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Magnetic resonance imaging (MRI) assesses pulmonary hypoplasia in fetal congenital diaphragmatic hernia (CDH). Neonatal mortality may occur with CDH. To quantify MRI parameters associated with neonatal survival in fetuses with isolated CDH. Fetal MRI for assessing CDH included region of interest (ROI) measurements for total lung volume (TLV), herniated liver volume, herniated other organ volume and predicted lung volume. Ratios of observed lung volume and liver up volume to predicted lung volume (observed to predicted TLV, percentage of the thorax occupied by liver) were calculated and compared to neonatal outcomes. Analyses included Wilcoxon rank sum test, multivariate logistic regression and receiver operating characteristic (ROC) curves. Of 61 studies, the median observed to predicted TLV was 0.25 in survivors and 0.16 in non-survivors (P=0.001) with CDH. The median percentage of the thorax occupied by liver was 0.02 in survivors and 0.22 in non-survivors (P 28 weeks was greater compared to GA ≤28 weeks. The ROC analysis demonstrated an area under the curve of 0.96 (95% confidence interval 0.91–1.00) for the combined observed to predicted TLV, percentage of the thorax occupied by liver and GA. The percentage of the thorax occupied by liver and observed to predicted TLV was predictive of neonatal survival in fetuses with CDH.

Recent advances have made it possible to precisely measure the extent to which any two words are used in similar contexts. In turn, this measure of similarity in linguistic context also captures the extent to which the concepts being denoted are similar. When extracted from massive corpora of text written by millions of individuals, this measure of linguistic similarity can provide insight into the collective concepts of a linguistic community, concepts that both reflect and reinforce widespread ways of thinking. Using this approach, we investigated the collective conceptperson/people, which forms the basis for nearly all societal decision- and policy-making. In three studies and three preregistered replications with similarity metrics extracted from a corpus of over 630 billion English words, we found that the collective conceptperson/peopleis not gender-neutral but rather prioritizes men over women—a fundamental bias in our species’ collective view of itself.

People rapidly form impressions of others based on their gender. Women tend to be liked more than men but men tend to be regarded as more powerful. However, a person’s nonverbal behavior has the potential to confirm or override these stereotypical impressions. Specifically, expansive, open body postures (e.g., based on widespread limbs) tend to convey high power compared to contracted, closed body positions. In three studies, we tested whether postural variations affected evaluations of men and women and impressions of their power. In Study 1, images of women elicited a more positive reactions than images of men in an affective misattribution procedure, but only when women enacted contracted body postures. In Studies 2 and 3, participants were slower to classify images of expansive postures as high power when enacted by women and slower to classify contracted postures as low power when enacted by men, but rated men and women similarly in explicit power-related judgments. Expansive body postures thus appeared to eliminate the usual positive reaction to women relative to men, but women still did not implicitly convey power to the same degree as men. Gender did not interfere with explicit, more controlled judgments of power. Together these studies demonstrate that gender implicitly interferes with perceptions of a person’s power, even in the presence of potentially individuating body postures.

People with biological essentialist beliefs about social groups also tend to endorse biased beliefs about individuals in those groups, including intensified emphasis on the group, stereotypes, and prejudices. These correlations could be due to biological essentialism causing bias, and some experimental studies support this causal direction. Given this prior work, we expected to find that biological essentialism would lead to increased bias compared with a control condition and set out to extend this prior work in a new direction (regarding “value-based” essentialism). But although the manipulation affected essentialist beliefs and essentialist beliefs were correlated with group emphasis (Study 1), stereotyping (Studies 2, 3a, 3b, and 3c), prejudice (Studies 3a), there was no evidence that biological essentialism caused these outcomes ( NTotal = 1,903). Given these findings, our initial research question became moot. We thus focus on reexamining the relationship between essentialism and bias.

Psychological essentialism has played an important role in social psychology, informing influential theories of stereotyping and prejudice as well as questions about wrongdoers' accountability and their ability to change. In the existing literature, essentialism is often tied to beliefs in shared biology-that is, the extent to which members of a social group are seen as having the same underlying biological features. Here we investigate the possibility of "value-based essentialism" in which people think of certain social groups in terms of an underlying essence, but that essence is understood as a value. Study 1 explored beliefs about a wide range of social groups and found that both groups with shared biology (e.g., women) and shared values (e.g., hippies) elicited similar general essentialist beliefs relative to more incidental social categories (e.g., English-speakers). In Studies 2-4, participants who read about a group either as being based in biology or in values reported higher general essentialist beliefs compared with a control condition. Because biological essences about social groups have been connected to a number of downstream consequences, we also investigated two test cases concerning value-based essentialism. In Study 3, beliefs about both shared biology and shared values increased inductive generalizations about the social group relative to control, but in Study 4, only the shared biology condition reduced blame for wrongdoing. Together these findings join with recent work to support a broader theoretical framework of essentialism about social groups that can be arrived at through multiple pathways, including, in the present case, shared values. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

