bluuebunny/crossref_metadata_2025 huggingface dataset:
Left ventricular function in asymptomatic patients with severe aortic regurgitation: Relation to clinical parameters and exercise performance
Authors: Thompson R. , Ross I. , McHaffie D. , Leslie P. , Easthope R. , Elmes R.
Published: October 2013

The optimal time for valve replacement in asymptomatic patients with severe aortic regurgitation is uncertain and is usually based on changing patterns in the ECG, radiographic heart size, or decreasing effort tolerance. The relationship between these parameters and changes in left ventricular function however has not been defined. In this study 28 patients, ages 20 to 66 years (mean 35 years) underwent gated pool radionuclide imaging at rest and at submaximal exercise (to greater than 85% maximum heart rate predicted for age) to quantitate ejection fraction (EF) and severity of aortic regurgitation. All patients had a 12‐lead ECG and chest x‐ray and 18 patients underwent echocardiography and maximal treadmill exercise testing. Severity of left ventricular hypertrophy on ECG was assessed by the Estes scoring system, heart size was expressed as cardiothoracic ratio (CTR). Echocardiograms were analyzed with respect to left ventricular end‐systolic diameter (LVESD) and fractional shortening. EF was below the normal range at rest (<0.45%) in only 6 patients (21%), but was abnormal during exercise in 18 patients (64%). Reduction in EF on exercise by 20% was judged to represent significant deterioration and occurred in 12 patients (43%), all of whom had an EF of less than 0.45% on exercise. Comparison of ECG, heart size, echocardiogram, exercise performance, and resting EF in this group of 12 patients with the remaining 16 patients showed no significant differences. In the group as a whole, stress EF was abnormal in 14 of 19 patients (73%) with an Estes score of 5 or greater, and was significantly lower (p < 0.05, mean 0.42) than in patients with an Estes score less than 5 (mean 0.52). There was no significant correlation between EF at rest or during exercise and any of the other parameters. Severity of aortic regurgitation (regurgitant fraction) showed poor correlation with heart size and LVESD (r = 0.24 and 0.32, respectively). It is concluded that abnormalities of left ventricular function can be demonstrated on exercise in a significant proportion of patients with aortic regurgitation despite the absence of symptoms, and that these changes cannot be predicted by readily available clinical parameters or by assessment of resting left ventricular function. Gated pool imaging may be a sensitive method for detection of early changes in LV function in these patients, but its value in assessing the timing of valve replacement requires serial investigation.
Risk factors and late recurrence of angina following myocardial revascularization
Authors: Schackman P. E. , Bamrah V. S. , Tristani F. E. , Barboriak J. J. , Hughes C. V. , Pedersen D. H. , Anderson A. J.
Published: October 2013

To assess the influence of risk factors on the recurrence of angina several years after myocardial revascularization, 316 patients were studied. We report that 249 patients obtained relief of angina from coronary bypass surgery and remained free of angina up to 4 years later. The remaining 67 patients experienced initial relief of angina 1 year following bypass surgery and then, subsequently, redeveloped angina 4 years postsurgery. There was no statistical difference in any risk factor between patients who remained free of angina after myocardial revascularization and those who developed angina. Of the total 316 patients, 79% were free of angina 4 years after coronary bypass surgery.
Combined supravalvular aortic stenosis and hypertrophic subaortic stenosis: Coexistence or association?
Authors: Bashour T. , Kabbani S. , Saalouke M. , Sandouk A. , Cheng T. O.
Published: October 2013

A 19‐year‐old male was found to have combined supravalvular aortic stenosis and hypertrophic subaortic stenosis. Two possible hypotheses with supportive evidence in the literature may explain this association: (1) long‐standing fixed supravalvular aortic stenosis may result in secondary hypertrophic subaortic stenosis, and (2) infantile hypercalcemia, a condition closely related to supravalvular aortic stenosis, may also be involved by continuous inotropic stimulation in the pathogenesis of muscular hypertrophy and subaortic stenosis of the left ventricle. We tend to favor the second theory in light of recent evidence in the literature.
Echocardiographic appearances of right atrial thrombus
Authors: Oldershaw P. J. , Coll L.
Published: October 2013

A 17‐year‐old male presented with a four‐day history of increasing shortness of breath and right basal pleuritic chest pain. Physical examination revealed central and peripheral cyanosis, sinus tachycardia, elevation of central venous pressure, hypotension, and added third heart sound. Echocardiography (M‐mode and two‐dimensional) showed a highly mobile mass in the right atrium apparently attached to the interatrial septum. A diagnosis of right atrial myxoma with pulmonary embolization was made and urgent surgery advised. At operation a string of thrombus in the right atrium (presumed from peripheral venous site) occluding a patent foramen ovale was found. The usefulness of echocardiography in diagnosing atrial thrombus and in differentiating clot from tumor is discussed.
Acute febrile mucocutaneous lymph node syndrome (Kawasaki disease) in an adult
Authors: Takamoto T. , Niwa A. , Taniguchi K. , Takeuchi J.
Published: October 2013

The patient is a 31 ‐year‐old man with a febrile condition accompanied by mucocutaneous changes and swelling of cervical lymph nodes. Clinical features and laboratory data meet the criteria for acute febrile mucocutaneous lymph node syndrome (MCLS). In addition, coronary artery aneurysms and stenotic lesions were observed in the coronary arteriograms. Previously reported cases of MCLS in adults have been extraordinarily rare.
Simplified application of bayesian analysis to multiple cardiologic tests
Authors: Staniloff H. M. , Diamond G. A. , Freeman M. R. , Berman D. S. , Forrester J. S.
Published: October 2013

