bluuebunny/crossref_metadata_2025 huggingface dataset:
Thoracic outlet syndrome: A neurological and vascular disorder
Authors: Klaassen Zachary , Sorenson Edward , Tubbs R. Shane , Arya Rahul , Meloy Patrick , Shah Rajnil , Shirk Samuel , Loukas Marios
Published: May 2013

Thoracic outlet syndrome (TOS) is a condition arising from compression of the subclavian vessels and/or brachial plexus as the structures travel from the thoracic outlet to the axilla. Despite the significant pathology associated with TOS, there remains some general disagreement among experts on the specific anatomy, etiology, and pathophysiology of the condition, presumably because of the wide variation in symptoms that manifest in presenting patients, and because of lack of a definitive gold standard for diagnosis. Symptoms associated with TOS have traditionally been divided into vascular and neurogenic categories, a distinction based on the underlying structure(s) implicated. Of the two, neurogenic TOS (nTOS) is more common, and typically presents as compression of the brachial plexus; primarily, but not exclusively, involving its lower trunk. Vascular TOS (vTOS) usually involves compression of the vessel, most commonly the subclavian artery or vein, or is secondary to thrombus formation in the venous vasculature. Any anatomical anomaly in the thoracic outlet has the potential to predispose a patient to TOS. Common anomalies include variations in the insertion of the anterior scalene muscle (ASM) or scalenus minimus muscle, the presence of a cervical rib or of fibrous and muscular bands, variations in insertion of pectoralis minor, and the presence of neurovascular structures, which follow an atypical course. A common diagnostic technique for vTOS is duplex imaging, which has generally replaced more invasive angiographic techniques. In cases of suspected nTOS, electrophysiological nerve studies and ASM blocks provide guidance when screening for patients likely to benefit from surgical decompression of TOS. Surgeons generally agree that the transaxillary approach allows the greatest field of view for first rib excision to relieve compressed vessels. Alternatively, a supraclavicular approach is favored for scalenotomies when the ASM impinges on surrounding structures. A combined supraclavicular and infraclavicular approach is preferred when a larger field of view is required. The future of TOS management must emphasize the improvement of available diagnostic and treatment techniques, and the development of a consensus gold standard for diagnosis. Helical computed tomography offers a three‐dimensional view of the thoracic outlet, and may be valuable in the detection of anatomical variations, which may predispose patients to TOS. This review summarizes the history of TOS, the pertinent clinical and anatomical presentations of TOS, and the commonly used diagnostic and treatment techniques for the condition. Clin. Anat. 27:724–732, 2014. © 2013 Wiley Periodicals, Inc.
Schedule‐dependent therapeutic efficacy of L19mTNF‐α and melphalan combined with gemcitabine
Authors: Mortara Lorenzo , Orecchia Paola , Castellani Patrizia , Borsi Laura , Carnemolla Barbara , Balza Enrica
Published: May 2013

L19‐tumor necrosis factor alpha (L19mTNF‐α; L), a fusion protein consisting of mouse TNFα and the human antibody fragment L19 directed to the extra domain‐B (ED‐B) of fibronectin, is able to selectively target tumor vasculature and to exert a long‐lasting therapeutic activity in combination with melphalan (M) in syngeneic mouse tumor models. We have studied the antitumor activity of single L19mTNF‐α treatment in combination with melphalan and gemcitabine (G) using different administration protocols in two histologically different murine tumor models: WEHI‐164 fibrosarcoma and K7M2 osteosarcoma. All responding mice showed significant reduction in myeloid‐derived suppressor cells (MDSCs) and an increase in CD4+ and CD8+ T cells in the tumor infiltrates, as well as significant reduction in regulatory T cells (Treg) at the level of draining lymph nodes. What is important is that all cured mice rejected tumor challenge up to 1 year after therapy. Targeted delivery of L19mTNF‐α synergistically increases the antitumor activity of melphalan and gemcitabine, but optimal administration schedules are required. This study provides information for designing clinical studies using L19mTNF‐α in combination with chemotherapeutic drugs.
Rights, Responsibilities and Pragmatic Practice: Family Participation in Case Reviews
Authors: Morris Kate , Brandon Marian , Tudor Paul
Published: May 2013

This article considers the experiences of families and professionals in case reviews where a child has died/suffered serious injury as a result or abuse or neglect. There is an expectation in the four UK nations that families will be included in such case reviews. The article draws on a study of policies and practices, and family accounts of involvement. An overview of UK policies and practices is described, and the broader questions that emerge for participatory practices identified. Family experiences in this complex area of practice are considered, and recommendations made for practice. The uneven picture of family involvement is argued to reflect uncertainty about the purpose, value and role of family involvement. Concerns are raised about the unresolved dilemmas arising from family involvement and the potential for practice to be unhelpful if not carefully examined. Copyright © 2013 John Wiley & Sons, Ltd.

‘An overview of UK policies and practices is described, and the broader questions that emerge for participatory practices identified’

Key Practitioner Messages:

Family involvement in reviews is an expectation across the UK nations, but with limited practice guidance.

Family perspectives add invaluable insights and support learning for future protective services.

Professionals have common drivers for family involvement in reviews, but few policies articulate the purpose of participation.

Family involvement raises difficult questions for participatory practices.

