bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered white matter structure in the visual system following early monocular enucleation
Authors: Wong Nikita A. , Rafique Sara A. , Kelly Krista R. , Moro Stefania S. , Gallie Brenda L. , Steeves Jennifer K. E.
Published: September 2017

Partial visual deprivation from early monocular enucleation (the surgical removal of one eye within the first few years of life) results in a number of long‐term morphological adaptations in adult cortical and subcortical visual, auditory, and multisensory brain regions. In this study, we investigated whether early monocular enucleation also results in the altered development of white matter structure. Diffusion tensor imaging and probabilistic tractography were performed to assess potential differences in visual system white matter in adult participants who had undergone early monocular enucleation compared to binocularly intact controls. To examine the microstructural properties of these tracts, mean diffusion parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were extracted bilaterally. Asymmetries opposite to those observed in controls were found for FA, MD, and RD in the optic radiations, the projections from primary visual cortex (V1) to the lateral geniculate nucleus (LGN), and the interhemispheric V1 projections of early monocular enucleation participants. Early monocular enucleation was also associated with significantly lower FA bidirectionally in the interhemispheric V1 projections. These differences were consistently greater for the tracts contralateral to the enucleated eye, and are consistent with the asymmetric LGN volumes and optic tract diameters previously demonstrated in this group of participants. Overall, these results indicate that early monocular enucleation has long‐term effects on white matter structure in the visual pathway that results in reduced fiber organization in tracts contralateral to the enucleated eye. Hum Brain Mapp 39:133–144, 2018. © 2017 Wiley Periodicals, Inc.
Justification of routine venous thromboembolism prophylaxis in head and neck cancer reconstructive surgery
Authors: Ong Hui Shan , Gokavarapu Sandhya , Al‐Qamachi Laith , Yin Min Yi , Su Li Xin , Ji Tong , Zhang Chen Ping
Published: September 2017

Background

Venous thromboembolism (VTE) is a preventable complication in which early ambulation is expected after head and neck surgery. Thus, the role of VTE prophylaxis is questionable and needs further assessment. The purpose of this study was to specify the relative contributing risk factors for patients who underwent head and neck cancer ablation with immediate reconstruction.

Methods

A retrospective analysis was conducted of consecutive head and neck cancer ablations with immediate reconstructions between 2008 and 2013. Dextran and prostaglandin E2 (PGE2) were routinely given as flap thromboprophylaxis. Logistic regression was applied to analyze the potentially significant risk factors.

Results

Of 1953 subjects, the incidence of symptomatic VTE was 2.2% with 0.1% mortality rate. Prolonged surgery (>592.5 minutes; P = .048), immobilization (>4 days; P = .019), and subjects without postoperative flap thromboprophylaxis (P = .002) are significant risk factors for VTE development.

Conclusion

Our flap thromboprophylaxis regime might have played a crucial role in keeping the incidence of VTE low. Despite prolonged immobilization in fibula flap reconstruction, the incidence of VTE remained low when flap thromboprophylaxis was given.
Cost analysis of a speech pathology synchronous telepractice service for patients with head and neck cancer
Authors: Burns Clare L. , Kularatna Sanjeewa , Ward Elizabeth C. , Hill Anne J. , Byrnes Joshua , Kenny Lizbeth M.
Published: September 2017

Background

The purpose of this study is to report the economic outcomes of a new synchronous telepractice service providing speech pathology intervention to patients with head and neck cancer at nonmetropolitan facilities.

Methods

A multisite randomized controlled trial comparing standard care versus a new synchronous telepractice model was conducted within a large Australian public cancer service. Data pertaining to health service costs (staff wages, equipment, and patient travel reimbursement), patient +/‐ carer costs (travel and wages), and patient‐reported quality of life (Assessment of Quality of Life questionnaire 4D) were collected.

Results

Eighty‐two referrals (39 standard care and 43 synchronous telepractice care) were managed. The new telepractice service reported average cost savings of 12% (P < .0058) for the health service and $40.05 saving per patient per referral. An equivalent positive increase in quality of life (0.04) was reported for both groups.

Conclusion

The synchronous telepractice service provides cost efficiencies over standard care for providing remote specialist speech pathology head and neck cancer intervention.
Modified technique for preservation of inferior alveolar nerve during mandibulectomy
Authors: Chen Min‐jie , Yang Chi , Huang Dong , He Dong‐mei , Wang Yi‐wen , Zhang Wen‐hao
Published: September 2017

Background

The purpose of this article is to introduce the modified technique of preservation of the inferior alveolar nerve (IAN) during mandibulectomy for a benign lesion.

Methods

Five cases of osteofibrous hyperplasia and 3 cases of centricity osteomyelitis were included. During surgery, the IAN was marked using a planned cutting guide. Using an oscillating saw, the depth of the osteotomy along the IAN was controlled until the bone cortex was cut through. After splitting, the bony section was removed, leaving the neurovascular bundle intact. The sensation of the lower lip was evaluated using current perceptive threshold testing during follow‐up.

Results

After follow‐up for 6‐27 months, no recurrence or secondary deformity was found. One patient had severe sensory disturbance.

