bluuebunny/crossref_metadata_2025 huggingface dataset:
EPID‐based dosimetry to verify IMRT planar dose distribution for the aS1200 EPID and FFF beams
Authors: Miri Narges , Keller Peter , Zwan Benjamin J. , Greer Peter
Published: February 2017

We proposed to perform a basic dosimetry commissioning on a new imager system, the Varian aS1200 electronic portal imaging device (EPID) and TrueBeam 2.0 linear accelerator for flattened (FF) and flattening filter‐free (FFF) beams, then to develop an image‐based quality assurance (QA) model for verification of the system delivery accuracy for intensity‐modulated radiation therapy (IMRT) treatments. For dosimetry testing, linearity of dose response with MU, imager lag, and effectiveness of backscatter shielding were investigated. Then, an image‐based model was developed to convert images to planar dose onto a virtual water phantom. The model parameters were identified using energy fluence of the Acuros treatment planning system (TPS) and, reference dose profiles and output factors measured at depths of 5, 10, 15, and 20 cm in water phantom for square fields. To validate the model, its calculated dose was compared to measured dose from MapCHECK 2 diode arrays for 36 IMRT fields at 10 cm depth delivered with 6X, 6XFFF, 10X, and 10XFFF energies. An in‐house gamma function was used to compare planar doses pixel‐by‐pixel. Finally, the method was applied to the same IMRT fields to verify their pretreatment delivery dose compared with Eclipse TPS dose. For the EPID commissioning, dose linearity was within 0.4% above 5 MU and above 2 MU, measured lag was smaller than the previous EPIDs, and profile symmetry was improved. The model was validated with mean gamma pass rates (standard deviation) of 99.0% (0.4%), 99.5% (0.6%), 99.3% (0.4%), and 98.0% (0.8%) at 3%/3 mm for respectively 6X, 6XFFF, 10X, and 10XFFF beams. Using the same comparison criteria, the beam deliveries were verified with mean pass rates of 100% (0.0%), 99.6% (0.3%), 99.9% (0.1%), and 98.7% (1.4%). Improvements were observed in dosimetric response of the aS1200 imager compared to previous EPID models, and the model was successfully developed for the new system and delivery energies of 6 and 10 MV, FF, and FFF modes.

PACS number(s): 87.53.Oq, 87.53.Xd
On correlations in IMRT planning aims
Authors: Roy Arkajyoti , Das Indra J. , Nohadani Omid
Published: February 2017

The purpose was to study correlations amongst IMRT DVH evaluation points and how their relaxation impacts the overall plan. 100 head‐and‐neck cancer cases, using the Eclipse treatment planning system with the same protocol, are statistically analyzed for PTV, brainstem, and spinal cord. To measure variations amongst the plans, we use (i) interquartile range (IQR) of volume as a function of dose, (ii) interquartile range of dose as a function of volume, and (iii) dose falloff. To determine correlations for institutional and ICRU goals, conditional probabilities and medians are computed. We observe that most plans exceed the median PTV dose (average prescribed dose). Furthermore, satisfying reduced the probability of also satisfying , constituting a negative correlation of these goals. On the other hand, satisfying increased the probability of satisfying , suggesting a positive correlation. A positive correlation is also observed between the PTV and . Similarly, a positive correlation between the brainstem and is measured by an increase in the conditional median of , when is violated. Despite the imposed institutional and international recommendations, significant variations amongst DVH points can occur. Even though DVH aims are evaluated independently, sizable correlations amongst them are possible, indicating that some goals cannot be satisfied concurrently, calling for unbiased plan criteria.

PACS number(s): 87.55.dk, 87.53.Bn, 87.55.Qr, 87.55.de.
Production, review, and impact of technical quality control guidelines in a national context
Authors: Nielsen Michelle K. , Malkoske Kyle E. , Brown Erika , Diamond Kevin , Frenière Normand , Grant John , Pomerleau‐Dalcourt Natalie , Schella Jason , Schreiner L. John , Tantôt Laurent , Villarreal‐Barajas J. Eduardo , Bissonnette Jean‐Pierre
Published: February 2017

A close partnership between the Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist's (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) has resulted in the development of a suite of Technical Quality Control (TQC) guidelines for radiation treatment equipment; they outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. The adopted framework for the development and maintenance of the TQCs ensures the guidelines incorporate input from the medical physics community during development, measures the workload required to perform the QC tests outlined in each TQC, and remain relevant (i.e., “living documents”) through subsequent planned reviews and updates. The framework includes consolidation of existing guidelines and/or literature by expert reviewers, structured stages of public review, external field‐testing, and ratification by COMP. This TQC development framework is a cross‐country initiative that allows for rapid development of robust, community‐driven living guideline documents that are owned by the community and reviewed to keep relevant in a rapidly evolving technical environment. Community engagement and uptake survey data shows 70% of Canadian centers are part of this process and that the data in the guideline documents reflect, and are influencing, the way Canadian radiation treatment centers run their technical quality control programs. For a medium‐sized center comprising six linear accelerators and a comprehensive brachytherapy program, we evaluate the physics workload to 1.5 full‐time equivalent physicists per year to complete all QC tests listed in this suite.