Without further clarity and adoption of principles for practice, dilemmas will remain whatever review models are adopted.
Triangulating consumers' perceptions of payment systems by using social representations theory: A multi‐method approach
Authors: Penz Elfriede , Sinkovics Rudolf R.
Published: May 2013

Social systems play a pivotal role in shaping customers' views, the adoption process and subsequent product diffusion for novel products. Perceptions of Austrian consumers regarding payment systems were assessed in a cross‐sectional analysis applying social representations theory. Social representations help to unravel the sources of individuals' attitudinal or perceptual similarities and differences, which often stem from inter‐group differences. In short, they are useful for the investigation of ‘deeper structure’ aspects of consumer behaviour, as has been shown in previous studies. This may be seen as a further step forward for marketing research, which operates largely on social phenomena.

This study addresses the shortage of non‐cognitive‐based research in marketing by offering a methodological approach that uses triangulation on the basis of associative answers from social groups. A four‐step analytic design revealed that consumer groups transpose the abstract concept of payment systems into tangible objects and processes in a similar way; however, their social background impacted which value was attached to established as well as new means of payment. Cash is still seen as the prototypical form of payment; newer forms, such as credit cards or ATM cards, appear already in the periphery of representations, urgently needing well‐concerted marketing efforts to become recognized as substitutes for cash. From a managerial view, the research employs social phenomena as a basis for segmenting natural rather than nominal groups in order to better serve consumers' needs in an increasingly connected social reality. Copyright © 2013 John Wiley & Sons, Ltd.
Separation, Hydrodynamics, and Joule Heating Effects in Continuous Annular Electrochromatography
Authors: Laskowski R. , Bart H.‐J.
Published: May 2013

First experimental results of the transfer from an analytical batch electrochromatography to a continuous annular electrochromatographic process are presented. In order to study the electrochromatographic effects, hydrodynamics and functionality tests were investigated in a planar reference system. As stationary phase inside the annular gap, an inorganic C8 reverse‐phase monolith prepared by an in situ sol‐gel process was implemented. The generation of Joule heating during the process was determined by a contact‐free thermal camera system. The volumetric flow rates of the electrolyte were detected by a gravimetric contact‐free measurement method. Finally, a mixture of neutral test substances was used to evaluate the continuous separation efficiency and to fractionate the single substances under process‐like conditions. The separation results were detected by an inline UV‐Vis detection cell and the analysis of the single fractions was performed by an analytical electrochromatograph. The results indicate uniform electroosmotic flow as well as successful separation and fractioning of a neutral test mixture.
State of the Art of Mini/Micro Jet Reactors
Authors: Santos R. J. , Sultan M. A.
Published: May 2013

For over three decades, opposed‐jets reactors have been applied particularly for fast complex chemical reactions where mixing affects the final product distribution. The first opposed‐jets reactors, i.e., confined impinging jets (CIJ), had cylindrical geometries. With the advent of microreactors, a new type of prismatic opposed‐jets reactors has been introduced, the so‐called T‐jets reactors. The state of the art of the know‐how on mixing in CIJ reactors as well as the current state of the art of T‐jets reactors is described. T‐jets and CIJ are generally small‐scale devices, ensuring that these units can mix fluids within very short mixing times on the order of milliseconds. The small scale has the disadvantage of compromising the reactors' throughput. This fact can prevent the dissemination of this type of mixers to applications where conventional reactors, such as stirred tanks, are used. Attention is paid to the issue on how to scale up opposed‐jets reactors without compromising mixing times. A short analysis of the main research questions to be answered in this field is made.
Separation of Selected Imidazole Enantiomers Using Dual Cyclodextrin System in Micellar Electrokinetic Chromatography
Authors: Wan Ibrahim Wan Aini , Abd Wahib Siti Munirah , Hermawan Dadan , Sanagi Mohd Marsin , Aboul‐Enein Hassan Y.
Published: May 2013

Cyclodextrin‐modified micellar electrokinetic chromatography (CD‐MEKC) method was developed for simultaneous enantioseparation of three imidazole drugs namely tioconazole, isoconazole and fenticonazole. Three easily available and inexpensive cyclodextrins namely 2‐hydroxypropyl‐β‐cyclodextrin (HP‐β‐CD), 2‐hydroxypropyl‐γ‐cyclodextrin (HP‐γ‐CD) and heptakis(2,6‐di‐O‐methyl)‐β‐cyclodextrin (DM‐β‐CD) were evaluated to discriminate the six stereoisomers of the drugs. However, none of the three CDs gave a complete enantioseparation of the drugs. Effective enantioseparation of tioconazole, isoconazole and fenticonazole was achieved using a combination of 35 mM HP‐γ‐CD and 10 mM DM‐β‐CD as chiral selectors. The best separation using both HP‐γ‐CD and DM‐β‐CD (35 mM:10 mM) as chiral selectors were accomplished in background electrolyte (BGE) containing 35 mM phosphate buffer (pH 7.0), 50 mM sodium dodecyl sulfate (SDS) and 15% (v/v) acetonitrile at 27 kV and 30 °C with all peaks resolved in less than 15 min with resolutions, Rs 1.90‐27.22 and peak efficiencies, N > 180 000. The developed method was linear over the concentration range of 25–200 mg l‐1 (r2 > 0.998) and the detection limits (S/N = 3) of the three imidazole drugs were found to be 2.7‐7.7 mg l‐1. The CD‐MEKC method was successfully applied to the determination of the three imidazole drugs in spiked human urine sample and commercial cream formulation of tioconazole and isoconazole with good recovery (93.6‐106.2%) and good RSDs ranging from 2.30‐6.8%. Chirality 25:328–335, 2013. © 2013 Wiley Periodicals, Inc.
Enantioselective Degradation of the Chiral Fungicides Metalaxyl and Furalaxyl by Brevibacillus brevis
Authors: Sulimma Lutz , Bullach Anke , Kusari Souvik , Lamshöft Marc , Zühlke Sebastian , Spiteller Michael
Published: May 2013