To compare prevalence and severity of multi-compartment pelvic floor dysfunction between supine magnetic resonance defecography with defecation (MRD) and supine dynamic MRI during Valsalva, both with and without rectal distention. This was an IRB-approved, HIPAA-compliant retrospective review of consecutive patients referred for MR Defecography. MRD protocol included imaging at rest, during pre-defecation Valsalva (Pre-DV), defecation (Def), and post-defecation Valsalva (Post-DV). The Post-DV images were performed after complete evacuation either during the defecation acquisition or, in cases where patient was unable to defecate during the examination, in a conventional toilet. Size of cystocele, vaginal prolapse, anorectal (AR) descent, and enterocele were measured on all acquisitions relative to the pubococcygeal line. Rectocele size was recorded in anteroposterior dimension. The presence or absence of rectal intussusception (RI) was documented. The prevalence, absolute size, and grades of prolapse, rectocele, and RI were compared between the acquisitions using pair-wise ANOVA, Friedman, Dunn pair-wise, and Cochran–Mantel–Haenszel tests. 30 patients were included in the final analysis. Higher prevalence of cystocele, vaginal prolapse, enterocele, AR descent grade 2 or higher, rectocele grade 2 or higher, and RI were seen on Def compared to Post-DV and Pre-DV. Cystocele, vaginal prolapse, enterocele, AR descent, and rectocele sizes were significantly larger on Def compared to Post-DV by 0.7−1.95 cm (p ≤ 0.007). Prolapse in all compartments and rectocele size were significantly larger on Def compared to Pre-DV (p

Concern that masculine generic language (e.g., man to mean humanity) perpetuates gender inequity has led several institutions to formally discourage its use. While previous experimental research indicates that generic terms like man bring more exemplars of men than women to mind, only recently have researchers begun exploring additional consequences of gendered language. Understanding the range of processes affected is of particular importance when evaluating real-world policies. Yale University recently changed the title of a leadership role from master to head. The present study (N = 341) investigated what exemplars come to mind (i.e., cognitive accessibility) while also probing memory for women and men in the leadership role both before and after Yale's language policy change. Students exposed to master generated a male exemplar more than would be expected by the incidence of men and recognized actual men in the role more accurately (d') than women in a face recognition task. Among students exposed to head, both biases were eliminated. The previous literature shows that masculine generic language brings men to mind. The present work demonstrates a similar effect but in an applied context while further documenting consequences for memory. Gender inclusive language polices have potential to reduce gender biased thinking with applied significance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Magnetic resonance imaging (MRI) assesses pulmonary hypoplasia in fetal congenital diaphragmatic hernia (CDH). Neonatal mortality may occur with CDH.To quantify MRI parameters associated with neonatal survival in fetuses with isolated CDH.Fetal MRI for assessing CDH included region of interest (ROI) measurements for total lung volume (TLV), herniated liver volume, herniated other organ volume and predicted lung volume. Ratios of observed lung volume and liver up volume to predicted lung volume (observed to predicted TLV, percentage of the thorax occupied by liver) were calculated and compared to neonatal outcomes. Analyses included Wilcoxon rank sum test, multivariate logistic regression and receiver operating characteristic (ROC) curves.Of 61 studies, the median observed to predicted TLV was 0.25 in survivors and 0.16 in non-survivors (P=0.001) with CDH. The median percentage of the thorax occupied by liver was 0.02 in survivors and 0.22 in non-survivors (P0.001). The association of observed to predicted TLV and percentage of the thorax occupied by liver with survival for gestational age (GA)28 weeks was greater compared to GA ≤28 weeks. The ROC analysis demonstrated an area under the curve of 0.96 (95% confidence interval 0.91-1.00) for the combined observed to predicted TLV, percentage of the thorax occupied by liver and GA.The percentage of the thorax occupied by liver and observed to predicted TLV was predictive of neonatal survival in fetuses with CDH.

On October 15, 2017, actress Alyssa Milano popularized the #metoo campaign, which sought to expose the prevalence of sexual harassment and assault in public domains by encouraging victims to share ...

Validated interventions that increase bias literacy (i.e., knowledge of gender bias) and decrease sexism are critical to addressing pervasive gender biases in science, technology, engineering, and mathematics (STEM). However, interventions that highlight existing gender inequities may inadvertently act as a social identity threat cue for women. Including identity-safe cues in diversity interventions (i.e., suggesting that women are valued in STEM) may lessen these problematic outcomes. To explore this possibility, we conducted three experiments utilizing Video Interventions for Diversity in STEM (VIDS), a validated diversity intervention relying on high quality videos to convey the existence of gender bias in STEM. Consistent with prior research, relative to control conditions, VIDS led to greater bias literacy and lower gender bias among both men and women (Experiments 1 and 2) and encouraged women’s intentions to take collective action (Experiment 2). At the same time, compared to control conditions, VIDS resulted in lower sense of belonging in the sciences, greater negative affect, and greater self-reported social identity threat, both among women from the general U.S. population (Experiments 1 and 2) and female scientists (Experiment 3). Including identity-safe cues, which present a positive female scientist role model (Experiment 2) or suggest that gender bias can be overcome (Experiments 2 and 3), helped alleviate VIDS’ harmful effects on women’s belonging and trust in the sciences, but had limited impact on stereotype threat. These findings highlight the need for researchers and practitioners to examine potential unintended negative consequences of diversity interventions and investigate techniques to buffer such outcomes.

