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Objectives Visuospatial neglect (VSN) is a common cognitive disorder after stroke. The primary aim of this systematic review was to provide an overview of the impact of VSN in 3 aspects: (1) activities of daily living (ADL), (2) participation, and (3) caregiver burden. The second aim was to investigate the differences in studies focusing on populations with mean age Methods PubMed, EMBASE, Web of Science, Cochrane Library, Emcare, PsychINFO, Academic Search Premier and CENTRAL were searched systematically. Quality was assessed with the Mixed Methods Appraisal Tool. Results Of the 115 included studies, 104 provided outcomes on ADL, 15 on participation (4 studies with mean age ≥ 65), and 2 on caregiver burden (1 study with mean age ≥ 65). Quality assessment yielded scores ranging from 0 to 100%. VSN had a negative impact on ADL (i.e., independence during ADL and performance in self-care, household tasks, reading, writing, walking, wheelchair navigation) and participation (i.e., driving, community mobility, orientation, work). The impact of VSN on fulfilling social roles was unclear. VSN had a negative effect on caregiver burden. We found no clear age-related differences. Conclusions and implications VSN has a negative impact not only on patients’ independence but particularly on the performance of ADL. Despite the far fewer studies of VSN as compared with ADL, VSN also seems to hamper participation and increase caregiver burden, but further research is needed. Because of the large impact, VSN should be systematically and carefully assessed during rehabilitation. A considerable number of different instruments were used to diagnose VSN. Diagnosing VSN at more than one level [function (i.e., pen-and-paper test), activities, and participation] is strongly recommended. Consensus is needed on how to assess VSN and its negative impact for research and rehabilitation practice. Systematic review Registration No. PROSPERPO Registration No. CRD42018087483.

A novel transmit lens array is proposed to provide broadband quasi-optical power distribution and beam-steering capabilities for array architectures in future submillimeter-wave heterodyne instruments. The transmit array is composed of a double array layer of lens antenna elements with high aperture efficiency. To enable broadband and low loss quasi-optical (QO) power distribution, the transmit lens array is coupled with a high aperture efficiency single lens antenna. The high aperture efficiency is achieved by using a recently introduced multi-mode leaky wave feed. The top lens array can be used to achieve beam-steering capabilities when fed coherently and mechanically translated using a piezo-motor. In this contribution, we present the development of a prototype based on a transmit lens array of 7 elements at 450-650 GHz with measurements showing a good agreement with simulations. This prototype demonstrates a quasi-optical power coupling efficiency of nearly 60%. Moreover it also shows beam-steering of a 36dBi directivity beam to few discrete angles up to +/-25 degrees with less than 2dB scan loss

Simple Summary Early image-based diagnosis is crucial to improve outcomes in pancreatic ductal adenocarcinoma (PDAC) patients, but is challenging even for experienced radiologists. Artificial intelligence has the potential to assist in early diagnosis by leveraging high amounts of data to automatically detect small (

Visuospatial neglect (VSN) adversely impacts both the length of rehabilitation and activities of daily living (ADL) of patients after stroke and can reduce their participation in community activities. Therefore, it is important to assess VSN after stroke in neurorehabilitation facilities. The process of assessing VSN comprehensively in current geriatric rehabilitation remains unclear. This study examined the process of VSN in post-stroke assessment emphasizing the details of the (systematic) routines and structure of VSN assessment in current geriatric rehabilitation facilities in the Netherlands and rehabilitation facilities in the United Kingdom (UK). Health care professionals in geriatric rehabilitation facilities in the Netherlands (n = 6) and in stroke and neurorehabilitation facilities in the UK (n = 6) were interviewed. VSN was not routinely assessed in any of the geriatric rehabilitation facilities in the Netherlands, and only in half of the neurorehabilitation facilities in the UK. Healthcare teams in the Netherlands detected no patients with VSN over a two month period. Several VSN assessment tools were employed. Neuropsychological tests were most frequently used. Nine interviewees indicated the need to improve the process of VSN assessment in actual practice. The suggestions focused on improving the process of assessing VSN and developing relevant knowledge development and training. This study showed that in current rehabilitation practice, VSN was not always assessed in a routine (every stroke patient) and structured (who, when, and, which tests) manner. VSN was not routinely assessed with more than one test (neuropsychological and during daily activities), contrary to best practice recommendations. VSN remains probably underrecognized, especially in geriatric rehabilitation facilities. It is important to improve the current process, including selecting the most appropriate tools for assessing VSN.