For almost four decades, the chiral fungicides metalaxyl and furalaxyl have been in use in plant protection on a global scale. Both substances are distributed as racemic mixtures, yet the desirable interference in nucleic acid synthesis of harmful fungi only occurs by the (‐)‐R‐enantiomer. As enantioselective degradation in Scheyern (Germany) and Yaoundé (Cameroon) soils has been documented, the influence of 50 isolated microorganisms on the R/S ratio was investigated. A high‐pressure liquid chromatography method with a chiral column to separate enantiomers of metalaxyl and furalaxyl, and subsequent detection by tandem mass spectrometry, was employed. Only one of these microorganisms, a strain of Brevibacillus brevis, showed an enantioselective degradation pattern in liquid culture; the respective (‐)‐R‐enantiomers were preferably degraded. Moreover, (‐)‐R‐furalaxyl was degraded faster in cultures supplemented simultaneously with both fungicides of the same concentration. Chirality 25:336–340, 2013. © 2013 Wiley‐Liss Inc. Chirality 00:000‐000:, 2013. © 2013 Wiley Periodicals, Inc.
Online Analysis of Enzymatic Polycondensation Reactions in Bubble Column Reactors by Means of ATR‐FTIR Spectroscopy
Authors: Gebhard Jakob , Sellin Daniel , Hilterhaus Lutz , Liese Andreas
Published: May 2013

Die enzymkatalysierte Polykondensation von 1,3‐Propandiol und 9‐((Z)‐Non‐3‐enyl)‐10‐octylnonadecandisäure führte in einem Blasensäulenreaktor zu einem Umsatz von 94 %. Auf Basis von kontinuierlich aufgenommenen Absorptionsspektren durch ein Fourier‐Transformations‐Infrarot‐Spektrometer mit einer abgeschwächten Totalreflexions‐Sonde im mittleren Infrarot‐Bereich wurde ein chemometrisches Modell zur Bestimmung des Umsatzes sowie des Molekulargewichtes erstellt. In einer internen Validierung zeigten beide Modelle eine gute Genauigkeit mit einem mittleren Fehler der Kreuzvalidierung von 2,14 % für den Umsatz und 319 g mol–1 für das Molekulargewicht.
Optimisation of photo‐Fenton‐like degradation of aqueous polyacrylic acid using Box‐Behnken experimental design
Authors: Ghafoori Samira , Mehrvar Mehrab , Chan Philip
Published: May 2013

The effectiveness of photo‐Fenton‐like process to degrade aqueous polyacrylic acid (PAA) is investigated in a batch recirculation system using two photoreactors in series. The response surface methodology (RSM) using the Box–Behnken experimental design combined with quadratic programming is employed for the experimental design, the statistical analysis and the optimisation. The effects of the initial concentration of PAA, the initial concentration of H2O2:Fe3+, pH and the recirculation rate on the percent removal of total organic carbon (TOC)and the ‘pseudo’‐second order rate constant as the process responses are studied. The statistical analysis of the results indicates a satisfactory prediction of the system behaviour by the developed quadratic models. Optimum operating conditions to maximise the percent TOC removal are also determined.
Sol‐gel Synthesis and Electrochemical Performance of Li4−xMgxTi5−xZrxO12 Anode Material for Lithium‐ion Batteries
Authors: Qiu Caixia , Yuan Zhongzhi , Liu Ling , Cheng Sijie , Liu Jincheng
Published: May 2013

The anode materials Li4−xMgxTi5−xZrxO12 (x=0, 0.05, 0.1) were successfully synthesized by sol‐gel method using Ti(OC4H9)4, CH3COOLi·2H2O, MgCl2·6H2O and Zr(NO3)3·6H2O as raw materials. The crystalline structure, morphology and electrochemical properties of the as‐prepared materials were characterized by XRD, SEM, cyclic voltammograms (CV), electrochemical impedance spectroscopy (EIS) and charge‐discharge cycling tests. The results show that the lattice parameters of the Mg‐Zr doped samples are slightly larger than that of the pure Li4Ti5O12, and Mg‐Zr doping does not change the basic Li4Ti5O12 structure. The rate capability of Li4−xMgxTi5−xZrxO12 (x=0.05, 0.1) electrodes is significantly improved due to the expansile Li+ diffusion channel and reduced charge transfer resistance. In this study, Li3.95Mg0.05Ti4.95Zr0.05O12 represented a relatively good rate capability and cycling stability, after 400 cycles at 10 C, the discharge capacity retained as 134.74 mAh·g−1 with capacity retention close to 100%. The excellent rate capability and good cycling performance make Li3.95Mg0.05Ti4.95Zr0.05O12 a promising anode material in lithium‐ion batteries.
A Review on State‐of‐the‐Art Data Regarding Safe Early Discharge Following Admission for Pulmonary Embolism: What Do We Know?
Authors: Barra Sérgio Nuno Craveiro , Paiva Luís , Providência Rui , Fernandes Andreia , Marques António Leitão
Published: May 2013

Background

Although most patients with acute pulmonary embolism (PE) remain hospitalized during initial therapy, some may be suitable for partial or complete outpatient management, which may have a significant impact on healthcare costs.

Hypothesis

This article reviews the state‐of‐the‐art data regarding recognition of very‐low‐risk PE patients who are potentially eligible for outpatient treatment, along with the safety, management, and cost‐effectiveness of this strategy. We propose an algorithm based on collected data that may be useful/practical for identifying patients truly eligible for early discharge.

