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To investigate the role of early context in theory of mind development, institutionalized children living in a boarding home (n = 34) in Turkey were compared to home-reared children coming from low (n = 32) and middle socioeconomic backgrounds (n = 44). Theory of mind was assessed with one deception and three false belief tasks; Peabody PVT and Raven CPM were administered to control for language and nonverbal intelligence. Results indicated a context effect whereby home-reared children performed better than institution-reared children on theory of mind tasks. Hierarchical regression analysis further revealed that institution rearing/adult-child ratio predicted theory of mind performance even after age, socioeconomic background, language and nonverbal intelligence were accounted for. Findings suggest the significance of adult-child interaction for theory of mind development.

Scandium (Sc), declared a critical raw material in the European Union (EU), could face further supply issues as the EU depends almost entirely on imports from China, Russia, and Ukraine. In this study, a tandem nanofiltration-solvent extraction procedure for Sc recovery from titania (TiO 2 ) acid waste was piloted and then augmented by antisolvent crystallization. The new process, comprising advanced filtration (hydroxide precipitation, micro-, ultra-, and nanofiltration), solvent extraction, and antisolvent crystallization, was assessed in relation to material and energy inputs and benchmarked on ScF 3 production. From ∼1 m 3 of European acid waste containing traces of Sc (81 mg L -1 ), ∼13 g of Sc (43% yield, nine stages) was recovered as (NH 4 ) 3 ScF 6 with a purity of approximately 95%, demonstrating the technical feasibility of the approach. The production costs per kilogram of ScF 3 were lower than reported market prices, which underscores a competitive process at scale. Although a few technical bottlenecks (e.g., S/L separation and electricity consumption) need to be overcome, combining advanced filtration with solvent extraction and antisolvent crystallization promises a future supply of this critical raw material from European secondary sources., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Anticipated future demand and limited primary sources of Sc highlight the importance of secondary Sc resources such as bauxite residue (red mud). In this study, a process route starting from red mud aiming to recover Sc as a concentrate by a combination of pyrometallurgical and hydrometallurgical processes was developed. Bauxite residue was treated in an electric arc furnace (EAF) for Fe removal as well as slag conditioning with varying flux additions and various cooling conditions. 95% of iron recovery to the metal was achieved. Resulting slags were subjected to identical H 2 O 2 supported H 2 SO 4 leaching conditions at 75 °C. The effect of slag mineralogy and crystallinity on the leaching efficiencies were investigated using XRD and QEMSCAN analysis. As a result of the highly amorphous nature of acidic slags, maximum of 72% Sc leaching was obtained. For leached slags, water quenched basic slag was found to be the most promising condition resulting in an extreme Sc leaching yield of 97% and this slag was selected for the further Sc precipitation. High impurity removal rates and selective Sc separation were achieved with a triple-stage successive precipitation to synthesize a Sc concentrate. Starting from EAF treatment followed by leaching and precipitation, 85% of the initial Sc in the red mud was successfully recovered as Sc phosphate.

The need of light weight alloys for future transportation industry puts Sc and Ti under a sudden demand. While these metals can bring unique and desired properties to alloys, lack of reliable sources brought forth a supply problem which can be solved by valorization of the secondary resources. Bauxite residue (red mud), with considerable Ti and Sc content, is a promising resource for secure supply of these metals. Due to drawbacks of the direct leaching route from bauxite residue, such as silica gel formation and low selectivity towards these valuable metals, a novel leaching process based on oxidative leaching conditions, aiming more efficient and selective leaching but also considering environmental aspects via lower acid consumption, was investigated in this study. Combination of hydrogen peroxide (H 2 O 2 ) and sulfuric acid (H 2 SO 4 ) was utilized as the leaching solution, where various acid concentrations, solid-to-liquid ratios, leaching temperatures and times were examined in a comparative manner. Leaching with 2.5 M H 2 O 2 : 2.5 M H 2 SO 4 mixture at 90 °C for 30 min was observed to be the best leaching conditions with suppressed silica gel formation and the highest reported leaching efficiency with high S/L ratio for Sc and Ti; 68% and 91%; respectively.

