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This review aims to provide a correlation between oral and oropharyngeal subsites and type of reconstruction used in the management of head and neck cancer patients. A literature search of PubMed, Embase and Web of Science was conducted. All study types describing long-term speech and swallow outcomes of adults following head and neck oncological reconstruction, which used a subsite classification, were included. Risk of bias was assessed using the Robbins-1 tool. A total of 2270 patients were found in 26 studies. The number of subsites/studies ranged from 2 to 18. Subsites were predominantly divided on an anatomical basis. Other classifications included functionally grouped subsites. Seven articles considered combinations, unilateral and bilateral defects. Base of tongue, FOM, and defects crossing the midline are negatively correlated with post-operative speech and swallow. Lateral distributions were associated with superior outcomes. The University of Washington Quality of Life Questionnaire (UW-QOL) was the most prevalent tool for speech and swallow assessment. Other factors that significantly affect speech and swallow outcomes include adjuvant therapy, size, type of reconstruction (free flap compared to pedicled or local). The role of neoadjuvant therapy remains unknown. A consistent and formalised approach including risk stratification for multiple contributing factors would be useful in clinical pre- and post-operative management. [ABSTRACT FROM AUTHOR]

Autologous fat grafting (AFG) is a versatile technique in reconstructive and cosmetic surgery. Graft processing is a key source of variability resulting in unreliable clinical outcomes, with no consensus on the optimal methodology. This systematic review identifies the evidence base supporting different processing paradigms. A systematic literature search was conducted using the PubMed, Scopus and The Cochrane Foundation databases. Studies comparing AFG processing methods and reporting long-term patient outcomes were identified. Twenty-four studies (2413 patients) were identified. Processing techniques evaluated included centrifugation, decantation, washing, filtration, gauze rolling, as well as commercial devices and adipose-derived stem/stromal cell (ASC) enrichment methods. Objective volumetric and subjective patient-reported outcomes were discussed. There was a variable reporting of complications and volume retention rates. Complications were infrequent; palpable cysts (0–20%), surgical-site infections (0–8%) and fat necrosis (0–58.4%) were the most reported. No significant differences in long-term volume retention between techniques were found in AFG in the breast. In head and neck patients, greater volume retention was documented in ASC enrichment (64.8–95%) and commercial devices (41.2%) compared to centrifugation (31.8–76%). Graft processing through washing and filtration, including when incorporated into commercial devices, results in superior long-term outcomes compared to centrifugation and decantation methods. ASC enrichment methods and commercial devices seem to have superior long-term volume retention in facial fat grafting. [ABSTRACT FROM AUTHOR]

Unconditional basic income (UBI) is one of the most discussed policy options for a degrowth transition. Advocates highlight UBI's theoretical potential to reduce unnecessary material consumption, alleviate poverty and redistribute social wealth, achieve wellbeing within ecological limits, shift activity from wage-labour to meaningful work, and facilitate increased social participation. However, UBI's radical potential remains under-examined within the empirical research, which focuses more on the policy's potential to increase the supply of wage-labour and stimulate economic growth. This paper aims to push back against this limiting trend. It begins by outlining some of the characteristics of more sustainable and just societies, based on post-growth perspectives, and outlines the arguments put forward to support UBI's compatibility with a degrowth transition. It then demonstrates that, despite support from UBI and many post-growth scholars, such arguments are not mainstreamed in the contemporary empirical UBI research. The paper argues that this increases the risk of UBI being captured by capitalist interests. To avoid this outcome, the paper proposes an alternative research agenda to help assess and advance UBI's radical potential in line with post-growth visions. • How do the characteristics of modern societies compare to those that align with post-growth perspectives? • UBI is advocated for having a role to play in the transition to more sustainable and just societies. • However, much of the empirical UBI research neglects to address many of the questions raised in the post-growth literature. • Understanding UBI's potential contribution to a degrowth transition therefore requires a new research agenda. [ABSTRACT FROM AUTHOR]