Methods

Comprehensive review of scientific data collected from the MEDLINE and Cochrane databases. Studies selected based on potential scientific interest. Qualitative information extracted regarding feasibility, safety, and cost‐effectiveness of outpatient treatment, postdischarge management, and selection of truly low‐risk patients.

Results

Early discharge of low‐risk patients seems feasible, safe, and particularly cost‐effective. Several risk scores have been developed and/or tested as prediction tools for the recognition of low‐risk individuals: the Pulmonary Embolism Severity Index (PESI), simplified PESI, Hestia criteria, Geneva score, the Low‐Risk Pulmonary Embolism Decision rule, and the Global Registry of Acute Cardiac Events, among others. PESI is the most well‐validated model, offering the safest approach at the current time, especially when combined with additional parameters such as troponin I, N‐terminal prohormone of brain natriuretic peptide, and echocardiographic markers of right‐ventricular dysfunction.

Conclusions

Recognition of truly low‐risk patients entitled to early hospital discharge and outpatient treatment is possible with current risk‐stratification schemes along with selected prognostic parameters, and it may have a colossal impact on healthcare costs.
Combined Delivery of Bone Marrow‐Derived Mononuclear Cells in Chronic Ischemic Heart Disease: Rationale and Study Design
Authors: Sürder Daniel , Radrizzani Marina , Turchetto Lucia , Cicero Viviana Lo , Soncin Sabrina , Muzzarelli Stefano , Auricchio Angelo , Moccetti Tiziano
Published: May 2013

Background

Treatment with bone marrow‐derived mononuclear cells (BM‐MNC) may improve left ventricular (LV) function in patients with chronic ischemic heart disease (IHD). Delivery method of the cell product may be crucial for efficacy.

Hypothesis

We aimed to demonstrate that the combination of intramyocardial and intracoronary injection of BM‐MNC is safe and improves LV function in patients with chronic IHD.

Methods

After a safety/feasibility phase of 10 patients, 54 patients will be randomly assigned in a 1:1:1 pattern to 1 control and 2 BM‐MNC treatment groups. The control group will be treated with state‐of‐the‐art medical management. The treatment groups will receive either exclusively intramyocardial injection or a combination of intramyocardial and intracoronary injection of autologous BM‐MNC. Left ventricular function as well as scar size, transmural extension, and regional wall‐motion score will be assessed by cardiac magnetic resonance imaging studies at baseline and after 6 months. The primary endpoint is the change in global LV ejection fraction by cardiac magnetic resonance from 6 months to baseline.

Results

The results, it is hoped, will have important clinical impact and provide essential information to improve the design of future regenerative‐medicine protocols in cardiology.

Conclusions

As cell delivery may play an important role in chronic IHD, we aim to demonstrate feasibility and efficacy of a combined cell‐delivery approach in patients with decreased LV function.
Optimization of Lead and Nickel Biosorption by Cystoseira trinodis (Brown Algae) Using Response Surface Methodology
Authors: Salehi Peyman , Tajabadi Fatemeh Mazraati , Younesi Habibollah , Dashti Yousef
Published: May 2013

Response surface methodology was used to optimize conditions for lead (Pb2+) and nickel (Ni2+) biosorption from aqueous solutions, using Cystoseira trinodis (brown algae). The experiments are carried out in a batch system with 0.2 g of biomass per batch. The variables as pH, initial metal concentration, and contact time were optimized as the critical components. A central composite rotatable design was used for experimental design and analysis of results. The experimental data for the uptake of the metal ions were best described by the quadratic models proposed. Using these models gave a coefficient of determination (R2) value of 0.9998 for Pb2+ and 0.9741 for Ni2+. The factors which showed the greatest influence on the biosorption of both ions were the initial ion concentration and contact time. Under optimum conditions, the biosorption of Pb2+ was found to be 49.08 mg/g, and 14.58 mg/g for Ni2+. These conditions for Pb2+ were a pH of 5.2, initial ion concentration of 200 mg/L and a contact time of 60 min. For Ni2+, they were a pH of 5.8, initial ion concentration of 190 mg/L and a contact time of 53 min.
Toxicity Analysis of Coal Mine Effluent on Vital Organs of Heteropneustes fossilis (Bloch) Using Biometric and Biochemical Parameters
Authors: Bharti Sandhya , Banerjee Tarun Kumar
Published: May 2013

Alteration of certain energy reserves (total glycogen, lipid, and protein contents) and cell regulatory (total nucleic acids) molecules were periodically analyzed (5, 12, 19, and 26 days) in seven vital organs (muscles, kidney, liver, gills, air‐breathing organs, brain, and skin) of coal mine effluent exposed Heteropneustes fossilis (a species of Asian catfish). Changes in the biometric parameters of four organs (liver, kidneys, brain, and gills) were also simultaneously measured. The fish did not survive after 26 days because of significant (p < 0.05) depletion in the concentration of all studied biomolecules. Increased concentration of glycogen and protein in most of the tissues between five and twelve days indicated induction of compensatory changes in the energy metabolism of the fish due to high‐energy utilization by these tissues for detoxification. An increased quantity of lipids in the skin throughout the exposure periods might be due to their release from the damaged membranes of degenerating cells. Furthermore, reduced weight, decreased condition factor and organosomatic indices following prolonged exposure corroborate the decreased biomolecule contents of these tissues and point towards extreme toxicity rendered by the coal mine effluent.
Laplace inversion of low‐resolution NMR relaxometry data using sparse representation methods
Authors: Berman Paula , Levi Ofer , Parmet Yisrael , Saunders Michael , Wiesman Zeev
Published: May 2013