Data from a nationally representative sample from Turkey (N = 1,017) were used to investigate the environmental factors that support the receptive vocabulary of 3-year-old children who differ in their developmental risk due to family low economic status and elevated maternal depressive symptoms. Children's vocabulary knowledge was strongly associated with language stimulation and learning materials in all families regardless of risk status. Maternal warmth and responsiveness supported vocabulary competence in families of low economic status only when maternal depressive symptoms were low. In families with the highest levels of risk, that is, with depression and economic distress jointly present, support by the extended family and neighbors for caring for the child protected children's vocabulary development against these adverse conditions. The empirical evidence on the positive contribution of extrafamilial support to young children's receptive vocabulary under adverse conditions allows an expansion of our current theorizing about influences on language development., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Background: The major aim of the study was to examine self-concept, emotional stability, and sociability of Turkish adolescents with orthopedic disability, and the links between these domains and sport participation., Method: Participants of the study were 95 students in grades 5-12 (mean age, 15.44 +/- 2.40 years). They were recruited from two boarding schools established for youth with orthopedic disabilities. Parents of the adolescents participated in the study by completing a form to provide information about the child, his/her condition (e.g. first appearance, severity, treatment), and the household in general. Adolescents filled in self-report scales that were developed to measure self-concept, emotional stability, and sociability., Results: Hierarchical multiple regression indicated that regular engagement in sports significantly predicted self-concept of adolescents with orthopedic disability, and the predictive value of playing sport was significant even after differences in participant age, sex, and severity of the disability were taken into account. Emotional stability and sociability of adolescents with disability were predicted by sports playing but to a low degree., Conclusion: Study findings underline the importance of understanding social aspects of disability, and the positive association between playing sports and an individuals positive beliefs about oneself.

Background: Medical therapy for hydatid disease of the brain has been reported with encouraging results especially in small or medium-sized cysts. To date, no other case correlating the metabolite levels of the cyst with albendazole treatment has been reported., Case Description: A 52-year-old woman presented with left hemiparesis and seizure. Cranial magnetic resonance revealed a right frontal cystic mass lesion. A diagnosis of hydatid cyst was made, and she was put on medical therapy with albendazole. An MRS before the medical therapy was begun revealed the typical findings of a hydatid cyst with resonance of alanine, acetate, and succinate that were specific for hydatid disease, and additional nonspecific lactate peaks with an additional small peak of choline. Comparison between the multiple MRS examinations was made by comparing the metabolite ratios specific for hydatid disease to choline, which seemed stable from the beginning. Two sequential MRS imaging revealed a prominent decrease of the succinate and acetate resonance, accompanied by a smaller decline of the alanine resonance progressively, correlated with the conventional MRI findings of the cyst, which had a smaller size with blurred margins in the meantime. After 5 months of medical treatment, the cyst had completely disappeared. The patient has been monitored for 5 years and remains well without recurrence., Conclusions: This case provides additional proof that the brain hydatid cyst is a medically treatable disease in appropriate cases. Furthermore, the changes in the metabolic profile of the cyst, especially those regarding succinate and acetate may represent the efficacy of the medical treatment.

Purpose: To investigate the utility of opposed phase imaging (OPI) (in-phase and out-of-phase) in lumbar disc disease., Materials and Methods: A total of 127 patients suspected of disc disease were examined with both traditional lumbar spine protocol (fast spin-echo [FSE] T1-weighted, T2-weighted sagittal, and T2-weighted axial) and OPI. Images were evaluated to detect the disc disease and to assess the anatomical clarity of certain spinal structures by two different radiologists using a four-point scale (1 = inadequate, 2 = adequate, 3 = good, and 4 = optimal). Results of two methods in terms of pathologic conditions and anatomical structures were compared. Comparison of the methods and the interpretations of two radiologists were performed by using kappa statistics. The difference among two methods in terms of anatomic clarity was assessed by using Wilcoxon analysis., Results: Disc disease detected by each technique demonstrated concurrence (agreement was 82.4% and 93.1% for two radiologists; P < 0.05). OPI received similar scores with conventional sequences for disc disease (P > 0.05). OPI was optimal in displaying disc, marrow, osteophytes, and hemangiomas, where other structures got higher scores on conventional images (P > 0.05 and P > 0.001). But these structures had equal scores at least in one of the opposed-phase images. Acquisition time for OPI and conventional images were 4.46 and 9.01 minutes, respectively., Conclusion: OPI can be a faster backup technique in evaluating the lumbar disc disease. It has a shorter image acquisition time with adequate diagnostic quality. It can be a "time saver" option for busy MR centers or may be used for patients who cannot tolerate longer acquisition times., ((c) 2007 Wiley-Liss, Inc.)