Conclusion

With the use of a cutting guide and osteotomy tricks, mandibulectomy with preservation of the IAN can be accurately performed.
18F‐Fluoromisonidazole positron emission tomography/CT‐guided volumetric‐modulated arc therapy‐based dose escalation for hypoxic subvolume in nasopharyngeal carcinomas: A feasibility study
Authors: Qiu Jianjian , Lv Bo , Fu Meina , Wang Xianglian , Zheng Xiangpeng , Zhuo Weihai
Published: September 2017

Background

The purpose of this study is to investigate the feasibility of a simultaneously integrated boost to the hypoxic subvolume of nasopharyngeal carcinomas (NCPs) under the guidance of 18F‐fluoromisonidazole (FMISO) positron emission tomography (PET)/CT using volumetric‐modulated arc therapy (VMAT) and intensity‐modulated radiotherapy (IMRT) techniques.

Methods

Eight patients with NPC were treated with simultaneous integrated boost‐IMRT (treatment plan named IMRT70) with dose prescriptions of 70 Gy, 66 Gy, 60 Gy, and 54 Gy to the gross tumor volume (GTV), positive neck nodes, the planning target volume (PTV), and the clinically negative neck, respectively. Based on the same datasets, experimental plans with the same dose prescription plus a dose boost of 14 Gy (an escalation of 20% of the prescription dose) to the hypoxic volume target contoured on the pretreatment 18F‐FMISO PET/CT imaging were generated using IMRT and VMAT techniques, respectively (represented by IMRT84 and VMAT84). Two or more arcs (approximately 2‐2.5 arcs, totally rotating angle <1000 degrees) were used in VMAT plans and 9 equally separated fields in IMRT plans. Dosimetric parameters, total monitor units, and delivery time were calculated for comparative study of plan quality and delivery efficiency between IMRT84 and VMAT84.

Results

In experimental plans, hypoxic target volumes successfully received the prescribed dose of 84 Gy in compliance with other dose constraints with either the IMRT technique or the VMAT technique. In terms of the target coverage, dose homogeneity, and organs at risk (OAR) sparing, there was no statistically significant difference between the actual treatment plan of IMRT70 and experimental plans. The total monitor unit of VMAT84 (525.7 ± 39.8) was significantly less than IMRT70 (1171.5 ± 167; P = .001) and IMRT84 (1388.3 ± 151.0; P = .001) per fraction, with 55.1% and 62.1% reduction. The average machine delivery time was 3.5 minutes for VMAT plans in comparison with approximately 8 minutes for IMRT plans, resulting in a reduction factor of 56.2%. For experimental plans, the 3D gamma index average was over 98.0% with no statistical significant difference when a 3%/3 mm gamma passing rate criteria was used.

Conclusion

With the guidance of 18F‐FMISO PET/CT imaging, dose escalation to hypoxic zones within NPC could be achieved and delivered efficiently with the VMAT technique in comparison with the IMRT technique.
Therapeutic lateral neck dissection in well‐differentiated thyroid cancer: Analysis on factors predicting distribution of positive nodes and prognosis
Authors: Lombardi Davide , Paderno Alberto , Giordano Davide , Barbieri Diego , Taboni Stefano , Piazza Cesare , Cappelli Carlo , Bertagna Francesco , Barbieri Verter , Piana Simonetta , Bellafiore Salvatore , Spriano Giuseppe , Mercante Giuseppe , Nicolai Piero
Published: September 2017

Background

Neck dissection is considered the treatment of choice in patients with lateral neck metastases from well‐differentiated thyroid cancer.

Methods

A multicenter, retrospective review of patients who underwent therapeutic lateral neck dissection for well‐differentiated thyroid carcinoma was carried out.

Results

The study included a total of 405 lateral neck dissections performed in 352 patients; 197 women (56%) and 155 men (44%). When considering ipsilateral neck metastases, levels IIa, IIb, III, IV, Va, Vb, and V (not otherwise specified) were involved in 42%, 6%, 73%, 67%, 11%, 31%, and 35% of cases, respectively. Five‐year and 10‐year overall survival (OS) were 93% and 81%, respectively. Age >55 years, pathologic T (pT)4 category, tumor diameter >4 cm, aggressive variants of well‐differentiated thyroid carcinoma, endovascular invasion, and number of positive nodes >5 turned out to be the most important prognostic factors.

Conclusion

Neck dissection is a valid treatment option in the presence of neck metastasis from well‐differentiated thyroid carcinoma. Levels IIa, III, IV, and Vb should always be removed.
Chairside molecular imaging of aberrant glycosylation in subjects with suspicious oral lesions using fluorescently labeled wheat germ agglutinin
Authors: Baeten John , Johnson Alexander , Sunny Sumsum , Suresh Amritha , Birur Praveen , Uma K , Kademani Deepak
Published: September 2017

Background

Aberrant sialylation is accepted as a carcinogenic biomarker. In previous work, fluorescently labeled wheat germ agglutinin (WGA) distinguished between cancerous and normal oral biopsies. The purpose of this study was to investigate WGA‐fluorescein isothiocyanate (FITC) as a point‐of‐care tool for detecting oral malignant and dysplastic lesions in vivo.

Methods

Subject recruitment was divided into two groups: (1) the clinically normal oral mucosa group; or (2) the presence of clinically suspicious oral lesion(s) group. A WGA‐FITC solution was topically applied to observable lesions or to half the subject's mouth (sagittal plane) if lesions were absent. Fluorescent molecular imaging was used to evaluate WGA‐FITC localization.