Low‐resolution nuclear magnetic resonance (LR‐NMR) relaxometry is a powerful tool that can be harnessed for characterizing constituents in complex materials. Conversion of the relaxation signal into a continuous distribution of relaxation components is an ill‐posed inverse Laplace transform problem. The most common numerical method implemented today for dealing with this kind of problem is based on L2‐norm regularization. However, sparse representation methods via L1 regularization and convex optimization are a relatively new approach for effective analysis and processing of digital images and signals. In this article, a numerical optimization method for analyzing LR‐NMR data by including non‐negativity constraints and L1 regularization and by applying a convex optimization solver PDCO, a primal‐dual interior method for convex objectives, that allows general linear constraints to be treated as linear operators is presented. The integrated approach includes validation of analyses by simulations, testing repeatability of experiments, and validation of the model and its statistical assumptions. The proposed method provides better resolved and more accurate solutions when compared with those suggested by existing tools. © 2013 Wiley Periodicals, Inc. Concepts Magn Reson Part A 42A: 72–88, 2013.
A multi‐institutional phase 2 study of neoadjuvant gemcitabine and oxaliplatin with radiation therapy in patients with pancreatic cancer
Authors: Kim Edward J. , Ben‐Josef Edgar , Herman Joseph M. , Bekaii‐Saab Tanios , Dawson Laura A. , Griffith Kent A. , Francis Isaac R. , Greenson Joel K. , Simeone Diane M. , Lawrence Theodore S. , Laheru Daniel , Wolfgang Christopher L. , Williams Terence , Bloomston Mark , Moore Malcolm J. , Wei Alice , Zalupski Mark M.
Published: May 2013

BACKGROUND

The purpose of this study was to evaluate preoperative treatment with full‐dose gemcitabine, oxaliplatin, and radiation therapy (RT) in patients with localized pancreatic cancer.

METHODS

Eligibility included confirmation of adenocarcinoma, resectable or borderline resectable disease, a performance status ≤2, and adequate organ function. Treatment consisted of two 28‐day cycles of gemcitabine (1 g/m2 over 30 minutes on days 1, 8, and 15) and oxaliplatin (85 mg/m2 on days 1 and 15) with RT during cycle 1 (30 Gray [Gy] in 2‐Gy fractions). Patients were evaluated for surgery after cycle 2. Patients who underwent resection received 2 cycles of adjuvant chemotherapy.

RESULTS

Sixty‐eight evaluable patients received treatment at 4 centers. By central radiology review, 23 patients had resectable disease, 39 patients had borderline resectable disease, and 6 patients had unresectable disease. Sixty‐six patients (97%) completed cycle 1 with RT, and 61 patients (90%) completed cycle 2. Grade ≥3 adverse events during preoperative therapy included neutropenia (32%), thrombocytopenia (25%), and biliary obstruction/cholangitis (14%). Forty‐three patients underwent resection (63%), and complete (R0) resection was achieved in 36 of those 43 patients (84%). The median overall survival was 18.2 months (95% confidence interval, 13–26.9 months) for all patients, 27.1 months (95% confidence interval, 21.2–47.1 months) for those who underwent resection, and 10.9 months (95% confidence interval, 6.1–12.6 months) for those who did not undergo resection. A decrease in CA 19‐9 level after neoadjuvant therapy was associated with R0 resection (P = .02), which resulted in a median survival of 34.6 months (95% confidence interval, 20.3–47.1 months). Fourteen patients (21%) are alive and disease free at a median follow‐up of 31.4 months (range, 24–47.6 months).

CONCLUSIONS

Preoperative therapy with full‐dose gemcitabine, oxaliplatin, and RT was feasible and resulted in a high percentage of R0 resections. The current results are particularly encouraging, because the majority of patients had borderline resectable disease. Cancer 2013;119:2692–2700. © 2013 American Cancer Society.
Pronecrotic mixed lineage kinase domain‐like protein expression is a prognostic biomarker in patients with early‐stage resected pancreatic adenocarcinoma
Authors: Colbert Lauren E. , Fisher Sarah B. , Hardy Claire W. , Hall William A. , Saka Burcu , Shelton Joseph W. , Petrova Aleksandra V. , Warren Matthew D. , Pantazides Brooke G. , Gandhi Khanjan , Kowalski Jeanne , Kooby David A. , El‐Rayes Bassel F. , Staley Charles A. , Adsay N. Volkan , Curran Walter J. , Landry Jerome C. , Maithel Shishir K. , Yu David S.
Published: May 2013

BACKGROUND

Mixed lineage kinase domain‐like protein (MLKL) is a necrosome component mediating programmed necrosis that may be an important determinant of cancer cell death. The goal of the current study was to evaluate the prognostic value of MLKL expression in patients with pancreatic adenocarcinoma (PAC).

METHODS

Tissue from 80 patients was collected from a prospectively maintained database of patients with PAC who underwent pancreaticoduodenectomy between January 2000 and October 2008. Immunohistochemistry analysis was performed and scored using an established scoring system. Kaplan‐Meier survival curves were generated for recurrence‐free survival (RFS) and overall survival (OS) for all patients and for patients receiving adjuvant chemotherapy. MLKL scores were correlated with RFS and OS using univariate and multivariate Cox regression analyses incorporating clinically relevant covariates.