Scholars are increasingly responding to calls for interventions to address persistent gender disparities in the sciences. Yet, interventions that emphasize the pervasiveness of bias may inadvertently damage efficacy to confront sexism by creating the perception that bias is immutable. We examined this possibility in the context of a successful bias literacy program, Video Interventions for Diversity in STEM (VIDS; Moss-Racusin et al., in press). In two studies with working adults from the general public ( N = 343) and science faculty ( N = 149), we modified VIDS by developing a module (UNITE) that offers tools for addressing bias and promotes the mindset that bias is malleable. VIDS alone was sufficient to increase awareness of bias, reduce sexism, and improve bias identification. However, UNITE buffered against perceptions that bias is immutable and restored self-efficacy to address bias. We conclude that interventions must aim not only to increase bias literacy but also offer concrete tools and avoid implying that these problems are insurmountable.

Objective The objective of this study was to evaluate acute liver injury (ALI) detected by diffusion-weighted magnetic resonance imaging (MRI) and the associated laboratory findings in women with hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome. Study Design This was a retrospective, observational study of women with HELLP syndrome defined by serum aspartate aminotransferase (AST) levels ≥100 U/L and thrombocytopenia with platelets ≤100,000/µL. All women underwent MRI postpartum including diffusion-weighted imaging to estimate the volume of ALI with reconstructed apparent diffusion coefficient (ADC) maps. The ADC map and the volume of ALI were compared with laboratory abnormalities by Spearman's correlation analysis. Results From March 2013 through August 2015, 16 women with HELLP syndrome underwent MRI, and of these, 14 (88%) women had areas of increased signal intensity suggestive of ALI. Their median (range) maximum AST level was 262 (140–1,958) IU/L, and at the time of MRI, AST was 103 (36–1,426) IU/L. Both of these AST levels significantly correlated with ADC map as well as the volume of ALI (both p-values Conclusion Women with HELLP syndrome frequently exhibited areas of abnormal diffusion in the liver on diffusion-weighted MRI, suggestive of ALI. The extent of liver injury was significantly correlated with serum AST.

Physical postures can instill a sense of power in the self as well as communicate power to others. Recent work indicates that a target’s gender interferes with the rapid identification of power pos...

To compare prevalence and severity of multi-compartment pelvic floor dysfunction between supine magnetic resonance defecography with defecation (MRD) and supine dynamic MRI during Valsalva, both with and without rectal distention.This was an IRB-approved, HIPAA-compliant retrospective review of consecutive patients referred for MR Defecography. MRD protocol included imaging at rest, during pre-defecation Valsalva (Pre-DV), defecation (Def), and post-defecation Valsalva (Post-DV). The Post-DV images were performed after complete evacuation either during the defecation acquisition or, in cases where patient was unable to defecate during the examination, in a conventional toilet. Size of cystocele, vaginal prolapse, anorectal (AR) descent, and enterocele were measured on all acquisitions relative to the pubococcygeal line. Rectocele size was recorded in anteroposterior dimension. The presence or absence of rectal intussusception (RI) was documented. The prevalence, absolute size, and grades of prolapse, rectocele, and RI were compared between the acquisitions using pair-wise ANOVA, Friedman, Dunn pair-wise, and Cochran-Mantel-Haenszel tests.30 patients were included in the final analysis. Higher prevalence of cystocele, vaginal prolapse, enterocele, AR descent grade 2 or higher, rectocele grade 2 or higher, and RI were seen on Def compared to Post-DV and Pre-DV. Cystocele, vaginal prolapse, enterocele, AR descent, and rectocele sizes were significantly larger on Def compared to Post-DV by 0.7-1.95 cm (p ≤ 0.007). Prolapse in all compartments and rectocele size were significantly larger on Def compared to Pre-DV (p 0.0001). Cystocele, vaginal prolapse, and enterocele sizes were significantly larger on Post-DV compared to Pre-DV (p 0.0001). There were significant differences in grading of all types of prolapse and rectocele between the various acquisitions of MRD (p 0.0001). Cystocele, AR descent, and rectocele grades were significantly higher on Def compared to Post-DV (p range ≤ 0.0002). Grading of all types of prolapse and rectocele was significantly higher on Def compared to Pre-DV (p 0.0001). Cystocele, vaginal prolapse, and enterocele grades were all significantly higher on Post-DV compared to Pre-DV (p ≤ 0.0007).Defecation images during supine MRD elicit higher prevalence and size of prolapse of all pelvic compartments in comparison to both pre- and post-defecation Valsalva images. Post-defecation Valsalva images show larger size of anterior and middle compartment prolapse than pre-defecation Valsalva images. Functional evaluation of pelvic floor dysfunction with MRI should include image acquisition during defecation. If Valsalva images are acquired, these should be performed after the defecation acquisition and without rectal distention.

Judging others’ power facilitates successful social interaction. Both gender and body posture have been shown to influence judgments of another’s power. However, little is known about how these two cues interact when they conflict or how they influence early processing. The present study investigated this question during very early processing of power-related words using event-related potentials (ERPs). Participants viewed images of women and men in dominant and submissive postures that were quickly followed by dominant or submissive words. Gender and posture both modulated neural responses in the N2 latency range to dominant words, but for submissive words they had little impact. Thus, in the context of dual-processing theories of person perception, information extracted from both behavior (i.e., posture) and from category membership (i.e., gender) are recruited side-by-side to impact word processing.

