Purpose This joint practice guideline or procedure standard was developed collaboratively by the European Association of Nuclear Medicine (EANM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI). The goal of this guideline is to assist nuclear medicine practitioners in recommending, performing, interpreting, and reporting the results of dopaminergic imaging in parkinsonian syndromes. Methods Currently nuclear medicine investigations can assess both presynaptic and postsynaptic function of dopaminergic synapses. To date both EANM and SNMMI have published procedural guidelines for dopamine transporter imaging with single photon emission computed tomography (SPECT) (in 2009 and 2011, respectively). An EANM guideline for D2 SPECT imaging is also available (2009). Since the publication of these previous guidelines, new lines of evidence have been made available on semiquantification, harmonization, comparison with normal datasets, and longitudinal analyses of dopamine transporter imaging with SPECT. Similarly, details on acquisition protocols and simplified quantification methods are now available for dopamine transporter imaging with PET, including recently developed fluorinated tracers. Finally, [ 18 F]fluorodopa PET is now used in some centers for the differential diagnosis of parkinsonism, although procedural guidelines aiming to define standard procedures for [ 18 F]fluorodopa imaging in this setting are still lacking. Conclusion All these emerging issues are addressed in the present procedural guidelines for dopaminergic imaging in parkinsonian syndromes.

Doxing is the intentional public release onto the Internet of personal information about an individual by a third party, often with the intent to humiliate, threaten, intimidate, or punish the identified individual. In this paper I present a conceptual analysis of the practice of doxing and how it differs from other forms of privacy violation. I distinguish between three types of doxing: deanonymizing doxing, where personal information establishing the identity of a formerly anonymous individual is released; targeting doxing, that discloses personal information that reveals specific details of an individual's circumstances that are usually private, obscure, or obfuscated; and delegitimizing doxing, which reveals intimate personal information that damages the credibility of that individual. I also describe how doxing differs from blackmail and defamation. I argue that doxing may be justified in cases where it reveals wrongdoing (such as deception), but only if the information released is necessary to reveal that such wrongdoing has occurred and if it is in the public interest to reveal such wrongdoing. Revealing additional information, such as that which allows an individual to be targeted for harassment and intimidation, is unjustified. I illustrate my discussion with the examples of the alleged identification of the creator of Bitcoin, Satoshi Nakamoto, by Newsweek magazine, the identification of the notorious Reddit user Violentacrez by the blog Gawker, and the harassment of game developer Zoe Quinn in the 'GamerGate' Internet campaign.

Errors associated with medication documentation account for a substantial fraction of preventable medical errors. Hence, the Joint Commission has called for the adoption of reconciliation strategies at all United States healthcare institutions. Although studies suggest that reconciliation tools can reduce errors, it remains unclear how best to implement systems and processes that are reliable and sensitive to clinical workflow. The authors designed a primary care process that supported reconciliation without compromising clinic efficiency. This manuscript describes the design and implementation of Automated Patient History Intake Device (APHID): ambulatory check-in kiosks that allow patients to review the names, dosage, frequency, and pictures of their medications before their appointment. Medication lists are retrieved from the electronic health record and patient updates are captured and reviewed by providers during the clinic session. Results from the roll-in phase indicate the device is easy for patients to use and integrates well with clinic workflow.

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Objectives: To test the hypothesis that the QTc of any lead of the ECG predicts death after stroke, and to determine which lead of the ECG carries the greatest risk of cardiac death when its QTc is measured. Design: Standard 12 lead ECGs were analysed by one observer who was blind to patient outcome. Setting: A major teaching hospital in Scotland. Patients: 404 stroke survivors were studied at approximately one year after the cerebrovascular event and followed for up to 6.3 years. Outcome measures: Death from any cause and cardiac mortality. Results: The QTc measured from any lead of the ECG (except aVR) was associated with death from any cause. A prolonged QTc in limb lead III and chest lead V6 carried the highest relative risk of cardiac death (a 3.1-fold incease). After adjusting for overt ischaemic heart disease, pulse pressure, glucose, and cholesterol, a prolonged QTc in lead V6 was associated with a relative risk of cardiac death of 2.8 (95% confidence interval (CI) 1.1 to 7.3) (p = 0.028) and of death from all causes of 2.9 (95% CI 1.6 to 5.3) (p < 0.001). If the QTc in V6 exceeded 480 ms, then the specificity of predicting cardiac death within five years after the stroke was 94%. Conclusions: Although treatment of the conventional modifiable risk factors is important, stroke survivors with a prolonged QTc in lead V6 are still at a high risk of cardiac death and may need more intensive investigations and treatments than are currently routine practice. In patients who have a stroke, the initial stroke is the main cause of death in the first 30 days. After the first year, nonstroke cardiovascular disease becomes the most common cause of death.1 If those patients at highest risk of impending non-stroke cardiovascular death could be identified then it might be possible to intervene to prevent or delay this event.There has been much recent interest in the measurement of QT dispersion (maximum − minimum QT) from the ECG. This is because it appears in some 2-6 but not all 7 studies to be able to predict cardiac death. Recently, it was shown that a prolonged maximum heart rate corrected QT interval (QTc max) was actually better than the QTc dispersion at predicting cardiac death in non-insulin dependent diabetic patients. 8 We therefore applied this technique in a large group of stroke patients to see if QT interval analysis could identify those who make a good recovery from their stroke only to succumb later from a non-stroke cardiac death. We compared QT interval analysis with other conventional risk factors such as pulse pressure, to see if it added to the risk assessment already available from the conventional factors.Our study also addressed a second question. Despite the wealth of evidence linking long QT dispersion to cardiac death, methodological concerns have hampered QT analysis. The major problem is that it is not always easy to define where flat T waves end, and crucially such difficulties in defining the end of the T wave are multiplied when the QT interval has to be calculated for 12 different ECG ...