"What needs to be seen": An exploration into the visual anticipation behaviour of different skill-level football referees while observing long passes on-field.

It is well established that elite football referees possess superior anticipatory skills in specific game scenarios such as when assessing foul situations. Referees might also have better anticipatory skills in other important scenarios such as when observing a long pass. In these often-occurring situations, a referee has to use visual information to anticipate the outcome of the pass, in particular to foresee any potential infringements that might occur when players battle for ball possession. However, little is known about if and how football referees might anticipate outcomes in these scenarios. The aim of the current study was therefore to analyse the visual anticipatory behaviour of football referees when long passes occur during actual football matches. Elite (N = 4) and sub-elite referees (N = 12) officiated an actual football match while wearing a mobile eye-tracker to analyse their gaze behaviour when long passes occurred (N = 196). The results revealed differences in the way that the elite and sub-elite referees tracked the ball and anticipated the outcome of the ball trajectories. The elite referees used a lower search rate (1.3 vs 1.8 fix/s; p < .05) and were more likely to direct their gaze towards the ball during the moment of kick (77 vs 52%; p < .05) and the early flight-phase of the pass (68 vs 45%; p < .05), and subsequently produced earlier anticipatory eye movements to the player(s) receiving the ball (at 50% vs 60% of the ball flight; p < .05). This earlier anticipation may help the elite referees to better pick-up relevant information about the receivers that could be vital in making adjudications about any potential infringement when the ball does arrive. Referee education programs can use the current study to highlight the importance of visual search behaviour and help referees to adapt a strategy that is beneficial for long-pass situations.

Are computed tomography-based measures of specific abdominal muscle groups predictive of adverse outcomes in older cancer patients?

PURPOSE: It is unknown whether computed tomography (CT)-based total abdominal muscle measures are representative of specific abdominal muscle groups and whether analysis of specific abdominal muscle groups are predictive of the risk of adverse outcomes in older cancer patients. METHODS: Retrospective single-center cohort study in elective colon cancer patients aged ≥65 years. CT-based skeletal muscle (SM) surface area, muscle density and intermuscular adipose tissue (IMAT) surface area were determined for rectus abdominis; external- and internal oblique and transversus abdominis (lateral muscles); psoas; and erector spinae and quadratus lumborum (back muscles). Outcomes were defined as severe postoperative complications (Clavien-Dindo score >2) and long-term survival (median follow-up 5.2 years). RESULTS: 254 older colon cancer patients were included (median 73.6 years, 62.2% males). Rectus abdominis showed the lowest SM surface area and muscle density and the back muscles showed the highest IMAT surface area. Psoas muscle density, and lateral muscle density and percentage IMAT were associated with severe postoperative complications independent of gender, age and cancer stage. CONCLUSIONS: CT-based total abdominal muscle quantity and quality do not represent the heterogeneity that exists between specific muscle groups. The potential added value of analysis of specific muscle groups in predicting adverse outcomes in older (colon) cancer patients should be further addressed in prospective studies.

Monitoring quality improvements and measuring results.

PIP: This paper presents a summary of the lessons learned from the Quality Assurance Project in monitoring quality improvements and measuring results in developing countries. The first lesson learned relates to essential data collection for key indicators while paying close attention to the validity of chosen indicators. The second lesson learned relates to keeping data collection in a simplified way for health staff with limited training. This can be done by identifying the problem and measuring its magnitude, verifying and measuring its causes, and monitoring the implementation and effectiveness of the solution. The third lesson learned relates to improvement of quality of data being collected through proper maintenance of clinical records and other data sources. The fourth lesson learned relates to utilization of information and the provision of timely feedback. In light of demonstrating quality improvements, it strengthens the confidence of Quality Assurance teams, enhances institutional and political support, and provides some directions for future activity planning.^ieng

Imaging the bone marrow with magnetic resonance during a crisis and in chronic forms of sickle cell disease.

Five patients with sickle cell disease have been studied by magnetic resonance imaging (MRI) in three instances during a crisis. Attention was directed to the pelvis and lower extremities. Bone marrow pathology has been classified according to generalised or circumscribed alterations in signal intensity on T1 weighted spin-echo sequences. Both acute and chronic changes were observed.

Magnetic resonance imaging of meniscal lesions of the knee.

In a prospective study of 25 patients, magnetic resonance imaging (MRI) was employed to detect meniscal tears in the symptomatic knee. All patients underwent arthroscopy and 21 underwent double contrast arthrography. When correlated with these two diagnostic procedures MRI produced no false negative results. There were, however, six false positive MRI findings all of which related to the posterior horn of the medial meniscus. MRI appears to be reliable in detecting meniscal tears but long examination times continue to limit its clinical usefulness.

Invasion of laryngeal cartilage by cancer: comparison of CT and MR imaging.