People view men as typically human, although some conditions may make this more or less likely. Language has been implicated as one factor, with masculine generic language (e.g., he used neutrally) leading to more androcentrism relative to its alternatives. However, the influence of two types of alternatives (e.g., they vs. he or she) remains unclear. The present study asked 297 male and female online participants from the United States to select typical representations of humanity from a set of White and Black male and female faces. The wording for the concept humanity was manipulated to be either a typical member of mankind, a typical human, or a typical man or woman (or woman or man). Overall, participants selected more White targets. Participants also selected more male targets, but the degree to which that was the case was affected by wording and participant’s gender. Participants, particularly male participants, in the mankind and human wording conditions were more likely to select a male target as representative, whereas in the man or woman condition, participants’ choices did not differ from chance. Thus, androcentric thinking may be more mutable than previously surmised, varying by participants’ gender and by context.

Purpose To provide normal biometry of the cerebellar vermis using fetal MR and determine threshold values associated with abnormal neurologic outcome. Materials and Methods Cerebellar vermis biometry was applied in prospective, cross-sectional evaluation of fetal brains. Vermis length and inferior vermian distance were obtained in mid-sagittal planes using T2-weighted, single-shot sequences with 1.5 Tesla MR. Measurements were compared with reference nomograms from a retrospective review of fetal brains with normal intracranial anatomy. Observed and predicted measurements of the cerebellar vermis were recorded. Neurologic outcome was classified as normal or abnormal. Unpaired t-tests and discriminate analysis were applied to the two measurements and differences between the observed and predicted values. Results The reference group included 64 fetuses of 13 to 38 weeks gestation. Both vermis length and inferior vermian distance increased linearly with time (r = 0.92, P

Purpose To compare saline infusion sonography (SIS) to tissue obtained from SIS-guided endometrial sampling (SISES) to determine sensitivity and specificity for benign and malignant conditions of the endometrium. Methods Added value of SISES after SIS was evaluated over 5 years. SIS and SISES techniques have been previously described. Women with abnormal uterine bleeding and endometrial findings underwent SIS. Criteria for SISES included atypical polypoid mass, focal irregularity or global endometrial thickening, nondiagnostic SIS, discordance between SIS and endometrial biopsy, or request from the primary team. Final surgical pathology was compared with SIS and SISES. Results One-hundred twenty-three SIS patients had SISES. SIS alone had a sensitivity of 100%, specificity of 42%, positive predictive value of 16%, and negative predictive value of 100%. A total of 120 patients had final clinical or surgical outcomes. Specificity was greatly improved with addition of SISES (95.5%, p < 0.001). Combination of SIS with SISES detected all 12 premalignant and malignant endometrial lesions. Three cases had small foci of hyperplasia (n = 2) or atypia (n = 1) in polyps on final surgical pathology, which were not prospectively identified on SISES. Conclusions SISES significantly improves the specificity in the diagnosis of endometrial lesions. False-negative findings of SISES in polyps in postmenopausal women with bleeding suggest the need for surgical removal in this setting. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound, 2016

As editors, reviewers, and authors, we are very pleased with the output of this Special Issue. We received a robust number of interesting and diverse submissions, and we were very lucky to convince...

People think of certain social roles (e.g., scientists) as being men, but perhaps even more fundamentally, people also tend to think of a person as a man. People list men more often than women as examples of humanity and describe men with generic labels (e.g., the person) but use gender-specific labels (e.g., the woman) for women. This is especially true of male respondents. Much of the research on this androcentric tendency to conflate men with people has measured more controllable behaviors. The present studies instead investigated androcentrism using adaptations of the implicit association test (IAT). The IAT more closely captures theoretically relevant categorization cognitive processes; responses on the IAT are more difficult to control and thus suitable for socially-sensitive topics like gender bias; and the IAT can help to explain gender differences in androcentrism. Results from three studies showed that participants associated broad human concepts (e.g., person) with men more than women (Studies 1–3), and gender-specific concepts (e.g., woman) with women more than men (Studies 2–3). These IAT associations were larger for male (vs. female) participants (Studies 1–3) and for participants exposed to a male-emphasizing (vs. gender-inclusive) term for humanity (i.e., mankind; Study 3). Participants were also more likely to notice a semantic redundancy between being male and being human compared to the same redundancy concerning women (Studies 2–3). Together, these findings support a categorization-based theoretical account of androcentrism, advancing understanding of the nature of androcentrism and gender differences therein.

The purpose of this study is to determine which MRI parameters of fetal head and neck masses predict high-morbidity neonatal outcomes, including ex utero intrapartum treatment (EXIT) procedure.This retrospective study (2004-2016) included parameters of polyhydramnios (based on largest vertical pocket), mass effect on the trachea, mass midline extension, and morphologic grade and size of masses. The morbid cohort included those requiring an EXIT procedure, difficult intubation at delivery, or lethal outcome. Predictive modeling with a multivariable logistic regression and ROC analysis was then performed.Of 36 fetuses, five were delivered by EXIT procedures, there was one neonatal death within 12 hours after delivery, and another neonate required multiple intubation attempts. The remaining 29 fetuses were delivered at outside institutions with no interventions or neonatal morbidity. The largest vertical pocket and mass effect on the trachea were selected as independent predictors by the logistic regression. The cross-validated ROC AUC was 0.951 (95% CI, 0.8795-1).The largest vertical pocket measurement and mass effect on the trachea were the most contributory MRI parameters that predicted significant morbidity in fetuses with masses of the face and neck, along with other significant parameters. These parameters predict significant morbid neonatal outcomes, including the need for EXIT procedures.