PACS number(s): 87.55.Qr, 87.56.Fc, 87.56.‐v
Development and evaluation of a clinical model for lung cancer patients using stereotactic body radiotherapy (SBRT) within a knowledge‐based algorithm for treatment planning
Authors: Chin Snyder Karen , Kim Jinkoo , Reding Anne , Fraser Corey , Gordon James , Ajlouni Munther , Movsas Benjamin , Chetty Indrin J.
Published: February 2017

The purpose of this study was to describe the development of a clinical model for lung cancer patients treated with stereotactic body radiotherapy (SBRT) within a knowledge‐based algorithm for treatment planning, and to evaluate the model performance and applicability to different planning techniques, tumor locations, and beam arrangements. 105 SBRT plans for lung cancer patients previously treated at our institution were included in the development of the knowledge‐based model (KBM). The KBM was trained with a combination of IMRT, VMAT, and 3D CRT techniques. Model performance was validated with 25 cases, for both IMRT and VMAT. The full KBM encompassed lesions located centrally vs. peripherally (43:62), upper vs. lower (62:43), and anterior vs. posterior (60:45). Four separate sub‐KBMs were created based on tumor location. Results were compared with the full KBM to evaluate its robustness. Beam templates were used in conjunction with the optimizer to evaluate the model's ability to handle suboptimal beam placements. Dose differences to organs‐at‐risk (OAR) were evaluated between the plans generated by each KBM. Knowledge‐based plans (KBPs) were comparable to clinical plans with respect to target conformity and OAR doses. The KBPs resulted in a lower maximum spinal cord dose by compared to clinical plans, Sub‐KBMs split according to tumor location did not produce significantly better DVH estimates compared to the full KBM. For central lesions, compared to the full KBM, the peripheral sub‐KBM resulted in lower dose to 0.035 cc and 5 cc of the esophagus, both by , For all lesions, compared to the full KBM, the posterior sub‐KBM resulted in higher dose to 0.035 cc, 0.35 cc, and 1.2 cc of the spinal cord by , Plans using template beam arrangements met target and OAR criteria, with an increase noted in maximum heart dose (, ) and GI (, ) for the nine‐field plans relative to KBPs planned with custom beam angles. A knowledge‐based model for lung SBRT consisting of multiple treatment modalities and lesion locations produced comparable plan quality to clinical plans. With proper training and validation, a robust KBM can be created that encompasses both IMRT and VMAT techniques, as well as different lesion locations.

PACS number(s): 87.55de, 87.55kh, 87.53Ly
Experimental evaluation of a GPU‐based Monte Carlo dose calculation algorithm in the Monaco treatment planning system
Authors: Paudel Moti R. , Kim Anthony , Sarfehnia Arman , Ahmad Sayed B. , Beachey David J. , Sahgal Arjun , Keller Brian M.
Published: February 2017

A new GPU‐based Monte Carlo dose calculation algorithm (GPUMCD), developed by the vendor Elekta for the Monaco treatment planning system (TPS), is capable of modeling dose for both a standard linear accelerator and an Elekta MRI linear accelerator. We have experimentally evaluated this algorithm for a standard Elekta Agility linear accelerator. A beam model was developed in the Monaco TPS (research version 5.09.06) using the commissioned beam data for a 6 MV Agility linac. A heterogeneous phantom representing several scenarios — tumor‐in‐lung, lung, and bone‐in‐tissue — was designed and built. Dose calculations in Monaco were done using both the current clinical Monte Carlo algorithm, XVMC, and the new GPUMCD algorithm. Dose calculations in a Pinnacle TPS were also produced using the collapsed cone convolution (CCC) algorithm with heterogeneity correction. Calculations were compared with the measured doses using an ionization chamber (A1SL) and Gafchromic EBT3 films for , and field sizes. The percentage depth doses (PDDs) calculated by XVMC and GPUMCD in a homogeneous solid water phantom were within of film measurements and within 1% of ion chamber measurements. For the tumor‐in‐lung phantom, the calculated doses were within of film measurements for GPUMCD. For the lung phantom, doses calculated by all of the algorithms were within of film measurements, except for the field size where the CCC algorithm underestimated the depth dose by in a larger extent of the lung region. For the bone phantom, all of the algorithms were equivalent and calculated dose to within of film measurements, except at the interfaces. Both GPUMCD and XVMC showed interface effects, which were more pronounced for GPUMCD and were comparable to film measurements, whereas the CCC algorithm showed these effects poorly.

PACS number(s): 87.53.Bn, 87.55.dh, 87.55.km
Difference in performance between 3D and 4D CBCT for lung imaging: a dose and image quality analysis
Authors: Thengumpallil Sheeba , Smith Kathleen , Monnin Pascal , Bourhis Jean , Bochud François , Moeckli Raphaël
Published: February 2017

The study was to describe and to compare the performance of 3D and 4D CBCT imaging modalities by measuring and analyzing the delivered dose and the image quality. The 3D (Chest) and 4D (Symmetry) CBCT Elekta XVI lung IGRT protocols were analyzed. Dose profiles were measured with TLDs inside a dedicated phantom. The dosimetric indicator cone‐beam dose index (CBDI) was evaluated. The image quality analysis was performed by assessing the contrast transfer function (CTF), the noise power spectrum (NPS) and the noise‐equivalent quanta (NEQ). Artifacts were also evaluated by simulating irregular breathing variations. The two imaging modalities showed different dose distributions within the phantom. At the center, the 3D CBCT delivered twice the dose of the 4D CBCT. The CTF was strongly reduced by motion compared to static conditions, resulting in a CTF reduction of 85% for the 3D CBCT and 65% for the 4D CBCT. The amplitude of the NPS was two times higher for the 4D CBCT than for the 3D CBCT. In the presence of motion, the NEQ of the 4D CBCT was 50% higher than the 3D CBCT. In the presence of breathing irregularities, the 4D CBCT protocol was mainly affected by view‐aliasing artifacts, which were typically cone‐beam artifacts, while the 3D CBCT protocol was mainly affected by duplication artifacts. The results showed that the 4D CBCT ensures a reasonable dose and better image quality when moving targets are involved compared to 3D CBCT. Therefore, 4D CBCT is a reliable imaging modality for lung free‐breathing radiation therapy.