Purpose; Returning to community living is an indicator for successful rehabilitation in older adults admittedto geriatric rehabilitation. Predicting successful rehabilitation could contribute to the deployment of earlydischarge planning, and leads to a more custom-made rehabilitation trajectory. This review aims to presentan overview of factors associated with successful rehabilitation following inpatient geriatric rehabilitation.Method; A systematic literature review was conducted in PubMed, CINAHL and Embase. Extracted factorswere analysed via Bakker’s five levels of evidence.Results; Nine studies with methodological quality of good to moderate were included. For 13 of the 18 extractedfactors, limited (n=3),moderate (n=5) and conflicting (n=5) evidence found a significant association.Conclusions; Caregiver, comorbidities, motor-function, nutritional status, time from onset are significantlyrelated to successful rehabilitation. These factors could support healthcare professionals to indicate successfulrehabilitation at admission and contributes to deployment of early discharge planning and developmentof more custom-made rehabilitation trajectories.

Accurate spatial dose delivery in radiotherapy is frequently complicated due to changes in the patient’s internal anatomy during and in-between therapy segments. The recent introduction of hybrid MRI radiotherapy systems allows unequaled soft-tissue visualization during radiation delivery and can be used for dose reconstruction to quantify the impact of motion. To this end, knowledge of anatomical deformations obtained from continuous monitoring during treatment has to be combined with information on the spatio-temporal dose delivery to perform motion-compensated dose accumulation (MCDA). Here, the influence of the choice of deformable image registration algorithm, dose warping strategy, and magnetic resonance image resolution and signal-to-noise-ratio on the resulting MCDA is investigated. For a quantitative investigation, four 4D MRI-datasets representing typical patient observed motion patterns are generated using finite element modeling and serve as a gold standard. Energy delivery is simulated intra-fractionally in the deformed image space and, subsequently, MCDA-processed. Finally, the results are substantiated by comparing MCDA strategies on clinically acquired patient data. It is shown that MCDA is needed for correct quantitative dose reconstruction. For prostate treatments, using the energy per mass transfer dose warping strategy has the largest influence on decreasing dose estimation errors.

Purpose The aim of this study was to determine whether direct verbal communication of results by a radiologist affected follow-up compliance rates for probably benign breast imaging findings. Methods This study was institutional review board approved and HIPAA compliant. A retrospective search identified all patients from January 1, 2010 to December 31, 2010 who had breast findings newly assessed as probably benign (BI-RADS category 3). Patients were categorized by whether the radiologist or the technologist verbally communicated the result and follow-up recommendation. Patient adherence to 6-, 12-, and 24-month follow-up imaging recommendations was recorded. Results Compliance data were available for 770 of 819 patients in the study. Overall compliance was 83.0% (639 of 770) for 6-month examinations, 68.1% (524 of 770) for 6- and 12-month examinations, and 57.4% (442 of 770) for 6-, 12-, and 24-month examinations. For patients who initially underwent diagnostic mammography alone, there was no significant difference in compliance between those who had and those who did not have radiologist-patient communication (6 months, 81.9% vs 80.8% [ P = .83]; 6 and 12 months, 70.8% vs 67.3% [ P = .58]; 6, 12, and 24 months, 54.2% vs 58.4% [ P = .53]). For patients who initially underwent diagnostic mammography alone versus ultrasound with or without diagnostic mammography, there was no significant difference in compliance (6 months, 81.1% vs 84.3% [ P = .24]; 6 and 12 months, 68.1% vs 68.0% [ P = .96]; 6, 12, and 24 months, 57.4% vs 57.4% [ P = .00]). Conclusions High initial compliance was achieved by radiologist or technologist verbal communication of findings and recommendations. Direct communication by the radiologist did not increase compliance compared with communication by a technologist.

SummaryLipases are successfully applied in enantioselective biocatalysis. Most lipases contain a lid domain controlling access to the active site, but Bacillus subtilis Lipase A (LipA) is a notable exception: its active site is solvent exposed. To improve the enantioselectivity of LipA in the kinetic resolution of 1,2-O-isopropylidene-sn-glycerol (IPG) esters, we replaced a loop near the active-site entrance by longer loops originating from Fusarium solani cutinase and Penicillium purpurogenum acetylxylan esterase, thereby aiming to increase the interaction surface for the substrate. The resulting loop hybrids showed enantioselectivities inverted toward the desired enantiomer of IPG. The acetylxylan esterase-derived variant showed an inversion in enantiomeric excess (ee) from −12.9% to +6.0%, whereas the cutinase-derived variant was improved to an ee of +26.5%. The enantioselectivity of the cutinase-derived variant was further improved by directed evolution to an ee of +57.4%.

