bluuebunny/crossref_metadata_2025 huggingface dataset:
The ypT category does not impact overall survival in node negative gastric cancer
Authors: Ikoma Naruhiko , Hofstetter Wayne L. , Estrella Jeannelyn S. , Das Prajnan , Minsky Bruce D. , Fournier Keith F. , Mansfield Paul F. , Ajani Jaffer A. , Badgwell Brian D.
Published: June 2018

Background

Although the eighth‐edition American Joint Committee on Cancer (AJCC) gastric cancer staging system created ypTNM staging for patients who underwent preoperative therapy, the ideal ypTNM grouping is unknown. We sought to investigate risk factors for OS in ypT0‐3N0M0 gastric cancer.

Methods

From an institutional database of The University of Texas MD Anderson Cancer Center and the National Cancer Database (NCDB), we identified patients with ypT0‐3N0M0 gastric adenocarcinoma who underwent R0 gastrectomy after chemotherapy or chemoradiation during 1995‐2015 (MD Anderson) or 2006‐2014 (NCDB).

Results

The study included 175 MD Anderson and 3200 NCDB patients. By multivariable analysis, ypT category was not associated with OS (hazard ratio [HR] for ypT3 vs ypT1: MD Anderson, 0.83 [95% CI, 0.36‐1.92], P = 0.669; NCDB, 0.96 [95% CI, 0.85‐1.08], P = 0.472). cN‐positive disease was not associated with OS in the MD Anderson cohort (HR, 0.96 [95% CI, 0.55‐1.67]; P = 0.873) but was weakly associated with shorter OS in the NCDB cohort (HR, 1.11 [95% CI, 1.01‐1.21]; P = 0.031).

Conclusions

The ypT category does not impact OS in ypT0‐3N0M0 gastric cancer. The impact of cN status on OS appeared limited. These findings should be considered in future systems of post‐neoadjuvant pathologic staging.
Microstructure transformation and physical and mechanical properties of ultrafine‐grained and nanocrystalline TiNi alloys in multiple martensitic transformations B2‐B19’
Authors: Churakova A.A. , Gunderov D.V. , Dmitriev S.V.
Published: June 2018

Comprehensive studies on the impact of multiple martensitic transformations B2‐B19′ on the structure and properties of ultrafine‐grained and nanocrystalline titanium‐nickel alloys are implemented. It is shown that in coarse‐grained, ultrafine‐grained and nanocrystalline titanium‐nickel alloys consecutive changes in the structure and properties take place, which are induced by phase hardening, when the number of thermocycles increases up to n = 100 with quick heating and quick cooling to ‐196 °C. During thermal cycling of coarse‐grained and ultrafine‐grained Ti50Ni50 alloys via the chosen regimes, the direction of martensitic transformation temperatures changes. First the temperatures reduce, then they increase with the number of thermocycles growing. The transformation temperatures in the ultrafine‐grained state of Ti49.15Ni50.85 are more resistant to thermal cycling than in the coarse‐grained state. Phase hardening occurs more intensively in ultrafine‐grained states of the studied titanium‐nickel alloys than in coarse‐grained state.
Angiographers no longer need to avoid digital zoom
Authors: Cecil Robert A. , Heupler Frederick , Shkumat Nicholas , Ellis Stephen , Kapadia Samir , Fares Haitham , Agarwal Ashok
Published: June 2018

The physics of angiographic digital flat‐panel detectors suggests that no increase in dose is required for appropriate image quality in image‐magnified fields of view. This is contrary to current practice. A dose‐saving protocol decreased radiation dose by an average of 32% for these zoomed fields of view with no observable image quality degradation. This change in protocol may be applicable across all manufactures of flat‐panel angiographic systems. Angiographers may preferentially use reduced‐dose zoomed fields to minimize scatter radiation, assure anatomical conspicuity and reduce patient radiation burden.
The cost of incentive compatibility in auction‐based mechanisms for carrier collaboration
Authors: Gansterer Margaretha , Hartl Richard F. , Vetschera Rudolf
Published: June 2018

Collaboration has been one of the important trends in vehicle routing. A typical mechanism to enable carrier collaboration is to use combinatorial auctions, where requests are not traded individually but are combined into bundles. Previous literature on carrier collaboration has focused on issues such as bundle formation or winner determination, typically assuming truthfulness of all agents and absence of any strategic behavior. This article considers the interdependencies and problems that arise from bidders acting as buyers and sellers of requests at the same time. From standard auction theory, desirable properties of exchange mechanisms are identified as efficiency, incentive compatibility, individual rationality, and budget balance. It is shown that these desirable properties cannot be fulfilled at the same time. In particular, the properties efficiency and incentive compatibility induce that budget balance is violated, that is, an outside subsidy is required. We propose two incentive compatible exchange mechanisms. One is more closely related to the classical VCG approach, while the other one uses a more complicated concept for computing payments to participants. A numerical study investigates how frequently desired properties are violated. We show that both mechanisms can be acceptable in practical situations, but none of them can satisfy all desired properties.
Fetal cerebral hemorrhage due to X‐linkedGATA1gene mutation
Authors: Bouchghoul Hanane , Quelin Chloé , Loget Philippe , Encha‐Razavi Féréchté , Senat Marie‐Victoire , Maheut Lorraine , Galimand Julie , Collardeau‐Frachon Sophie , Da Costa Lydie , Martinovic Jelena
Published: June 2018

We report a multiplex family with aGATA1gene mutation responsible for a massive fetal cerebral hemorrhage occurring at 36 weeks. Two other stillbirth cousins presented with fetal hydrops and congenital hemochromatosis' phenotype at 37 and 12 weeks of gestation. Molecular screening revealed the presence of a c.613G>A pathogenic allelic variation in exon 4 ofGATA1gene in the 3 male siblings and their carrier mothers.

