bluuebunny/crossref_metadata_2025 huggingface dataset:
Cavitation transition in the energy landscape: Distinct tensile yielding behavior in strongly and weakly attractive systems
Authors: Altabet Y. Elia , Fenley Andreia L. , Stillinger Frank H. , Debenedetti Pablo G.
Published: March 2018

Particles with cohesive interactions display a tensile instability in the energy landscape at the Sastry density ρS. The signature of this tensile limit is a minimum in the landscape equation of state, the pressure–density relationship of inherent structures sampled along a liquid isotherm. Our previous work [Y. E. Altabet, F. H. Stillinger, and P. G. Debenedetti, J. Chem. Phys. 145, 211905 (2016)] revisited the phenomenology of Sastry behavior and found that the evolution of the landscape equation of state with system size for particles with interactions typical of molecular liquids indicates the presence of an athermal first-order phase transition between homogeneous and fractured inherent structures, the latter containing several large voids. Here, we study how this tensile limit manifests itself for different interparticle cohesive strengths and identify two distinct regimes. Particles with sufficiently strong cohesion display an athermal first-order phase transition, consistent with our prior characterization. Weak cohesion also displays a tensile instability. However, the landscape equation of state for this regime is independent of system size, suggesting the absence of a first-order phase transition. An analysis of the voids suggests that yielding in the energy landscape of weakly cohesive systems is associated with the emergence of a highly interconnected network of small voids. While strongly cohesive systems transition from exclusively homogeneous to exclusively fractured configurations at ρS in the thermodynamic limit, this interconnected network develops gradually, starting at ρS, even at infinite system size.
Magnetic-field-dependent slow light in strontium atom-cavity system
Authors: Liu Zeng-Xing , Wang Bao , Kong Cui , Xiong Hao , Wu Ying
Published: March 2018

Realizing and controlling a long-lived slow light is of fundamental importance in physics and may find applications in quantum router and quantum information processing. In this work, we propose a feasible scheme to realize the slow light in a strontium atom-cavity system, in which the value of group delay can be continuously adjusted within a range of different Zeeman splittings and vacuum Rabi frequencies by varying the applied static magnetic field and the atom number instead of a strong coherent field. In our scheme, the major limitations of the slow-light structure, namely, dispersion and loss, can be effectively resolved, and so our scheme may help to achieve the practical application of slow light relevant to the optical communication network.
Fast and unbiased estimator of the time-dependent Hurst exponent
Authors: Pianese Augusto , Bianchi Sergio , Palazzo Anna Maria
Published: March 2018

We combine two existing estimators of the local Hurst exponent to improve both the goodness of fit and the computational speed of the algorithm. An application with simulated time series is implemented, and a Monte Carlo simulation is performed to provide evidence of the improvement.
Influence of Functional Groups and Modification Sites of Metal-Organic Frameworks on CO2/CH4 Separation: A Monte Carlo Simulation Study
Authors: Gong Jie , Li Wei , Li Song
Published: March 2018

In order to explore the influence of modification sites of functional groups on landfill gas (CO2/CH4) separation performance of metal-organic frameworks (MOFs), six types of organic linkers and three types of functional groups (i.e. -F, -NH2, -CH3) were used to construct 36 MOFs of pcu topology based on copper paddlewheel. Grand canonical Monte Carlo simulations were performed in this work to evaluate the separation performance of MOFs at low (vacuum swing adsorption) and high (pressure swing adsorption) pressures, respectively. Simulation results demonstrated that CO2 working capacity of the unfunctionalized MOFs generally exhibits pore-size dependence at 1 bar, which increases with the decrease in pore sizes. It was also found that -NH2 functionalized MOFs exhibit the highest CO2 uptake due to the enhanced Coulombic interactions between the polar -NH2 groups and the quadrupole moment of CO2 molecules, which is followed by -CH3 and -F functionalized ones. Moreover, positioning the functional groups -NH2 and -CH3 at sites far from the metal node (site b) exhibits more significant enhancement on CO2/CH4 separation performance compared to that adjacent to the metal node (site a).
A Novel Ag3PO4/Ag/Ag2Mo2O7 Nanowire Photocatalyst: Ternary Nanocomposite for Enhanced Photocatalytic Activity
Authors: Li Chun-xue , Li Xiu-ying , Liu Bo , Wang Xiu-yan , Che Guang-bo , Lin Xue
Published: March 2018

Ag3PO4/Ag/Ag2Mo2O7 composite photocatalyst was successfully prepared via an in situ precipitation method. The as-prepared Ag3PO4/Ag/Ag2Mo2O7 nanocomposite included Ag3PO4 nanoparticles (NPs) as well as Ag NPs assembling on the surface of Ag2Mo2O7 nanowires. Under visible light irradiation (λ>420 nm), the Ag3PO4/Ag/Ag2Mo2O7 composite degraded rhodamine B (Rh B) efficiently and showed much higher photocatalytic efficiency than pure Ag3PO4, Ag2Mo2O7, or Ag3PO4/Ag2Mo2O7. It was elucidated that the excellent photocatalytic performance of Ag3PO4/Ag/Ag2Mo2O7 for the degradation of Rh B under visible light could be ascribed to the high specific surface area, the extended absorption in the visible light region resulting from the Ag3PO4/Ag loading, and the efficient separation of photogenerated electrons and holes through the ternary heterostrucure composed of Ag3PO4, Ag and Ag2Mo2O7.
A Novel Initiator Containing Alkyne Group for the Polymerization of 2-Ethyl-2-oxazoline
Authors: Ali Muhammad Waqas , Gao Ya-ting , Siddiq Muhammad , Ye Xiao-dong
Published: March 2018