Results

Fluorescent imaging in 55 subjects demonstrated that WGA‐FITC could detect histopathologically‐confirmed cancerous and dysplastic lesions with high sensitivity (100% and 81%, respectively) and specificity (82%).

Conclusion

This study supports in vivo fluorescent molecular imaging of WGA‐FITC to visualize aberrant sialic acid expression associated with carcinogenesis. This technique resulted in the immediate chairside detection of oral cancerous and dysplastic lesions.
Meta‐analysis of the association of maternal smoking and passive smoking during pregnancy with neural tube defects
Authors: Meng Xin , Sun Yanxin , Duan Wenhou , Jia Chongqi
Published: September 2017

Background

It is unclear whether the incidence of neural tube defects (NTDs) is greater with maternal smoking or with passive smoking during pregnancy.

Objectives

To compare the effects of smoking and passive smoking during pregnancy on the risk of NTDs.

Search strategy

English and Chinese databases were searched for relevant papers published before March 2017, using search terms including “smoking” and “NTD.”

Selection criteria

Case–control and cohort studies on the aforementioned association were included.

Data collection and analysis

Two authors independently extracted the original data. Meta‐analyses were performed to assess the risks associated with smoking and passive smoking, followed by a comparison of the two pooled effect estimates. The I2 statistic was used to examine between‐study heterogeneity.

Main results

The final analysis included 23 articles representing 33 studies. The pooled odds ratio (OR) and 95% confidence interval (CI) for the risk of NTDs was 1.052 (0.907–1.220) with smoking and 1.898 (1.557–2.313) with passive smoking. Comparison of these ORs indicated that the risk of NTDs was higher with passive smoking than with smoking (OR 1.804, 95% CI 1.409–2.309).

Conclusions

Compared with smoking, exposure to passive smoking during pregnancy carries a higher risk of having infants with NTDs.
Surface modification of valve metals using plasma electrolytic oxidation for antibacterial applications: A review
Authors: Rizwan Muhammad , Alias Rodianah , Zaidi Umi Zhalilah , Mahmoodian Reza , Hamdi Mohd
Published: October 2017

Plasma electrolytic oxidation (PEO) is an advance technique to develop porous oxidation layer on light metals, primarily to enhance corrosion and wear resistance. The oxidation layer can also offer a wide variety of mechanical, biomedical, tribological, and antibacterial properties through the incorporation of several ions and particles. Due to the increasing need of antimicrobial surfaces for biomedical implants, antibacterial PEO coatings have been developed through the incorporation of antibacterial agents. Metallic nanoparticles that have been employed most widely as antibacterial agents are reported to demonstrate serious health and environmental threats. To overcome the current limitations of these coatings, there is a significant need to develop antibacterial surfaces that are not harmful for patient's health and environment. Attention of the readers has been directed to utilize bioactive glasses as antibacterial agents for PEO coatings. Bioactive glasses are well known for their excellent bioactivity, biocompatibility, and antibacterial character. PEO coatings incorporated with bioactive glasses can provide environment‐friendly antimicrobial surfaces with exceptional bioactivity, biocompatibility, and osseointegration. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 590–605, 2018.
Influence of various air‐abrasive powders on the viability and density of periodontal cells: An in vitro study
Authors: Sygkounas Eleftherios , Louropoulou Anna , Schoenmaker Ton , de Vries Teun J. , Van der Weijden Fridus A.
Published: September 2017

Remnants of air‐abrasive powders on treated surfaces and tissues may affect tissue healing. The purpose of this in vitro study was to investigate the possible effect of five commercially available air‐abrasive powders on the viability and cell density of three types of periodontal cells. A sodium bicarbonate powder, two amino acid glycine powders, an amino acid glycine and tricalcium phosphate powder and an erythritol powder were tested. Suspensions of these powders in three different concentrations were prepared and incubated with gingival epithelial cells, gingival fibroblasts, and periodontal ligament (PDL) fibroblasts for 6 hours. Mitochondrial activity, as a measure for cell viability, was evaluated by means of fluorescence activity of a redox indicator. Amount of DNA was measured as indication of cell density. All powders affected in different degrees cell viability and/or density. The most pronounced adverse effect was observed with the sodium bicarbonate followed by the erythritol‐containing powder and at the highest concentration. A fivefold reduction or more in the number of cells was observed. The tricalcium phosphate containing powder had the least effect on all types of cells. Even, increased numbers of epithelial cells (twofold) were observed. Within the limits of the present study, it was concluded that careful selection of the powder is important to improve the clinical outcomes of air powder abrasive treatment. A tricalcium phosphate containing powder may improve the biologic responses. A sodium bicarbonate powder should be used with caution. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1955–1963, 2018.
Evaluation of the in‐vitro behavior of nanostructured hydroxyapatite and zinc doped hydroxyapatite coatings obtained using solution precursor plasma spraying
Authors: Candidato Rolando T. , Thouzellier Camille , Pawłowski Lech
Published: September 2017