The diagnosis of aGATA1gene mutation may be suspected in cases of male fetuses with intracerebral bleeding, particularly if a history of prior fetal loss(es) and mild maternal thrombocytopenia are also present.
The effect of light conditions on interpreting oil composition engineering in Arabidopsis seeds
Authors: Karki Nischal , Bates Philip D.
Published: June 2018

Arabidopsis thaliana is the most developed and utilized model plant. In particular, it is an excellent model for proof‐of‐concept seed oil engineering studies because it accumulates approximately 37% seed oil by weight, and it is closely related to important Brassicaceae oilseed crops. Arabidopsis can be grown under a wide variety of conditions including continuous light; however, the amount of light is strongly correlated with total seed oil accumulation. In addition, many attempts to engineer novel seed oil fatty acid compositions in Arabidopsis have reported significant reductions in oil accumulation; however, the relative reduction from the nontransgenic controls varies greatly within the literature. A set of experiments were conducted to systematically analyze the effect of light conditions (including day/night cycle vs. continuous light, and different light intensities) on the relative accumulation of seed oil between three different transgenic lines producing novel hydroxy fatty acids and their nontransgenic background. Oil content was measured per seed and as a percentage of seed weight. Our results indicate the relative amount of seed oil between transgenic lines and nontransgenic controls is dependent on both the light conditions and the type of oil content measurement utilized. In addition, the light conditions effect the relative accumulation of the novel fatty acids between various transgenic lines. Therefore, the success of novel fatty acid proof‐of‐concept engineering strategies on both oil accumulation and fatty acid composition in Arabidopsis seeds should be considered in light of the select growth and measurement conditions prior to moving engineering strategies into crop plants.
An Algorithm for Evaluation of Potential Hazards in Research and Development of New Energetic Materials in Terms of their Detonation and Ballistic Profiles
Authors: Bondarchuk Sergey V. , Yefimenko Nadezhda A.
Published: June 2018

In the present paper we report recommendations for safe handling with unknown explosive materials and compositions. These are based on quantum‐chemical evaluations of the detonation and ballistic profiles of newly synthesized explosives and their comparison with the known reference compounds. The proposed methodology is rather simple, fast and does not require special skills. Meanwhile, it allows an effective quenching of the potential risk associated with injuries caused by accidental explosions. Additionally, we have developed two utilities, which significantly simplify the calculation process. The proposed algorithm was found to be more successful in estimation of detonation velocity of several common explosives in comparison with commercially available software EMDB, EXPLO5 and Cheetah 8.0. The reported results will be useful for scientific personnel working in the field of development and testing of explosives.
Identification and preliminary study of immunogens involved in autoimmune prostatitis in human males
Authors: Lu Jin‐Chun , Shen Jia‐Ming , Hu Xue‐Chun , Peng Long‐Ping , Hong Zhi‐Wei , Yao Bing
Published: June 2018

Background

Experimental models have confirmed that autoimmunity is an important factor in the onset of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS); however, there is no conclusive evidence on whether autoimmune prostatitis exists in human males.

Methods

Rabbits were immunized with either human prostate tissue homogenates or normal saline and the antiserum was collected. Two‐dimensional electrophoresis (2‐DE) was performed on the homogenates and Western blotting was conducted on the sera. The identified human prostate tissue immunodominant antigens (HPTIAs) were detected by mass spectrometry. The serum immunoglobulin (Ig)G from the immunized rabbits was purified with protein A‐agarose, and the purified IgG was linked with Sepharose to purify HPTIAs by affinity chromatography. Non‐obese diabetic (NOD) mice were immunized with the purified HPTIAs, and the levels of serum antibodies, INF‐γ, and histopathological changes in their prostate tissues were detected. The purified HPTIAs were coated into polystyrene pores and serum autoantibodies in CP/CPPS patients were detected by enzyme‐linked immunosorbent assay (ELISA). Meanwhile, serum interleukin 2 (IL‐2), interferon gamma (IFNγ), and tumor necrosis factor alpha (TNFα) levels in CP/CPPS patients were also determined by ELISA.

Results

Sixteen HPTIAs were identified. Among them, three types were reported to be associated with prostatic diseases. Prostatitis was induced in mice immunized with the 16‐HPTIA complex, with positive serum autoantibody and increased prostatic IFN‐γ levels. The positive rate of serum autoantibodies against HPTIAs was significantly higher in CP/CPPS patients (23.1%, 18/78) than in the control (2.7%, 2/75). But there was no significant difference in serum TNFα, IFNγ, and IL‐2 levels between the CPPS patients with positive and negative autoantibodies against HPTIAs.