RESULTS

The median age of the patients was 63 years and 53% were men. Low MLKL expression was associated with decreased OS (6 months vs 17 months; P = .006). In the subset of 59 patients who received adjuvant chemotherapy, low MLKL expression was associated with decreased RFS (5 months vs 15 months; P = .006) and decreased OS (6 months vs 19 months; P < .0001). On multivariate analysis, low MLKL expression was associated with poor OS in all patients (hazards ratio, 4.6 [95% confidence interval, 1.6‐13.8]; P = .006) and in patients receiving adjuvant chemotherapy (hazards ratio, 8.1 [95% confidence interval, 2.2‐29.2]; P = .002).

CONCLUSIONS

Low expression of MLKL is associated with decreased OS in patients with resected PAC and decreased RFS and OS in the subset of patients with resected PAC who receive adjuvant chemotherapy. The use of this biomarker in patients with PAC may provide important prognostic information. Cancer 2013;119:3148–3155. © 2013 American Cancer Society.
Relationship between 6‐ and 9‐month progression‐free survival and overall survival in patients with metastatic urothelial cancer treated with first‐line cisplatin‐based chemotherapy
Authors: Galsky Matthew D. , Krege Susan , Lin Chia‐Chi , Hahn Noah , Ecke Thorsten , Moshier Erin , Sonpavde Guru , Godbold James , Oh William K. , Bamias Aristotle
Published: May 2013

BACKGROUND

Use of progression‐free survival (PFS) as a clinical trial endpoint in first‐line treatment of patients with metastatic urothelial carcinoma (UC) is attractive, but would be enhanced by establishing a correlation between PFS and overall survival (OS).

METHODS

Data was pooled from 7 phase 2 and 3 trials evaluating cisplatin‐based chemotherapy in metastatic UC. An independent cohort of patients enrolled on a phase 3 trial was used for external validation. Landmark analyses for progression at 6 and 9 months after treatment initiation were performed to minimize lead‐time bias. A proportional hazards model was used to assess the utility of PFS for predicting OS.

RESULTS

A total of 364 patients were included in the initial cohort. The median PFS was 8.21 months (95% confidence interval = 7.43, 8.39) and the median OS was 13.50 months (95% confidence interval = 11.80, 15.67). In the landmark analysis, the median OS for patients who progressed at 6 months was 3.87 months compared with 15.06 months for those patients who did not progress (P < .0001) and the median OS for patients who progressed at 9 months was 5.65 months compared with 21.39 months for those patients who did not progress (P < .0001). A Fleischer model demonstrated a statistically significant dependent correlation between PFS and OS. The findings were externally validated in an independent cohort.

CONCLUSIONS

PFS at 6 and 9 months predicted OS in this analysis of patients with metastatic UC treated with first‐line cisplatin‐based chemotherapy and could potentially serve as endpoints in (randomized) phase 2 trials to screen the activity of novel regimens. Cancer 2013;119:3020—3026. © 2013 American Cancer Society.
Differential expression and prognostic value of ERCC1 and thymidylate synthase in resected gastric adenocarcinoma
Authors: Squires Malcolm H. , Fisher Sarah B. , Fisher Kevin E. , Patel Sameer H. , Kooby David A. , El‐Rayes Bassel F. , Staley Charles A. , Farris Alton B. , Maithel Shishir K.
Published: May 2013

BACKGROUND

Excision repair cross‐complementing gene‐1 (ERCC1) and thymidylate synthase (TS) are key regulatory enzymes whose expression patterns are associated with overall survival (OS) in several malignancies. Their expression patterns and prognostic value in resected gastric adenocarcinoma (GAC) are not known.

METHODS

In total, 109 patients who underwent resection for GAC between January 2000 and June 2011 had tissue available for analysis. The primary objective was to assess for the differential expression of ERCC1 and TS using immunohistochemistry. The secondary objective was to assess for the association between OS and the expression of ERCC1 and TS.

RESULTS

The median follow‐up was 21.2 months, and the median OS was 28.8 months. Resected GAC exhibited differential expression of ERCC1 (high expression, 23%; n = 25) and TS (high expression, 43%; n = 47). ERCC1 and TS expression were not associated with OS. In a subset analysis of patients who received chemotherapy (n = 73), high ERCC1 expression was associated with decreased OS (16.7 months vs 53.8 months; P = 0.03). After controlling for known adverse pathologic features, high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis (hazard ratio, 2.5; 95% confidence interval, 1.03‐6.0; P = .04). Conversely, in patients who underwent resection only (n = 35), high ERCC1 expression demonstrated a trend toward improved OS (40.4 months vs 12.7 months; P = .10); a positive prognostic influence also was present on multivariate analysis (hazard ratio, 0.20; 95% confidence interval, 0.04‐0.86; P = .03).

CONCLUSIONS

Resected GAC exhibited differential expression of TS and ERCC1. Among all patients, ERCC1 and TS expression levels were not associated with OS. High ERCC1 tumor expression was associated with decreased OS in the patients who received chemotherapy but was associated with increased OS in those who underwent surgery alone. ERCC1 expression had prognostic value in resected gastric cancer, and further investigation is warranted. Cancer 2013;119:3242–3250. © 2013 American Cancer Society.
Mindfulness‐based Narrative Therapy for Depression in Cancer Patients
Authors: Rodríguez Vega B. , Bayón Pérez C. , PalaoTarrero A. , Fernández Liria A.
Published: May 2013

Mindfulness‐based narrative therapy (MBNT) is a therapeutic intervention for the treatment of depression in cancer patients. In a previous randomized controlled trial, MBNT was found to ameliorate anxiety and depression, improve functional dimensions of quality of life, and enhance treatment adherence. In this review, we describe MBNT and its technical characteristics in the context of other psychotherapeutic interventions for depression in cancer patients. We highlight needed adjustments to other narrative approaches and recommend clinical modifications tailored to the needs of cancer patients that are intended to encompass the client's initial depressive narrative. The narrative construction is supported by emotional regulation and attachment relationships on the one hand and by individual and social linguistic capabilities on the other. Through destabilization of the depressive narrative, MBNT facilitates the emergence of new meanings using both verbal and non‐verbal techniques based on mindfulness. The attitude and practice of mindfulness are integrated throughout the therapeutic process. In summary, MBNT makes use of linguistic interventions, promotes mindfulness and emotional regulation, and can be adapted specifically for use with cancer patients. Copyright © 2013 John Wiley & Sons, Ltd.