Background and Purpose: One former study reported higher prefrontal N-acetylaspartate (NAA) levels in patients with Asperger syndrome (AS). The objective of the current study was to test the hypothesis that patients with AS would have higher dorsolateral prefrontal and anterior cingulate cortex NAA/creatine (Cr) and that NAA/Cr would be correlated with symptom severity., Materials and Methods: NAA/choline (Cho), NAA/Cr, and Cho/Cr values revealed by (1)H-MR spectroscopy in 14 right-handed male patients with AS (6 medicated with risperidone), 17-38 years of age, diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were compared with those of 21 right-handed male controls frequency-matched by age and intelligence quotient scores., Results: Patients with AS had significantly higher anterior cingulate NAA/Cho levels (z = -2.18, P = .028); there was a statistical trend for higher anterior cingulate NAA/Cr (z = -1.81, P = .069) that was significant when only the unmedicated patients with AS were taken into account (z = -1.95, P = .050). There were no significant differences in dorsolateral prefrontal MR spectroscopy values., Conclusions: Our findings show that individuals with AS had higher NAA/Cho levels in the right anterior cingulate compared with healthy controls and that higher anterior cingulate NAA/Cho levels were correlated with higher Yale-Brown Obsessive Compulsive Scale total scores.

Orbital wall infarction and subperiosteal haematomas are unusual manifestations of sickling disorders. Here we report an 11-year-old girl with sickle cell anaemia having multiple skull infarctions including the orbital bony structures associated with subperiosteal haematomas. The diagnosis was made by MRI, which showed bone marrow changes and associated haemorrhagic collections. The patient was successfully managed without surgical intervention.

Purpose: To evaluate the results of surgical intervention and rate of recurrence in patients with periocular lymphangioma with respect to the anatomic extent of tumor involvement determined by neuroimaging studies., Design: Retrospective noncomparative case series., Participants: Eighteen patients with periocular lymphangioma., Methods: All patients underwent complete ocular examination and preoperative orbital imaging with either computed tomography or magnetic resonance imaging. Tumor location in the orbit was defined as intraconal, extraconal, or diffuse. For extraconal cases, a further classification was made as intraorbital, extraorbital, or mixed. All patients underwent orbitotomy via either a conjunctival or a skin-crease approach, depending on the tumor location. The indications for surgical intervention were varied and included preservation of visual function or cosmetic appearance in some cases and exploration of an unidentified orbital mass in others. The diagnosis of lymphangioma was established histopathologically in each case. Cases that showed recurrence at follow-up also were treated using an orbitotomy approach., Main Outcome Measures: Anatomic extent of tumor location in the orbit as determined by neuroimaging studies, completeness of surgical excision, pathological findings, recurrence, and visual outcome., Results: Seven patients had extraconal tumors; 4, intraconal tumors, and 7, diffuse tumors. Of the patients with extraconal tumors, 4 had mixed lymphangioma and 3 had extraorbital lymphangioma. In 5 cases, the extraconal lymphangiomas were totally resected. In the remaining 13 cases with diffuse, intraconal, and infiltrating extraconal lymphangiomas, the tumors were treated with a subtotal resection procedure. At a mean follow-up of 29.4 months (range: 3-77), 2 patients with diffuse tumors developed 4 recurrences and underwent further surgical intervention for 3 recurrent events. The mean interval between treatment and recurrence was 16 months (range: 12-20). Two patients experienced decreased visual acuity due to compressive optic neuropathy in one case and operative damage in the other., Conclusions: Surgically well-delineated extraconal lymphangiomas can be resected totally with no clinical recurrence at short-term follow-up. Although intraconal, diffuse, and some extraconal lymphangiomas were treated with a subtotal resection procedure, many such cases did not demonstrate recurrence. These results are encouraging because they demonstrate that many periocular lymphangiomas can be treated successfully with good visual outcome and satisfactory cosmesis.

Background: Pituitary carcinomas are extremely rare tumors of the adenohypophysis. The presence of craniospinal and/or systemic extracranial metastases is the only reliable criterion for the diagnosis of pituitary carcinoma. To date, only 2 cases have been reported correctly by fine needle aspiration biopsy (FNAB). We present an additional case of pituitary carcinoma with FNAB features., Case: A 60-year-old woman presented with clinical features of Cushing's disease and a pituitary tumor. She underwent transsphenoidal resection of the tumor. The initial diagnosis was an adrenocorticotrophic hormone (ACTH)-producing invasive pituitary adenoma. The patient presented again with neck pain 6 years after the operation. Magnetic resonance imaging revealed metastatic tumor masses at the level of C5-C6 of the cervical vertebrae. Intraoperative fine needle aspiration and incomplete excision of metastatic tumors were performed. Cytologically, tumor cells were composed of a combination of loose groups and single cells. Neoplastic cells had a relatively monotonous appearance and displayed characteristic neuroendocrine tumor features. Immunocytochemistry from cell block sections revealed AE1/ AE3, synaptophysin chromogranin A and ACTH positivity in the tumor cells., Conclusion: Pituitary carcinoma with extracranial systemic metastases demonstrates typical neuroendocrine features on fine needle aspiration. In the differential diagnosis, metastatic neuroendocrine carcinomas should be kept in mind. In the absence of sufficient clinical data, these 2 entities cannot be distinguished correctly through the cytologic features.