Conclusions

Autoantibodies against HPTIAs exist in part in CP/CPPS patients, which implies that autoimmunity and the 16 HPTIAs are important factors in the onset of CP/CPPS. The detection of serum autoantibodies could be applied in clinical diagnoses of autoimmune prostatitis; treatment protocols might change. Additional studies are needed to determine which of the 16 HPTIAs is the most important.
Spin–Orbit and Coulomb Effects in Single‐Layered Ruthenates
Authors: Zhang Guoren , Pavarini Eva
Published: June 2018

Single‐layered ruthenates continue to surprise us decades after their discovery. Here we briefly review some recent advances in the understanding of their electronic properties. They have been obtained via the LDA + DMFT method, the state‐of‐the‐art approach for strongly correlated systems. In particular, we discuss the effects of the spin–orbit interaction and its interplay with the crystal field in the presence of electron–electron repulsion. We focus on the Fermi surface of Sr2RuO4 and the metal–insulator transition in Ca2−xSrxRuO4.
The scale dependence of initial‐condition sensitivities in simulations of convective systems over the southeastern United States
Authors: Weyn Jonathan A. , Durran Dale R.
Published: June 2018

The sensitivity of ensemble simulations of deep convective events in the southeastern United States to initial‐condition (IC) errors is examined by imposing idealized moisture perturbations at small and large scales. Four severe weather events are considered, ranging from a springtime frontal system to convection driven almost exclusively by daytime heating. Events with strong synoptic‐scale forcing were insensitive to the scale of IC errors, but weakly forced events exhibited greater sensitivity to small‐scale than large‐scale IC errors. Additional ensemble simulations of idealized convective systems suggest that the greater sensitivity to small‐scale IC errors of the weakly forced cases arises from their higher sensitivity to the strength and location of the first convective elements. Ensemble spread and predictability are characterized by two measures: the ratio of the perturbation kinetic energy (KE) about the ensemble mean to the background KE and the neighborhood‐based fractions skill score (FSS) of hourly precipitation with respect to that in an unperturbed reference simulation. For simulations of both observed events and idealized convective systems, the FSS appears to be a more discriminating indicator of differences in predictability between different convective events.
Similarity‐based approximations for the evolution of a gravity current
Authors: Rooney Gabriel Gerard
Published: June 2018

Approximations to similarity solutions for two‐dimensional and axisymmetric gravity currents are described. These are based on the entrainment behaviour and its implication for the evolution of gravity‐current height and reduced gravity. It is shown how this approach permits the approximation of gravity‐current behaviour without the need for information about the buoyancy or, equivalently, distance from the point of origin. It is also shown that the usual front‐speed scaling may be derived from consideration of baroclinic vorticity generation at the front in both two‐dimensional and axisymmetric configurations. The importance of vorticity in defining the flow direction is also discussed.
4′‐Phenyl‐2,2′:6′,2′′‐terpyridine Derivatives Containing 1‐Substituted‐2,3‐Triazole Ring: Synthesis, Characterization and Anticancer Activity
Authors: Zych Dawid , Slodek Aneta , Krompiec Stanisław , Malarz Katarzyna , Mrozek‐Wilczkiewicz Anna , Musiol Robert
Published: June 2018

Terpyridine moiety is known for chelating and interesting physicochemical properties enabling some applications. Its biological activity, particularly anticancer potency is not well studied. Herein we present six 4′‐(1‐substituted‐2,3‐triazol‐4‐yl)phenyl‐2,2′:6′,2′′‐terpyridine derivatives with glycidyl, cyclohexylmethyl, benzyl, 4‐tert‐butylbenzyl, pentafluorobenzyl, and 2,6‐dichlorobenzyl groups which were obtained via Cu(I)‐catalysed 1,3‐dipolar cycloaddition reaction. The photophysical such as optical (absorption and photoluminescence spectra, quantum yields and lifetimes) and thermal (by using differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA)) properties were examined. In addition, theoretical studies (DFT and TD‐DFT) were performed to provide a deeper understanding of the experimental results. In vitro studies on the obtained novel structures were conducted with selected series of cell lines to check their bioactivity and toxicity. The most active compound reached a nanomolar level with good selectivity index better than doxorubicin. Mechanism of action for these terpyridines was also investigated which suggest intercalation of DNA as a trigger of cell death.
FeP@C Nanotube Arrays Grown on Carbon Fabric as a Low Potential and Freestanding Anode for High‐Performance Li‐Ion Batteries
Authors: Xu Xijun , Liu Jun , Liu Zhengbo , Wang Zhuosen , Hu Renzong , Liu Jiangwen , Ouyang Liuzhang , Zhu Min
Published: June 2018

An anode of self‐supported FeP@C nanotube arrays on carbon fabric (CF) is successfully fabricated via a facile template‐based deposition and phosphorization route: first, well‐aligned FeOOH nanotube arrays are simply obtained via a solution deposition and in situ etching route with hydrothermally crystallized (Co,Ni)(CO3)0.5OH nanowire arrays as the template; subsequently, these uniform FeOOH nanotube arrays are transformed into robust carbon‐coated Fe3O4 (Fe3O4@C) nanotube arrays via glucose adsorption and annealing treatments; and finally FeP@C nanotube arrays on CF are achieved through the facile phosphorization of the oxide‐based arrays. As an anode for lithium‐ion batteries (LIBs), these FeP@C nanotube arrays exhibit superior rate capability (reversible capacities of 945, 871, 815, 762, 717, and 657 mA h g−1 at 0.1, 0.2, 0.4, 0.8, 1.3, and 2.2 A g−1, respectively, corresponding to area specific capacities of 1.73, 1.59, 1.49, 1.39, 1.31, 1.20 mA h cm−2 at 0.18, 0.37, 0.732, 1.46, 2.38, and 4.03 mA cm−2, respectively) and a stable long‐cycling performance (a high specific capacity of 718 mA h g−1 after 670 cycles at 0.5 A g−1, corresponding to an area capacity of 1.31 mA h cm−2 at 0.92 mA cm−2).
Quality of Meliponinae honey: Pesticides residues, pollen identity, and microbiological profiles
Authors: Rodrigues Carina da Silva , Ferasso Debora Cristina , Prestes Osmar Damian , Zanella Renato , Grando Remili Cristiani , Treichel Helen , Coelho Geraldo Ceni , Mossi Altemir José
Published: June 2018