In our study, we sought to report the management, clinical outcomes, and follow-up rates of patients who presented for evaluation of breast abscess in the Emergency Department (ED) after hours. A retrospective search of ultrasound reports at our institution identified all patients from January 1, 2009 to June 30, 2013 who were scanned in the ED after hours to evaluate for breast abscess. Patient demographics, clinical information, imaging findings, follow-up rates, and outcomes were reviewed. One hundred eighty-five patients were included in the study. Forty-four percent (86/185) of the patients were diagnosed with abscess based on ultrasound findings in the ED. Twenty-seven percent (23/86) were recently post-operative, and 12 % (10/86) were postpartum/breastfeeding. Mastitis was the diagnosis in the remaining 54 % (99/185). Only 1/86 cases were associated with breast cancer. Seventy-seven percent (66/86) of patients were treated with an invasive procedure; 39 % (26/66) had surgical evacuation, 30 % (20/66) image-guided drainage, 23 % (15/66) bedside or clinic incision and drainage, and 8 % (5/66) palpation-guided fine needle aspiration (FNA). Seventy-seven percent (143/185) of patients had clinical and/or imaging follow-up. Forty-four percent (63/143) had long-term follow-up (≥ 3 months). Almost 50 % of the patients who presented to the ED for evaluation of abscess were diagnosed with abscess while the remaining patients were diagnosed with mastitis. Appropriate clinical and/or imaging follow-up occurred in 77 %. Long-term follow-up (≥ 3 months) occurred more frequently in patients older than 30 years of age. Appropriate follow-up does not occur in approximately one fourth of cases, suggesting that additional clinician and patient education is warranted.

Purpose: To evaluate the skin dose by performing the measurements on cylindrical phantom with 6X beam. Methods: A cylindrical phantom was used to best model a patient surface. The source to surface distance (SSD) was 100 cm at phantom surface along central axis (CAX). The EBT2 films were cut into 2×2 cm2 pieces. Each piece of film was placed at CAX on phantom surface for each measurement at 0°, 15°, 30°, 45°, 60°, 75°, and 90° gantry angles for field sizes of 5×5, 10×10, 15×15, and 20×20 cm2 respectively. One hundred monitor units (MU) with 6X beam were delivered for each set up. Similarly, the measurements were repeated using lithium fluoride (LiF) thermoluminescent dosimeter (TLD) chips (1X1X1 mm3). Two TLD chips were placed for each gantry angle and field size. The calibration curves were produced for both film and TLD. The computed tomography (CT) was also performed on the same cylindrical phantom and dose was evaluated at the phantom surface using Eclipse treatment planning system ( AAA algorithm) for skin dose comparison. Results: Data showed small differences at smaller angles among EBT2, TLD and Eclipse treatment planning system. But Eclipse treatment planning system under estimated the skin dose between 20% and 50% at larger gantry angles (between 40° and 80°) at all field sizes before dose differences began to converge. Conclusion: Given this data, we can conclude that Eclipse treatment planning system under estimated the dose especially between 40 and 80 degrees of obliquity compared to the measurements results. Ideally, this study can be applied largely to head and neck patients where contours differ drastically and where skin dose is paramount.