The impact of neoadjuvant chemotherapy (NACT) on surgical outcomes following immediate breast reconstruction (IBR) remains unclear. While it is generally considered safe practice to perform an IBR post NACT, reported complication rates in published data are highly variable with the majority of studies including fewer than 50 patients in the NACT and IBR arm. To evaluate this further, we conducted a systematic review and meta-analysis on the effect of NACT on autologous and implant based immediate breast reconstructions. We aimed to assess for differences in the post-operative course following IBR between patients who received NACT with those who did not. PubMed, EMBASE, and Cochrane Library were searched from 1995 to Sept 2, 2020 to identify articles that assessed the impact of NACT on IBR. All included studies assessed outcomes following IBR. Only studies comparing reconstructed patients receiving NACT to a control group of women who did not receive NACT were included. Unadjusted relative risk of outcomes between patients who received or did not receive NACT were synthesized using a fixed-effect meta-analysis. The evidence was assessed using the Newcastle Ottawa Scale scores and GRADE. Primary effect measures were risk ratios (RRs) with 95% confidence intervals. A total 17 studies comprising 3249 patients were included in the meta-analyses. Overall, NACT did not increase the risk of complications after immediate breast reconstructions (risk ratio [RR]: 0.91, 95% CI 0.74 to 1.11, p = 0.34). There was a moderate, but not significant, increase in flap loss following NACT compared with controls (RR: 1.23, 95% CI 0.70 to 2.18, p = 0.47; I 2 = 0%). Most notably, there was a statistically significant increase in implant/expander loss after NACT (RR: 1.54, 95% CI 1.04 to 2.29, p = 0.03; I 2 = 34%). NACT was not shown to significantly increase the incidence of hematomas, seromas or wound complications, or result in a significant delay to commencing adjuvant therapy (RR: 1.59, 95% CI 0.66 to 3.87, p = 0.30). Immediate breast reconstruction after NACT is a safe procedure with an acceptable post-operative complication profile. It may result in a slight increase in implant loss rates, but it does not delay commencing adjuvant therapy. [ABSTRACT FROM AUTHOR]

Diabetic foot syndrome (DFS) contributes to significant morbidity in diabetic patients. Diagnostic and therapeutic approaches to DFS may be summarised in clinical practice guidelines (CPGs) to aid clinical practice but may only benefit patients if the CPG is of high quality. This study determines the methodological quality of DFS CPGs using a validated assessment tool to identify CPGs adequate for use in clinical practice. Medline, EMBASE, and CPG databases were searched to 31 May 2019. Reference lists were also searched. Full text English evidence based DFS CPGs were included. CPGs based on expert consensus, guideline summaries, or those only available if purchased were excluded. Four reviewers independently assessed methodological quality using the Appraisal of Guidelines for Research and Evaluation II instrument. An overall guideline assessment scaled score of ≥80% was considered to be of adequate quality to recommend use. Sixteen CPGs were identified. Good inter-reviewer reliability (ICC 0.985, 95% CI 0.980–0.989) was achieved. Poor scores were noted in domains 2 (stakeholder involvement), 5 (applicability), and 6 (editorial independence). Significant methodological heterogeneity was observed in all domains with the most noted in domain 6 (mean scaled score 43.2 ± 32.1%). Four CPGs achieved overall assessment scores of ≥80%. Four CPGs were considered to be adequate for clinical practice based on methodological quality. However, elements of methodological quality were still lacking, and all CPGs had areas for improvement, potentially through increased multidisciplinary team involvement and trial application of recommendations. Methodological rigour may be improved using structured approaches with validated CPG creation tools in the future. Future work should also assess recommendation accuracy using available validated assessment tools. [ABSTRACT FROM AUTHOR]

Median arcuate ligament syndrome (MALS) describes the clinical presentation associated with direct compression of the celiac artery by the median arcuate ligament. The poorly understood pathophysiologic mechanism, variable symptom severity, and unpredictable response to treatment make MALS a controversial diagnosis. This review summarizes the literature pertaining to the pathophysiologic mechanism, presentation, diagnosis, and management of MALS. A suggested diagnostic workup and treatment algorithm are presented. Individuals with MALS present with signs and symptoms of foregut ischemia, including exercise-induced or postprandial epigastric pain, nausea, vomiting, and weight loss. Consideration of MALS in patients' diagnostic workup is typically delayed. Currently, no group consensus agreement as to the diagnostic criteria for MALS exists; duplex ultrasound, angiography, and gastric exercise tonometry are used in different combinations and with varying diagnostic values throughout the literature. Surgical management involves decompression of the median arcuate ligament's constriction of the celiac artery; robotic, laparoscopic, endoscopic retroperitoneal, and open surgical intervention can provide effective symptom relief, but long-term follow-up data (>5 years) are lacking. Patients treated nonoperatively appear to have worse outcomes. MALS is an important clinical entity with significant impact on affected individuals. Presenting symptoms, patient demographics, and radiologic signs are generally consistent, as is the short-to medium-term (<5 years) response to surgical intervention. Future prospective studies should directly compare long-term symptomatic and quality of life outcomes after nonoperative management with outcomes after open, laparoscopic, endoscopic retroperitoneal, and robotic celiac artery decompression to enable the development of evidence-based guidelines for the management of MALS. [ABSTRACT FROM AUTHOR]