PACS number(s): 87.57.C‐, 87.57.uq, 87.53.Ly
Generation and analysis of an acoustic radiation pattern database for forty-one musical instruments
Authors: Shabtai Noam R. , Behler Gottfried , Vorländer Michael , Weinzierl Stefan
Published: February 2017

A database of acoustic radiation patterns was recorded, modeled, and analyzed for 41 modern or authentic orchestral musical instruments. The generation of this database included recordings of each instrument over the entire chromatic tone range in an anechoic chamber using a surrounding spherical microphone array. Acoustic source centering was applied in order to align the acoustic center of the sound source to the physical center of the microphone array. The acoustic radiation pattern is generated in the spherical harmonics domain at each harmonic partial of each played tone. An analysis of the acoustic radiation pattern complexity has been performed in terms of the number of excitation points using the centering algorithm. The database can be used both for studying the radiation of musical instruments itself, as well as for the implementation of radiation patterns in room acoustical simulations and auralization in order to obtain a spatial excitation of the room closer to reality.
Stable components of sound fields in the ocean
Authors: Virovlyansky A. L.
Published: February 2017

A method is proposed for finding the wave field components which are weakly sensitive to the sound speed perturbation in the ocean acoustic waveguides. Such a component is formed by a narrow beam of rays whose spread in vertical direction, up to the observation range, remains less than the vertical scale of perturbation. These rays pass through practically the same inhomogeneities and therefore their phases are incremented by the same amount. If the ray amplitudes vary insignificantly, then (i) the stable components of the monochromatic field in the perturbed and unperturbed waveguide differ by only a constant phase factor, and (ii) in the case of transient wave field the perturbation causes only an additional time delay of the stable component as a whole. It is shown how the stable components can be selected from the total wave field using the field expansions in the coherent states and in the normal modes. The existence of stable components is demonstrated by numerical simulation of sound field in a deep water waveguide. It turns out, that even though the assumptions (i) and (ii) are not met exactly, the stable components in the perturbed and unperturbed waveguides are quite close.
Sound transmission loss through metamaterial plate with lateral local resonators in the presence of external mean flow
Authors: Wang Ting , Sheng Meiping , Qin Qinghua
Published: February 2017

In the context of sound incident upon a metamaterial plate, explicit formulas for sound transmission loss (STL) are derived in the presence of external mean flow. Metamaterial plate, consisting of homogeneous plate and lateral local resonators (LLRs), is homogenized by using effective medium method to obtain the effective mass density and facilitate the calculation of STL. Results show that (a) vigorously oscillating LLRs lead to higher STL compared with bare plate, (b) increasing Mach number of the external mean flow helps obtain higher STL below the coincidence frequency but decreases STL above the coincidence frequency due to the added mass effect of light fluid loading and aerodynamic damping effect, (c) the coincidence frequency shifts to higher frequency range for the refracted effect of the external mean flow. However, effects of the flow on STL within negative mass density range can be neglected because of the lateral local resonance occurring. Moreover, hysteretic damping from metamaterial can only smooth the transmission curves by lowering higher peaks and filling dips. Effects of incident angles on STL are also examined. It is demonstrated that increasing elevation angle can improve the sound insulation, while the azimuth angle does not.
An experimental study of the wall-pressure fluctuations beneath low Reynolds number turbulent boundary layers
Authors: Van Blitterswyk Jared , Rocha Joana
Published: February 2017

A more complete understanding of the physical relationships, between wall-pressure and turbulence, is required for modeling flow-induced noise and developing noise reduction strategies. In this study, the wall-pressure fluctuations, induced by low Reynolds number turbulent boundary layers, are experimentally studied using a high-resolution microphone array. Statistical characteristics obtained using traditional cross-correlation and cross-spectra analyses are complimented with wall-pressure–velocity cross-spectra and wavelet cross-correlations. Wall-pressure–velocity correlations revealed that turbulent activity in the buffer layer contributes at least 40% of the energy to the wall-pressure spectrum at all measured frequencies. As Reynolds number increases, the low-frequency energy shifts from the buffer layer to the logarithmic layer, as expected for regions of uniform streamwise momentum formed by hairpin packets. Conditional cross-spectra suggests that the majority of broadband wall-pressure energy is concentrated within the packets, with the pressure signatures of individual hairpin vortices estimated to decay on average within traveling ten displacement thicknesses, and the packet signature is retained for up to seven boundary layer thicknesses on average.
In Vitro
Activity of Bedaquiline against Nontuberculous Mycobacteria in China
Authors: Pang Yu , Zheng Huiwen , Tan Yaoju , Song Yuanyuan , Zhao Yanlin
Published: February 2017