A novel trifunctional initiator with one alkyne and two trifluoromethanesulfonate moieties was synthesized from a protected alcohol 5-hydroxyl-2-phenyl-1, 3-dioxane. The alkyne functionalized intermediate with two protected alcohol groups was synthesized by reacting with propargyl bromide. The alcohol groups were cleaved using a mixture of tetrahydrofuran and hydrochloric acid aqueous solution. In the last step the initiator was synthesized using triflic anhydride in carbon tetrachloride. The initiator was characterized by 1H NMR and used for the polymerization of 2-ethyl-2-oxazoline which gives polymers with narrow distribution. For comparison a similar initiator with two tosylates was prepared and used for the polymerization of the monomer 2-ethyl-2-oxazoline, the resulting product has a wide molecular weight distribution and most of the initiator remains unreacted after 24 h which may be due to the steric hindrance between the two tosylate groups. To further explore the steric hindrance phenomenon, a linear tosylate initiator was synthesized, but still some of the initiator remains unreacted, illustrating that both steric hindrance and electrophilic balance affect the efficiency of the cationic ring-opening polymerization. All of the polymers were characterized in detail by using 1H NMR, matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy, and size exclusion chromatography to confirm the purity and distribution of the polymers.
Coordination to lanthanide ions distorts binding site conformation in calmodulin
Authors: Edington Sean C. , Gonzalez Andrea , Middendorf Thomas R. , Halling D. Brent , Aldrich Richard W. , Baiz Carlos R.
Published: March 2018

Significance

Calmodulin is essential to life in all eukaryotic cells and serves as a popular model for ion binding and activation in proteins. Calmodulin transduces complex calcium signals and acts on hundreds of effector proteins, but the sensitivity and complexity of this process make it difficult to characterize. Much work uses lanthanides as luminescent calcium substitutes to study ion binding and activation in calmodulin and other proteins. Using ultrafast 2D IR spectroscopy, we show that lanthanide ions perturb the finely tuned structure and dynamics of calmodulin’s binding sites. The temporal and spatial resolution of our measurements opens a new window into the study of protein−ion binding and demonstrates that seemingly innocuous ligand substitutions can significantly alter protein conformation.
Benefactive and malefactive constructions in Taiwan Southern Min
Authors: Lin Huei-Ling
Published: March 2018

This paper aims to investigate bothFagerli’s (2001)proposal that in serializing languages benefactive and malefactive constructions often involve the morpheme denoting ‘give’, andRadetzky & Smith’s (2010)proposal that East and South Asian languages often involve different morphemes or structures in expressing benefaction or malefaction. Checking the proposals against benefactive and malefactive constructions in Taiwan Southern Min (TSM) which involve optional benefactee and malefactee, this paper shows that both proposals find only partial support from TSM data. TSM uses the morpheme denoting ‘give’, i.e.hoo, in the malefactive construction involving optional malefactee, but not the benefactive construction involving optional benefactee, which involves the use ofka. Moreover,kacan also be used for introducing the malefactive. Even though thehoomalefactive construction and thekabenefactive construction have different structures, the constructions involvingka, no matter whether denoting benefaction or malefaction, have the same syntactic structure.
Artist-for-work metonymy
Authors: Weiland-Breckle Hanna , Schumacher Petra B.
Published: March 2018

There is an on-going debate about how the language system handles expressions that may refer to different word senses. Some theories propose derivational operations triggered by a type-mismatch; others assume underspecified lexical representations that engage in sense selection. Previous studies yielded mixed evidence. To further understand the diverse results and to tease apart type conflicts from sense selection, we conducted an ERP study on one type of metonymy using question-answer pairs. We capitalized on the fact that the metonymic relation could be anticipated by awh-word, yielding a type clash between thewh-word and the predicate that cannot be resolved in the question (Whom did she read?vs.What did she read?) – in contrast to the answer (She read Brecht.). These conditions were contrasted with a non-metonymic reading. The results revealed a pronounced N400 at the verb of thewhom-question in contrast to the questions without a type clash, and no reliable differences at the artist’s name in the answer. We therefore argue for an underspecification account for this metonymy-type which is not preceded by the detection of a type conflict. In comparison with other metonymy-types, this substantiates a classification of sense alternations into sense selection and sense creation.
Understanding indigenous knowledge: Its role and potential in fisheries resources management in Malawi
Authors: Donda S. , Manyungwa-Pasani C. L.
Published: March 2018