The in‐vitro behavior of hydroxyapatite (HA) and zinc (Zn) doped HA coatings obtained using solution precursor plasma spraying is evaluated in this work. The modifications of the surface morphology and phase composition of the coatings after immersion in simulated body fluid (SBF) were analyzed. In particular, apatite layer was formed on the pure HA coating's surface and inside their micropores. The layer exhibited needle‐like nanostructures where needles had diameter of 7–10 nm. The formation of apatite was explained by the surface charge mechanism. The formed thin apatite layer is considered to be bone‐like apatite based from the thin film‐X‐ray diffraction analysis. The nanometric/submicrometric deposits of the HA coatings resulted to greater effective surface area exposed to SBF which allows for the accelerated formation of homogeneous apatite layer. Moreover, apatite was not formed in all Zn doped HA coatings due to the inhibiting effect of Zn ions present at the coatings' surface. This observation helped understand the mechanism of apatite formation based on the exchange of ionic charges between the SBF and the surface of the HA coating. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2101–2108, 2018.
Soluble Inflammatory Markers and Risk of Incident Fractures in Older Adults: The Cardiovascular Health Study
Authors: Stojanović Danijela , Bůžková Petra , Mukamal Kenneth J , Heckbert Susan R , Psaty Bruce M , Fink Howard A , Cauley Jane A , Wallace Erin , Curtis Lesley H , Hirsch Calvin , Budoff Matthew , Li Dong , Young Rebekah , Jalal Diana , Delaney Joseph AC
Published: October 2017

Several in vitro and animal studies have showed that inflammatory markers play a role in bone remodeling and pathogenesis of osteoporosis. Additionally, some human longitudinal studies showed suggestive associations between elevated inflammatory markers and increased risk of nontraumatic fractures. We examined several inflammatory markers and multiple fracture types in a single study of older individuals with extensive follow-up. We assessed the association of four inflammatory markers with the risk of incident hip fractures among 5265 participants of the Cardiovascular Health Study (CHS) and a composite endpoint of incident fractures of the hip, pelvis, humerus, or proximal forearm in 4477 participants. Among CHS participants followed between 1992 and 2009, we observed 480 incident hip fractures during a median follow-up of 11 years. In the composite fracture analysis cohort of 4477 participants, we observed 711 fractures during a median follow-up of 7 years. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for hip fracture associated with doubling of IL-6 were HR 1.15 (95% CI, 1.02 to 1.30) overall and HR 1.17 (95% CI, 1.01 to 1.35) in women. We also observed a positive association between each unit increase in white blood cell (WBC) count and risk of hip fracture: HR 1.04 (95% CI, 1.01 to 1.06) overall and HR 1.06 (95% CI, 0.95 to 1.20) in women. We observed no significant associations between any of the four inflammatory markers and a composite fracture endpoint. Our findings suggest that chronic inflammatory and immune processes may be related to higher rates of incident hip fractures. © 2017 American Society for Bone and Mineral Research.
Relevance of the DFT method to study expanded porphyrins with different topologies
Authors: Torrent‐Sucarrat Miquel , Navarro Sara , Cossío Fernando P. , Anglada Josep M. , Luis Josep M.
Published: September 2017

Meso‐aryl expanded porphyrins present a structural versatility that allows them to achieve different topologies with distinct aromaticities. Several studies appeared in the literature studying these topological switches from an experimental and theoretical point of view. Most of these publications include density functional theory calculations, being the B3LYP the most used methodology. In this work, we show that the selection of the functional has a critical role on the geometric, energetic, and magnetic results of these expanded porphyrins, and that the use of an inadequate methodology can even generate spurious stationary points on the potential energy surface. To illustrate these aspects, in this article we have studied different molecular distortions of two expanded porphyrins, [32]‐heptaphyrin and [26]‐hexaphyrin using 11 DFT functionals and performing single point energy calculations at the local pair natural orbital coupled cluster DLPNO‐CCSD(T) method, which have been carried out for benchmarking purposes. For some selected functionals, the dispersion effects have also been evaluated using the D3‐Grimme's dispersion correction with Becke–Johnson damping. Our results let us to conclude that the CAM‐B3LYP, M05‐2X, and M06‐2X functionals are the methodologies that provide a more consistent description of these topological switches, while other methods, such as B3LYP, BPE, and BP86, show a biased description. © 2017 Wiley Periodicals, Inc.
Fragmentation of organic ions bearing fixed multiple charges observed in MALDI MS
Authors: Lou Xianwen , Li Bao , de Waal Bas F.M. , Schill Jurgen , Baker Matthew B. , Bovee Ralf A.A. , van Dongen Joost L.J. , Milroy Lech‐Gustav , Meijer E.W.
Published: September 2017

Matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry (MALDI TOF MS) was used to analyze a series of synthetic organic ions bearing fixed multiple charges. Despite the multiple intrinsic charges, only singly charged ions were recorded in each case. In addition to the pseudo‐molecular ions formed by counterion adduction, deprotonation and electron capture, a number of fragment ions were also observed. Charge splitting by fragmentation was found to be a viable route for charge reduction leading to the formation of the observed singly charged fragment ions. Unlike multivalent metal ions, organic ions can rearrange and/or fragment during charge reduction. This fragmentation process will evidently complicate the interpretation of the MALDI MS spectrum. Because MALDI MS is usually considered as a soft ionization technique, the fragment ion peaks can easily be erroneously interpreted as impurities. Therefore, the awareness and understanding of the underlying MALDI‐induced fragmentation pathways is essential for a proper interpretation of the corresponding mass spectra. Due to the fragment ions generated during charge reduction, special care should be taken in the MALDI MS analysis of multiply charged ions. In this work, the possible mechanisms by which the organic ions bearing fixed multiple charges fragment are investigated. With an improved understanding of the fragmentation mechanisms, MALDI TOF MS should still be a useful technique for the characterization of organic ions with fixed multiple charges.
A numerical‐analytical methodology for acquiring the electrical force of carbon nanotube–based nanoactuator assuming an out‐of‐plane electrodes arrangement
Authors: Ouakad Hassen M.
Published: October 2017