• Forests constitute important refuge habitats for bats. • Relative activity of ten hawking bat species was analysed using acoustic surveys. • 713 point counts in 46 forests across mainland France were monitored over 6 years. • Ground deadwood cover and vegetation volume heterogeneity influenced bat activity. • Complex vegetation structures may enhance both ecosystem and bat conservation. Forests constitute one of the most important feeding and foraging habitats for bats. Because bat populations are declining, most likely due to habitat loss or fragmentation, it is imperative to understand the issues concerned with timber exploitation on bat conservation. We investigated the foraging activity of edge- and open-space foragers in relation to stand and vegetation structure, characteristics that are commonly affected by forestry. Acoustic surveys, culminating to 713 point count sites were undertaken covering 46 different forest massifs across mainland France over 6 years. We used generalized linear mixed models to analyse the activity of ten species: 6 edge-habitat and 4 open-habitat foragers. Pipistrellus pipistrellus was the most detected edge-habitat forager, while Nyctalus leisleri was the most recorded of the open-habitat foragers. Eptesicus serotinus and P. pipistrellus responded positively to heterogeneous vertical vegetation volume. In addition, P. kuhlii and P. nathusii responded negatively to tree basal area. Barbastella barbastellus , Hypsugo savii , and P. nathusii were associated with either ground deadwood and/or logging tracks and minor-traffic roads, confirming the importance of edge space. Finally, B. barbastellus, E. serotinus, and P. nathusii were positively linked to the presence of tree microhabitats. This study demonstrates that bat use in forests is complex and multifaceted. Maintaining ground deadwood and heterogeneity of vegetation, at the forest plot scale, should ensure the ecological functioning of exploited forest systems and the conservation of edge- and open-habitat foraging bats. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: Lung resection for primary bronchogenic carcinoma in the setting of chronic obstructive pulmonary disease often requires a detailed assessment of lung function to avoid perioperative complications and long-term disability. The aim of this study was to test the hypothesis that a novel technique of spiral computed tomographic (CT) subtraction imaging provides accuracy equal to the current standard of radioisotope perfusion scintigraphy in predicting postoperative lung function. Methods and Materials: Preoperative lung function, radioisotope perfusion scintigraphy, spiral CT subtraction imaging, and assessment of postoperative lung function were performed in 25 patients with surgically resectable primary bronchogenic carcinoma. Comparisons of predicted postoperative lung function between the two modalities and to true postoperative lung function were performed using Pearson's correlation and linear regression analysis. Results: Among the 25 patients enrolled in the study, there was a high degree of agreement between the predicted value of postoperative forced expiratory lung volume in 1 second (FEV(1)) generated on novel contrast CT subtraction imaging and that on radioisotope perfusion scintigraphy (r = 0.96, P < .001). Furthermore, there was a strong correlation between the predicted and actual postoperative FEV(1) values for both imaging modalities (r = 0.87, P < .001, and r = 0.88, P < .001, respectively), among the 14 patients completing the study protocol. Conclusion: A novel technique of CT subtraction imaging is equally accurate at predicting postoperative lung function as radioisotope perfusion scintigraphy, which may obviate the need for additional nuclear imaging in the context of the preoperative assessment of resectable lung cancer in high-risk patients. [ABSTRACT FROM AUTHOR]