Fisheries resources have existed on earth for centuries and their management has depended on the knowledge available to those that were, and are, entrusted with management responsibilities. Formal technical and traditional knowledge have formed the basis for the formulation of fisheries management approaches. In the midst of global fisheries crises, such as fish stock over-exploitation and effects of climate change on fisheries, there has been great interest in fostering sustainable fisheries management as a means to improve the capacity of fishing communities to adapt to the changes. However, the approaches to achieve sustainable fisheries management in Malawi have not adequately involved local people who have acquired traditional knowledge through their direct experience with nature. This article reviewed indigenous knowledge used in fisheries management within the wider context of livelihood systems. The purpose of the review was two pronged: first to document the indigenous knowledge used in fisheries management in order to offer insights of its value to biological scientists and fisheries managers; second, to demonstrate the value of indigenous knowledge as a lens through which biological scientists can look when managing fishery resources. It argues that policies that seek to support sustainable fisheries management need to build on a better understanding of the wide range of knowledge systems acquired by the fisher-folk. The article drew from theories of conservation; information was gathered through literature review and direct consultations with fishing communities in Malawi on indigenous knowledge in fisheries.
Rethinking impact evaluation and carbon reduction analysis on electric bus vehicles in China
Authors: Li Zhenyu , Li Chao , Liao Kai , Yin Zhifang
Published: March 2018

New energy bus vehicles (NEBVs) are expanding in China, but they have some problems such as technology, high cost and safety etc., thus NEBVs should be comprehensively evaluated from costs, technologies, environment, and based on the evaluation results, some changes should be improved. This paper firstly analyses the current status of both vehicle development and existing policies, identifies the main characteristics and the main problems in term of the economic, standard, policy, etc., by scenario analysis, forecasts the future growth from now to 2030 and calculates the emission reduction in low level scenario and high level scenario. In 2020 and 2030, 6 million and 24 million ton of CO2 emission will be reduced respectively. Finally, the paper makes a conclusion of Chinese experiences and gives some measures for the future development.
The Peripheral Nervous System
Authors: Fisch Adam J
Published: March 2018

This chapter focuses on learning the origination and components of the peripheral nervous system and how to draw them. Structures addressed include the neuron, glial cells, neuroglia, neurotransmitters, peripheral nerves, muscle tissues, motor units, and skeletal muscle myofibril. The processes of membrane potential, neural signaling, postsynaptic neuronal integration, and histology are also illustrated in detail,.
The Autonomic Nervous System
Authors: Fisch Adam J
Published: March 2018

This chapter provides an overview of the autonomic nervous system and respective instructions for drawing its various components. These include the, parasympathetic nervous system, sympathetic nervous system, lower urinary system, baroreceptor reflex, respiration, and digestive tract. The chapter discusses the various functions of elements of these systems, and it presents conditions and illnesses specifically related to disorders in elements of the autonomic nervous system, such as cardiac rhythm abnormalities (arrhythmias), respiratory failure, gut dysmotility, bladder dysmotility, and skin manifestations, such as hair fiber loss and sweating.
Cranial Neuropathies & Brainstem Syndromes
Authors: Fisch Adam J
Published: March 2018

This chapter addresses the various cranial neuropathies and brainstem syndromes and their respective anatomical components. Included among these disorders are pupillary reflex pathologies, oral-palatal deviations, gag reflex, facial palsy, Bell’s palsy, internuclear ophthalmoplegia, midbrain syndromes, pontine syndromes, and medullary syndromes. Instructions are presented on how to draw the elements of the neuropathies and syndromes, as well as the trigeminal nerve, central pathways, central somatotopic maps, and smooth pursuit eye movements. Finally, case histories of specific disorders are presented along with discussion of the elements involved in making the diagnosis.
The Special Senses: Vision, Audition, & Olfaction
Authors: Fisch Adam J
Published: March 2018

This chapter focuses on learning about the anatomical elements that make up the processes of vision, audition, and olfaction. Instructions are provided on how to draw the eye, aqueous humor, visual pathways, the ear, semicircular canals, and the olfactory system. Also provided are the mechanics of focusing light, optic refraction, light detection, and phototransduction and signs for recognizing retina histology, visual field deficits, and benign paroxysmal positional vertigo (BPPV). Finally, case histories of specific disorders are presented along with discussion of the elements involved in making the diagnosis.
The Diencephalon, Basal Ganglia, & Limbic System
Authors: Fisch Adam J
Published: March 2018

This chapter focuses on learning the anatomy of the diencephalon, basal ganglia, and limbic system. It provides instruction on how to draw the basal ganglia, the thalamus, the hypothalamus, diencephalon, limbic system, hippocampus, Papez circuit, parahippocampal gyrus, intrahippocampal circuitry, olfactory cortex, and basal forebrain. Also addressed is the neurocircuitry of sleep, including the anatomical location of the sleep center, the physiology of the thalamocortical circuits, the pathway for the generation of REM sleep, and the biology of sleep and wakefulness. The chapter concludes with key discoveries in the biology of sleep and wakefulness.
Breast MRI Overview: Imaging Techniques and Equipment, Clinical Uses, Image Interpretation
Authors: Dang Pragya , Lehman Constance D.
Published: March 2018