This study aims at evaluating the quality of honey of Melipona quadrifasciata quadrifasciata Tetragonisca angustula and Scaptotrigona depilis. Pollen analysis was performed to identify the floral resources used for the production of honey, and 19 pollen types were identified. Microbiological analyses identified the presence of coliforms, molds, and yeasts, but Clostridium botulinum was not found. Using the modified “Quick, Easy, Cheap, Effective, Rugged, and Safe” method followed by ultra‐high performance liquid chromatography‐tandem mass spectrometry determination, eight pesticides were detected in the honey of T. angustula and only two in the honey from S. depilis. The honey of M. q. quadrifasciata did not present pesticide residues. The data pointed out the relevance of good practices to avoid the contamination of honey with sources of microbiological contaminants, which may impair the product's safety for human consumption.
Every Child, Every Classroom, Every Day: From Vision to Action in Literacy Learning
Authors: Fountas Irene C. , Pinnell Gay Su
Published: June 2018

Improving literacy outcomes for each and every student is a goal worthy of educators’ best efforts. This high goal is made more challenging by shifting mandates in education that can leave literacy professionals and school leaders disoriented, seeking a guaranteed fix. The authors propose a more coherent, more effective way to attain this goal: thinking of the school as a system. The authors discuss four essential elements for designing a schoolwide system for literacy learning: a shared vision and set of core values; common goals, common language, and collective responsibility; a high level of teacher expertise; and a culture of continuous professional learning.
Searching for axion-like particles with proton tagging at the LHC
Authors: Baldenegro C. , Fichet S. , von Gersdorff G. , Royon C.
Published: June 2018

Abstract

The existence of an axion-like particle (ALP) would induce anomalous scattering of light by light. This process can be probed at the Large Hadron Collider in central exclusive production of photon pairs in proton-proton collisions by tagging the surviving protons using forward proton detectors. Using a detailed simulation, we estimate the expected bounds on the ALP-photon coupling for a wide range of masses. We show that the proposed search is competitive and complementary to other collider bounds for masses above 600 GeV, especially for resonant ALP production between 600 GeV and 2 TeV. Our results are also valid for a CP-even scalar, and the efficiency of the search is independent of the width of the ALP.
Self-dual 6d 2-form fields coupled to non-abelian gauge field: quantum corrections
Authors: Huang Kuo-Wei , Roiban Radu , Tseytlin Arkady A.
Published: June 2018

Abstract

We study a 6d model of a set of self-dual 2-form B-fields interacting with a non-abelian vector A-field which is restricted to a 5d subspace. One motivation is that if the gauge vector could be expressed in terms of the B-field or integrated out, this model could lead to an interacting theory of B-fields only. Treating the 5d gauge vector as a background field, we compute the divergent part of the corresponding one-loop effective action which has the (DF)2 + F
3 structure and compare it with similar contributions from other 6d fields. We also discuss a 4d analog of the non-abelian self-dual model, which turns out to be UV finite.
Extended gauge theory deformations from flux backgrounds
Authors: Lambert Neil , Orlando Domenico , Reffert Susanne , Sekiguchi Yuta
Published: June 2018

Abstract

We consider supersymmetric deformations of gauge theories in various dimensions obtained from a String Theory realisation of branes embedded in flux backgrounds. In particular we obtain deformations which take the form of Wilson line defects, also obtained by a twisting of the R-symmetry into the gauge symmetry. Furthermore we construct higher-order generalisations, also expressed a twisting of the R-symmetry, that have symmetries associated to co-dimension two and three defects.
Gravitational memory in higher dimensions
Authors: Pate Monica , Raclariu Ana-Maria , Strominger Andrew
Published: June 2018

Abstract

It is shown that there is a universal gravitational memory effect measurable by inertial detectors in even spacetime dimensionsd≥ 4. The effect falls off at large radiusrasr3−d. Moreover this memory effect sits at one corner of an infrared triangle with the other two corners occupied by Weinberg’s soft graviton theorem and infinite-dimensional asymptotic symmetries.
Scale invariance with fundamental matters and anomaly: a holographic description
Authors: Banerjee Avik , Kundu Arnab , Ray Augniva
Published: June 2018

Abstract

Generally, quantum field theories can be thought as deformations away from conformal field theories. In this article, with a simplebottom upmodel assumed to possess a holographic description, we study a putative largeNquantum field theory with large and arbitrary number of adjoint and fundamental degrees of freedom and a non-vanishing chiral anomaly, in the presence of an external magnetic field and with a non-vanishing density. Motivated by the richness of quantum chromodynamics under similar condition, we explore the solution space to find an infinite class of scale-invariant, but not conformal, field theories that may play a pivotal role in defining the corresponding physics. In particular, we find two classes of geometries: Schrödinger isometric and warped AdS3geometries with an SL(2, R)×U(1) isometry. We find hints of spontaneous breaking of translational symmetry, at low temperatures, around the warped backgrounds.
Utilization of Genetic Testing for RET Mutations in Patients with Medullary Thyroid Carcinoma: a Single‐Center Experience
Authors: Parkhurst Emily , Calonico Elise , Abboy Sridevi
Published: June 2018

