This study examines the occurrence of resisting arrest in 1,108 police-citizen arrest encounters at the Port Authority Bus Terminal in midtown Manhattan between July 1, 1990, and June 30, 1991. The study utilizes the Logit regression procedure to identify factors related to resisting arrest. The most powerful of all the factors tested was arrestee disrespect towards the police officer. Other arrestee factors that were found to be positively related to resisting arrest were the presence of other arrestee violence (besides resisting arrest), arrestee intoxication, and the seriousness of the crime charged. Of more than 30 police officer factors tested, only two attitudinal factors were found to be related to resisting arrest: Desiring to remain a police officer was negatively related, and believing that the law governing the use of force is overly restrictive of the police was positively related. Among the situational factors tested, arrests initiated by police officers were found to be positively related to resisting arrest. The results suggest that police officers may play a smaller role in the occurrence of resisting arrest than had been thought. The implication of this finding is that future researchers should devote greater attention to the role of the arrestee in police-citizen violence.

Introduction: HER2 mutations occur in 1-3% of lung adenocarcinomas. With increasing use of next-generation sequencing at diagnosis, more patients with HER2-mutant tumors are presenting for treatment. Few data are available to describe the clinical course and outcomes of these patients when treated with afatinib, a pan-HER inhibitor. Methods:We identified patients with metastatic or recurrent HER2-mutant lung adenocarcinomas treated with afatinib among 7 institutions across Europe, Australia, and North America between 2009 and 2017. We determined the partial response rate to afatinib, types of HER2 mutations, duration of response, time on treatment, and survival.

Background: Supine or prone positioning of the patient on the gantry table is the current standard of care for CT-guided lung biopsy; positioning biopsy side down was hypothesized to be associated with lower pneumothorax rate.Purpose: To assess the effect of positioning patients biopsy side down during CT-guided lung biopsy on the incidence of pneumothorax, chest drain placement, and hemoptysis. Materials and Methods:This retrospective study was performed between January 2013 and December 2016 in a tertiary referral oncology center. Patients undergoing CT-guided lung biopsy were either positioned in (a) the standard prone or supine position or (b) the lateral decubitus position with the biopsy side down. The relationship between patient position and pneumothorax, drain placement, and hemoptysis was assessed by using multivariable logistic regression models.Results: A total of 373 consecutive patients (mean age 6 standard deviation, 68 years 6 10), including 196 women and 177 men, were included in the study. Among these patients, 184 were positioned either prone or supine depending on the most direct path to the lesion and 189 were positioned biopsy side down. Pneumothorax occurred in 50 of 184 (27.2%) patients who were positioned either prone or supine and in 20 of 189 (10.6%) patients who were positioned biopsy side down (P , .001). Drain placement was required in 10 of 184 (5.4%) patients who were positioned either prone or supine and in eight of 189 (4.2%) patients who were positioned biopsy side down (P = .54). Hemoptysis occurred in 19 of 184 (10.3%) patients who were positioned prone or supine and in 10 of 189 (5.3%) patients who were positioned biopsy side down (P = .07). Prone or supine patient position (P = .001, odds ratio [OR] = 2.7 [95% confidence interval {CI}: 1.4, 4.9]), emphysema along the needle path (P = .02, OR = 2.1 [95% CI: 1.1, 4.0]), and lesion size (P = .02, OR = 1.0 [95% CI: 0.9, 1.0]) were independent risk factors for developing pneumothorax. Conclusion:Positioning a patient biopsy side down for percutaneous CT-guided lung biopsy reduced the incidence of pneumothorax compared with the supine or prone position.