Introduction This review paper identifies and describes the role of clinicians' memory, emotions and physical responses in clinical reasoning processes. Clinical reasoning is complex and multi-factorial and key models of clinical reasoning within musculoskeletal physiotherapy are discussed, highlighting the omission of emotion and subsequent physical responses and how these can impact upon a clinician when making a decision. Discussion It is proposed that clinicians should consider the emotions associated with decision-making, especially when there is concern surrounding a presentation. Reflecting on practice in the clinical environment and subsequently applying this to a patient presentation should involve some acknowledgement of clinicians' physical responses, emotions and how they may play a part in any decision made. Presenting intuition and gut-feeling as separate reasoning methods and how these processes co-exist with other more accepted reasoning such as hypothetico-deductive is also discussed. Conclusion Musculoskeletal physiotherapy should consider the elements of feelings, emotions and physical responses when applying reflective practice principles. Furthermore, clinicians dealing with difficult and challenging presentations should look at the emotional as well as the analytical experience when justifying decisions and learning from practice. [ABSTRACT FROM AUTHOR]

Introduction Employing allied health professionals in extended scope roles has developed relatively recently in health-care. Within physiotherapy, the extended role has provided clinicians with autonomy to use knowledge and clinical acumen to request investigations such as Magnetic Resonance Imaging (MRI) and X-ray as part of the diagnostic process, a practice beyond the traditional scope of physiotherapy. In these advancing roles, little is written about the clinical reasoning processes that clinicians use in managing patients with musculoskeletal pain and knowledge of these processes would advance training for new recruits to this arena. Study This qualitative study has explored the processes by which extended scope physiotherapists (ESPs) clinically reason their decisions regarding patients reporting low back pain in a musculoskeletal outpatient setting. The study used a multiple case study design informed by grounded theory methodology, using focus groups (involving ESPs and non-ESPs/musculoskeletal physiotherapists) and semi-structured interviews with a think-aloud method (ESPs only) to investigate these processes. Conclusions The themes identified include: prior thinking; patient interaction; formal testing; time; safety and accountability; external and internal factors; and gut-feeling (which challenges current physiotherapy models of reasoning). Extended scope physiotherapists reported experiencing greater stress due to higher levels of perceived accountability, safety requirements and internal drivers for competence than non-ESPs. Further research is indicated to explore the role of gut-feeling in musculoskeletal physiotherapy clinical reasoning. [ABSTRACT FROM AUTHOR]

Background and purpose The purpose of this pilot study was to examine the potential for a spa bath intervention to reduce the perception of pain and anxiety, and to improve well-being, among palliative patients. Materials and methods 52 palliative care patients rated their pain, anxiety and well-being before and after taking a bath in a purpose-built spa bath designed to accommodate frail and unwell patients. Results The intervention improved patients’ self-reported pain (t(51) = −6.13, p <.001, d z  = .85), anxiety (t(51) = −4.58, p <.001, d z  = .64), and well-being (t(48) = −7.19, p  < .001, d z  = 1.03). Conclusion The provision of a spa bath may be a simple and effective way to improve patients’ quality of life, within the normal course of nursing duties. Whether these results are achieved in a controlled trial and the duration of these effects is unknown. These preliminary results justify further investigation of the potential for water-based relaxation therapy for patients at the end-of-life. [ABSTRACT FROM AUTHOR]

Groundwater, a critical resource in many parts of the world, is often characterized as a common pool resource ( Brozovic et al., 2006 ). Multiple individuals utilize groundwater from a basin, and each person has the capacity to reduce the quantity or quality available to others. We turn to a case study of the Pajaro Groundwater Basin in Central California to re-envision the characterization of “commons.” While providing a useful frame from which to analyze groundwater depletion in the Pajaro, we find Common Pool Resource (CPR) theory to be imprecise in its approach to a geographic scale. The notion of the “commons” is central to CPR studies, but there is wide divergence in what the “commons” constitutes, both spatially and socially ( Laerhoven and Ostrom, 2007 ). Rather than propose a normative definition for the “commons,” we suggest that the “commons” as a geographic category is socially constructed and dynamically active over time, akin to the analytic of scale as developed within the fields of political ecology and geography. This move from situating the “commons” as a fixed and discrete geographic area to that which is constantly changing and relational helps us to better understand the ways in which water users collaborate and communicate around shared groundwater sources. [ABSTRACT FROM AUTHOR]