Medullary thyroid carcinoma (MTC) is often due to the hereditary condition multiple endocrine neoplasia type 2 (MEN2) and it is standard of care to offer genetic testing to all diagnosed patients. This study used the Kaiser Permanente integrated medical record system to identify patients at risk for MEN2, assess adherence to clinical practice guidelines, and offer genetic counseling and testing. A query of the electronic medical records system identified patients with MTC. All patients with MTC who had not had RET gene testing, as well as patients who had positive RET gene testing, but had not yet had genetic counseling, were contacted and offered a genetics consultation. The query identified 142 patients with MTC. Fifty‐six (40%) of those patients had not had the RET testing that all endocrine professional groups recommend. Forty‐nine patients were eligible for the outreach, and, from this, 14 patients were scheduled for genetic counseling. Of the 94 individuals at our institution who had RET genetic testing, 25 (27%) were positive for a mutation. Of the 82 apparently sporadic cases, 13 (16%) carried a RET mutation. A family history of endocrine cancer and younger age at diagnosis significantly increased the risk carrying a RET mutation. However, approximately half of RET‐positive patients did not have a significant family history of cancer and one‐third were over age 50 at diagnosis. This study concludes that a significant proportion of patients with MTC are not receiving standard of care genetic testing and reinforces previous research that sporadic‐appearing cases of MTC are often, in fact, hereditary.
Imaging Approach to the Diagnosis of Acute Appendicitis in a Group of Teaching Hospitals with 24/7 In-house Availability of Ultrasound Technologist: Effect of Timing of Request on Imaging Modality
Authors: Alzahrani Hassan , Maghdoori Babak , Islam Shadman , Maghdoori Sara , Atri Mostafa
Published: June 2018

Purpose

The study sought determine effect of requisition timing on the initial-choice imaging modality in appendicitis evaluation.

Methods

This was an institutional review board–approved retrospective study, encompassing 3 University of Toronto teaching hospitals, offering 24/7 radiology coverage. All surgically proven appendicitis cases, from 2012-2014, were included and presurgical ultrasound (US) or computed tomography (CT) reports were analysed. Examinations were all requested by the emergency department, performed by the same technologists and reviewed or finalized by the same radiology group (residents fellows or attending). Two coverage categories, namely regular hours (8 am-5 pm, Monday-Friday) or after hours (5 pm-8 am, Monday-Friday and weekends) were compared. The percentage of the starting modality (US or CT), the rate of CT following an indeterminate US, and the sensitivity of each modality was compared between the 2 categories, utilising Mann-Whitney U and chi-square tests.

Results

Presurgical US or CT studies of 494 patients, from February 2012-August 2014, were evaluated. Regular-hours and after-hours coverage demonstrated 174 (89:85 women:men) and 320 (141:179 women:men; P < .04) patients. The average age, 37.9 ± 17.1 women versus 35.2 ± 13.7 men was not statistically different ( P = .8). Regular hours included 89 of 174 (51.1%) of US-only examinations, 50 of 174 (29%) of CT-only examinations, and 35 of 174 (20%) of US examinations followed by CT examinations. After hours included 147 of 320 (46%) of US-only examinations, 147 of 320 (46%) of CT-only examinations, and 26 of 320 (8%) of US examinations followed by CT examinations ( P < .001). The total diagnostic sensitivities for US and CT were 86% (81% regular hours, 90% after hours; P = .041) and 99.2% (100% regular hours, 99% after hours; P > .05), respectively.

Conclusions

US was less utilised in acute appendicitis detection after hours, although its diagnostic sensitivity was better than regular-hours coverage.
Age of onset and quality of life among males and females with schizophrenia: A national study
Authors: Rotstein Anat , Roe David , Gelkopf Marc , Levine Stephen Z.
Published: June 2018

Background:

Age of onset is considered central to understanding the course of schizophrenia, yet little is known regarding its association with quality of life in general, and specifically among males and females.

Aims:

To examine the association between the age of schizophrenia onset and quality of life, in general, and among males and females, using data from a national sample and competing statistical models.

Methods:

Participants with a diagnosis of schizophrenia (N = 1624) completed the Manchester Short Assessment of Quality of Life (MSA-QoL) and were rated on a parallel measure by their professional caregivers (N = 578). Multiple regression analysis models were computed for self-appraised quality of life, and mixed models with random intercepts were used for caregivers. Six competing models were tested for parsimony for each rating source. Three models without adjustment and three models adjusted for confounding variables. Sensitivity analyses were conducted for males and females separately.

Results:

Age of onset was statistically significantly (P <.05) negatively associated with self-appraised and caregiver-appraised quality of life on aggregate and among females. Among males, a significant (P <.01) quadratic effect of onset age on self-appraised quality of life demonstrated a negative association up to onset age of 36.67 years, after which the association was positive.