Contrast-enhanced breast MRI is a highly sensitive modality for early detection and diagnosis of breast cancer, particularly in high-risk populations. It has also been shown to be superior to mammography in establishing the extent of disease in patients with newly diagnosed breast cancer. This chapter, appearing in the section on breast cancer overview, reviews breast MRI imaging technique, clinical uses, gives an overview of image interpretation, and applied physics. Topics discussed include equipment such as hardware, imaging protocols, patient preparation and positioning, and relevant physics. Additionally, clinical situations where the use of breast MRI is appropriate, systematic review of images, and formulation of final assessment and recommendations in accordance with the ACR BI-RADS imaging lexicon are discussed in this chapter.
Breast Cancer Staging and Treatment
Authors: Prati Raquel , Olevsky Olga
Published: March 2018

Breast carcinomas are a heterogeneous group of diseases that can be further characterized based on their histology, biomarkers, and molecular profiles. These characteristics, gathered during disease staging, provide crucial information with regard to treatment decisions. Staging has evolved from informing the operability of breast tumors to providing prognostic information, and consequently helping establish local and systemic treatment guidelines. This chapter provides a succinct overview of breast cancer staging and treatment. Topics covered include the histological classification of breast cancers, as well as classification by tumor size and location, lymph node involvement, and metastatic involvement. The topic of molecular assays for prognostic information is reviewed. Finally, current treatment paradigms, including surgery, radiation, and chemotherapy regimens for different types of breast cancer, are discussed.
Circumscribed Mass: Fibroadenoma
Authors: Kettler Mark D.
Published: March 2018

A fibroadenoma is a benign fibroepithelial breast tumor arising from the terminal duct-lobular unit (TDLU), composed of epithelial and stromal elements. The overwhelming majority of fibroadenomas present as palpable or imaging-detected circumscribed masses showing sharp demarcation between the lesion and the adjacent breast tissue. Fibroadenomas are the most common benign breast tumor occurring in women, with a peak incidence in the third and fourth decades, but they can occur from childhood through the eight decade of life. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key clinical and imaging features, differential diagnosis, and management recommendations for fibroadenomas.
Circumscribed Mass: Invasive Cancer
Authors: Kettler Mark D.
Published: March 2018

Most invasive breast cancers present as focal asymmetries, areas of architectural distortion, or irregular masses with indistinct or spiculated margins. Some present as round or oval masses with circumscribed margins; however, most round or oval masses have microlobulated, indistinct, or spiculated margins and may be associated with characteristic malignant calcifications. This chapter, appearing in the section on circumscribed mass, reviews the key clinical and imaging features, differential diagnosis, and management recommendations for invasive breast cancers, which can present as circumscribed masses on mammography and sonography. Examples include medullary carcinoma, mucinous carcinoma, invasive papillary carcinoma, and high-grade invasive ductal carcinoma. These lesions may present as solid or complex masses with circumscribed margins and may be confused with several benign breast conditions.
Fat-Containing, Circumscribed Mass(es)
Authors: Lam Diana L. , Scheel John R.
Published: March 2018

The majority of fat-containing masses are asymptomatic, but can present as painless, soft, mobile masses. A fat-containing mass within the breast is a benign finding, with the exception of the rare liposarcoma. The differential in non-lactating woman includes a lipoma, hamartoma, lymph node, and fat necrosis. Any atypical presentation of a fat-containing mass (such as thick, nodular septation or capsule, large size >10 cm, a mass that is clinically increasing in size) should raise suspicion for a rare fat-containing tumor such as an atypical lipomatous tumor or well-differentiated liposarcoma. This chapter reviews the key clinical and imaging features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for a fat-containing, circumscribed mass. Topics discussed include lipomas, hamartomas, oil cysts, fat necrosis, and steatocystoma multiplex. Fat-containing lesions in the setting of lactation (galactocoele) as well as intramammary lymph nodes are discussed in separate chapters.
Microlobulated Mass
Authors: Fowler Amy M.
Published: March 2018

According to the fifth edition of the ACR BI-RADS®Atlas, a complete description of masses detected on mammogram and ultrasound requires assessment of the margins using the appropriate lexicon. On mammography, margins of a mass are described as circumscribed, obscured, microlobulated, indistinct, or spiculated. On ultrasound, margins of a mass are described as circumscribed or not circumscribed, which includes angular, microlobulated, indistinct, and spiculated. Thus, microlobulated is a term common to both the mammography and ultrasound BI-RADS® lexicons. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for microlobulated masses.
Obscured Mass
Authors: Elezaby Mai
Published: March 2018

An obscured mass is a mass with greater than 25% of its margin hidden by surrounding fibroglandular tissue on mammography; hence, it cannot be fully assessed. This term is commonly used when the portion of the margin that is visualized is circumscribed and it usually implies a lower likelihood of malignancy. If the portion of the visualized margin is microlobulated, indistinct, or spiculated, then these descriptors (which are more suspicious) should take precedence over the descriptor of an “obscured margin,” and that mass would have a higher likelihood of malignancy. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for an obscured mass.
Mass with Indistinct Margins
Authors: Salkowski Lonie R.
Published: March 2018