Cervical cancer metastatic to the para-aortic lymph nodes (PALNs) carries a poor prognosis. Despite extended-field radiation therapy (EFRT), only 30% to 50% of patients will survive 3 years. We sought to examine the treatment regimens used, associated toxicities, and treatment outcomes in patients with cervical cancer metastatic to PALN.A retrospective review was performed of all patients with cervical cancer treated at a single institution between January 1, 2007 and November 1, 2014. Included patients had PALN metastases as the most distant site of disease, and all treatment plans were designated as curative. Excluded patients had other distant disease or treatment plans considered palliative. Standard treatment consisted of EFRT with concurrent platinum-based chemotherapy.Fifty-one of 344 patients (14.8%) fulfilled the inclusion criteria. The median age was 48.4 years. Forty-four patients received standard EFRT; 7 also received adjuvant platinum/taxane chemotherapy. Thirty-nine of 51 (76%) of patients achieved a complete response to primary treatment. Twelve of 51 (24%) had persistent disease or progression at the completion of treatment. Of responders, 15 of 39 (38%) recurred for an overall treatment failure rate of 27 of 51 (53%). Nineteen of 27 (70%) of treatment failures occurred outside the radiated field. Adjuvant chemotherapy following EFRT was not predictive of progression-free survival or overall survival. PALN diameter ≥1 cm was a significant negative prognostic indicator for overall survival.Over half of patients with cervical cancer metastatic to the PALN failed extended-field chemoradiation. Most failures occurred outside the radiated field suggesting PALN involvement is a surrogate marker of systemic disease. These findings underscore the need for effective systemic therapy, especially in patients with PALN ≥1 cm in size.

To compare quantitative multiparametric magnetic resonance imaging (mpMRI) data of symptomatic uterine fibroids being considered for MR-guided high-intensity focused ultrasound ablation with fibroid characterization based on the Funaki Classification scheme.This was a prospective, Institutional Review Board -approved, Health Insurance Portability, and Accountability Act-compliant study. Informed consent was obtained. From December 2013 to April 2015, 48 women with symptomatic fibroids underwent screening with mpMRI protocol including sagittal/axial T2-weighted fast spin-echo, sagittal diffusion-weighted, and sagittal dynamic contrast-enhanced 3D T1-weighted gradient echo imaging on a 3T magnet. All fibroids were assigned Funaki type 1, 2, or 3 based on T2-weighted imaging. Differences in size, perfusion, and diffusion/intravoxel incoherent motion parameters among the three Funaki types were determined using linear mixed model. A logistic regression analysis was performed to select the best model in predicting type 3 fibroids.A total of 100 fibroids were assessed (20 type 1, 66 type 2, and 14 type 3). Apparent diffusion coefficient and D of type 3 fibroids were significantly higher than those of type 1 (P0.0001, P0.0001) and 2 fibroids (P = 0.004, P0.0001) respectively. Transfer constant of type 3 fibroids was significantly higher than type 1 (P = 0.0357), but not than type 2 (P = 0.0752). A cutoff value of D = 1 × 10mpMRI-derived quantitative parameters may enable a more objective selection of patients prior to MR-guided high-intensity focused ultrasound therapy.

The preference for morality in others is regarded as a dominant factor in person perception. Moral traits are thought to foster liking, and immoral traits are thought to foster disliking, irrespective of the context in which they are embedded. We report the results of four studies that oppose this view. Using both explicit and implicit measures, we found that the preference for morality vs. immorality in others is conditional on the evaluator’s current goals. Specifically, when immorality was conducive to participants’ current goals, the preference for moral vs. immoral traits in others was eliminated or reversed. The preferences for mercifulness vs. mercilessness (experiment 1), honesty vs. dishonesty (experiment 2), sexual fidelity vs. infidelity (experiment 3), and altruism vs. selfishness (experiment 4) were all found to be conditional. These findings oppose the consensus view that people have a dominant preference for moral vs. immoral traits in others. Our findings also speak to nativist and empiricist theories of social preferences and the stability of the “social contract” underlying productive human societies.

Objective Ovarian preservation is an option for some premenopausal patients with early stage endometrial cancer. Studies have shown that ovarian preservation in selected patients does not negatively impact survival outcomes. The objective of this study is to determine the frequency and characteristics of ovarian involvement when endometrial cancer is clinically confined to the uterus. Methods Patients with endometrioid adenocarcinoma of uterus treated at our institution between 2000 and 2013 were identified. Patients with ovarian metastasis or synchronous primary ovarian cancer were included. Patients were excluded if there was gross extrapelvic disease on examination or imaging. Results Seven hundred and fifty-nine patients were found to have endometrial cancer with the disease confined to the pelvis (stages I, II, and III). Fifteen patients (2%) had ovarian metastasis. Twenty-three patients (3%) had synchronous uterine and ovarian cancer. Most ovarian lesions (32 out of 38) were either enlarged or had abnormal appearing surface involvement. Six patients had microscopic ovarian involvement, accounting for 0.8% of the endometrial cancer patients with pelvis-confined disease. All of the patients were greater than 50years of age. For those patients with microscopic ovarian metastasis, all had FIGO grade 3 disease, deep myometrial invasion, and extrauterine involvement of either cervix or lymph nodes. Conclusions Microscopic ovarian involvement occurred in 0.8% of patients with endometrial cancer. For premenopausal patients with endometrial cancer, normal appearing ovaries may be considered for preservation in the absence of extrauterine spread, grade 3 disease and deep myometrial invasion.