Introduction There is a lack of standardisation in the guidelines for post-operative exercises following breast cancer surgery. Adherence to exercise programmes is low, and complementary therapies such as yoga often appeal to patients and may encourage practise. A step-by-step guide to yoga DVD was evaluated in addition to the standard care exercises (SC) compared to SC alone. Methods Women with early-stage breast cancer were randomised to SC plus or minus a yoga DVD for 10-weeks. Patient-reported outcomes were collected at baseline, 10 weeks and 6 months. The primary study-endpoint was the Trial Outcome Index (TOI) of the Functional Assessment of Cancer Treatment-Breast; a recognised quality of life (QoL) tool with an arm morbidity subscale (FACT-B+4). Results 92/103 (89%) women were randomised to the study. The SC group reported practising post-operative exercises more often than the yoga DVD group. There was a 69% improvement from baseline in FACT-B+4 TOI, which included an arm subscale, at 10 weeks and 6 months in the SC group. This was 62% and 81% respectively for the yoga DVD group. Numbness in the affected arm was greater in the SC group (OR = 2.5, 95% CI: 1.1, 5.6) and in patients receiving chemotherapy (OR = 2.17, 95% CI: 1, 4.6). Despite no group differences, 74% of women would definitely recommend following the yoga DVD after surgery. Conclusions Practising post-operative exercises does improve arm and shoulder morbidity following breast cancer surgery. The addition of a self-practise general yoga programme was well received and appeared to improve QoL at 6 months. [ABSTRACT FROM AUTHOR]

Background The 2 Cohort randomised PrefHer trial examined the preferences of HER2+ve primary breast cancer patients for intravenous (IV) or subcutaneous (SC) delivery of trastuzumab via a Single Injectable Device (SID) or hand-held syringe (HHS). The novel approach and design of the study permitted an in-depth exploration of patients' experiences, the impact that different modes of delivery had on patients' well-being and implications for future management. Methods The preferences, experiences and general comments of patients in the PrefHer study were collected via specific semi-structured interview schedules. Exploratory analyses of data were conducted using standard methodology. The final question invited patients to make further comments, which were divided into 9 thematic categories – future delivery, compliments, time/convenience, practical considerations, pain/discomfort, study design, side-effects, psychological impact, and perceived efficacy. Results 267/467 (57%) patients made 396 additional comments, 7 were neutral, 305 positive and 86 negative. The three top categories generating the largest number of comments were compliments and gratitude about staff and being part of PrefHer (75/396; 19%), the potential future delivery of SC trastuzumab (73/396; 18%), and practical considerations about SC administration (60/396; 15%). Conclusions Eliciting patient preferences about routes of administration of drugs via comprehensive interviews within a randomised cross-over trial yielded rich and important information. The few negative comments made demonstrated a need for proper staff training in SC administration Patients were grateful to have been part of the trial, and would have liked to continue with SC delivery. The possibility of home administration in the future also seemed acceptable. EudraCT number 2010-024099-25. [ABSTRACT FROM AUTHOR]

Abstract: Sea-level rise, potential changes in the intensity and frequency of storms, and consequent shoreline erosion and flooding will have increasing impacts on the economy and culture of coastal regions. A growing body of evidence suggests that coastal ecosystems—natural infrastructure—can play an important role in reducing the vulnerability of people and property to these impacts. To effectively inform climate adaptation planning, experts often struggle to develop relevant local and regional information at a scale that is appropriate for decision-making. In addition, institutional capacity and resource constraints often limit planners' ability to incorporate innovative, scientifically based approaches into planning. In this paper, we detail our collaborative process in two coastal California counties to account for the role of natural infrastructure in climate adaptation planning. We used an interdisciplinary team of scientists, economists, engineers, and law and policy experts and planners, and an iterative engagement process to (1) identify natural infrastructure that is geographically relevant to local jurisdictional planning units, (2) refine data and models to reflect regional processes, and (3) develop metrics likely to resonate within the local decision contexts. Using an open source decision-support tool, we demonstrated that protecting existing natural infrastructure—including coastal dunes and wetlands—could reduce the vulnerability of water resource-related structures, coastal populations, and farmland most exposed to coastal flooding and erosion. This information formed part of the rationale for priority climate adaptation projects the county governments are now pursuing. Our collaborative and iterative approach, as well as replicable use of an open source decision-support tool, facilitated inclusion of relevant natural infrastructure information into regional climate adaptation planning processes and products. This approach can be applied in diverse coastal climate adaptation planning contexts to locate and characterize the degree to which specific natural habitats can reduce vulnerability to sea-level rise and storms. [Copyright &y& Elsevier]