Masses described as having indistinct margins lack a clear demarcation of a portion or the entire margin from the surrounding tissues. The indistinctness of the margin raises the possibility of infiltration; therefore, this descriptor implies suspicion for malignancy. “Indistinct” differs from “obscured.” A mass with obscured margins insinuates that the surrounding tissues masks or covers the presence of the lesion. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for masses with indistinct margins. Topics discussed include differentiation of the mass with indistinct margins from an obscured mass and focal asymmetry, and how the presence of adjacent features can increase the suspicion of the mass with indistinct margins.
Multiple Irregular Masses
Authors: Prince Erin L. , Umphrey Heidi R.
Published: March 2018

Irregular masses seen on two-view mammography are defined as masses with margins that are neither round nor oval. They may demonstrate indistinct, microlobulated, obscured, or spiculated margins and have a variety of densities, ranging from high to low or fat density. Irregular masses tend to imply a more suspicious finding. Multiple irregular masses may be seen unilaterally or bilaterally, and are usually further evaluated with either ultrasound or magnetic resonance imaging and correlated with clinical information. The etiology of multiple irregular masses is vast. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for multiple irregular masses. Topics discussed include metastases, granulomatous mastitis, diabetic mastopathy, and second synchronous cancers.
Enhancing Mass on MRI
Authors: Scheel John R. , Lam Diana L.
Published: March 2018

The ACR BI-RADS Atlas defines a “mass” on MRI as a space-occupying lesion with convex borders. Masses are characterized by their morphology and their internal enhancement characteristics. Mass morphology descriptor categories include shape (oval, round, irregular), margins (circumscribed, irregular, spiculated), and internal enhancement (homogeneous, heterogeneous, rim enhancement, dark internal septations). Suspicious morphology descriptors of MRI masses include irregular shape, irregular or spiculated margins, and heterogeneous internal enhancement. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols, differential diagnoses, and management recommendations for an enhancing mass on MRI. Topics discussed include characteristics of benign and malignant masses, classic benign masses, and enhancement curve assessment.
Round and Punctate Calcifications
Authors: Newell Mary S.
Published: March 2018

Round calcifications are aptly defined as calcifications that are round (or sometimes oval) in shape and smooth in contour. Punctate calcifications are a subset of round calcifications and, by definition, are <0.5 mm in size. Both these types of calcifications are considered typically benign when regional or diffuse in distribution. However, there are certain circumstances where round or punctate calcifications should be evaluated with diagnostic views and possibly recommended for biopsy. Distribution should be carefully evaluated, as should clinical circumstances. This chapter describes the appearance, differential diagnosis, workup, and management of round (and punctate) calcifications when encountered on screening and diagnostic mammography. While typically benign, circumstances where biopsy might be indicated are reviewed. Common histological causes, including sclerosing adenosis, are discussed. Distribution is stressed as an important factor in determining management.
Coarse Heterogeneous Calcifications
Authors: Fischer Cheryce Poon
Published: March 2018

Coarse heterogeneous calcifications are irregular calcifications that are between 0.5 mm and 1 mm in size. They are usually in a group and are smaller in size than dystrophic calcifications. Although they are of intermediate risk for breast cancer (most commonly, DCIS), they are also associated with benign entities, such as hyalinized/degenerating fibroadenoma, areas of fibrosis, papilloma, and evolving dystrophic calcifications from prior surgery or trauma. Generally, numerous bilateral groups of coarse heterogeneous calcifications may be considered benign. However, baseline magnification views may be helpful to confirm the morphology of the calcifications and to exclude more suspicious pleomorphic morphology. Coarse heterogeneous calcifications in a linear or segmental distribution are suspicious. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for coarse heterogeneous calcifications.
Skin and Trabecular Thickening
Authors: Freer Phoebe E.
Published: March 2018

Normal skin measures 0.5–2 mm thick, but may be thicker in the periareolar, axillary, parasternal, and inframammary fold regions. Trabecular thickening—thickening of the Cooper’s ligaments and fibrous stroma—is an imaging finding of breast edema, usually secondary to dilated lymphatics. Their differential diagnosis may be narrowed by considering the distribution of the findings; for example, considering if the finding is focal or diffuse, or if the process is unilateral or bilateral. This chapter reviews the key imaging and clinical features of skin and trabecular thickening. Skin thickening and trabecular thickening often occur together, and they have similar differential diagnoses. The differential diagnosis will be reviewed based on distribution (unilateral vs. bilateral, focal vs. diffuse). Topics discussed include mastitis, inflammatory cancer, systemic causes of edema (congestive heart failure), and other rare presentations of disease such as lymphoma and granulomatous mastitis.
Skin Lesions
Authors: Freer Phoebe E.
Published: March 2018