The main goal of our study was to evaluate the
in vitro
bedaquiline susceptibility of six prevalent species of pathogenic nontuberculous mycobacteria (NTM) in China. In addition, we investigated the potential molecular mechanisms contributing to bedaquiline resistance in the different NTM species. Among slowly growing mycobacteria (SGM), bedaquiline exhibited the highest activity against
Mycobacterium avium
; the MIC
50
and MIC
90
values were 0.03 and 16 mg/liter, respectively. Among rapidly growing mycobacteria (RGM),
Mycobacterium abscessus
subsp.
abscessus
(
M. abscessu
s) and
Mycobacterium abscessus
subsp.
massiliense
(
M. massiliense
) seemed more susceptible to bedaquiline than
Mycobacterium fortuitum
, with MIC
50
and MIC
90
values of 0.13 and >16 mg/liter, respectively, for both species. On the basis of bimodal distributions of bedaquiline MICs, we proposed the following epidemiological cutoff (ECOFF) values: 1.0 mg/liter for SGM and 2.0 mg/liter for RGM. Among
M. avium
,
Mycobacterium intracellulare
,
Mycobacterium kansasii
,
M. abscessus
,
M. massiliense
, and
M. fortuitum
isolates, 14 (29.8%), 41 (27.2%), 33 (39.3%), 44 (20.2%), 42 (25.8%), and 7 (31.8%), respectively, were resistant to bedaquiline. No significant differences in the proportions of bedaquiline resistance among these species were observed (
P
> 0.05). Genetic mutations were observed in 74 isolates (10.8%), with all nucleotide substitutions being synonymous. In conclusion, our data demonstrate that bedaquiline shows moderate
in vitro
activity against NTM species. Using the proposed ECOFF values, we could distinguish between bedaquiline-resistant and -susceptible strains with the broth dilution method. In addition, no nonsynonymous mutations in the
atpE
gene that conferred bedaquiline resistance in all six NTM species were identified.
Integron-Associated DfrB4, a Previously Uncharacterized Member of the Trimethoprim-Resistant Dihydrofolate Reductase B Family, Is a Clinically Identified Emergent Source of Antibiotic Resistance
Authors: Toulouse Jacynthe L. , Edens Thaddeus J. , Alejaldre Lorea , Manges Amee R. , Pelletier Joelle N.
Published: February 2017

Whole-genome sequencing of trimethoprim-resistant
Escherichia coli
clinical isolates identified a member of the trimethoprim-resistant type II dihydrofolate reductase gene family (
dfrB
). The
dfrB4
gene was located within a class I integron flanked by multiple resistance genes. This arrangement was previously reported in a 130.6-kb multiresistance plasmid. The DfrB4 protein conferred a >2,000-fold increased trimethoprim resistance on overexpression in
E. coli
. Our results are consistent with the finding that
dfrB4
contributes to clinical trimethoprim resistance.
Enterococcus faecalis Uses a Phosphotransferase System Permease and a Host Colonization-Related ABC Transporter for Maltodextrin Uptake
Authors: Sauvageot Nicolas , Mokhtari Abdelhamid , Joyet Philippe , Budin-Verneuil Aurélie , Blancato Víctor S. , Repizo Guillermo D. , Henry Céline , Pikis Andreas , Thompson John , Magni Christian , Hartke Axel , Deutscher Josef
Published: February 2017

Maltodextrin is a mixture of maltooligosaccharides, which are produced by the degradation of starch or glycogen. They are mostly composed of α-1,4- and some α-1,6-linked glucose residues. Genes presumed to code for the
Enterococcus faecalis
maltodextrin transporter were induced during enterococcal infection. We therefore carried out a detailed study of maltodextrin transport in this organism. Depending on their length (3 to 7 glucose residues),
E. faecalis
takes up maltodextrins either via MalT, a maltose-specific permease of the phosphoenolpyruvate (PEP):carbohydrate phosphotransferase system (PTS), or the ATP binding cassette (ABC) transporter MdxEFG-MsmX. Maltotriose, the smallest maltodextrin, is primarily transported by the PTS permease. A
malT
mutant therefore exhibits significantly reduced growth on maltose and maltotriose. The residual uptake of the trisaccharide is catalyzed by the ABC transporter, because a
malT mdxF
double mutant no longer grows on maltotriose. The trisaccharide arrives as maltotriose-6″-P in the cell. MapP, which dephosphorylates maltose-6′-P, also releases P
i
from maltotriose-6″-P. Maltotetraose and longer maltodextrins are mainly (or exclusively) taken up via the ABC transporter, because inactivation of the membrane protein MdxF prevents growth on maltotetraose and longer maltodextrins up to at least maltoheptaose.
E. faecalis
also utilizes panose and isopanose, and we show for the first time, to our knowledge, that in contrast to maltotriose, its two isomers are primarily transported via the ABC transporter. We confirm that maltodextrin utilization via MdxEFG-MsmX affects the colonization capacity of
E. faecalis
, because inactivation of
mdxF
significantly reduced enterococcal colonization and/or survival in kidneys and liver of mice after intraperitoneal infection.

IMPORTANCE
Infections by enterococci, which are major health care-associated pathogens, are difficult to treat due to their increasing resistance to clinically relevant antibiotics, and new strategies are urgently needed. A largely unexplored aspect is how these pathogens proliferate and which substrates they use in order to grow inside infected hosts. The use of maltodextrins as a source of carbon and energy was studied in
Enterococcus faecalis
and linked to its virulence. Our results demonstrate that
E. faecalis
can efficiently use glycogen degradation products. We show here that depending on the length of the maltodextrins, one of two different transporters is used: the maltose-PTS transporter MalT, or the MdxEFG-MsmX ABC transporter. MdxEFG-MsmX takes up longer maltodextrins as well as complex molecules, such as panose and isopanose.
American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score: a study protocol for the translation and validation of the Dutch language version
Authors: Van Lieshout Esther M M , De Boer A Siebe , Meuffels Duncan E , Den Hoed P Ted , Van der Vlies Cornelis H , Tuinebreijer Wim E , Verhofstad Michael H J
Published: February 2017

Introduction

The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score is among the most commonly used instruments for measuring the outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It combines a clinician-reported and a patient-reported part. A valid Dutch version of this instrument is currently not available. Such a translated and validated instrument would allow objective comparison across hospitals or between patient groups, and with shown validity and reliability it may become a quality of care indicator in future. The main aims of this study are to translate and culturally adapt the AOFAS Ankle-Hindfoot Score questionnaire into Dutch according to international guidelines, and to evaluate the measurement properties of the AOFAS Ankle-Hindfoot Score-Dutch language version (DLV) in patients with a unilateral ankle or hindfoot fracture.