Key Practitioner Message

In this review, we describe mindfulness‐based narrative therapy (MBNT) for the treatment of depression in cancer patients.

In a previous controlled trial, we found significant benefits of MBNT in terms of reducing depressive symptoms and improving treatment adherence and quality of life in depressed, non‐metastatic cancer patients.

Narrative construction is socially and neurobiologically derived.

MBNT makes use of linguistic interventions, promotes mindfulness and emotional regulation, and can be adapted specifically for use with cancer patients.

MBNT is proposed as an interesting and promising intervention, particularly for patients with somatic pathologies.
High efficiency wireless optical links in high transmission speed wireless optical communication networks
Authors: Rashed Ahmed Nabih Zaki
Published: May 2013

Power link budgets are prepared for wireless optical communication systems to illustrate the optical losses that happen during transmission. This paper has presented optical wireless links, which offer ultra multi gigabit per second data rates and low system complexity. For ground space and/or terrestrial communication systems, these links suffer from atmospheric loss mainly due to fog, and scintillation. Optical wireless links provide high bandwidth solution to the last mile access bottleneck. However, an appreciable availability of the link is always a concern. Wireless optical links are highly weather dependent, and fog is the major attenuating factor reducing the link availability. Link margin, received signal power, transmission bit rate, bit rate distance product, signal‐to‐noise ratio, and BER are the major interesting design parameters in the current study. Copyright © 2013 John Wiley & Sons, Ltd.
An energy‐efficient anti‐jam cognitive system for wireless OFDM communication
Authors: Javed I. , Loan A. , Mahmood W.
Published: May 2013

In this paper, anti‐jamming capabilities are proposed for a generic OFDM‐based wireless communication system. The performance of a wireless system may severely degrade in presence of jamming or intentional interferences. A malicious entity can send strong interference or noisy signals in the same transmit frequency band thus preventing the intended receiver to correctly decode the transmitted data. As a countermeasure, our work proposes algorithms and techniques to restore the system performance in presence of such malicious entities. Proposed anti‐jamming system consists of an adaptive framework that adapts itself to varying jammer behavior and wireless environment, and then, it chooses an optimal strategy to effectively cancel out the effect of jamming and channel fading. Optimization problem is formulated as a multi‐objective criterion for maximization of system throughput and minimization of energy consumption. Simulation results computed in Rayleigh fading channels with different wideband jamming modes and powers show that the proposed system effectively cancels out the jamming and channel fading effects thus maximizing the system performance and minimizing cost of energy consumption. Copyright © 2013 John Wiley & Sons, Ltd.
Unified performance analysis of maximal‐ratio combining for spectrum sharing systems with antenna correlation
Authors: Huang Yuzhen , Wu Qihui , Wang Jinlong , Cheng Yunpeng , Zhang Yuming
Published: May 2013

A comprehensive analytical framework of a spectrum sharing system, in which secondary receiver (SR) is equipped with multiple antennas, is presented over Rayleigh fading channels. The impact of spatial fading correlation on the performance of spectrum sharing system with maximal‐ratio combining at the SR is investigated. In particular, we explicitly derive the CDF and moment generating function of the end‐to‐end signal‐to‐noise ratio by assuming a correlation model with arbitrary eigenvalue multiplicities at the SR. On the basis of these results, we conduct an evaluation of secondary system performance in terms of the outage probability, the average symbol error probability, and the ergodic capacity. All analytical results are verified by Monte Carlo simulations. Furthermore, to obtain an insight of system performance, the asymptotic analysis is studied to obtain the diversity gain and the coding gain in the peak transmit power dominated region. Our results show that the diversity gain is unaffected by antenna correlation whereas the coding gain is degraded. Copyright © 2013 John Wiley & Sons, Ltd.
An efficient t‐out‐of‐n oblivious transfer for information security and privacy protection
Authors: Lou Der‐Chyuan , Huang Hui‐Feng
Published: May 2013

In t‐out‐of‐n oblivious transfer (OT), the receiver can only receive t messages out of n messages sent by the sender, and the sender has no idea about which ones have been received. Majority of the existence of previous efficient OT schemes require t calls of 1‐out‐of‐n OT to construct the t‐out‐of‐n OT. Its computational requirements and bandwidth consumption are quite demanding. On the basis of the elliptic curves cryptography, we propose a new t‐out‐of‐n OT protocol for private information retrieval in this article. It is more suitable for the smart cards or mobile units. Copyright © 2013 John Wiley & Sons, Ltd.
Optimal power‐aware relay placement for cooperative wireless sensor networks
Authors: Abdizadeh Mohammad , Jamali‐Rad Hadi , Abolhassani Bahman
Published: May 2013