Forty-two patients with laryngeal carcinomas were examined with computed tomography (CT) and magnetic resonance (MR) imaging. The accuracy of both CT and MR imaging in the depiction of cartilage invasion was evaluated in 16 patients by comparing findings at CT and MR with pathologic findings. Calcified cartilage that has been invaded by cancer is frequently seen on CT scans as having an intact contour. Tumor approaching nonossified cartilage may simulate cartilage invasion. On T1-weighted MR images, invaded marrow of ossified cartilage is of intermediate signal intensity, allowing it to be differentiated from normal bone marrow. On proton-density images, tumor is of increased signal intensity, which allows it to be differentiated from nonossified cartilage. In our experience, the specificities of CT and MR imaging were approximately equal (91% and 88%, respectively), but CT had a considerably lower sensitivity than MR (46% vs. 89%). Gross movement artifacts, which resulted in nondiagnostic images, occurred in 16% of the MR examinations. MR imaging is recommended as the modality of choice in the diagnosis of cartilage invasion.

Nuclear magnetic resonance imaging of bone marrow in childhood leukaemia.

Bone marrow infarction is known to occur in childhood leukaemia. Although it may be suspected on clinical grounds, radiographic evidence is infrequent. We present three cases in which magnetic resonance imaging demonstrated unexpectedly extensive bone marrow lesions and discuss the evidence that these lesions were due to bone marrow infarction.

Bone marrow magnetic resonance studies in childhood leukemia. Evaluation of osteonecrosis.

In 25 patients under treatment or during follow-up for acute lymphoblastic leukemia magnetic resonance imaging (MRI) of both knees was compared to history and physical examination to detect osteonecrosis. Results of MRI were classified as: O, normal bone marrow (BM); 1, diffuse decrease in signal intensity; 2, circumscript lesions. Patients clinically suspected of osteonecrosis had a statistically significant increased incidence of Type 2 lesions. Three patients with a BM relapse also showed Type 2 lesions. Circumscript lesions of the epiphyses were seen exclusively in the four patients with clinical suspicion of osteonecrosis during BM remission and this may be a MR finding strongly indicative of osteonecrosis. Patients with Type 2 lesions during BM remission had received systemic chemotherapy for a statistically significant longer period than the other patients. Using MRI findings we suspect that at least four patients suffered osteonecrosis due to chemotherapy. MRI is a promising means of detecting this disorder.

Intravenous urography as a prognostic indicator in vesical carcinoma.

A retrospective analysis of 1378 cases of urinary bladder tumor, showed that unilateral or bilateral ureteric obstruction seen on an intravenous urogram at presentation, was significantly associated with both decreased overall survival and tumor-free interval. A tumor shadow shown on standard projections did not correlate with survival. At 24 months only 35% of the ureteric obstruction group were tumor-free as compared with 65% of the unobstructed group. Survival at 5 years was 27% in the obstructed ureter group and 73% in the non-obstructed group. This difference although less marked, persists at 9-year follow-up.

Prospective study on the dose relationship of mitomycin C-induced interstitial pneumonitis.

Lung damage after mitomycin C (MMC) was first reported in 1978. Although this side effect has been frequently reported since then, there are no data on dose dependency nor on incidence. Therefore, the authors initiated a prospective study to obtain more data on this subject. Forty-four patients treated with MMC entered the study; 37 were evaluable. All patients were subjected to repeated physical examinations, chest x-rays, chest computed tomography (CT) scan and pulmonary function tests. The results were evaluated per cumulative dose level. None of the patients had clinical pulmonary toxicity develop; one patient had pulmonary changes on CT scan, the significance of which remained unclarified. The world literature on this subject was also reviewed. Based on the combined data of the present study as well as the literature review, the authors concluded that MMC-related lung toxicity is a dose-dependent side effect, occurring at cumulative dose levels of 20 mg/m2 or more. The incidence is likely to be less than 10%.

Ventriculo-peritoneal shunt procedure complicated by liver capsule perforation. A case report.

A 29-year-old woman in childbed, presented with obstruction hydrocephalus due to a cerebellar spongioblastoma, was treated by ventriculo-peritoneal shunting. The peritoneal spring catheter used in this procedure caused a perforation of the liver capsule. The type and length of a catheter appropriate to such a case are discussed.

Osteosarcoma with calcific mediastinal lymphadenopathy.

A case of osteosarcoma with calcific mediastinal lymphadenopathy is presented. The lesion caused increasing dysphagia and bronchial erosion, showed uptake of isotope on a bone scan and was seen to enlarge on follow-up CT scans.

CT findings in paravertebral synovial sarcoma.

Two patients with synovial sarcoma in paravertebral location (cervical and lumbar areas) presented with soft tissue masses that exhibited calcifications on CT. In one patient an unusual pattern of metastasis was found in the pancreas.