Abstract: Objectives: We modified an educational intervention developed to improve communication about clinical trials and enhance multidisciplinary team (MDT) working for specialist breast cancer MDTs. We assessed the effect of one day MDT training on team members' awareness & clarity about trials in their portfolio, and individuals' confidence & communication about clinical trials. Materials and methods: Six MDTs in England participated between May 2012 and January 2013. Teams identified a breast trial from their portfolio that was about to start or one for which recruitment was proving difficult. Participants completed questionnaires identifying their roles and awareness of trial activity. The interactive workshop contained several generic elements: including PPT presentations, relevant exercises, and practical sessions but were also customised to fit the individual MDT requirements. Participants completed post-course questionnaires and the team leaders completed a 6-month review. Results: Eighty healthcare professionals participated. There were significant positive changes (P < 0.001) post-workshop for all 15 key areas probed concerning awareness and clarity about the trial(s) discussed during the training intervention. Six month questionnaire data revealed 5/6 teams had greater awareness of actual roles played by their colleagues and that more team members were willing and able to discuss trial(s) with patients. Additionally, 5/6 team leaders said that dynamics had changed for the better and enthusiasm for trials improved. Conclusion: Workshops focussed on clinical trials can be conducted in one day and produce improvements in team awareness, knowledge of teams' trials portfolios and communication skills. [Copyright &y& Elsevier]

Abstract: Coastal development is spreading along the World''s coasts. Sea levels are rising, so major future asset losses are expected. Planned retreat from the sea behind natural ecological defences is one adaptation option. To maintain it, land could be set aside for colonisation by coastal ecosystems, or buildings constructed on condition they are removed when sea level reaches a specified distance from the building. Similarities among coastal issues in high-income countries encouraged us to produce a generalisable analytical framework for exploring planned retreat. We applied it to South East Queensland, Australia, where the option of planned retreat is disappearing because (1) State Government promotes population increase; (2) the need to provide places for naturally protective coastal ecosystems to occupy does not seem urgent, so houses are built there; (3) liability laws favour development; (4) planning ignores cumulative impacts, the path dependent nature of development and irreversible social–ecological threshold changes; (5) political pressure to build defences grows as the value of built assets increases. To implement planned retreat, changes to coastal governance would be needed, for which we propose five guiding principles: (a) allocate authority and resources between levels of governance according to their effectiveness at each level; (b) strengthen development rules and incentives to relocate as an unwanted threshold is approached; (c) allow for uncertainties by enabling rules and incentives to be changed when circumstances change; (d) reassign public and private benefits, costs, risks, uncertainties and responsibilities from governments to beneficiaries of development; (e) institutionalise catastrophes as opportunities for change, not signals to rebuild. Following from this research, one of our next the priorities is the psychology of social change, uncertainty, rights, obligations, incentives and trust. The other is to extend and deepen understanding of the responses of developers, bankers, insurers, house buyers, sellers and owners to changes in development rules and incentives. [Copyright &y& Elsevier]

Rationale and Objectives: Lung resection for primary bronchogenic carcinoma in the setting of chronic obstructive pulmonary disease often requires a detailed assessment of lung function to avoid perioperative complications and long-term disability. The aim of this study was to test the hypothesis that a novel technique of spiral computed tomographic (CT) subtraction imaging provides accuracy equal to the current standard of radioisotope perfusion scintigraphy in predicting postoperative lung function. Methods and Materials: Preoperative lung function, radioisotope perfusion scintigraphy, spiral CT subtraction imaging, and assessment of postoperative lung function were performed in 25 patients with surgically resectable primary bronchogenic carcinoma. Comparisons of predicted postoperative lung function between the two modalities and to true postoperative lung function were performed using Pearson''s correlation and linear regression analysis. Results: Among the 25 patients enrolled in the study, there was a high degree of agreement between the predicted value of postoperative forced expiratory lung volume in 1 second (FEV1) generated on novel contrast CT subtraction imaging and that on radioisotope perfusion scintigraphy (r = 0.96, P < .001). Furthermore, there was a strong correlation between the predicted and actual postoperative FEV1 values for both imaging modalities (r = 0.87, P < .001, and r = 0.88, P < .001, respectively), among the 14 patients completing the study protocol. Conclusion: A novel technique of CT subtraction imaging is equally accurate at predicting postoperative lung function as radioisotope perfusion scintigraphy, which may obviate the need for additional nuclear imaging in the context of the preoperative assessment of resectable lung cancer in high-risk patients. [Copyright &y& Elsevier]

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