Defining the Agenda for Serious Tort Reform

In this Article, the authors support Prof. Sugarman\u27s tort reform proposals, but argue that these proposals need more development before they will produce actual change

Dark matter line emission constraints from NuSTAR observations of the Bullet Cluster

Line emission from dark matter is well motivated for some candidates e.g. sterile neutrinos. We present the first search for dark matter line emission in the 3-80keV range in a pointed observation of the Bullet Cluster with NuSTAR. We do not detect any significant line emission and instead we derive upper limits (95% CL) on the flux, and interpret these constraints in the context of sterile neutrinos and more generic dark matter candidates. NuSTAR does not have the sensitivity to constrain the recently claimed line detection at 3.5keV, but improves on the constraints for energies of 10-25keV.Comment: 7 pages, 5 figures, submitted to Ap

Quantitative imaging:systematic review of perfusion/flow phantoms

Background: We aimed at reviewing design and realisation of perfusion/flow phantoms for validating quantitative perfusion imaging (PI) applications to encourage best practices. Methods: A systematic search was performed on the Scopus database for “perfusion”, “flow”, and “phantom”, limited to articles written in English published between January 1999 and December 2018. Information on phantom design, used PI and phantom applications was extracted. Results: Of 463 retrieved articles, 397 were rejected after abstract screening and 32 after full-text reading. The 37 accepted articles resulted to address PI simulation in brain (n = 11), myocardial (n = 8), liver (n = 2), tumour (n = 1), finger (n = 1), and non-specific tissue (n = 14), with diverse modalities: ultrasound (n = 11), computed tomography (n = 11), magnetic resonance imaging (n = 17), and positron emission tomography (n = 2). Three phantom designs were described: basic (n = 6), aligned capillary (n = 22), and tissue-filled (n = 12). Microvasculature and tissue perfusion were combined in one compartment (n = 23) or in two separated compartments (n = 17). With the only exception of one study, inter-compartmental fluid exchange could not be controlled. Nine studies compared phantom results with human or animal perfusion data. Only one commercially available perfusion phantom was identified. Conclusion: We provided insights into contemporary phantom approaches to PI, which can be used for ground truth evaluation of quantitative PI applications. Investigators are recommended to verify and validate whether assumptions underlying PI phantom modelling are justified for their intended phantom application

Imaging cardiac innervation in amyloidosis

Cardiac amyloidosis is a form of restrictive cardiomyopathy resulting in heart failure and potential risk on arrhythmia, due to amyloid infiltration of the nerve conduction system and the myocardial tissue. The prognosis in this progressive disease is poor, probably due the development of cardiac arrhythmias. Early detection of cardiac sympathetic innervation disturbances has become of major clinical interest, because its occurrence and severity limits the choice of treatment. The use of iodine-123 labelled metaiodobenzylguanidine ([I-123]MIBG), a chemical modified analogue of norepinephrine, is well established in patients with heart failure and plays an important role in evaluation of sympathetic innervation in cardiac amyloidosis. [I-123]MIBG is stored in vesicles in the sympathetic nerve terminals and is not catabolized like norepinephrine. Decreased heart-to-mediastinum ratios on late planar images and increased wash-out rates indicate cardiac sympathetic denervation and are associated with poor prognosis. Single photon emission computed tomography provides additional information and has advantages for evaluating abnormalities in regional distribution in the myocardium. [I-123]MIBG is mainly useful in patients with hereditary and wild-type ATTR cardiac amyloidosis, not in AA and AL amyloidosis. The potential role of positron emission tomography for cardiac sympathetic innervation in amyloidosis has not yet been identified

Initial evidence for the criterion-related and structural validity of the long versions of the direct and meta-perspectives of the Coach-Athlete Relationship Questionnaire

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2010 Taylor & Francis.The aim of the present study was to develop and initially validate a longer version of the direct (Jowett & Ntoumanis, 2004) and meta-perspectives (Jowett, 2009a, 2009b) of the Coach-Athlete Relationship Questionnaire (CART-Q). In Study 1, instruments (e.g. questionnaires, scales, and inventories) that have been used to assess relationship quality in the broader psychological literature were examined and items potentially relevant to the coach-athlete relationship were identified. The content validity of the identified items was then assessed using expert panels. A final questionnaire was subsequently prepared and administered to 693 participants (310 coaches and 383 athletes). Confirmatory factor analysis was employed to assess the multidimensional nature of the questionnaire based on the 3Cs (i.e. closeness, commitment, and complementarity) model of the coach-athlete relationship. The findings indicated that the direct and meta-perspective items of the long versions of the CART-Q approached an adequate data fit. Moreover, evidence for the internal consistency and criterion validity of the new instruments was also obtained. In Study 2, the newly developed measure was administered to an independent sample of 251 individuals (145 athletes and 106 coaches). Further statistical support was gained for the factorial validity and reliability of the longer version of the CART-Q

F-18-FDG-Uptake in Mediastinal Lymph Nodes in Suspected Prosthetic Valve Endocarditis:Predictor or Confounder?

Introduction: Prosthetic valve endocarditis (PVE) is a serious disease affecting ~0.4% of prosthetic valve recipients per year. 18F-FDG-PET/CT has high sensitivity and specificity for PVE and is included as major criterion for the diagnosis in recent guidelines of the European Society of Cardiology. We addressed the question whether increased FDG-uptake in mediastinal lymph nodes could help to support the visual diagnostic assessment of PVE.Methods: In this sub-analysis of a previously published retrospective multicentre study, 160 unique patients were identified who underwent 18F-FDG-PET/CT for evaluation of suspected PVE. 18F-FDG-PET/CT was performed in adherence to the European Association of Nuclear Medicine guidelines of 2015 and scans were assessed for signs of mediastinal lymph node activity by 2 experienced nuclear medicine physicians who were blinded to clinical context. Clinical diagnosis of PVE had been established based on surgical findings or multidisciplinary consensus after a 1-year follow-up in 80 of 160 patients (50%).Results: In total, 52 patients showed increased mediastinal lymph node activity. Mediastinal lymph node activity on 18F-FDG-PET/CT did not increase diagnostic accuracy when added to the visual analysis of scans for signs of PVE: X2: 0.118, p = 0.731). After excluding patients with known confounders for 18F-FDG-PET/CT, namely use of Bioglue® during prosthetic valve implantation and C-reactive protein levels below 40 mg/L, mediastinal lymph node activity was still not of additional diagnostic value compared to visual analysis alone (X2:0.129, p = 0.723).Discussion: Assessment of mediastinal lymph node activity did not improve 18F-FDG-PET/CT diagnostic accuracy for suspected PVE compared to visual assessment of the valve alone, as it seems to be a rather a specific finding, that might be caused by sternal wound or mediastinal infections or even by subclinical respiratory infections. Future studies might elucidate whether increased FDG active lymph nodes indicate a high-risk patient group and whether more detailed assessment of mediastinal lymph nodes could improve their additional diagnostic benefit