Skin lesions are commonly seen on breast imaging. Often, a raised skin lesion is encountered incidentally during screening mammography and can be mistaken for a mass within the breast parenchyma. In most cases, lesions confined within the dermis are benign. Occasionally, focal skin involvement may be the presenting sign of a breast cancer that is either locally extensive to the skin or has an inflammatory component. This chapter reviews the key imaging and clinical features of skin lesions that may be encountered either incidentally on breast imaging or on diagnostic imaging as an area of patient concern. Imaging features of skin lesions, the differential diagnoses, and further management will be reviewed. Topics discussed include benign epithelial cysts (i.e., sebaceous cyst and epidermal inclusion cysts), seborrheic keratosis, keloid and dermal nevi, cellulitis, and inflammatory and locally advanced breast cancers.
Radiology–Pathology Correlation
Authors: Denham S. LeeAnn , Umphrey Heidi R.
Published: March 2018

Over 1 million image-guided breast biopsies, guided by mammography, ultrasound, or magnetic resonance imaging, are performed annually in the United States. When the imaging characteristics of a lesion correspond to the histopathological diagnosis (e.g., suspicious imaging findings and malignant pathology), the biopsy results are deemed concordant. However, when the imaging characteristics differ from the pathological results (e.g., suspicious imaging findings but benign pathology), this biopsy result is considered discordant. This chapter, appearing in the section on interventions and surgical change, reviews the process of determining concordance between imaging and pathological findings, and managing discordant findings. Topics discussed include benign pathology results with suspicious imaging appearances, as well as the management of high-risk lesions, locally aggressive breast lesions, and malignant breast lesions.
Breast Implants
Authors: DeBruhl Nanette D. , Yaghmai Nazanin
Published: March 2018

The presence of breast implants limits the amount of tissue that can be visualized on mammography and tomosynthesis. The proper mammographic positioning of the breasts of women with implants requires special training. More tissue can be visualized in women with sub-pectoral implants than in women with sub-glandular implants. Women with implants are recommended to have age-appropriate routine interval screening mammography for detection of cancer. If an implant rupture is suspected, ultrasound and MRI are used as adjunct imaging modalities. This chapter, appearing in the section on breast implants, reviews the key imaging and clinical features, imaging protocols and pitfalls, and management recommendations for breast implants. Topics discussed include types of implants, imaging findings of intact implants, and signs of ruptured implants, using mammography, ultrasound, and magnetic resonance imaging.
Post-Reconstruction Breast
Authors: Joines Melissa M.
Published: March 2018

Breast reconstruction may be performed after mastectomy to improve breast symmetry. Each reconstruction technique leads to a characteristic appearance on post-operative imaging; thus, familiarity with the surgical techniques as well as the imaging features of the reconstructed breast across multiple modalities is important for radiologists. In addition, an understanding of the common benign complications as well as features of tumor recurrence is important. This chapter, appearing in the section on interventions and surgical change, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for the reconstructed breast. Topics discussed include tissue expander/implant and autologous tissue flap reconstruction, reconstruction complications, tumor recurrence, and management recommendations.
Depression
Authors: Lam Raymond W.
Published: March 2018

Depression, Third Edition provides a succinct clinical guide for the recognition, diagnosis, management, and modalities of treatment of depressive disorders. This new edition includes the DSM-5 diagnostic criteria, updates the latest neurobiological and psychological findings, and summarizes the Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder. The initial chapters deal with the epidemiology, pathogenesis, clinical features, and diagnosis of depression. Basic principles of clinical management are provided, as well as individual chapters dealing with the spectrum of available treatments for depression, including pharmacological, psychological, somatic, and complementary medicine approaches. A final chapter focuses on treatment-resistant depression (TRD) and other special populations including peripartum, elderly and medically ill, and children and adolescents.
Introduction
Authors: Lam Raymond W.
Published: March 2018

Depression is a common psychiatric condition that is now recognized as the leading medical cause of functional disability. The high prevalence and its common comorbidity with other medical conditions mean that depression must be recognized and managed by all physicians and health professionals. There are many evidence-based treatments for depression, including psychotherapy, pharmacotherapy, and other somatic treatments. Unfortunately, however, many patients are not able to access treatments because of limitations in healthcare delivery systems. The principles of care for major depressive disorder include: thorough assessment and diagnosis, selection of appropriate and evidence-based treatments, and careful follow up using measurement-based care.
Clinical features and diagnosis
Authors: Lam Raymond W.
Published: March 2018

The core clinical features of depression include physical (sleep and appetite disturbances, psychomotor changes, fatigue, low energy), emotional (sadness, loss of interest, anhedonia), and cognitive (guilt, suicidal thoughts and behaviours, concentration and memory difficulties, indecisiveness) symptoms. DSM-5 classifies depressive disorders in adults as major depressive disorder (MDD), other depressive disorders, and persistent depressive disorder; the latter includes chronic MDD, unremitted MDD, and dysthymia (chronic, low-grade depressive symptoms). DSM-5 also includes specifiers, or sub-types, of MDD that have implications for prognosis and treatment choice and selection. The differential diagnosis of depression includes bereavement, bipolar disorder, and other medical or substance-induced conditions.
Associated clinical features
Authors: Lam Raymond W.
Published: March 2018