The synthesis and structural and physical properties of iron lanthanide oxypnictide superconductors, ${L}_{4}{\mathrm{Fe}}_{2}{\mathrm{As}}_{2}{\mathrm{Te}}_{1\ensuremath{-}x}{\mathrm{O}}_{4}$ $(L\phantom{\rule{0.16em}{0ex}}=\phantom{\rule{0.16em}{0ex}}\mathrm{Pr},\phantom{\rule{0.16em}{0ex}}\mathrm{Sm},\phantom{\rule{0.16em}{0ex}}\mathrm{Gd})$, with transition temperature at \ensuremath{\sim}25 K are reported. Single crystals have been grown at high pressure using the cubic anvil technique. The crystal structure consists of layers of ${L}_{2}{\mathrm{O}}_{2}$ tetrahedra separated by alternating layers of chains of Te and of ${\mathrm{Fe}}_{2}{\mathrm{As}}_{2}$ tetrahedra: $\ensuremath{-}{L}_{2}{\mathrm{O}}_{2}\ensuremath{-}\mathrm{Te}\ensuremath{-}{L}_{2}{\mathrm{O}}_{2}\ensuremath{-}{\mathrm{Fe}}_{2}{\mathrm{As}}_{2}\ensuremath{-}{L}_{2}{\mathrm{O}}_{2}\ensuremath{-}\mathrm{Te}\ensuremath{-}{L}_{2}{\mathrm{O}}_{2}\ensuremath{-}$ (space group: $I\mathrm{4/}\mathit{mmm}$, $a\phantom{\rule{0.16em}{0ex}}\ensuremath{\sim}\phantom{\rule{0.16em}{0ex}}4.0$, $c\phantom{\rule{0.16em}{0ex}}\ensuremath{\sim}\phantom{\rule{0.16em}{0ex}}29.6\phantom{\rule{0.16em}{0ex}}\AA{})$. Substitution of oxygen by fluorine increases the critical temperature, e.g., in ${\mathrm{Gd}}_{4}{\mathrm{Fe}}_{2}{\mathrm{As}}_{2}{\mathrm{Te}}_{1\ensuremath{-}x}{\mathrm{O}}_{4\ensuremath{-}y}{\mathrm{F}}_{y}$ up to 45 K. Magnetic torque measurements reveal an anisotropy of the penetration depths of \ensuremath{\sim}31.

We report crystal growth at high pressure, structure determination, and magnetic and transport studies of an oxypnictide superconductor Pr4Fe2As2Te1-xO4. Its structure resembles the known 1111 phase except for the considerably larger c lattice constant and intercalated tellurium atoms and it crystallizes in a tetragonal lattice [a = 4.0165(2) angstrom, c = 29.8572(16) angstrom, and space group I4/mmm (no. 139)]. The electrical resistivity rho(T) and magnetization measurement show a transition at T-c approximate to 25 K. The lower (H-c1) and upper (H-c2) critical fields are 2 mT and 6.5 T, respectively. The Ginzburg- Landau parameter of kappa approximate to 80 places this compound in the family of strong type-II superconductors.

Intravenous antibiotics and enteral tube feeding at home for the treatment of pulmonary exacerbations and underweight condition in cystic fibrosis (CF) patients have become tools that are used in many cystic fibrosis centres. The experience with home care programmes from different countries is quite conclusive. If the necessary preparations are made, such as training of staff and patients, and financial support is arranged, home care is easy to put into practice. Optimal patient compliance is also necessary. Home care is as effective as hospital treatment for selected patients, and less expensive. Experience has increased during many treatment periods in different cystic fibrosis centres, and only a few adverse events have been recorded, indicating that home care is safe. However, the most important gain for cystic fibrosis patients is the reduction of hospital admission time, which means a definite improvement in the quality of life.

Single crystals of the $Ln$FeAsO ($Ln$1111, $Ln$ $=$ Pr, Nd, and Sm) family with lateral dimensions up to 1 mm were grown from NaAs and KAs flux at high pressure. The crystals are of good structural quality and become superconducting when O is partially substituted by F (PrFeAsO${}_{1\ensuremath{-}x}$F${}_{x}$ and NdFeAsO${}_{1\ensuremath{-}x}$F${}_{x}$) or when Fe is substituted by Co (SmFe${}_{1\ensuremath{-}x}$Co${}_{x}$AsO). From magnetization measurements, we estimate the temperature dependence and anisotropy of the upper critical field and the critical current density of underdoped PrFeAsO${}_{0.7}$F${}_{0.3}$ crystal with ${T}_{c}$ \ensuremath{\approx} 25 K. Single crystals of SmFe${}_{1\ensuremath{-}x}$Co${}_{x}$AsO with maximal ${T}_{c}$ up to 16.3 K for $x$ \ensuremath{\approx} 0.08 were grown. From transport and magnetic measurements, we estimate the critical fields and their anisotropy and find these superconducting properties to be quite comparable to the ones in SmFeAsO${}_{1\ensuremath{-}x}$F${}_{x}$ with a much higher ${T}_{c}$ \ensuremath{\approx} 50 K. The magnetically measured critical current densities are as high as 10${}^{9}$ A/m${}^{2}$ at 2 K up to 7 T, with indication of the usual fishtail effect. The upper critical field estimated from resistivity measurements is anisotropic with slopes of \ensuremath{\sim}\ensuremath{-}8.7 T/K ($H$||$ab$ plane) and \ensuremath{\sim}\ensuremath{-}1.7 T/K ($H$||$c$ axis). This anisotropy (\ensuremath{\sim}5) is similar to that in other $Ln$1111 crystals with various higher ${T}_{c}$'s.