Conclusions

An earlier age of onset is associated with a better quality of life in schizophrenia which is tentatively explained by social decline. Specific trends in psychiatric symptom severity may account for this association among females while social advantages may account for the particular results found among males.
TENNESSEE BEEF PRODUCERS' WILLINGNESS TO PARTICIPATE IN A STATE-BRANDED BEEF PROGRAM
Authors: MCLEOD ELIZABETH , JENSEN KIMBERLY , GRIFFITH ANDREW P. , DELONG KAREN L.
Published: June 2018

Tennessee cattle producer willingness to participate in a hypothetical Tennessee Branded Beef Program (TBBP) was examined using 2016 survey data. Willingness to participate in the TBBP was modeled using a probit model. Among those willing to participate, a Tobit model was used to estimate the pounds of live-weight beef producers were willing to supply into a TBBP. Age, production practices, and risk attitudes influenced willingness to participate. Among those willing to participate, projected TBBP supply per farm averaged 32,329 pounds and was influenced by on-farm animal units, production practices, perceived barriers, risk attitudes, and consequentiality beliefs.
P.006 Role of repeat antithyroid antibody testing in the diagnosis of Hashimoto’s Encephalopathy
Authors: Nedd K , Goodridge A
Published: June 2018

Background: We present a case of a previously well 71-year-old woman who developed rapidly progressive dementia. She had several prolonged hospital admissions and extensive investigations were performed. Her illness was steroid-responsive with clinical features suggestive of Hashimoto’s Encephalopathy (HE). However, multiple thyroid antibody panels acquired were initially normal, becoming elevated during subsequent relapses that occurred 3 years after initial presentation. The case signifies the importance of repeating antithyroid antibody levels in a patient with a clinical picture suggestive of HE. Methods: Case report. Results: The diagnosis of HE was established because of a compatible clinical picture including a relapsing encephalopathy with motor involvement and steroid responsiveness. In addition, although initial antithyroid antibody testing was negative, subsequent attacks were associated with significant elevations and reverted to normal with resolution of the attacks. Conclusions: In a patient with normal levels of antithyroid antibodies and a clinical presentation suggestive of HE, we recommend repeat antithyroid antibody testing to confirm diagnosis. Further studies are necessary to clarify the pathogenic role of elevated antithyroid antibodies in the mechanism of HE.
P.021 Childhood small vessel primary angiitis of the CNS: a potentially treatable cause of super-refractory status epilepticus
Authors: Chiu M , Datta A
Published: June 2018

Background: Childhood primary angiitis of the central nervous system (cPACNS) is a rare inflammatory disease of brain vessels. The small vessel subtype is diagnosed on brain biopsy and often presents with cognitive and behavioural changes, headaches and seizures. However, there are few reported cases of super-refractory status epilepticus. Methods: We present a case of small vessel cPACNS complicated by super-refractory status epilepticus and review the literature. Results: Our patient is a previously healthy 11-year-old boy who presented with new-onset seizures and encephalopathy in the context of fever. He developed super-refractory status epilepticus, requiring burst suppression for four weeks with various IV infusions. During this time, he was on the ketogenic diet and tried eight anti-seizure medications. Extensive investigations included brain biopsy confirming small vessel cPACNS. He was treated with IV methylprednisolone, oral steroids, IVIG, and cyclophosphamide. After prolonged rehabilitation, he recovered almost completely and has a normal neurological examination with no epileptiform activity on EEG. Conclusions: Small vessel cPACNS should be considered in the differential diagnosis of super-refractory status epilepticus. Despite being in SE for four weeks, symptomatic management of seizures and immunosuppression to treat the underlying pathology resulted in favourable neurological outcomes. This is one of the longest cases of SE in small vessel cPACNS in the literature.
P.033 Biopsy versus subtotal versus gross total resection in patients with low-grade glioma: a systematic review and meta-analysis
Authors: Yang K , Nath S , Koziarz A , Sourour M , Catana D , Alotaibi M , Manoranjan B , Sharma S , Singh S , Almenawer S
Published: June 2018

Background: The role of extent of surgical resection (EOR) on clinical outcomes in patients with low-grade glioma requires further examination. Methods: We systematically searched MEDLINE, Embase, and the Cochrane Library for studies published between January 1, 1990 and January 5, 2018 on predefined patient outcomes regarding different EOR of low-grade glioma. Results: Our literature search yielded 60 studies including 13,289 patients. Pooled estimates of overall survival showed an increase from 3.79 years (95% CI, 2.37–5.22) in the biopsy group to 6.68 years (95% CI, 4.19–9.16) in STR to 10.65 years (95% CI, 6.78–14.52) in GTR. When compared to STR, GTR prolonged progression-free survival by 2.08 years (95% CI, 0.26–3.89; P=0.025). Pooled estimates of seizure control showed an improvement from 47.8% (95% CI, 26.7–69.6) with biopsy to 54.2% (95% CI, 48.7–59.6) with STR to 81.0% (95% CI, 74.6–86.2) with GTR. Compared to STR, GTR delayed malignant transformation (RR, 0.43; 95% CI, 0.20–0.93; P=0.032), without increasing postoperative mortality (RR, 0.38; 95% CI, 0.07–1.97; P=0.250) or morbidity (RR, 1.22; 95% CI, 0.65–2.28; P=0.540). Conclusions: Among patients with low grade gliomas, higher degrees of safe EOR, were associated with longer overall and progression-free survival, better seizure control, and delayed malignant transformation, without increased mortality or morbidity.
P.035 Peritumoral brain edema in meningiomas: correlation with surgical findings and prognosis
Authors: Seleem AM , Farag AA
Published: June 2018