Methods and analysis

The design of the study will be a multicentre prospective observational study (case series) in patients who presented to the emergency department with a unilateral ankle or hindfoot fracture or (fracture) dislocation. A research physician or research assistant will complete the AOFAS Ankle-Hindfoot Score-DLV based on interview for the subjective part and a physical examination for the objective part. In addition, patients will be asked to complete the Foot Function Index (FFI) and the Short Form-36 (SF-36). Descriptive statistics (including floor and ceiling effects), internal consistency, construct validity, reproducibility (ie, test–retest reliability, agreement and smallest detectable change) and responsiveness will be assessed for the AOFAS DLV.

Ethics and dissemination

This study has been exempted by the Medical Research Ethics Committee (MREC) Erasmus MC (Rotterdam, the Netherlands). Each participant will provide written consent to participate and remain anonymised during the study. The results of the study are planned to be published in an international, peer-reviewed journal.

Trial registration number

NTR5613. pre-result.
Onset seasons and clinical outcomes in patients with Stanford type A acute aortic dissection: an observational retrospective study
Authors: Chen Zhaoran , Huang Bi , Yang Yanmin , Hui Rutai , Lu Haisong , Zhao Zhenhua , Lu Zhinan , Zhang Shu , Fan Xiaohan
Published: February 2017

Objectives

To evaluate the association of onset season with clinical outcome in type A acute aortic dissection (AAD).

Design

A single-centre, observational retrospective study.

Setting

The study was conducted in Fuwai Hospital, the National Centre for Cardiovascular Disease, Beijing, China.

Participants

From 2008 to 2010, a set of consecutive patients with type A AAD, confirmed by CT scanning, were enrolled and divided into four groups according to onset season: winter (December, January and February), spring (March, April and May), summer (June, July and August) and autumn (September, October and November). The primary end points were in-hospital death and all-cause mortality during follow-up.

Results

Of the 492 cases in this study, 129 occurred in winter (26.2%), 147 in spring (29.9%), 92 in summer (18.7%), and 124 in autumn (25.2%). After a median follow-up of 20.4 months (IQR 9.7–38.9), the in-hospital mortality in cases occurring in autumn was higher than in the other three seasons (23.4% vs 8.4%, p<0.01). Long-term mortality was comparable among the four seasonal groups (p=0.63). After adjustment for age, gender and other risk factors, onset in autumn was still an independent factor associated with increased risk of in-hospital mortality (HR 2.05; 95% CI 1.15 to 3.64, p=0.02) in addition to surgical treatment. Further analysis showed that the seasonal effect on in-hospital mortality (autumn vs other seasons: 57.4% vs 27.3%, p<0.01) was only significant in patients who did not receive surgical treatment. No seasonal effect on long-term clinical outcomes was found in this cohort.

Conclusions

Onset in autumn may be a factor that increases the risk of in-hospital death from type A AAD, especially in patients who receive conservative treatment. Immediate surgery improves the short-term and long-term outcomes regardless of onset season.
Tsallis and Kaniadakis statistics from the viewpoint of entropic gravity formalism
Authors: Abreu Everton M. C. , Neto Jorge Ananias , Barboza Edésio M. , Nunes Rafael C.
Published: February 2017

It has been shown in the literature that effective gravitational constants, which are derived from Verlinde’s formalism, can be used to introduce the Tsallis and Kaniadakis statistics. This method provides a simple alternative to the usual procedure normally used in these non-Gaussian statistics. We have applied our formalism in both Jeans mass criterion of stability and the free fall time collapsing of a self-gravitating system where new results were obtained. A possible connection between our formalism and deviations of Newton’s law of gravitation in a submillimeter range was carried out.
Bilinear form and soliton solutions for the fifth-order Kaup–Kupershmidt equation
Authors: Wang Pan
Published: February 2017

In this paper, multi-soliton solutions of the fifth-order Kaup–Kupershmidt (KK) equation have been derived via the auxiliary function in conjunction with the bilinear method. These solutions have not been previously obtained. Propagation and interactions of three solitons have been presented analytically. The direction of the soliton is related to the signs of the parameters [Formula: see text]. The distances of the solitons are related to the values of the parameters [Formula: see text].
Effects of convincing power and neutrality on minority opinion spreading
Authors: Wu Yue , Xiong Xi , Zhang Yi
Published: February 2017

The dynamics evolution of the minority opinion in public debates is studied using a convincing power (CP) model with neutrality. In a given group, an agent with a definite standpoint (yes or no) can be persuaded to be a neutral agent, if its capacity of persuasion is lower than the average CP of its opponents. Besides that a neutral agent will change its state and follow a more persuasive opinion. Starting from two opposite opinions with different rates, repeated local discussions are found to drive the minority reversal. It reveals that in addition to the initial minority, the number of neutral agents is also an important factor to the eventual winners. During the process of consensus, there exists a threshold of initial fraction to guarantee one side win. The results have a guiding significance for designing strategies to win a public debate.
Analytical investigation on the minimum traffic delay at a three-phase signalized T-type intersection
Authors: Zhang Hong-Ze , Jiang Rui , Hu Mao-Bin , Jia Bin
Published: February 2017