A vortex lock-in transition was directly detected by torque magnetometry in an overdoped YBa${}_{2}$Cu${}_{3}$O${}_{7}$ single crystal of low anisotropy ($\ensuremath{\approx}7$). The locked-in state was observed below the two- to three-dimensional crossover temperature ${T}_{\mathrm{cr}}=76$ K, independently of extrinsic pinning effects, thanks to a high-quality clean crystal and the use of a vortex shaking technique. The lock-in effect is enhanced by decreasing temperature and increasing magnetic field. The shape of the torque signal as a function of the angle between the applied magnetic field and the crystallographic $c$ axis is in very good agreement with the model developed by Feinberg and Ettouhami [Int. J. Mod. Phys. B 7, 2085 (1993)] for quasi-2D superconductors, despite the low anisotropy of the material.

An extended study of the superconducting and normal-state properties of various as-grown and post-annealed Rb${}_{x}$Fe${}_{2\ensuremath{-}y}$Se${}_{2}$ single crystals is presented. Magnetization experiments evidence that annealing of Rb${}_{x}$Fe${}_{2\ensuremath{-}y}$Se${}_{2}$ at 413 K, well below the onset of phase separation ${T}_{\mathrm{p}}\ensuremath{\simeq}489$ K, neither changes the magnetic nor the superconducting properties of the crystals. In addition, annealing at 563 K, well above ${T}_{\mathrm{p}}$, suppresses the superconducting transition temperature ${T}_{\mathrm{c}}$ and leads to an increase of the antiferromagnetic susceptibility accompanied by the creation of ferromagnetic impurity phases, which are developing with annealing time. However, annealing at $T=488\phantom{\rule{0.28em}{0ex}}\mathrm{K}\ensuremath{\simeq}{T}_{\mathrm{p}}$ increases ${T}_{\mathrm{c}}$ up to 33.3 K, sharpens the superconducting transition, increases the lower critical field, and strengthens the screening efficiency of the applied magnetic field. Resistivity measurements of the as-grown and optimally annealed samples reveal an increase of the upper critical field along both crystallographic directions as well as its anisotropy. Muon spin rotation and scanning transmission electron microscopy experiments suggest the coexistence of two phases below ${T}_{\mathrm{p}}$: a magnetic majority phase of Rb${}_{2}$Fe${}_{4}$Se${}_{5}$ and a nonmagnetic minority phase of Rb${}_{0.5}$Fe${}_{2}$Se${}_{2}$. Both microscopic techniques indicate that annealing the specimens just at ${T}_{\mathrm{p}}$ does not affect the volume fraction of the two phases, although the magnetic field distribution in the samples changes substantially. This suggests that the microstructure of the sample, caused by mesoscopic phase separation, is modified by annealing just at ${T}_{\mathrm{p}}$, leading to an improvement of the superconducting properties of Rb${}_{x}$Fe${}_{2\ensuremath{-}y}$Se${}_{2}$ and an enhancement of ${T}_{\mathrm{c}}$.

The anisotropic superconducting properties of a RbxFe2−ySe2 single crystal with Tc≃32 K were investigated by means of superconducting quantum interference device (SQUID) and torque magnetometry, probing the effective magnetic penetration depth λeff and the magnetic penetration depth anisotropy γλ. Interestingly, γλ is found to be temperature independent in the superconducting state but strongly field dependent: γλ(0.2 T) 8. This unusual anisotropic behavior, together with a large zero-temperature λeff(0)≃1.8 μm, is possibly related to a superconducting state heavily biased by the coexisting antiferromagnetic phase.

Muon-spin rotation (µSR) experiments are often used to study the magnetic field distribution in type-II superconductors in the vortex state. Based on the determination of the magnetic penetration depth it is frequently speculated—also controversially—about the order-parameter symmetry of the studied superconductors. This article reports on a combined µSR and magnetization study of the mixed state in the cuprate high-temperature superconductor La1.83Sr0.17CuO4 in a low magnetic field of 20 mT applied along the c axis of a single crystal. The macroscopic magnetization measurements reveal substantial differences for various cooling procedures. Yet, indicated changes in the vortex dynamics between different temperature regions as well as the results of the microscopic µSR experiments are virtually independent of the employed cooling cycles. Additionally, it is found that the mean magnetic flux density, locally probed by the muons, strongly increases at low temperatures. This can possibly be explained by a non-random sampling of the spatial field distribution of the vortex lattice in this cuprate superconductor caused by intensified vortex pinning.