Background: Peritumoral brain edema(PTBE) in meningiomas had been a subject of interest; its occurrence in an extra-axial tumor was the reason of many studies and published data.Our study was made to evaluate the exact implication of Peritumoral brain edema in meningiomas in intraoperative and short postoperative prognosis. Methods: During 2006 to 2011,45 patients with supratentorial meningiomas were studied.Intraoperatively,certain findings were reported including: easy or difficult resection,Simpson’s grade of removal,brain tumor interface,plane of cleavage, pial vascularization of the tumor and arachnoid disruption.Morbidity and mortality were recorded;also postoperative CT and/or MRI were obtained within the first 3 months. Results: There were 26 meningiomas (57.7%) with peritumoral edema and 19 meningiomas without (42.3%).Pial vascularization of the tumor was defined in 24 patients (53.3%),four patients(21%) had a pial blood supply in edema negative group compared to 20 patients (76.9%) in edema positive group. In this study, there was one case mortality (2.2%) in edema positive group.As regard morbidity, eight (30.6%) patients in edema positive group suffered an early postoperative morbidity this is in comparison to four patients(21%) in the edema negative group. Conclusions: Our study shows that PTBE in meningiomas affects the surgical prognosis and confers a higher risk of morbidity and postoperative complications.Preoperative management of PTBE and immediate post-operative monitoring are important.
P.046 Flow cytometry in cerebrospinal fluid: utility in the diagnosis of central nervous system lymphoma
Authors: Au K , Latonas S , Shameli A , Auer I , Hahn C
Published: June 2018

Background: Flow cytometry in the cerebrospinal fluid (CSF) is used as an adjunct to cytology to increase the sensitivity of detecting central nervous system (CNS) lymphoma. We aim to evaluate CSF flow cytometry as a diagnostic tool for lymphoma in patients presenting with undifferentiated neurologic symptoms. Methods: We retrospectively reviewed all CSF flow cytometry samples sent in the Calgary region from 2012-2015. Clinical data, laboratory investigations, radiologic imaging studies, and pathological data were analyzed. Clinical review extended to 2 years post CSF flow cytometric testing. Results: The number of samples of CSF flow cytometry that were positive for a hematological malignancy was 43/763 (5.6%). The overall sensitivity of the test was 72.9%. A positive result was more likely to occur in patients with a prior history of a hematological malignancy or abnormal enhancement on MRI (p<0.0001). In fact, CSF flow cytometry was negative in all patients who did not have a previous hematological malignancy or abnormal enhancement on MRI (n = 247). Conclusions: CSF flow cytometry has very limited role in the screening for primary CNS lymphoma, unless a strictly endorsed testing algorithm is applied. It is, however, an invaluable tool in assessing CNS involvement in patients with previous diagnosis of hematolymphoid malignancy.
P.047 IDH mutations are associated with pro-inflammatory microglia and macrophages in heterogeneously infiltrated glioblastomas
Authors: Poon CC , Yang R , Sheikh T , Liu K , Sarkar S , Yong VW , Kelly JJ
Published: June 2018

Background: CNS innate immune cells, microglia and macrophages (MMs), are the largest component of the inflammatory infiltrate in glioblastoma (GBM). They initially participate in tumor surveillance, but are co-opted by GBM to further angiogenesis and invasion. There are no effective immunotherapies against GBM in part because GBM-associated MMs are not well understood. We hypothesized that the extent and inflammatory phenotype of MM infiltration into GBM is variable between patients. This variability could have important implications on immunotherapy selection and treatment outcomes. Methods: Using automated quantitation of fluorescently labeled human GBMs, flow cytometry/live cell sorting, collection of conditioned GBM-associated MM media, and corroboration with TCGA and previously published scRNA-seq data, we have uncovered there is surprisingly marked variation in the amount of MM infiltration between tumors. Results: MM infiltration can range from almost non-existent, to comprising ~70% of GBM cells. By detecting cell surface markers and secreted cytokines, we determined that a mixture of pro- and anti-inflammatory MMs are found in each tumor. The overall inflammatory phenotype did not depend on the amount of infiltration. Interestingly, IDH-mutant GBM-associated MMs are more pro-inflammatory and less heterogeneous than IDH-wildtype GBMs. Conclusions: Taken together, the highly variable immunologic status of GBMs suggests the success of immunotherapies hinges on selecting appropriately vulnerable tumors.
P.058 Introduction of continuous video EEG monitoring into two different NICU models by training neonatal nurses
Authors: Goswami I , Bello-Espinosa L , Buchhalter J , Amin H , Howlett A , Esser M , Thomas S , Metcalfe C , Lind J , Oliver N , Kozlik S , Mohammad K
Published: June 2018

Background: Continuous video-EEG (cvEEG) monitoring is the standard of care for diagnosis and management of neonatal seizures. However, it is labour-intensive. We aimed to establish consistency in monitoring of newborns utilising NICU nurses. Methods: Neonatal nurses were trained to apply scalp electrodes, troubleshoot technical issues. Guidelines, checklists and visual training modules were developed. A central network system allowed remote access to the cvEEGs by the epileptologist for timely interpretation and feedback. We compared 100 infants with moderate to severe HIE before and after the training program. Results: 192 cvEEGs were performed. Of the 100 infants compared; time to initiate brain monitoring decreased by average of 31.5 hours, in electrographic seizure detection increased(20% compared to 34% a), seizure clinical misdiagnosis decreased (65% compared to 36% ), and Anti-Seizure burden decreased. Conclusions: Training experienced NICU nurses to set-up, start and monitor cvEEG can decrease the time to initiate cvEEG which may lead to better seizure diagnosis and management.
P.064 Preoperative mapping using fMRI and DTI: a multimodal approach to assessing language dominance
Authors: Gould L , Kelly M , Ekstrand C , Ellchuk T , Borowsky R
Published: June 2018