The traffic delay at intersections is crucial for the performance of urban traffic system. This paper analytically investigated the minimum traffic delay at a three-phase T-type intersection. We firstly demonstrate that the minimum traffic delay must be achieved on the surface of the 3D space constituted by the three constraints. Next, we prove that the minimum traffic delay must be achieved on the three borderlines of the surface. Finally, we show that the minimum delay is achieved either on one specific borderline or at the vertex of the surface. In the former case, extra green time is needed for the stream with largest demand, while no extra green time should be assigned to any stream in the latter case.
OPTIMAL INVESTMENT IN HEDGE FUNDS UNDER LOSS AVERSION
Authors: ZOU BIN
Published: February 2017

We study optimal investment problems in hedge funds for a loss averse manager under the framework of cumulative prospect theory. We obtain explicit solutions for a general utility function satisfying the Inada conditions and a piece-wise exponential utility function. Through a sensitivity analysis, we find that the manager reduces the risk of the hedge fund when her/his loss aversion, risk aversion, ownership in the fund, or management fee ratio increases. However, the increase of incentive fee ratio drives the manager to seek more risk in order to achieve higher prospect utility.
The name is the message: eagle-stones and materia medica in South America
Authors: Podgorny Irina
Published: February 2017

This chapter presents one case history – the transfer of the name and virtues of ‘eagle-stones’ to Andean minerals and terebratulid brachiopods such as
Clarkeia antisiensis
. Eagle-stones, an ancient remedy of Asian origin, were used in early modern Europe to prevent abortion and as a charm to assist obstetric delivery. In the eighteenth century eagle-stones were the subject of what G. Baronti (
Tra bambini e acque sporche Immersioni nella collezione di amuleti di Giuseppe Bellucci
, Morlacchi, Perugia, 2008) calls the process of folklorization of European learned medicine, becoming a ‘superstition’ and a popular remedy of medical lore. Based on secondary bibliography and documents from the Archivo de Indias in Seville, the paper discusses the uses of eagle-stones in Spain and Spanish America in connection to the texts published, written or translated in the Iberian Peninsula (lapidaries, early modern medical books). The last section proposes clues to analyse the expansion of the trade in eagle-stones to Spanish America, to finally survey the references to ‘eagle-stones’ in Latin American popular medicine of the late nineteenth and early twentieth centuries. Eagle-stones are inscribed not only in the
longue-durée
but also in the intricate networks of commerce.
Central Hyperthermia Treated with Bromocriptine
Authors: Natteru P. , George P. , Bell R. , Nattanmai P. , Newey C. R.
Published: February 2017

Introduction. Central hyperthermia is common in patients with brain injury. It typically has a rapid onset with high temperatures and marked fluctuations and responds poorly to antibiotics and antipyretics. It is also associated with worse outcomes in the brain injured patient. Recognizing this, it is important to aggressively manage it. Case Report. We report a 34-year-old male with a right thalamic hemorrhage extending to the midbrain and into the ventricles. During his admission, he developed intractable fevers with core temperatures as high as 39.3°C. Infectious workup was unremarkable. The fever persisted despite empiric antibiotics, antipyretics, and cooling wraps. Bromocriptine was started resulting in control of the central hyperthermia. The fever spikes were reduced to minor fluctuations that significantly worsened with any attempt to wean off the bromocriptine. Conclusion. Diagnosing and managing central hyperthermia can be challenging. The use of bromocriptine can be beneficial as we have reported.
A PLZT Novel Sensor with Pt Implanted for Biomedical Application: Cardiac Micropulses Detection on Human Skin
Authors: González-Morán Carlos O. , Miranda-Hernández José G. , Flores Cuautle José de Jesús Agustín , Suaste-Gómez Ernesto , Herrera-Hernández Héctor
Published: February 2017

Advances in sensors for biomedical applications have been a great motivation. In this research, a PLZT (lead lanthanum zirconate titanate) novel sensor with platinum wire implanted in its longitudinal section was developed through of the synthesis process based on powder technology. The raw materials as lead (PbO), lanthanum (La2O3), zircon (ZrO2), and titanium (TiO2) were used in the formation of the chemical composition (62.8% PbO, 4.5% La2O3, 24.2% ZrO2, and 8.5% TiO2). Then, these powders were submitted to mix-mechanical milling at high energy; cylindrical samples with the implant of the platinum wire were obtained with the load application. Finally, the compacted samples were sintered at 1200°C for 2 hours, then followed by a polarization potential of 1500 V/mm at 60°C to obtain a novel sensor. The density and porosity were evaluated using the Archimedes’ principle, while the mechanical properties such as fracture toughness value and Young’s modulus were determined by indentation and ultrasonic methods, respectively. A microscopic examination was also carried out to investigate the structural properties of the material. The PLZT novel sensor is electronically arranged for monitoring the cardiac pulses through a data acquisition system. The results obtained in this research are analyzed and discussed.
Forecasting the Incidence and Prevalence of Patients with End-Stage Renal Disease in Malaysia up to the Year 2040
Authors: Bujang Mohamad Adam , Adnan Tassha Hilda , Hashim Nadiah Hanis , Mohan Kirubashni , Kim Liong Ang , Ahmad Ghazali , Bak Leong Goh , Bavanandan Sunita , Haniff Jamaiyah
Published: February 2017