We present a combination of magnetization and magnetic torque experiments to investigate the magnetic orders in undoped EuFe${}_{2}$As${}_{2}$ and Co-doped EuFe${}_{1.8}$Co${}_{0.2}$As${}_{2}$ single crystals. Although at low temperatures typical results for an antiferromagnetic (AFM) state in EuFe${}_{2}$As${}_{2}$ were found, our data strongly indicate the occurrence of a canted antiferromagnetic (C-AFM) order of the Eu${}^{2+}$ moments between 17 and 19 K, observed even in the lowest studied magnetic fields. However, unlike in the parent compound, no low-field and low-temperature AFM state of the Eu${}^{2+}$ moments was observed in the doped EuFe${}_{1.8}$Co${}_{0.2}$As${}_{2}$. Only a C-AFM phase is present at low fields and low temperatures, with a reduced magnetic anisotropy as compared to the undoped system. We discuss for both EuFe${}_{2}$As${}_{2}$ and EuFe${}_{1.8}$Co${}_{0.2}$As${}_{2}$ the experimentally deduced magnetic phase diagrams of the magnetic ordering of the Eu${}^{2+}$ sublattice with respect to the temperature, the applied magnetic field, and its orientation to the crystallographic axes. It is likely that the magnetic coupling of the Eu and the Fe sublattice is strongly dependent on Co doping, having detrimental influence on the magnetic phase diagrams as determined in this work. Their impact on the occurrence of superconductivity with higher Co doping is discussed.

An overdoped YBa${}_{2}$Cu${}_{3}$O${}_{7}$ single crystal was studied by SQUID and torque magnetometry in order to investigate the temperature dependence of the anisotropy parameter close to the transition temperature ${T}_{\mathrm{c}}$ ($0.87{T}_{\mathrm{c}}lTl{T}_{\mathrm{c}}$). Angle-dependent torque measurements were performed and analyzed with the widely used Kogan model [Phys. Rev. B 38, 7049 (1988)] as well as with an extended model by Hao and Clem [Phys. Rev. Lett. 67, 2371 (1991)], taking into account the influence of the vortex cores on the magnetization. Both approaches yield similar results, with an out-of-plane anisotropy parameter around 6.5 which slightly increases with decreasing temperature, and a temperature independent in-plane anisotropy parameter ${\ensuremath{\gamma}}_{ab}=1.12(5)$.

Since 1982, 229 terminally ill cancer pain patients were treated by the administration of epidural opioids. An adequate level of aid was provided by the coordinated efforts of the patients' general practitioner, the district nurse, and the anesthesiologist. Based on 9 yr of experience with this model, a project on quality improvement and organization of cancer pain control by infusion techniques in the home situation was proposed. The purpose of the study is to create a nationwide organization for cancer pain control for terminal patients on a home-care basis. Specially trained ambulatory field teams will be set up to collect and process the information necessary to make protocols and instructions.

Aortic ulcerlike projections are focal, contrast-filled outpouchings projecting from the aortic lumen. Our aim was to document the CT findings and natural history of ulcerlike projections developing in patients with preexisting noncommunicating aortic dissection, including intramural hematoma or false lumen thrombosis.By searching the radiology information system, we found 38 ulcerlike projections arising in an underlying noncommunicating aortic dissection that were identified at CT in 24 patients. Clinical factors were determined from patient records. CT scans were reviewed to determine aortic pathology type and appearance time of ulcerlike projections and to measure the diameters of the aorta and ulcerlike projections for comparison over time. Complications were defined as an increase of at least 20% in the diameters of the ulcerlike projections or aorta, the need for surgical repair, or both. Comparisons of ulcerlike projections with and without complications were performed using various statistical tests.The underlying aortic disease of the 38 ulcerlike projections was intramural hematoma in 26, false lumen thrombosis in nine, and unknown in three. The mean time of ulcerlike projection appearance was 2.4 months (SD, 1.8) for intramural hematoma and 19.3 months (SD, 18.1) for false lumen thrombosis. Nine of the 28 ulcerlike projections with follow-up scans showed stability, size decrease, or resolution; 10 increased in size; and nine were incorporated into an expanded aortic lumen. Four of 36 ulcerlike projections with imaging or clinical follow-up (or both) required surgical repair. The only clinical or imaging feature significantly associated with the development of complications was false lumen thrombosis (p = 0.04).Ulcerlike projections forming in noncommunicating dissections may enlarge over time, although they rarely require surgical repair. Given the potential for critical complications, these lesions should be followed with serial CT scans.