Power hierarchies in interaction are maintained due to a variety of cues, including gender and body language, and can keep competent individuals from being regarded as high status. The present study primed participants with an image consisting of two components—gender (man or woman) and body pose (dominant or submissive)—and then asked participants to classify written target words as either dominant or submissive. In response to these target words, we measured accuracy (% incorrect) and classification speed (RT), in addition to event-related potentials (ERPs), from 23 participants. Although we did not find ERP differences in the predicted N400 component, error rate and RT measures indicated that regardless of the gender of the prime, dominant poses facilitated identification of dominant words. Interestingly, whereas female submissive posing facilitated classification of submissive target words, male submissive posing did not. These results support the idea that women can use counter-stereotypical nonverbal displays, dominant poses, to change how they are initially perceived in terms of power. Interestingly, men may be more limited in the success of their counter-stereotypical, submissive, posing. Potential underlying mechanisms are discussed.

ABSTRACT In cervical cancer, para-aortic nodal (PALN) metastases at presentation is a strong indicator of poor prognosis. Despite this, International Federation of Gynecology and Obstetrics staging system does not require evaluation of lymph node involvement and does not incorporate clinically detected PALN into the staging system. In the USA, despite screening, a significant number of women still present at an advanced stage often with nodal metastases. While the presence of PALN metastases often indicates occult systemic disease, it is possible with modern therapies to provide long-term control of disease in a percentage of patients. We review the epidemiology, diagnosis and treatment of PALN metastases in cervical cancer outlining advances in modern imaging and combined modality therapies (surgery, chemotherapy and radiation therapy).

Necrotizing fasciitis is a rare and potentially fatal infection, with mortality of up to 30%. This case report describes a patient recovering from a laryngectomy for laryngeal squamous cell cancer who developed nosocomial necrotizing fasciitis of the lower extremity due to Serratia marcescens. Only eight cases of necrotizing fasciitis exclusive to the lower extremity due to S marcescens have been previously reported. Patients with S marcescens necrotizing fasciitis of the lower extremity often have multiple comorbidities, are frequently immunosuppressed, and have a strikingly high mortality rate.

Background and objectives Age and frailty have been correlated with poor clinical outcomes in cancer. Core muscle index (CMI) and nutritional status are integral in assessing frailty. We explored the effect of pre-operative serum albumin and body composition on clinical outcomes in patients with epithelial ovarian cancer (EOC). Methods We identified stage III-IV EOC patients undergoing primary cytoreductive surgery from 2007 to 2015. Data were abstracted from medical records. Body composition measurements were obtained from pre-operative imaging. Psoas muscle cross-sectional area was normalized to height2 to determine CMI. Sarcopenia was defined as CMI below the population mean. The influence of sarcopenia on short-term morbidity was evaluated. Relationships among body composition measurements and albumin were assessed with Spearman correlations. Patient characteristics and body composition measurements between patients with and without sarcopenia were compared with parametric and non-parametric statistical methods. Kaplan-Meier survival curves were compared using log-rank. Results 102 women met inclusion criteria. Sarcopenia correlated with albumin (P = 0.0002). Sarcopenia was not associated with short-term morbidity or time to recurrence. Sarcopenia was associated with nearly a fourfold increased risk of death when hypoalbuminemia was present (P = 0.02). Conclusions Pre-operative sarcopenia in combination with hypoalbuminemia was associated with significantly worse survival.

It is well established that hand gestures affect comprehension and learning of semantic aspects of a foreign language (FL). However, much less is known about the role of hand gestures in lower-level language processes, such as perception of phonemes. To address this gap, we explored the role that metaphoric gestures play in perceiving FL speech sounds that varied on two dimensions: length and intonation. English speaking adults listened to Japanese length contrasts and sentence-final intonational distinctions in the context of congruent, incongruent and no gestures. For intonational contrasts, identification was more accurate for congruent gestures and less accurate for incongruent gestures relative to the baseline no gesture condition. However, for the length contrasts, there was no such clear and consistent pattern, and in fact, congruent gestures made speech processing more effortful. We conclude that metaphoric gestures help with some—but not all—novel speech sounds in a FL, suggesting that gesture and speech are phonemically integrated to differing extents depending on the nature of the gesture and/or speech sound.