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Results: 53 patients with 54 lesions were diagnosed as having a PT. The median age was 27.5, 35.0 and 38.5 years for benign, borderline and malignant PT, respectively. Borderline and malignant PTs were larger than benign PTs, with mean sizes of 33 and 42 mm compared with 29 mm. 38% of PTs were labelled by the reporting radiologist as fibroadenomas, including two borderline PTs and one malignant PT. In 24% of cases, the radiologist raised the possibility of PT in the report. 17 patients (40%) developed a new fibroepithelial breast lesion during follow-up of which 4 were recurrent PTs. Conclusion: Despite adequate surgical management, the development of further fibroepithelial lesions in the ipsilateral breast is common. 3-year clinical surveillance, with the addition of 6-monthly ultrasound is advised for females with initial borderline or malignant PT histology. Advances in knowledge:We propose a follow-up protocol with ultrasound based on the grade of the PT diagnosed for 3 years to detect recurrence.Phyllodes tumours (PTs) are rare biphasic fibroepithelial neoplasms accounting for ,1% of all breast lesions. 1 In the literature, they have been described as occurring in females aged 35-55 years, typically 15-20 years older than females with fibroadenomas (FAs) and with a higher incidence in Asian females.2,3 Imaging findings of PT and FA overlap and as such lesions may be misdiagnosed. 4 Histologically, PTs can be identified by their distinctive leaf-like architecture and increased stromal cellularity. 5 Typically, PTs present as a palpable breast lump and were traditionally differentiated from FAs based on their larger size at presentation.6 However, with increased breast awareness and screening programmes, smaller and incidental lesions are being found on imaging. 6 In symptomatic breast clinics, including this institution, "triple assessment" consisting an initial physical examination, followed by radiological imaging (ultrasound and/or mammography) and histological sampling either by fine-needle aspiration cytology (FNAC) or core biopsy is the standard diagnostic pathway for palpable breast lesions. The purpose of triple assessment is to provide a more accurate pre-operative diagnosis to ensure proper surgical planning and avoiding re-excision or tumour recurrence. 7According to the World Health Organization criteria, there are two grading systems for PTs; a two-tiered system or a three-tiered system. 8 Our institution employs the threetiered system, the subgroups being benign, borderline and malignant. Grading is based on semi-quantitative assessment of stromal cellularity, cellular pleomorphism, mitotic activity, margin appearance and stromal distribution. The standard procedure for treatment, no matter what the grade of the PT, is surgical wide local excision, preferably with clear margins of at least 1 cm. However, owing to the fact that most PTs are not fully diagnosed pre-operatively, initial surgery does not always provide adequate margins necessitating frequent post-operative re-excision of the margi...

Purpose To assess the incidence of lung cancer in a cohort of patients with negative findings at previous lung cancer screening. Materials and Methods In this prospective cohort study, the authors first identified 4782 individuals who had negative screening results as part of the International Early Lung Cancer Action Program (1993-2005). Subjects were assigned a lung cancer risk score by using a validated risk model. Starting with those at highest risk, subjects were interviewed by phone and invited to undergo low-dose CT between March 2013 and October 2016. Subjects with a diagnosis of lung cancer and those who had died of lung cancer were determined. Descriptive statistics were used to summarize data. The independent samples t test and Fisher exact test were used to compare age, sex, and risk scores. Results A total of 327 study participants were contacted, and 200 subjects participated in this study. The average age was 74 years (range, 57-88 years), and the median time since previous CT was 7 years. The incidence rate of developing lung cancer during the next 6 years was estimated at 5.6%. The period prevalence of lung cancer was 20.8% (new and preexisting lung cancer, 68 of total cohort of 327). The detection rate of low-dose CT was 7% (14 of 200 subjects). Of the 14 screening-detected cancers, 12 were stage I or II. Conclusion High-risk individuals have a high incidence of lung cancer after previous negative lung cancer screening. Early-stage lung cancer can be successfully detected in older high-risk individuals. © RSNA, 2018 Online supplemental material is available for this article.

ung cancer is the leading cause of cancer-related mortality globally (1). Staging and surgical methods have evolved since the Lung Cancer Study Group randomized trial more than 2 decades ago (2). There is controversy regarding the best surgical approach for early-stage lung cancer. A metaanalysis of 12 studies and 1078 patients revealed similar long-term survival outcomes for lobectomy and intentional sublobar resection (in patients eligible for lobectomy) for small, peripheral non-small cell lung cancer (NSCLC) (3). Although sublobar resection has a higher risk of positive resection margins (4) and local recurrence (5), these complications may be salvaged with curative intent. In surgical candidates, NSCLC stage IA tumors should be resected with adequate margins. Preoperative nodule localization techniques such as the CTguided microcoil have the potential to achieve this goal. CT-guided microcoil localization is safe and effective in aiding the resection of nonpalpable (6,7) and small peripheral (8-10) nodules with adequate resection margins (11). It has been shown to reduce the need for thoracotomy or video-assisted thoracoscopic surgery (VATS) anatomic resection in a prospective randomized controlled trial (12), with shorter operative time and length of stay compared with lobectomy