Background. The incidence of patients with end-stage renal disease (ESRD) requiring dialysis has been growing rapidly in Malaysia from 18 per million population (pmp) in 1993 to 231 pmp in 2013.Objective. To forecast the incidence and prevalence of ESRD patients who will require dialysis treatment in Malaysia until 2040.Methodology. Univariate forecasting models using the number of new and current dialysis patients, by the Malaysian Dialysis and Transplant Registry from 1993 to 2013 were used. Four forecasting models were evaluated, and the model with the smallest error was selected for the prediction.Result. ARIMA (0, 2, 1) modeling with the lowest error was selected to predict both the incidence (RMSE = 135.50, MAPE = 2.85, and MAE = 87.71) and the prevalence (RMSE = 158.79, MAPE = 1.29, and MAE = 117.21) of dialysis patients. The estimated incidences of new dialysis patients in 2020 and 2040 are 10,208 and 19,418 cases, respectively, while the estimated prevalence is 51,269 and 106,249 cases.Conclusion. The growth of ESRD patients on dialysis in Malaysia can be expected to continue at an alarming rate. Effective steps to address and curb further increase in new patients requiring dialysis are urgently needed, in order to mitigate the expected financial and health catastrophes associated with the projected increase of such patients.
Values, Norms, and Peer Effects on Weight Status
Authors: Nie Peng , Gwozdz Wencke , Reisch Lucia , Sousa-Poza Alfonso
Published: February 2017

This study uses data from the European Social Survey in order to test the Prinstein-Dodge hypothesis that posits that peer effects may be larger in collectivistic than in individualistic societies. When defining individualism and collectivism at the country level, our results show that peer effects on obesity are indeed larger in collectivistic than in individualistic societies. However, when defining individualism and collectivism with individual values based on the Shalom Schwartz universal values theory, we find little support for this hypothesis.
Epac1 Blocks NLRP3 Inflammasome to Reduce IL-1βin Retinal Endothelial Cells and Mouse Retinal Vasculature
Authors: Jiang Youde , Liu Li , Curtiss Elizabeth , Steinle Jena J.
Published: February 2017

Inflammation is an important component of diabetic retinal damage. We previously reported that a novelβ-adrenergic receptor agonist, Compound 49b, reduced Toll-like receptor 4 (TLR4) signaling in retinal endothelial cells (REC) grown in high glucose. Others reported that TLR4 activates high-mobility group box 1 (HMGB1), which has been associated with the NOD-like receptor 3 (NLRP3) inflammasome. Thus, we hypothesized that Epac1, a downstream mediator ofβ-adrenergic receptors, would block TLR4/HMGB1-mediated stimulation of the NLRP3 inflammasome, leading to reduced cleavage of caspase-1 and interleukin-1 beta (IL-1β). We generated vascular specific conditional knockout mice for Epac1 and used REC grown in normal and high glucose treated with an Epac1 agonist and/or NLRP3 siRNA. Protein analyses were done for Epac1, TLR4, HMGB1, NLRP3, cleaved caspase-1, and IL-1β. Loss of Epac1 in the mouse retinal vasculature significantly increased all of the inflammatory proteins. Epac1 effectively reduced high glucose-induced increases in TLR4, HMGB1, cleaved caspase-1, and IL-1βin REC. Taken together, the data suggest that Epac1 reduces formation of the NLRP3 inflammasome to reduce inflammatory responses in the retinal vasculature.
Microbiological Sealing Analysis of a Tapered Connection and External Hexagon System
Authors: Costa Gardel Nepomuceno , Martinez Elizabeth Ferreira , Ruellas Aluísio Martins de Oliveira , Peruzzo Daiane Cristina , Joly Júlio Cesar , Napimoga Marcelo Henrique
Published: February 2017

Considering the variety of implant connection systems available in the market and the contrasting literature regarding tapered connection systems in terms of bacterial leakage, the aim of this in vitro study was to compare the effectiveness of the bacterial seal at the implant/abutment interface between an external hexagon and a tapered connection system. Twelve sets of indexed tapered connection components and twelve sets of external hexagon connection components were used for microbiological analysis. In addition, for each model, an implant with its respective prosthetic abutment was used as a negative control and another as a positive control of microbial contamination. Failure of the abutment/implant interface seal was observed via turbidity or presence of deposits in the culture. Descriptive analysis of the data and relative frequency (percentage) as well as Fisher’s exact test were used at a significance level of 5%. Two of ten (20%) external hexagon specimens showed contamination against 0/10 (0%) tapered connection implants. In conclusion, both implant/abutment connections were able to prevent bacterial leakage in vitro.
Experimental Studies on Breakup and Fragmentation Behavior of Molten Tin and Coolant Interaction
Authors: Li Yankai , Wang Zefeng , Lin Meng , Zhong Mingjun , Zhou Yueshan , Yang Yanhua
Published: February 2017

Jet breakup and fragmentation behavior significantly affect the likelihood (and ultimate strength) of steam explosion, but it is very challenging to assess the potential damage to reactor cavity due to general lack of knowledge regarding jet breakup phenomena. In this study, the METRIC (mechanism study test apparatus for melt-coolant interaction) was launched at Shanghai Jiao Tong University to investigate FCI physics. The first five tests on molten tin and water interactions are analyzed in this paper. Significant breakup and fragmentation were observed without considerable pressure pulse, and intense expansion of droplets in local areas was observed at melt temperature higher than 600°C. The chain interactions of expansion all ceased, however, and there was no energetic steam explosion observed. Quantitative analysis on jet breakup length and debris was studied to investigate the effect of the melt temperature, initial diameter of the jet, and so on. Furthermore, the results of tests were compared with current theories. It is found that melt temperature has strong impact on fragmentation that need to be embodied in advanced fragmentation models.
The Threshold of a Stochastic SIRS Model with Vertical Transmission and Saturated Incidence
Authors: Zhu Chunjuan , Zeng Guangzhao , Sun Yufeng
Published: February 2017