Evaluation of acute abdominal and pelvic pain in pregnancy presents a diagnostic challenge for clinicians and radiologists alike. The differential diagnosis includes obstetric and nonobstetric conditions unique to pregnancy, in addition to causes of acute abdominal and pelvic pain unrelated to the pregnancy. The clinical presentation and course of disease may be altered in pregnancy, and several pathologies are exacerbated by pregnancy. Discriminating clinical features in the diagnosis of abdominal and pelvic pain are often confounded by expected anatomic and physiologic changes in pregnancy. Moreover, while diagnostic pathways may be altered in pregnancy, the necessity for a timely and accurate diagnosis must be underscored, as delay in treatment may result in an undesirable increase in morbidity and/or mortality for both the patient and fetus. Advances in magnetic resonance imaging (MRI) through faster acquisition and motion-insensitive techniques, coupled with increased awareness and education regarding the value of MRI in diagnosing a wide range of pathology, have established MRI as a valuable strategy in the investigation of acute abdominal and pelvic pain in the pregnant patient. This review presents a practical approach to common obstetric and nonobstetric causes of acute abdominal and pelvic pain during pregnancy, as well as safety considerations for performing MRI in this patient population.

As fetal gestational age increases, other modalities such as ultrasound have demonstrated increased levels of heterogeneity in the normal placenta. In this study, we introduce and apply ROI-based texture analysis to a retrospective fetal MRI database to characterize the second-order statistics of placenta and to evaluate the relationship between heterogeneity and gestational age. Positive correlations were observed for several Haralick texture metrics derived from fetal-brain specific T2-weighted and gravid uterus T1-weighted and T2-weighted images, confirming a quantitative increase in placental heterogeneity with gestational age. Our study shows the importance of identifying baseline MR textural changes at certain gestational ages from which placental diseased states may be compared. Specifically, when evaluating for placental invasion or insufficiency, findings should be evaluated in the context of the normal placental aging process, which occurs throughout gestation.

Pelvic floor dysfunction encompasses an extremely common set of conditions, with various surgical and nonsurgical treatment options. Surgical options include injection of urethral bulking agents, native tissue repair with or without bioabsorbable or synthetic graft material, placement of synthetic midurethral slings or use of vaginal mesh kits, and mesh sacrocolpopexy procedures. Numerous different synthetic products with varied imaging appearances exist, and some of these products may be difficult to identify at imaging. Patients often present with recurrent or new symptoms after surgery; and depending on the presenting complaint and the nature of the initial intervention, imaging with ultrasonography (US), magnetic resonance (MR) imaging, voiding cystourethrography, or computed tomography (CT) may be indicated. US and MR imaging can both be used to image urethral bulking agents; US is often used to follow potential changes in bulking agent volume with time. Compared with MR imaging, US depicts midurethral slings better in the urethrovaginal space, and MR imaging is better than US for depiction of the arms in the retropubic space and obturator foramen. Mesh along the vaginal wall may be depicted with both US and MR imaging; however, the distal arms of the mesh traversing the sacrospinous ligaments or within the ischiorectal fossae (ischioanal fossae) are better depicted with MR imaging. Scarring can mimic slings and mesh at both US and MR imaging. MR imaging is superior to US for depiction of sacrocolpopexy mesh and associated complications. Voiding cystourethrography and CT are used less commonly because they rarely allow direct depiction of implanted material. Online supplemental material is available for this article. (©)RSNA, 2016.

Fetal magnetic resonance (MR) imaging plays an increasing and valuable role in antenatal diagnosis and perinatal management of fetal gastrointestinal (GI) abnormalities. Advances in MR imaging data acquisition and use of motion-insensitive techniques have established MR imaging as an important adjunct to obstetric ultrasonography (US) for fetal diagnosis. In this regard, MR imaging provides high diagnostic accuracy for antenatal diagnosis of common and uncommon GI pathologic conditions. In the setting of fetal GI disease, T1-weighted images demonstrate the amount and distribution of meconium, which is crucial to the diagnostic capability of fetal MR imaging. Specifically, knowledge of the T1 signal intensity characteristics of fetal meconium, the normal pattern of meconium with advancing gestational age, and the expected caliber of small and large bowel in the fetus is key to diagnosis of abnormalities of the GI tract. Use of ultrafast T2-weighted sequences for evaluation of the expected location and morphology of fluid-containing structures, including the stomach and small bowel, in the fetal abdomen further aids in diagnostic confidence. Uncommonly encountered fetal GI pathologic conditions, especially cloacal dysmorphology, may demonstrate characteristic MR imaging patterns, which may add additional information to that from fetal US, allowing improved fetal and neonatal management. This article discusses common indications for fetal MR imaging of the GI tract, imaging protocols for fetal GI MR imaging, the normal appearance of the fetal GI tract with advancing gestational age, and the imaging appearances of common fetal GI abnormalities, as well as uncommon fetal GI conditions with characteristic appearances. (©)RSNA, 2016.

Magnetic resonance (MR) imaging of the abdomen and pelvis can be limited for assessment of different conditions when imaging inadequately distended hollow organs. Endoluminal contrast agents may provide improved anatomic definition and detection of subtle pathology in such scenarios. The available routes of administration for endoluminal contrast agents include oral, endorectal, endovaginal, intravesicular, and through non-physiologic accesses. Appropriate use of endoluminal contrast agents requires a thorough understanding of the clinical indications, available contrast agents, patient preparation, and interaction of the contrast agent with the desired MR imaging protocol. For example, biphasic oral enteric contrast agents are preferred in MR enterography as their signal properties on T1- and T2-weighted imaging allow for evaluation of both intraluminal and bowel wall pathology. In specific situations such as with MR enterography, MR defecography, and accurate local staging of certain pelvic tumors, the use of an endoluminal contrast agent is imperative in providing adequate diagnostic imaging. In other clinical scenarios, the use of an endoluminal contrast agent may serve as an indispensable problem-solving tool.