In this paper, we develop a simple expression to evaluate the electric force acting on a carbon nanotube–(CNT) based nanoactuator assuming a nonparallel actuating plates (out‐of‐plane) arrangement. The actuating force is initiated by the asymmetry of the resultant electric fringing fields caused mainly due to the nonparallel electrodes arrangement. The nanoactuator is designed based on a CNT flexible electrode (nonstationary) and 2 symmetrically located actuating stationary rectangular shaped out‐of‐plane plates. The resultant electric force is mathematically approximated from the outcomes of a planar (2‐D) numerical solution of the electric problem via a finite element–based numerical analysis. The influence of the design geometrical parameters on the resultant electric force are examined. Several key design parameters were inspected: the width and thickness of the stationary actuating electrodes, the radius of the flexible electrode (the CNT), and the lateral and vertical separation distances between the movable and grounded electrodes. Through several simulations, we show the effect of the lateral and vertical offsets as well as the electrodes thickness in the optimization of the performance of the nanoactuator assuming such nonparallel plates actuating configuration. We also simulate the effect on the resultant actuating force level with the electrode thickness as well as the electrodes lateral separation distance.
High oxygen facilitates wound induction of suberin polyphenolics in kiwifruit
Authors: Wei Xiaopeng , Mao Linchun , Han Xueyuan , Lu Wenjing , Xie Dandan , Ren Xingchen , Zhao Yuying
Published: September 2017

BACKGROUND

Rapid wound healing would be critical for successful long‐term storage of fruits and vegetables. However, there was no direct evidence for the requirement and efficiency of oxygen in the fruit wound‐healing process. This study was conducted to investigate the role of oxygen in wound‐induced suberization by analyzing melanin, suberin polyphenolics (SPPs) and related enzymes in half‐cut kiwifruits exposed to 100%, 50%, 21% and 0% oxygen.

RESULTS

By 3 days after wounding, the wound surface of kiwifruit in high (50 and 100%) oxygen appeared as a continuous layer of melanin and SPPs underneath, which effectively prevent excessive water vapor loss from the fruit halves. In contrast, melanin and SPPs deposition in the wound surface in 0% oxygen was significantly reduced, with high water vapor loss. Rapid decrease of soluble phenolic acids (caffeic, p‐coumaric, ferulic acids) was coupled with the increase of bound ferulic acid (coniferyl diacetate) especially in high oxygen by 9 days after wounding. Meanwhile, high oxygen enhanced peroxidase, catalase, phenylalanine ammonia‐lyase, and polyphenol oxidase activities.

CONCLUSION

Oxygen is required for wound‐induced melanin and SPPs formation, and high oxygen is effective in promoting wound suberization in postharvest kiwifruit. © 2017 Society of Chemical Industry
MRI to predict nipple‐areola complex (NAC) involvement: An automatic method to compute the 3D distance between the NAC and tumor
Authors: Giannini Valentina , Bianchi Veronica , Carabalona Silvia , Mazzetti Simone , Maggiorotto Furio , Kubatzki Franziska , Regge Daniele , Ponzone Riccardo , Martincich Laura
Published: October 2017

Objectives

To assess the role in predicting nipple‐areola complex (NAC) involvement of a newly developed automatic method which computes the 3D tumor‐NAC distance.

Patients and Methods

Ninety‐nine patients scheduled to nipple sparing mastectomy (NSM) underwent magnetic resonance (MR) examination at 1.5 T, including sagittal T2w and dynamic contrast enhanced (DCE)‐MR imaging. An automatic method was developed to segment the NAC and the tumor and to compute the 3D distance between them. The automatic measurement was compared with manual axial and sagittal 2D measurements. NAC involvement was defined by the presence of invasive ductal or lobular carcinoma and/or ductal carcinoma in situ or ductal intraepithelial neoplasia (DIN1c − DIN3).

Results

Tumor‐NAC distance was computed on 95/99 patients (25 NAC+), as three tumors were not correctly segmented (sensitivity = 97%), and 1 NAC was not detected (sensitivity = 99%). The automatic 3D distance reached the highest area under the receiver operating characteristic (ROC) curve (0.830) with respect to the manual axial (0.676), sagittal (0.664), and minimum distances (0.664). At the best cut‐off point of 21 mm, the 3D distance obtained sensitivity = 72%, specificity = 80%, positive predictive value = 56%, and negative predictive value = 89%.

