In the 2009 European Guidelines on the diagnosis and treatment of pulmonary hypertension (PH), one section covers aspects of pathophysiology, diagnosis and treatment of chronic thromboembolic pulmonary hypertension (CTEPH). The practical implementation of the guidelines for this disease is of crucial importance, because CTEPH is a subset of PH which can potentially be cured by pulmonary endarterectomy (PEA). Nowadays, CTEPH is commonly underdiagnosed and not properly managed. Any patient with unexplained PH should be evaluated for the presence of CTEPH, and a ventilation/perfusion (V/Q) lung scan is recommended as screening method of choice. If the V/Q scan or CT angiography reveals signs of CTEPH, the patient should be referred to a specialized center with expertise in the medical and surgical management of this disease. Every case has to be reviewed by an experienced PEA surgeon for the assessment of operability. In this updated recommendation, important contents of the European guidelines were commented, and more recent information regarding diagnosis and treatment was added.

Is transformational leadership healthy for employees? A multilevel analysis in 16 nations ** This study examines the potential health promoting and hampering effects of transformational, contingent reward and laissez-faire leadership across 16 countries with a multi-source dataset comprising 93,576 subordinates in 11,177 teams of a large international company. We analyze how leadership climate strength, defined as the shared perceptions of employees concerning their supervisor's leadership behavior, affects individual employees' health and if leaders who are both transformational and transactional have more healthy employees (augmentation effect). In addition, we investigate how national power distance moderates these relationships. The results of multi-level analysis provide strong support for the health promoting effect of transformational leadership (r = .16 to r = .50), contingent reward (r = .14 to r = .48) and the health hampering effect of laissez-faire leadership (r =-.15 to r =-.43) within the analyzed 16 nations. Having a strong transformational leadership climate is also associated with better perceived health in eight countries. Finally, the augmentation effect was significant in six countries and we also found, as expected, that a high power distance strengthens the health promoting effects of transformational leadership. Overall, this study indicates that having a shared vision as well as clear goals, roles and rewards at work is important for promoting employees' health worldwide.

These findings provide initial evidence of a striatal creatine/glutamatergic dysregulation in ADHD.

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h i g h l i g h t s Multifunctional test bench and indirect operated reactor developed and in operation. Proof of principal for a 10 kW, 20 kg calcium hydroxide thermochemical storage reactor. Several charge and discharge cycles were performed at adjustable storage temperatures.

Image quality metrics (IQMs) such as root mean square error (RMSE) and structural similarity index (SSIM) are commonly used in the evaluation and optimization of accelerated magnetic resonance imaging (MRI) acquisition and reconstruction strategies. However, it is unknown how well these indices relate to a radiologist's perception of diagnostic image quality. In this study, we compare the image quality scores of five radiologists with the RMSE, SSIM, and other potentially useful IQMs: peak signal to noise ratio (PSNR) multi-scale SSIM (MSSSIM), information-weighted SSIM (IWSSIM), gradient magnitude similarity deviation (GMSD), feature similarity index (FSIM), high dynamic range visible difference predictor (HDRVDP), noise quality metric (NQM), and visual information fidelity (VIF). The comparison uses a database of MR images of the brain and abdomen that have been retrospectively degraded by noise, blurring, undersampling, motion, and wavelet compression for a total of 414 degraded images. A total of 1017 subjective scores were assigned by five radiologists. IQM performance was measured via the Spearman rank order correlation coefficient (SROCC) and statistically significant differences in the residuals of the IQM scores and radiologists' scores were tested. When considering SROCC calculated from combining scores from all radiologists across all image types, RMSE and SSIM had lower SROCC than six of the other IQMs included in the study (VIF, FSIM, NQM, GMSD, IWSSIM, and HDRVDP).In no case did SSIM have a higher SROCC or significantly smaller residuals than RMSE. These results should be considered when choosing an IQM in future imaging studies.

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