The threshold of a stochastic SIRS model with vertical transmission and saturated incidence is investigated. If the noise is small, it is shown that the threshold of the stochastic system determines the extinction and persistence of the epidemic. In addition, we find that if the noise is large, the epidemic still prevails. Finally, numerical simulations are given to illustrate the results.
An OCT Study of Anterior Nodular Episcleritis and Scleritis
Authors: Christakopoulos Christos
Published: February 2017

Anterior scleritis and episcleritis are a well-known presentation in tuberculosis. The case of a female patient with presumed tuberculous anterior scleritis and episcleritis is discussed in this article. Anterior segment OCT was efficient in diagnosis and evaluation of the therapeutic outcome. Antituberculosis chemotherapy was sufficient to achieve clinical remission.
Atypical Complications of Graves’ Disease: A Case Report and Literature Review
Authors: Baagar Khaled Ahmed , Siddique Mashhood Ahmed , Arroub Shaimaa Ahmed , Ebrahim Ahmed Hamdi , Jayyousi Amin Ahmed
Published: February 2017

Graves’ disease (GD) may display uncommon manifestations. We report a patient with rare complications of GD and present a comprehensive literature review. A 35-year-old woman presented with a two-week history of dyspnea, palpitations, and edema. She had a raised jugular venous pressure, goiter, and exophthalmos. Laboratory tests showed pancytopenia, a raised alkaline phosphatase level, hyperbilirubinemia (mainly direct bilirubin), and hyperthyroidism [TSH: <0.01 mIU/L (reference values: 0.45–4.5), fT4: 54.69 pmol/L (reference values: 9.0–20.0), and fT3: >46.08 pmol/L (reference values: 2.6–5.7)]. Her thyroid uptake scan indicated GD. Echocardiography showed a high right ventricular systolic pressure: 60.16 mmHg. Lugol’s iodine, propranolol, cholestyramine, and dexamethasone were initiated. Hematologic investigations uncovered no reason for the pancytopenia; therefore, carbimazole was started. Workup for hepatic impairment and pulmonary hypertension (PH) was negative. The patient became euthyroid after 3 months. Leukocyte and platelet counts and bilirubin levels normalized, and her hemoglobin and alkaline phosphatase levels and right ventricular systolic pressure (52.64 mmHg) improved. This is the first reported single case of GD with the following three rare manifestations: pancytopenia, cholestatic liver injury, and PH with right-sided heart failure. With antithyroid drugs treatment, pancytopenia should resolve with euthyroidism, but PH and liver injury may take several months to resolve.
Quasi-Exact Coulomb Dynamics of n Charges n-1 of Which Are Equal
Authors: Skrypnik Wolodymyr
Published: February 2017

For n≥3 point charges n-1 of which are negative and equal quasi-exact periodic solutions of their Coulomb equation of motion are found. These solutions describe a motion of the negative charges around a coordinate axis in such a way that their coordinates coincide with vertices of a regular polygon in planes perpendicular to the axis along which the positive charge moves. The Weinstein and center Lyapunov theorems are utilized.
NLRP3 Deficiency Attenuates Renal Fibrosis and Ameliorates Mitochondrial Dysfunction in a Mouse Unilateral Ureteral Obstruction Model of Chronic Kidney Disease
Authors: Guo Honglei , Bi Xiao , Zhou Ping , Zhu Shijian , Ding Wei
Published: February 2017

Background and Aims. The nucleotide-binding domain and leucine-rich repeat containing PYD-3 (NLRP3) inflammasome has been implicated in the pathogenesis of chronic kidney disease (CKD); however, its exact role in glomerular injury and tubulointerstitial fibrosis is still undefined. The present study was performed to identify the function of NLRP3 in modulating renal injury and fibrosis and the potential involvement of mitochondrial dysfunction in the murine unilateral ureteral obstruction (UUO) model of CKD. Methods. Employing wild-type (WT) and NLRP3−/− mice with or without UUO, we evaluated renal structure, tissue injury, and mitochondrial ultrastructure, as well as expression of some vital molecules involved in the progression of fibrosis, apoptosis, inflammation, and mitochondrial dysfunction. Results. The severe glomerular injury and tubulointerstitial fibrosis induced in WT mice by UUO was markedly attenuated in NLRP3−/− mice as evidenced by blockade of extracellular matrix deposition, decreased cell apoptosis, and phenotypic alterations. Moreover, NLRP3 deletion reversed UUO-induced impairment of mitochondrial morphology and function. Conclusions. NLRP3 deletion ameliorates mitochondrial dysfunction and alleviates renal fibrosis in a murine UUO model of CKD.
Nocardia brasiliensis Infection Complicating Cryptogenic Organizing Pneumonia
Authors: Fernandes Alison M. , Sluzevich Jason C. , Mira-Avendano Isabel
Published: February 2017

Pulmonary nocardiosis is a severe and uncommon opportunistic infection caused by Nocardia species. We present a patient with cryptogenic organizing pneumonia who was receiving long-term immunosuppressive therapy, whose treatment course was complicated by cutaneous and pulmonary nocardiosis. Tissue cultures confirmed Nocardia brasiliensis. Nocardiosis should be a diagnostic consideration for patients treated with long-term immunosuppression who have worsening pulmonary symptoms and relapsing pustular skin lesions.