Conclusions

This method could provide a reproducible biomarker to preoperatively select breast cancer patients candidates to NSM, thus helping surgical planning and intraoperative management of patients.
Estimation of Ophidiomyces prevalence to evaluate snake fungal disease risk
Authors: Hileman Eric T. , Allender Matthew C. , Bradke Danielle R. , Faust Lisa J. , Moore Jennifer A. , Ravesi Michael J. , Tetzlaff Sasha J.
Published: October 2017

Pathogenic fungi have become a global concern to wildlife populations over the last 2 decades. However, the threat of snake fungal disease (SFD; caused by Ophidiomyces ophiodiicola) to snake populations is still largely unknown. From 2014–2016, we monitored 3 disjunct populations of the federally threated eastern massasauga (Sistrurus catenatus) in Michigan, USA. We used clinical signs of SFD, quantitative TaqMan polymerase chain reaction (qPCR), repeated sampling of individuals and sites, and single‐season occupancy models to estimate site‐specific prevalence of Ophidiomyces. Point estimates of Ophidiomyces prevalence in 2016 were larger at the northernmost study site (0.17, 95% CI = 0.04–0.50), where 17 of 34 snakes were implanted with radio‐transmitters, and smaller at southern sites (0.03, 95% CI = 0.00–0.19). However, Ophidiomyces prevalence was not different between snakes with transmitters and snakes without transmitters. Swabbing snakes with 1 applicator resulted in a high probability of failure in detecting Ophidiomyces DNA for individuals with clinical signs of SFD and the probability was even higher for individuals without clinical signs of SFD. Repeated sampling of individuals reduced the probability of obtaining a false‐negative qPCR result by 72% for snakes with clinical signs and 12% for snakes without clinical signs when we swabbed individuals with 5 applicators. We recommend resampling individuals and sites as a sampling design for estimating fine‐scale, site‐specific Ophidiomyces prevalence and population‐level responses to SFD. If clinical signs are used as a surrogate for SFD, we recommend researchers standardize diagnosis of clinical signs of SFD by providing technicians adequate field training and educational materials, and minimize the number of observers recording clinical signs. We discourage the use of radio‐telemetry methods where SFD occurs unless sterile surgical, handling, and equipment protocols can be ensured and the benefits to the population from such activities outweigh the increased health risks to individuals. © 2017 The Wildlife Society.
Turkish Standardization of Movement Disorders Society Unified Parkinson's Disease Rating Scale and Unified Dyskinesia Rating Scale
Authors: Akbostanci Muhittin C. , Bayram Ece , Yilmaz Volkan , Rzayev Sefer , Özkan Serhat , Tokcaer Ayse Bora , Saka Esen , Durmaz Celik Fatma N. , Barut Banu Özen , Tüfekcioglu Zeynep , Acarer Ahmet , Balaban Hatice , Erer Sevda , Dogu Okan , Kibaroglu Seda , Aydin Nursel , Hanagasi Hasmet , Elibol Bülent , Emre Murat , Stebbins Glenn T. , Goetz Christopher G.
Published: September 2017

Background

Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) and Unified Dyskinesia Rating Scale (UDysRS) were developed as standard tools to rate Parkinson's disease (PD) and drug‐induced dyskinesias of PD. As these scales have become widely used, there is a need for translation to non‐English languages. Here we present the standardization for the Turkish translations.

Methods

The scales were translated into Turkish and then back‐translated to English. These back‐translations were reviewed by the MDS team. After cognitive pretesting, movement disorder specialists from nine centers tested 352 patients for MDS‐UPDRS, and 250 patients for UDysRS. Confirmatory factor analyses (CFAs) were used to determine if the factor structures for the reference standards could be confirmed in the Turkish data. The comparative fit indexes (CFIs) for the scales were required to be 0.90 or higher. Exploratory factor analyses (EFAs) were conducted to explore the underlying factor structure without the constraint of a pre‐specified factor structure.

Results

For both scales, the CFIs were 0.94 or greater as compared to the reference standard factor structures. The factor structures were consistent with that of reference standards, although there were some differences in some areas as compared to the EFA of the reference standard dataset. This may be due to the inclusion of patients with different stages of PD and different cultural properties of raters and patients.

Conclusions

These results demonstrate that the Turkish translations of MDS‐UPDRS and UDysRS have adequate clinimetric properties. They are established as the official translations and can be reliably used in Turkish speaking populations.
Development and validation of prognostic survival models in newly diagnosed Parkinson's disease
Authors: Macleod Angus D. , Dalen Ingvild , Tysnes Ole‐Bjørn , Larsen Jan Petter , Counsell Carl E.
Published: October 2017

Objective

The objective of this study was to develop valid prognostic models to predict mortality, dependency, and “death or dependency” for use in newly diagnosed Parkinson's disease (PD).

Methods

The models were developed in the Parkinsonism Incidence in North‐East Scotland study (UK, 198 patients) and validated in the ParkWest study (Norway, 192 patients), cohorts that attempted to identify and follow‐up all new PD cases in the study area. Dependency was defined using the Schwab & England scale. We selected variables measured at time of diagnosis to include in the models. Internal validation and external validation were performed by calculating C‐statistics (discrimination) and plotting observed versus predicted risk in quantiles of predicted risk (calibration).

Results

Older age, male sex, increased severity of axial features, and Charlson comorbidity index were independent prognostic factors in the mortality model. Increasing age, higher smoking history, increased severity of axial features, and lower MMSE score were independent predictors in the models of dependency and “death or dependency.” Each model had very good internal calibration and very good or good discrimination (internal and external C‐statistics for the models were 0.73–0.75 and 0.68–0.78, respectively). Although each model clearly separated patients into groups according to risk, they tended to overestimate risk in ParkWest. The models were recalibrated to the baseline risk in the ParkWest study and then calibrated well in this cohort.