We study the problem of optimizing the symbol error probability (SEP) performance of cluster‐based cooperative wireless sensor networks. Recent studies in literature show that an efficient relay selection protocol based on simple geographical information of the nodes to execute cooperative diversity can significantly improve the SEP performance at the destination of such networks. As well, similar line of research on optimal power allocation (for the source and relay nodes) can be found in literature. However, to achieve the best SEP performance at the destination of a cooperative wireless sensor network, joint optimization of power allocation and relay placement should be accomplished. To this aim, we reformulate the SEP of a multi‐hop cooperative communication in a general form and optimize transmitted power level and relay placement simultaneously. This analysis is developed for both amplify‐and‐forward and decode‐and‐forward relaying protocols. Simulation results demonstrate that the proposed joint optimization can effectively improve the SEP performance of the network. Copyright © 2013 John Wiley & Sons, Ltd.
Direct and efficient liquid chromatographic‐tandem mass spectrometric method for opiates in urine drug testing – importance of 6‐acetylmorphine and reduction of analytes
Authors: Andersson Maria , Stephanson Nikolai , Öhman Inger , Terzuoli Tommy , Lindh Jonatan D , Beck Olof
Published: May 2013

Opiates comprise a class of abused drugs that is of primary interest in clinical and forensic urine drug testing. Determination of heroin, codeine, or a multi‐drug ingestion is complicated since both heroin and codeine can lead to urinary excretion of free and conjugated morphine. Liquid chromatography‐tandem mass spectrometry (LC‐MS/MS) offers advantage over gas chromatography‐mass spectrometry by simplifying sample preparation but increases the number of analytes. A method based on direct injection of five‐fold diluted urine for confirmation of morphine, morphine‐3‐glucuronide, morphine‐6‐glucuronide, codeine, codeine‐6‐glucuronide and 6‐acetylmorphine was validated using LC‐MS/MS in positive electrospray mode monitoring two transitions using selected reaction monitoring. The method was applied for the analysis of 3155 unknown urine samples which were positive for opiates in immunochemical screening. A linear response was observed for all compounds in the calibration curves covering more than three orders of magnitude. Cut off was set to 2 ng/ml for 6‐acetylmorphine and 150 ng/ml for the other analytes. 6‐Acetylmorphine was found to be effective (sensitivity 82%) in detecting samples as heroin intake. Morphine‐3‐glucuronide and codeine‐6‐glucuronide was the predominant components of total morphine and codeine, 84% and 93%, respectively. The authors have validated a robust LC‐MS/MS method for rapid qualitative and quantitative analysis of opiates in urine. 6‐Acetylmorphine has been demonstrated as a sensitive and important parameter for a heroin intake. A possible interpretation strategy to conclude the source of detected analytes was proposed. The method might be further developed by reducing the number of analytes to morphine‐3‐glucuronide, codeine‐6‐glucuronide and 6‐acetylmorphine without compromising test performance. Copyright © 2013 John Wiley & Sons, Ltd.
Desialylation improves the detection of recombinant erythropoietins in urine samples analyzed by SDS‐PAGE
Authors: Desharnais Philippe , Naud Jean‐François , Ayotte Christiane
Published: May 2013

Recombinant erythropoietin (rhEPO) has been misused for over two decades by athletes, mainly but not only in endurance sports. A direct rhEPO detection method in urine by isoelectric focusing (IEF) was introduced in 2000, but the emergence of third‐generation erythropoiesis‐stimulating agents and so‐called biosimilar rhEPOs, together with the sensitivity of human endogenous EPO (huEPO) pattern to enzymatic activities and its modification following short strenuous exercise, prompted the development of a complementary test based on SDS‐PAGE analysis. While Mircera and NESP are easily detected with the existing IEF and SDS‐PAGE methods, some samples containing both epoetin‐α/β and huEPO present profiles that are still difficult to interpret. As doping practices have moved to micro‐dosing, these mixed patterns are more frequently observed. We investigated the impact of enzymatic desialylation on the urinary and serum EPO profiles obtained by SDS‐PAGE with the aim of improving the separation of the bands in these mixed EPO populations. We observed that the removal with neuraminidase of the sialic acid moieties from the different EPOs studied reduced their apparent molecular weight (MW) and increased the migration distance between huEPO and rhEPO centroids, therefore eliminating the size overlaps between them and improving the detection of rhEPO. Copyright © 2013 John Wiley & Sons, Ltd.
Toll‐like receptor 6 senses Mycobacterium avium and is required for efficient control of mycobacterial infection
Authors: Marinho Fábio A. V. , de Paula Rafaella R. , Mendes Aline C. , de Almeida Leonardo A. , Gomes Marco T. R. , Carvalho Natália B. , Oliveira Fernanda S. , Caliari Marcelo V. , Oliveira Sergio C.
Published: May 2013

Mycobacterium avium has been reported to signal through both Toll‐like receptor (TLR2) and TLR9. To investigate the role of TLR6 in innate immune responses to M. avium, TLR6, MyD88, TLR2, and TLR2/6 KO mice were infected with this pathogen. Bacterial burdens were higher in the lungs and livers of infected TLR6, TLR2, TLR2/6, and MyD88 KO mice compared with those in C57BL/6 mice, which indicates that TLR6 is required for the efficient control of M. avium infection. However, TLR6 KO spleen cells presented with normal M. avium induced IFN‐γ responses as measured by ELISA and flow cytometry. In contrast, the production of IFN‐γ in lung tissue was diminished in all studied KO mice. Furthermore, only MyD88 deficiency reduced granuloma areas in mouse livers. Moreover, we determined that TLR6 plays an important role in controlling bacterial growth within macrophages and in the production of TNF‐α, IL‐12, and IL‐6 by M. avium infected DCs. Finally, the lack of TLR6 reduced activation of MAPKs and NF‐κB in DCs. In summary, TLR6 is required for full resistance to M. avium and for the activation of DCs to produce proinflammatory cytokines.