Inferior vena cava (IVC) agenesis is a rare anomaly that is usually an incidental finding in radiologic work-up or it can rarely be symptomatic due to deep venous thrombosis of iliac veins. In this report, we present a case of IVC agenesis detected on lumbar spinal MR imaging scans by extensive epidural-paravertebral collateral vessels compressing the thecal sac and causing low back pain in a child.

Vascular malformations are infrequent causes of aqueductal stenoses, developmental venous anomaly (DVA) being the rarest among them. DVAs, also known as venous angiomas, are congenital in origin and characterized by dilatation of vessels in the superficial and deep venous system. Although they are usually clinically silent, they can be complicated by hemorrhage, seizures and neurologic deficits. Herein, we report MR imaging findings of a 7-year-old girl whose hydrocephalus was due to an abnormal vein coursing through the aqueduct.

Background: The aim of this study was to perform a detailed anatomical analysis of petroclival venous structures as well as their patencies with 3D contrast-enhanced (CE) magnetic resonance venography (MRV) and to identify the potential contribution of these data to the therapeutic approach., Methods: Ten patients (8 women and 2 men) with unilateral petroclival meningioma were examined using 3D CE MRV in addition to conventional brain protocol. Both coronal source and multiplanar reconstructed images were evaluated for the anatomical orientation. Patency of the cavernous sinus, superior petrosal sinus (SPS), and inferior petrosal sinus (IPS) was assessed., Results: All the patients had a unilateral meningioma (7 on the right and 3 on the left) at the petroclival region. Both SPS and IPS were visualized with adequate intraluminal contrast enhancement in 6 patients, but IPS was absent in 3 on the lesion side, with a patent superior petrosal sinus as the drainage route. One patient had a partially occluded SPS, with IPS being the main course of cavernous sinus drainage., Conclusions: Cerebral venous anatomy is a challenge to display with noninvasive methods because of flow dynamics, and CE 3D imaging seems to be the modality of choice to evaluate the variational anatomy and patency, which is essential in petroclival meningiomas. Because the cavernous sinus drains into either IPS or SPS, the patent sinus should be protected in surgery if there is tumoral occlusion of the others.

Objective: Our aims were to evaluate the detectability, configuration, location, and dimensions of the cisterna chyli on heavily T2-weighted images obtained with a single-shot fast spin-echo technique and to determine whether the disorders that have the potential to affect the abdominal lymphatic drainage could change the cisternal dimensions., Materials and Methods: Thin-collimated axial and coronal images that were originally obtained for MR cholangiopancreatography in 125 patients were reviewed by three observers individually for the presence of abdominal lymphatic confluence. The configuration, location, and dimensions of hyperintense ductal or saccular structures immediately anterior to the vertebral bodies below the diaphragma were recorded. The differences between the mean values of the diameters of the cisterna chyli obtained in the control group and in groups in which lymphatic drainage was expected to be abnormally high were compared using a one-way analysis of variance test., Results: Abdominal confluence of the lymphatics was shown in 96% of patients. The most common configuration of the cisterna chyli was tubular (42.5%). It was located at the level of L1-2 in 33% of cases and at the midline in 70%. Mean longitudinal, anteroposterior, and transverse diameters of the duct were 33.45 +/- 1.74 (SD) mm, 5.23 +/- 0.13 mm, and 5.23 +/- 0.15 mm, respectively. No significant difference was found in the mean values of antero-posterior, transverse, and longitudinal diameters of the cisterna chyli in the control group and in the groups expected to have an increased flow into the cisterna chyli., Conclusion: Abdominal confluence of lymphatics seems to be present on most of the heavily T2-weighted images. Its morphologic details and extensions can be visualized on images reconstructed with a maximum-intensity-projection algorithm. Any disorder does not necessarily lead to dilatation of these lymphatic structures.