Conclusions

We have developed prognostic models for predicting medium‐term risk of important clinical outcomes in newly diagnosed PD. These models have validity for use for stratification of randomization, confounder adjustment, and case‐mix correction, but they are inadequate for individualized prognostication. © 2017. The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
Automatic segmentation of the clinical target volume and organs at risk in the planning CT for rectal cancer using deep dilated convolutional neural networks
Authors: Men Kuo , Dai Jianrong , Li Yexiong
Published: September 2017

Purpose

Delineation of the clinical target volume (CTV) and organs at risk (OARs) is very important for radiotherapy but is time‐consuming and prone to inter‐observer variation. Here, we proposed a novel deep dilated convolutional neural network (DDCNN)‐based method for fast and consistent auto‐segmentation of these structures.

Methods

Our DDCNN method was an end‐to‐end architecture enabling fast training and testing. Specifically, it employed a novel multiple‐scale convolutional architecture to extract multiple‐scale context features in the early layers, which contain the original information on fine texture and boundaries and which are very useful for accurate auto‐segmentation. In addition, it enlarged the receptive fields of dilated convolutions at the end of networks to capture complementary context features. Then, it replaced the fully connected layers with fully convolutional layers to achieve pixel‐wise segmentation. We used data from 278 patients with rectal cancer for evaluation. The CTV and OARs were delineated and validated by senior radiation oncologists in the planning computed tomography (CT) images. A total of 218 patients chosen randomly were used for training, and the remaining 60 for validation. The Dice similarity coefficient (DSC) was used to measure segmentation accuracy.

Results

Performance was evaluated on segmentation of the CTV and OARs. In addition, the performance of DDCNN was compared with that of U‐Net. The proposed DDCNN method outperformed the U‐Net for all segmentations, and the average DSC value of DDCNN was 3.8% higher than that of U‐Net. Mean DSC values of DDCNN were 87.7% for the CTV, 93.4% for the bladder, 92.1% for the left femoral head, 92.3% for the right femoral head, 65.3% for the intestine, and 61.8% for the colon. The test time was 45 s per patient for segmentation of all the CTV, bladder, left and right femoral heads, colon, and intestine. We also assessed our approaches and results with those in the literature: our system showed superior performance and faster speed.

Conclusions

These data suggest that DDCNN can be used to segment the CTV and OARs accurately and efficiently. It was invariant to the body size, body shape, and age of the patients. DDCNN could improve the consistency of contouring and streamline radiotherapy workflows.
Toward optimization of in vivo super‐resolution ultrasound imaging using size‐selected microbubble contrast agents
Authors: Ghosh Debabrata , Xiong Fangyuan , Sirsi Shashank R. , Shaul Philip W. , Mattrey Robert F. , Hoyt Kenneth
Published: October 2017

Purpose

Microvascular processes play key roles in many diseases including diabetes. Improved understanding of the microvascular changes involved in disease development could offer crucial insight into the relationship of these changes to disease pathogenesis. Super‐resolution ultrasound (SR‐US) imaging has showed the potential to visualize microvascular detail down to the capillary level (i.e., subwavelength resolution), but optimization is still necessary. The purpose of this study was to investigate in vivo SR‐US imaging of skeletal muscle microvascularity using microbubble (MB) contrast agents of various size and concentration while evaluating different ultrasound (US) system level parameters such as imaging frame rate and image acquisition length.

Methods

An US system equipped with a linear array transducer was used in a harmonic imaging mode at low transmit power. C57BL/6J mice fed a normal diet were used in this study. An assortment of size‐selected MB contrast agents (1–2 μm, 3–4 μm, and 5–8 μm in diameter) were slowly infused in the tail vein at various doses (1.25 × 107, 2.5 × 107, or 5 × 107 MBs). US image data were collected before MB injection and thereafter for 10 min at 30 frames per s (fps). The US transducer was fixed throughout and between each imaging period to help capture microvascular patterns along the same image plane. An adaptive SR‐US image processing technique was implemented using custom Matlab software.

Results

Experimental findings illustrate the use of larger MB results in better SR‐US images in terms of skeletal muscle microvascular detail. A dose of 2.5 × 107 MBs resulted in SR‐US images with optimal spatial resolution. An US imaging rate of at least 20 fps and image acquisition length of at least 8 min also resulted in SR‐US images with pronounced microvascular detail.

Conclusions

This study indicates that MB size and dose and US system imaging rate and data acquisition length have significant impact on the quality of in vivo SR‐US images of skeletal muscle microvascularity.
Crashworthiness characteristics of carbon–jute–glass reinforced epoxy composite circular tubes
Authors: Attia Mohamed A. , Abd El–Baky Marwa A. , Hassan Mohamad A. , Sebaey Tamer A. , Mahdi Elsadig
Published: September 2017