Although ultrasound is the primary means of screening for fetal central nervous system (CNS) malformations, MRI has demonstrated added value in the evaluation of abnormalities not well assessed with sonography and in select circumstances for screening. In many fetal MRI practices, evaluation of the CNS is the most common indication for fetal MRI. MRI has demonstrated particular utility in evaluating the posterior fossa, midline structures, and cortex in the progressively ossifying fetal skull. The most common CNS indications are identified in Table 6.1 [98].

BACKGROUND AND PURPOSE: Children with shunted hydrocephalus have been undergoing surveillance neuroimaging, generally in the form of head CT, for evaluation of ventricular size. As the life expectancy of these children has improved due to better shunt technology and medical care, risks related to the ionizing radiation incurred during multiple head CT examinations that they are expected to undergo throughout their lifetime have become a concern. The purpose of this study is to estimate the LAR of developing fatal cancer due to head CT for ventricular size assessment in children with shunted hydrocephalus and to assess the impact of instituting a rapid brain MR imaging protocol in reducing radiation exposure. MATERIALS AND METHODS: Retrospective review of medical records yielded 182 patients who underwent neuroimaging for assessment of ventricular size. Available neuroimaging studies (head CT and rapid brain MR) were counted and annual neuroimaging frequency was calculated. It was assumed that these patients undergo a similar number of neuroimaging studies annually through 20 years of age. A risk estimate was calculated based on the BEIR VII report and effective doses obtained using the International Commission on Radiologic Protection Report 103 organ weighting factors. RESULTS: The mean annual neuroimaging study frequency was 2.1. Based on the average age of 1.89 years, it was assumed neuroimaging surveillance commences in the second year of life. LAR was calculated assuming that a patient undergoes neuroimaging in the form of head CT at this frequency (2/year) through 20 years of age. Assuming 2 scans are performed per year and the low-dose head CT protocol is used, approximately 1 excess lifetime fatal cancer would be generated per 230 patients; with standard head CT, there would be 1 excess lifetime fatal cancer per 97 patients. CONCLUSIONS: Children with shunted hydrocephalus are at increased risk of developing fatal cancer if they are to undergo surveillance using head CT. Implementation of a rapid brain MR imaging protocol with no radiation detriment will reduce this risk.

This paper reports experiences of non-traditional students in a specially designed section of seminar course which was primarily designed for first-year traditional business students. The College of Business’s BSN101, Foundations of Business Administration (FBA), is designed to serves as a course to assist the students with transitioning into the business program. Typical traditional classes have enrollments of about 80 students. The special section for non-traditional students had seven students, 24 years of age or older, who were returning to undergraduate business school. This paper reports results of the implementation of the new program design in the FBA classes. Results are important not only to the College of Business, but also to the other Colleges as interest in first-year seminar courses and better serving the needs of non-traditional student increases. Currently, the University Retention Committee and the First-Year Seminar Sub-Committee are exploring the possibility of implementing a first-year seminar courses in the College of Arts and Sciences and the College of Education and Human Services to be recommended to the Provost. Data collected for the experimental section in the study reported here will support decision-making regarding new seminar courses.

Business students' perceptions concerning several academic advising resources are presented. Using a Likert scale, students evaluated resources such as their academic advisor, course instructors, staffs, friends, and parents as well as the university catalog and the Foundations of Business Administration (FBA) course. Selected demographic information was also collected. Results show that students ranked the FBA course, which provides an overview of an individual's 4-year study plan, as the most helpful. The course instructors and academic advisors were ranked second and fourth, respectively. Enrollment status, declared major, and gender were related to students' views on some advising resources, but transfer status was not. Moreover, we found some connection between the effectiveness of advising resources perceived by students and the students' developmental stages. Relative Emphasis: practice, research, theory

To compare saline infusion sonography (SIS) to tissue obtained from SIS-guided endometrial sampling (SISES) to determine sensitivity and specificity for benign and malignant conditions of the endometrium.Added value of SISES after SIS was evaluated over 5 years. SIS and SISES techniques have been previously described. Women with abnormal uterine bleeding and endometrial findings underwent SIS. Criteria for SISES included atypical polypoid mass, focal irregularity or global endometrial thickening, nondiagnostic SIS, discordance between SIS and endometrial biopsy, or request from the primary team. Final surgical pathology was compared with SIS and SISES.One-hundred twenty-three SIS patients had SISES. SIS alone had a sensitivity of 100%, specificity of 42%, positive predictive value of 16%, and negative predictive value of 100%. A total of 120 patients had final clinical or surgical outcomes. Specificity was greatly improved with addition of SISES (95.5%, p0.001). Combination of SIS with SISES detected all 12 premalignant and malignant endometrial lesions. Three cases had small foci of hyperplasia (n = 2) or atypia (n = 1) in polyps on final surgical pathology, which were not prospectively identified on SISES.SISES significantly improves the specificity in the diagnosis of endometrial lesions. False-negative findings of SISES in polyps in postmenopausal women with bleeding suggest the need for surgical removal in this setting. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:416-422, 2016.