Background and Purpose: Subarachnoid hemorrhage (SAH) constitutes an important neurologic emergency. Some authors have suggested that fluid-attenuated inversion recovery (FLAIR) MR imaging can detect SAH that may not be apparent on CT scans but may be revealed by lumbar puncture. We sought to determine how often FLAIR MR imaging findings are positive for SAH in cases with negative CT findings and positive lumbar puncture results., Methods: The CT scans and FLAIR MR images of all patients with suspected SAH during a 3-year interval (2000-2002) were retrospectively reviewed by a blinded reader. Among these cases, we identified 12 with CT findings that were negative for SAH, lumbar puncture results that were positive for SAH, and FLAIR MR imaging findings that were available for review. Eleven of the 12 patients had undergone FLAIR MR imaging within 2 days of CT and lumbar puncture. The 12 patients with negative CT findings were comprised of six male and six female patients with an age range of 7 to 69 years. We evaluated the true and false negative and positive FLAIR MR imaging findings for SAH by using the lumbar puncture results as the gold standard. The FLAIR MR imaging findings of 12 additional patients without SAH (as revealed by lumbar puncture) were used as control data for a blinded reading., Results: For all 12 control cases without SAH, the FLAIR MR imaging findings were interpreted correctly. Of the 12 cases that had positive lumbar puncture results but false-negative CT findings for SAH, FLAIR MR imaging findings were true-positive in only two cases and were false-negative in 10. One of the two true-positive cases had the highest concentration of RBC in the series (365 k/cc), and the other had the second highest value of RBC (65 k/cc)., Conclusion: FLAIR MR imaging cannot replace lumbar puncture to detect the presence of SAH. FLAIR MR imaging findings are infrequently positive (16.7%) when CT findings are negative for SAH. This is likely because there is a minimum concentration of RBC/cc that must be exceeded for CSF to become hyperintense on FLAIR MR images.

Background: Aneurysmal bone cysts (ABCs) are uncommon lesions of the temporal bone and their occurrence in the calvarium is rare., Case Description: A case of a right temporal ABC is reported in a 14-year-old boy who presented swelling of the right temporal region. Magnetic resonance imaging showed a destructive and expansile bone lesion on the right anterior temporal and orbital bone. The lesion was removed in total by the right temporal craniotomy and orbitozygomatic osteotomy. ABC was diagnosed in the pathologic examination. The patient had good recovery during the postoperative course., Conclusions: This report presents the diagnosis and imaging of an ABC in the temporal bone. This localization is very rare for ABC. Total excision, if feasible, is the ideal treatment.

The objective of this article was to review the magnetic resonance imaging (MRI) findings of four different neuroarthropathic extremities, and discuss the role of MRI in establishing a correct diagnosis. The shoulder, ankle, and knee had predominantly atrophic neuroarthropathic changes, whereas both atrophic and productive changes could be seen in the elbow. Bone marrow edema, suggesting a recent stress fracture, was detected in the elbow and knee. Osteochondral defects, or "detritic" synovitis with effusion, were extensive in all joints but exceptionally profound in the shoulder with amputation-like osteolysis and a total loss of the humeral head. Radiologists may encounter the joint manifestations of neuropathy, which may be confused with various pathologies, including tumor and septic arthritis, before the neurological diagnosis is established. MRI is helpful in detecting the extension of the disease as well as to differentiate chronic Charcot's arthropathy from septic arthritis before radiographic findings suggest the diagnosis.

We report a case of osteoblastoma in the uncommon location of the L5 lumbar vertebra, detailing the clinical and radiologic aspects. Although the plain radiographs of the patient were normal, computed tomographic scans of the lumbar region confirmed the diagnosis of osteoblastoma or osteoid osteoma of the L5 vertebra. The patient was referred to the orthopedic department for operation. Histologic examination revealed osteoblastoma of the L5 vertebra. Following surgery, the patient's pain resolved completely. Although osteoblastoma is extremely rare in the spine, it should be included in the differential diagnosis as a cause of chronic back pain, especially in young males with painful scoliosis and/or radicular-type leg pain. The tumor is often not readily apparent on plain radiographs. Therefore, advanced radiological investigation is necessary to establish the correct diagnosis.

We report a case in which an intrarenal arteriovenous fistula caused the nutcracker effect. Color Doppler sonography of the left renal artery showed a peak systolic velocity of 150 cm/second and renoaortic ratio of 2.1. The left renal vein was significantly dilated, and the adjacent renal artery was kinked. A stenosis in the left renal vein at the aorto-mesenteric bifurcation was demonstrated, with a maximum velocity of 201 cm/second. Renal Doppler evaluation showed an area of high-velocity, low-resistance arterial flow consistent with an arteriovenous fistula in the inferior half of the left kidney. Angiography confirmed the fistula. The fistula was successfully occluded by coil embolization. Follow-up sonography showed almost complete obliteration of the fistula, regression of the renal vein dilatation, and a reduction in renal venous and arterial flow velocities. Given the reversibility of the fistula's effects, we suggest the term "pseudonutcracker effect" to describe this case., (Copyright 2002 John Wiley & Sons, Inc.)