and lack of comprehensive molecular data. Here, we use one nuclear DNA (ITS1–5.8S–ITS2) and three plastid DNA regions (trnL–trnF, rpl20–rps12, matK) sequenced for about half of the species in Zehneria and its segregate genera Anangia, Neoachmandra, and Pilogyne to test the monophyly of the genus and analyse the evolutionary history of the group. We find that Zehneria s.l. is monophyletic and splitting is not supported by molecular, morphological or biogeographical evidence. Within Zehneria, we recover two strongly supported clades, one consisting mainly of species placed in Pilogyne, the other including Anangia, Neoachmandra and the type of Zehneria. Both clades comprise African, Asian, and Australian/Pacific Island species, which is evidence for high dispersal capacity in this young bird–dispersed group. For India, we accept the five species Z. bodinieri, Z. hookeriana, Z. maysorensis, Z. odorata, and Z. thwaitesii. For Myanmar, we increase the number of known species from four to eight, including three still unnamed species. The diversity hotspots for the genus, however, remain Indonesia and Thailand with together 25 species.