In addition to the core depressive symptoms, patients with depression often have other non-specific clinical features including anxiety, irritability and anger, and pain. These features may be present as associated symptoms during a depressive episode or as specific comorbidities (e.g. generalized anxiety disorder). Other symptoms, including fatigue or low energy and cognitive dysfunction (problems with concentration, memory, decision-making), warrant special attention because they are major mediators of functional impairment and are common residual symptoms during treatment. The presence of these associated clinical features can affect the differential diagnosis and management of depression, e.g. in the selection and use of an antidepressant and/or a psychological treatment.
Clinical management
Authors: Lam Raymond W.
Published: March 2018

Clinical management of depression includes targeted screening, comprehensive assessment, developing a therapeutic alliance, selecting treatment(s), monitoring outcomes, and regular follow up. The treatment of depression has two phases: the acute phase to achieve full remission of symptoms and restore functioning, and the maintenance phase to prevent relapse/recurrence and optimize functioning and quality of life. Measurement-based care using validated rating scales to guide clinical decisions can improve patient outcomes. Self-management by patients is an important component of disease management programmes for depression. Self-management can be enhanced by books and e-health resources, including internet information sites and health applications and emerging mobile apps for tablets and smartphones.
Psychological treatments
Authors: Lam Raymond W.
Published: March 2018

Evidenced-based psychological treatments for acute depression include problem solving therapy, behavioural activation, cognitive behavioural therapy, interpersonal psychotherapy, and, for chronic depression, cognitive behavioural-analysis system of psychotherapy. Mindfulness-based cognitive therapy, originally developed as a maintenance treatment, also has benefit in acute depressive episodes. Technologies that can deliver therapy via computer, internet or mobile devices, with or without therapist guidance, have increasing evidence to support their use as alternate forms of therapy. For mild to moderate severity of depression, evidence-based psychological treatments are first-line treatments and are as effective as pharmacotherapy. Combined treatment with psychotherapy and pharmacotherapy is more effective than either monotherapy and is clinically indicated for more severe, chronic or comorbid depressions.
Pharmacological treatments
Authors: Lam Raymond W.
Published: March 2018

The pharmacological treatments for depression include antidepressants and adjunctive agents. Most of the newer antidepressants (e.g. selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenaline reuptake inhibitors (SNRIs), other agents) are first-line medications owing to improved safety and tolerability over first-generation medications (e.g. tricyclic antidepressants, monoamine oxidase inhibitors). Selection of an antidepressant must be personalized to an individual patient and must consider factors including efficacy, side-effect profile, safety, specific symptoms, comorbid conditions, concurrent medications, simplicity of use, and cost. Switching antidepressants must take into account factors such as side effects, discontinuation effects, potential drug interactions, and rapidity of switch. Maintenance treatment (6 months to 2 years or longer, depending on individual risk factors) is recommended for all patients treated with antidepressants.
Inversions
Authors: McKinlay Gardner R. J , Amor David J
Published: March 2018

Inversions are intrachromosomal structural rearrangements. The most common is the simple (or single) inversion. If the inversion coexists with another rearrangement in the same chromosome, it is a complex inversion. In an inversion, a segment of chromosome is switched 180 degrees. If this segment includes the centromere, this is a pericentric inversion; if not, it is a paracentric inversion. In principle, and almost always in practice, it is only the pericentric inversion that conveys an important genetic risk to carriers of the inversion: Their children may inherit a “recombinant” chromosome that would inevitably be imbalanced. This chapter considers these two type of inversions and discusses the degree of genetic risk that may—or may not—be associated.
Chromosome Abnormalities Detected at Prenatal Diagnosis
Authors: McKinlay Gardner R. J , Amor David J
Published: March 2018

Prenatal diagnosis has given medical cytogenetics one of its major areas of application: from amniocentesis in the earliest days to the recent developments of noninvasive prenatal testing based upon a sample of maternal blood. This chapter explores in detail the specific diagnoses that may be made and the decisions, with particular reference to continuation or termination of pregnancy, that face those women/couples for whom a specific diagnosis has been made. The difficulties of decision inherent in a sex chromosome aneuploidy, a microarray-level rearrangement, and in the context of mosaicism are rehearsed. This discussion is offered on the background of a review of the applied embryology.
Comparison of Fusion Rates Based on Graft Material Following Occipitocervical and Atlantoaxial Arthrodesis in Adults and Children
Authors: Robinson Leslie C , Anderson Richard C E , Brockmeyer Douglas L , Torok Michelle R , Hankinson Todd C ,   Pediatric Craniocervical Society
Published: March 2018

BACKGROUND

Fusion rates following rigid internal instrumentation for occipitocervical and atlantoaxial instability approach 100% in many reports. Based on this success and the morbidity that can be associated with obtaining autograft for fusion, surgeons increasingly select alternative graft materials.

OBJECTIVE

To examine fusion failure using various graft materials in a retrospective observational study.