This article provides an experimental investigation into the crashworthiness of carbon–jute–glass reinforced epoxy circular composite tubes. The test specimens were fabricated of 6 layers with different stacking sequence using wet‐wrapping process and tested under uniaxial quasi‐static compression loading up to complete crushing. The effects of hybrid reinforcement, stacking sequence, and relative reinforcement amounts on the energy absorption capabilities and failure modes were studied. Also, the crush load–displacement response, initial crushing failure load, total energy absorption, specific energy absorption, average crushing load, and crushing force efficiency were determined and discussed. The scanning electron microscope study was considered to analyze the failure modes of the crushed specimens. Results indicate that specimens' failure modes and energy absorption capabilities were highly dominated by the reinforcement combinations and plies stacking sequence. Also, hybrid carbon–jute–glass reinforced epoxy composite tubes have the potential to be used as energy absorbers as compared to jute‐reinforced epoxy composite tubes. The JGC composite tube has a higher load carrying capacity and energy absorption capability compared to other hybrid composite tubes, so it seems to be the best appropriate choice for energy absorbing devices. POLYM. COMPOS., 39:E2245–E2261, 2018. © 2017 Society of Plastics Engineers
Trowels and Tribulations: Review of Antimicrobial‐Impregnated Bone Cements in Prosthetic Joint Surgery
Authors: Athans Vasilios , Veve Michael P. , Davis Susan L.
Published: October 2017

Antimicrobial‐impregnated bone cement (AIBC) is a staple of contemporary orthopedic surgery and has been used to either treat or prevent prosthetic joint infection. Applied intraoperatively during primary arthroplasty or prosthetic joint exchange, this drug‐delivery vehicle has become a popular means of maximizing drug concentrations within a joint space while minimizing systemic exposure. Antimicrobial characteristics conducive to cement loading include availability of a crystalline powder formulation, molecular characteristics, minimal impact on cement integrity, and other variables promoting drug elution. Antimicrobials most commonly incorporated into cements are vancomycin and aminoglycosides, usually in combination due to synergistic antibacterial activity and enhanced cement elution. Other classes include the β‐lactams, lipopeptides, oxazolidinones, and antifungals. With the exception of several commercially available AIBCs, most products are compounded extemporaneously without a formal safety or efficacy assessment. Few randomized controlled trials have been conducted to assess the benefit or optimal use of these cement preparations, and variable methodology renders cross‐study comparison challenging. Given the lack of standardization and multidisciplinary oversight often seen with practical AIBC use, additional data are needed. This review presents information intended to guide AIBC preparation, selection, dosing, and safe use. In addition, opportunities for best practice development, antimicrobial stewardship, and future research are discussed.
Comparison of Targeted Mass Spectrometry Techniques with an Immunoassay: A Case Study for HSP90α
Authors: Güzel Coşkun , Govorukhina Natalia I. , Stingl Christoph , Dekker Lennard J. M. , Boichenko Alexander , van der Zee Ate G. J. , Bischoff Rainer P.H. , Luider Theo M.
Published: October 2017

Purpose

The objective of this study is to better understand factors governing the variability and sensitivity in SRM and PRM, compared to immunoassay.

Experimental design

A 2D‐LC–MS/MS‐based SRM and PRM assay is developed for quantitative measurements of HSP90α in serum. Forty‐three control sera are compared by SRM, PRM, and ELISA following the manufacturer's instructions. Serum samples are trypsin‐digested and fractionated by strong cation exchange chromatography prior to SRM and PRM measurements. Analytical parameters such as linearity, LOD, LOQ, repeatability, and reproducibility of the SRM, PRM, and ELISA are determined.

Results

PRM data obtained by high‐resolution MS correlate better with ELISA measurements than SRM data measured on a triple quadrupole mass spectrometer. While all three methods (SRM, PRM, and ELISA) are able to quantify HSP90α in serum at the ng mL–1 level, the use of PRM on a high‐resolution mass spectrometer reduces variation and shows comparable sensitivity to immunoassay.

Conclusions and clinical relevance

Using fractionation, it is possible to measure ng mL–1 levels of HSP90α in a reproducible, selective, and sensitive way using PRM in serum. This opens up the possibility to use PRM in a multiplexed way as an attractive alternative for immunoassays without the use of antibodies or comparable binders.
Two‐domain analysis of JmjN‐JmjC and PHD‐JmjC lysine demethylases: Detecting an inter‐domain evolutionary stress
Authors: Slama Patrick
Published: October 2017

Residues at different positions of a multiple sequence alignment sometimes evolve together, due to a correlated structural or functional stress at these positions. Co‐evolution has thus been evidenced computationally in multiple proteins or protein domains. Here, we wish to study whether an evolutionary stress is exerted on a sequence alignment across protein domains, i.e., on longer sequence separations than within a single protein domain. JmjC‐containing lysine demethylases were chosen for analysis, as a follow‐up to previous studies; these proteins are important multidomain epigenetic regulators. In these proteins, the JmjC domain is responsible for the demethylase activity, and surrounding domains interact with histones, DNA or partner proteins. This family of enzymes was analyzed at the sequence level, in order to determine whether the sequence of JmjC‐domains was affected by the presence of a neighboring JmjN domain or PHD finger in the protein. Multiple positions within JmjC sequences were shown to have their residue distributions significantly altered by the presence of the second domain. Structural considerations confirmed the relevance of the analysis for JmjN‐JmjC proteins, while among PHD‐JmjC proteins, the length of the linker region could be correlated to the residues observed at the most affected positions. The correlation of domain architecture with residue types at certain positions, as well as that of overall architecture with protein function, is discussed. The present results thus evidence the existence of an across‐domain evolutionary stress in JmjC‐containing demethylases, and provide further insights into the overall domain architecture of JmjC domain‐containing proteins.