Background: Language mapping is a key goal in neurosurgical planning. With the discontinuation of the Wada test in Canada, neurosurgeons often rely on fMRI and intraoperative techniques for determining language lateralization. Recent studies have also evaluated the utility of diffusion tensor imaging (DTI) for preoperative language lateralization, but further research is needed to confirm its efficacy. We report a patient with a left frontal AVM. fMRI and DTI was used to localize language and motor functioning. Methods: The tasks included word reading, picture naming, pseudohomophones (e.g., dawg) and semantic questions. All fMRI analyses were performed using BrainVoyager. Tensors were tracked from 30-direction diffusion MR images using DSI-Studio. Results: The fMRI results revealed consistent Broca’s and Wernicke’s areas, confirming left hemisphere dominance. There was also a region of activation in the precentral gyrus near the surgical resection. The results were loaded onto the neuronavigation system to help determine safe surgical margins. The DTI results revealed that the left arcuate and uncinate -fasciculus had three times more tracts than the right hemisphere, further supporting left hemisphere dominance. Conclusions: This case highlights the value of a combined, multimodal approach for preoperative language localization, which will further enhance surgical safety by helping preserve regions for essential brain functions.
P.074 Clinical features of a family with distal myopathy and rimmed vacuoles due to a digenic interaction
Authors: Pontifex CS , Hamilton LE , Martens K , Pfeffer G
Published: June 2018

Background: The interaction between mutations in two or more genes is increasingly recognised as an important contributor to the phenotypic variability in genetic disorders. Co-occurrence of variants in SQSTM1 and TIA1 is reported as a cause of myopathy in 3 prior cases, but limited clinical data were presented. We present detailed clinical features of a family with two siblings having a distal myopathy with rimmed vacuoles (DMRV), and genetic variants in SQSTM1 and TIA1. Methods: Clinicopathologic study of a family with DMRV to describe clinical features, laboratory and neurophysiology studies, neuroimaging, and genetic sequencing. Results: Two siblings with variants in SQSTM1 and TIA1 developed myopathy in their early 60’s, with early involvement of ankle dorsiflexors and finger extensors. A decade after onset, patients remain ambulatory and have not developed cardiac or respiratory complications. MRI of the legs showed selective involvement of adductor magnus, vastus lateralis, and in lower legs the anterior compartment and medial gastrocnemius. Muscle pathology demonstrated rimmed vacuoles, disrupted myofibrillar architecture, and mislocalised TDP43. Two unaffected family members had one genetic variant but not both. Conclusions: We describe a fourth family with co-occurrence of TIA1 and SQSTM1 genetic variants and describe their detailed phenotype. Future study should address the mechanism of the interaction between these two variants.
P.075 Inflammatory Myositis associated with Myasthenia Gravis with and without thymic pathology: case series and literature review
Authors: Huang K , Mezei M , Shojania K , Amiri N , Dehghan N , Chapman K
Published: June 2018

Background: The association of myasthenia gravis (MG) and inflammatory myositis (IM) is rare and often only one of the diseases is diagnosed. Methods: In this study, we reviewed medical records of patients seen at NMDU from 2004 to 2017 who had diagnosis of concurrent MG and IM. The data is presented descriptively. -Results: We identified 7 patients with MG-IM overlap. Clinical features, laboratory and pathology data of the patients are summarized in Table 1. Conclusions: This is one of the largest case series with MG-IM overlap. It is very important to recognize such association and the different pattern of muscle involvement because therapies may be adjusted to treat both conditions. In patients with thymic pathology, conventional disease modifying agents, IVIG and glucocorticoid in addition to thymoma resection appear to be effective. In patients with refractory MG and myositis who were AChR negative, rituximab may be effective.
P.096 Iatrogenic pseudoaneurysm of the MCA secondary to VP shunt insertion
Authors: Chalil A , Staudt MD , Lownie SP
Published: June 2018

Background: Ventriculoperitoneal (VP) shunting is a common treatment for hydrocephalus. Complications of VP shunt include infection, malfunction, and hemorrhage. Vascular complications such as pseudoaneurysm are rare, and usually involve the choroid plexus or branches of the external carotid artery. We present the case of a fusiform pseudoaneurysm of the middle cerebral artery arising due to VP shunt insertion. Methods: A 36-year-old female presented with a hypertensive cerebellar hemorrhage and hydrocephalus. This was treated with VP shunt placement with limited dural opening. Three weeks afterward there developed a diffuse intraventricular hemorrhage associated with hemorrhage at the cortical insertion site of the ventricular catheter. CT and catheter angiography revealed a fusiform pseudoaneurysm of the M4 segment of the MCA immediately adjacent to the ventricular catheter. Results: The VP shunt was removed, and the aneurysmal segment was coagulated and occluded. Delayed repeat VP shunt insertion was performed through the same entry point and trajectory via a larger dural opening. Conclusions: Pseudoaneurysm formation secondary to catheter insertion is a rare complication. To our knowledge, this is the second reported case of a cortical branch pseudoaneurysm in an adult. Careful consideration should be given to vascular anatomy when planning shunt insertions, and cruciate dural opening for local cortex visualization may help avoid this complication.