METHODS

Insurance claims databases (Truven Health MarketScan® [Truven Health Analytics, Ann Arbor, Michigan] and IMS Health Lifelink/PHARMetrics [IMS Health, Danbury, Connecticut]) were used to identify patients with CPT codes 22590 and 22595. Patients were divided by age (≥18 yr = adult) and arthrodesis code, establishing 4 populations. Each population was further separated by graft code: group 1 = 20938 (structural autograft); group 2 = 20931 (structural allograft); group 3 = other graft code (nonstructural); group 4 = no graft code. Fusion failure was assigned when ≥1 predetermined codes presented in the record ≥90 d following the last surgical procedure.

RESULTS

Of 522 patients identified, 419 were adult and 103 were pediatric. Fusion failure occurred in 10.9% (57/522) of the population. There was no statistically significant difference in fusion failure based on graft material. Fusion failure occurred in 18.9% of pediatric occipitocervical fusions, but in 9.2% to 11.1% in the other groups.

CONCLUSION

Administrative data regarding patients who underwent instrumented occipitocervical or atlantoaxial arthrodesis do not demonstrate differences in fusion rates based on the graft material selected. When compared to many contemporary primary datasets, fusion failure was more frequent; however, several recent studies have shown higher failure rates than previously reported. This may be influenced by broad patient selection and fusion failure criteria that were selected in order to maximize the generalizability of the findings.
Stereoelectroencephalography-Guided Laser Ablations in Patients With Neocortical Pharmacoresistant Focal Epilepsy: Concept and Operative Technique
Authors: Ross Louis , Naduvil Ahsan M , Bulacio Juan C , Najm Imad M , Gonzalez-Martinez Jorge A
Published: March 2018

BACKGROUND

Laser ablation surgery has had encouraging results in the treatment of multiple intracranial diseases including primary and metastatic brain tumors, radiation necrosis, and epilepsy. The use of the stereoelectroencephalography (SEEG) method in combination with laser thermocoagulation therapy with the goal of modulating epileptic networks in patients with neocortical nonlesional phamacoresistant epilepsy has not been previously described.

OBJECTIVE

To describe the novel methodological and conceptual aspects related to SEEG-guided laser ablations in patients with magnetic resonance imaging (MRI)-negative pharmacoresistant neocortical focal epilepsy.

METHODS

Guided by previous SEEG intracranial data, a laser ablation probe was inserted by using a robotic guidance device in a 17-yr-old medically refractory epilepsy patient with difficult to localize seizures and nonlesional MRI. The laser applicator position was confirmed by MRI, targeting the left mesial rostral superior frontal gyrus. The ablation was performed under multiplanar digital imaging views and real-time thermal imaging and treatment estimates in each plane. A postablation MRI (contrasted T1 sequence) confirmed the ablation's location and size.

RESULTS

The entire procedure was achieved in approximately 100 min. The actual ablation was performed in less than 3 min. Approximately, additional 30 min preoperatively were used for positioning and robot registration. Precise placement of laser application (in comparison with preplanned trajectories) was achieved using the robotic guidance and confirmed by the intraoperative magnetic resonance images. No complications were reported. The patient has been seizure-free since surgery. The follow-up period is 20 mo. Two additional patients, treated with similar methodology, are also described.

CONCLUSION

The preliminary experience with the described method shows the feasibility of a unique combination of the SEEG methodology with laser thermocoagulation in patients with neocortical MRI-negative pharmacoresistant focal epilepsy.
A Novel Approach for Responsive Neural Stimulator Implantation With Infraclavicular Placement of the Internal Pulse Generator
Authors: Philipp Lucas R , Witcher Mark R , Gross Robert E
Published: March 2018

INTRODUCTION

The Responsive Neurostimulation System (RNS, Neuropace, Mountain View, California) has been proven to be effective at reducing seizures in patients with partial-onset epilepsy. The system incorporates a skull-mounted neurostimulator that requires a cranial incision for replacement. Although integral to the functioning of the system, in some circumstances, such as in the setting of infection, this can be disadvantageous. At present, there are no alternatives to cranial implantation of the RNS System.

METHODS

We describe a novel procedure enabling implantation of the neurostimulator within the chest wall, using components from a peripheral nerve stimulator. In a patient who achieved complete seizure freedom with the use of the RNS System, distant site implantation provided a viable means of continuing therapy in a setting where device explantation would have otherwise been inevitable as a result of cranial infection. We present continuous electrocorticographic data recorded from the device documenting the performance of the system with the subclavicular neurostimulator.

RESULTS

Band pass detection rates increased by 50%, while line length detection rates decreased by 50%. The number of detections decreased from 1046 to 846, with a resultant decrease in stimulations. Although there was some compromise of function due to the elevated noise floor, more than 2 yr following the procedure the patient remains free of seizures and infection.

CONCLUSION

The salvage procedure we describe offered an alternative therapeutic option in a patient with a complicated cranial wound issue, using heterogeneous components with marginal compromises in device functionality and no sacrifice in patient outcome.