Rural Nostalgia: Revisiting the lost idyll in British Library Crime Classics

This article examines the marketing of the recent British Library Crime Classics series of republished novels and short stories. Focusing on works by John Bude, the article analyses the recycling of early twentieth-century crime fiction in order to tap into contemporary nostalgia. The British Library uses a 1930s railway poster advertising Ullswater, for instance, as the cover of The Lake District Murder, despite being set at a ‘newish stone-and-cement garage’ on ‘a very bleak’ road. By examining these novels within a contemporary context, this article investigates concepts of landscape, nostalgia, and the past that characterise crime fiction as well as broader representations of the rural idyll. Throughout, the article suggests that while the re-publication of lost Golden Age novels allows readers to engage with a broader variety of crime writing, the marketing of the texts potentially conceals both historic and contemporary issues about the ways that rural landscapes are represented

The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

BACKGROUND: The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature. METHODS: The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services. RESULTS: Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes. CONCLUSION: There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes

Expanding the phenotype of SPARC-related osteogenesis imperfecta: clinical findings in two patients with pathogenic variants in SPARC and literature review

BACKGROUND: Secreted protein, acidic, cysteine rich (SPARC)-related osteogenesis imperfecta (OI), also referred to as OI type XVII, was first described in 2015, since then there has been only one further report of this form of OI. SPARC is located on chromosome 5 between bands q31 and q33. The encoded protein is necessary for calcification of the collagen in bone, synthesis of extracellular matrix and the promotion of changes to cell shape. METHODS: We describe a further two patients with previously unreported homozygous SPARC variants with OI: one splice site; one nonsense pathogenic variant. We present detailed information on the clinical and radiological phenotype and correlate this with their genotype. There are only two previous reports by Mendozo-Londono et al and Hayat et al with clinical descriptions of patients with SPARC variants. RESULTS: From the data we have obtained, common clinical features in individuals with OI type XVII caused by SPARC variants include scoliosis (5/5), vertebral compression fractures (5/5), multiple long bone fractures (5/5) and delayed motor development (3/3). Interestingly, 2/4 patients also had abnormal brain MRI, including high subcortical white matter changes, abnormal fluid-attenuated inversion in the para-atrial white matter and a large spinal canal from T10 to L1. Of significance, both patients reported here presented with significant neuromuscular weakness prompting early workup. CONCLUSION: Common phenotypic expressions include delayed motor development with neuromuscular weakness, scoliosis and multiple fractures. The data presented here broaden the phenotypic spectrum establishing similar patterns of neuromuscular presentation with a presumed diagnosis of 'myopathy'

Amalgamated Reference Data for Size-Adjusted Bone Densitometry Measurements in 3598 Children and Young Adults-the ALPHABET Study

The increasing use of dual‐energy X‐ray absorptiometry (DXA) in children has led to the need for robust reference data for interpretation of scans in daily clinical practice. Such data need to be representative of the population being studied and be “future‐proofed” to software and hardware upgrades. The aim was to combine all available pediatric DXA reference data from seven UK centers to create reference curves adjusted for age, sex, ethnicity, and body size to enable clinical application, using in vivo cross‐calibration and making data back and forward compatible. Seven UK sites collected data on GE Lunar or Hologic Scanners between 1996 and 2012. Males and females aged 4 to 20 years were recruited (n = 3598). The split by ethnic group was white 2887; South Asian 385; black Afro‐Caribbean 286; and mixed heritage 40. Scans of the total body and lumbar spine (L1 to L4) were obtained. The European Spine Phantom was used to cross‐calibrate the 7 centers and 11 scanners. Reference curves were produced for L1 to L4 bone mineral apparent density (BMAD) and total body less head (TBLH) and L1 to L4 areal bone mineral density (aBMD) for GE Lunar Prodigy and iDXA (sex‐ and ethnic‐specific) and for Hologic (sex‐specific). Regression equations for TBLH BMC were produced using stepwise linear regression. Scans of 100 children were randomly selected to test backward and forward compatibility of software versions, up to version 15.0 for GE Lunar and Apex 4.1 for Hologic. For the first time, sex‐ and ethnic‐specific reference curves for lumbar spine BMAD, aBMD, and TBLH aBMD are provided for both GE Lunar and Hologic scanners. These curves will facilitate interpretation of DXA data in children using methods recommended in ISCD guidelines. The databases have been created to allow future updates and analysis when more definitive evidence for the best method of fracture prediction in children is agreed. © 2016 American Society for Bone and Mineral Research

White Matter, Gray Matter and Cerebrospinal Fluid Segmentation from Brain 3D MRI Using B-UNET

The accurate segmentation of brain tissues in Magnetic Resonance (MR) images is an important step for detection and treatment planning of brain diseases. Among other brain tissues, Gray Matter, White Matter and Cerebrospinal Fluid are commonly segmented for Alzheimer diagnosis purpose. Therefore, different algorithms for segmenting these tissues in MR image scans have been proposed over the years. Nowadays, with the trend of deep learning, many methods are trained to learn important features and extract information from the data leading to very promising segmentation results. In this work, we propose an effective approach to segment three tissues in 3D Brain MR images based on B-UNET. The method is implemented by using the Bitplane method in each convolution of the UNET model. We evaluated the proposed method using two public databases with very promising results. (c) Springer Nature Switzerland AG 2019