Bayes' theorem is an accepted method to integrate the results of multiple tests for coronary artery disease, but complicated calculations make its application awkward for the clinician. This report presents tables which allow the reader to serially apply Bayes' theorem to the results of stress electrocardiography, thallium scintigraphy, technetium blood‐pool scintigraphy, and cardiac fluoroscopy.
Reassessment of electrovectorcardiographic signs of left atrial enlargement
Authors: Perosio A. M. , Suarez L. D. , Torino A. , Llera J. J. , Ballester A. , Roisinblit J. M.
Published: October 2013

Echocardiographic left atrial size was correlated with 27 electrovectorcardiographic parameters in 93 subjects. In 20 of them hemodynamic studies, including calculation of the left atrial volume, were performed. Subjects were divided into four groups as follows: Group I, 21 healthy subjects; group II, 45 patients with heart disease but no left atrial enlargement; group III, 15 patients with heart disease and left atrial size from 4.1 to 5 cm; and group IV, 12 patients with heart disease and a left atrial size exceeding 5 cm. A good correlation was found between left atrial size and the following parameters: Duration of P wave in standard lead II, voltage of both terminal forces of P wave in lead V1 and its maximal vector in the frontal and sagittal planes. A new index (duration/voltage of P wave in lead II) was postulated, which showed an excellent correlation with left atrial size (p < 0.001). In all cases the superposition between groups was excessive. These findings indicate the limitations of the classical patterns and raise interest in new parameters concerning the electrocardiographic diagnosis of left atrial enlargement.
Clinical characteristics and prognosis of patients with postinfarction angina caused by coronary artery spasm
Authors: Koiwaya Y. , Nakagaki O. , Takeshita A. , Nakamura M.
Published: October 2013

Clinical features and the course of 15 patients with postinfarction angina caused by coronary artery spasm are described. Episodes of postinfarction angina in the patients recurred at rest in the early recovery phase and were accompanied by transient ST‐segment elevation. The area where ST‐segment elevations were demonstrated on a 12‐lead ECG always included the leads with newly developed abnormal Q waves. Pain resolved spontaneously or after sublingual nitroglycerin in several minutes. Holter ECGs during a 24‐h period demonstrated frequent episodes of ST‐segment elevation that were not always associated with chest pain. Treatment with calcium antagonist and/or nitrates effectively suppressed angina, and only one patient developed reinfarction. The patient's subjective symptoms were abolished by diltiazem and isosorbide dinitrate. A Holter ECG of the patient revealed silent ST‐segment elevations before and after the reinfarction and an increase of the drugs completely suppressed the recurrence of silent ischemic ECG changes. Coronary arteriograms were obtained from 8 patients, which demonstrated more than 75% segmental stenosis on one coronary artery in 5 patients and no significant obstruction in the remaining 3. All patients performed a treadmill exercise stress test before discharge and most demonstrated excellent tolerance. All patients experienced no form of chest pain for an average of 25 months follow‐up under medication. We conclude that among patients with postinfarction angina, those cases caused by coronary artery spasm have a relatively good prognosis.
Current problems in hypertension
Authors: Franciosa J. A.
Published: October 2013

Although the beneficial effects of treating hypertension remain firmly established, concern has recently arisen that certain antihypertensive drugs may adversely modify cardiovascular risk factors. Equipotent blood pressure‐lowering agents may also have differing effects on cardiac structure and function. Thus, established approaches to antihypertensive therapy are being questioned and revised or new approaches are being suggested.
Fluorophore‐Labeled Cyclooxygenase‐2 Inhibitors for the Imaging of Cyclooxygenase‐2 Overexpression in Cancer: Synthesis and Biological Studies
Authors: Bhardwaj Atul , Kaur Jatinder , Wuest Frank , Knaus Edward E.
Published: October 2013

A group of cyclooxygenase‐2 (COX‐2)‐specific fluorescent cancer biomarkers were synthesized by linking the anti‐inflammatory drugs ibuprofen, (S)‐naproxen, and celecoxib to the 7‐nitrobenzofurazan (NBD) fluorophore. In vitro COX‐1/COX‐2 inhibition studies indicated that all of these fluorescent conjugates are COX‐2 inhibitors (IC50 range: 0.19–23.0 μM) with an appreciable COX‐2 selectivity index (SI≥4.3–444). In this study the celecoxib–NBD conjugate N‐(2‐((7‐nitrobenzo[c][1,2,5]oxadiazol‐4‐yl)amino)ethyl)‐4‐(5‐(p‐tolyl)‐3‐(trifluoromethyl)‐1H‐pyrazol‐1‐yl)benzenesulfonamide (14), which displayed the highest COX‐2 inhibitory potency and selectivity (COX‐2 IC50=0.19 μM; SI=443.6), was identified as an impending COX‐2‐specific biomarker for the fluorescence imaging of cancer using a COX‐2‐expressing human colon cancer cell line (HCA‐7).
Kinetic Modeling of Hydrogen Abstractions Involving Sulfur Radicals
Authors: Vandeputte Aäron G. , Reyniers Marie‐Françoise , Marin Guy B.
Published: October 2013

One of the requisites for the development of detailed reaction networks is the availability of accurate kinetic data. Group additivity based models linking the Arrhenius parameters to structural characteristics of the transition state have proven to be a valuable tool to obtain those data. In this work, group additivity values are presented to allow a broad range of CH and SH hydrogen abstraction reactions by S radicals to be modeled. Rate coefficients in the temperature range from 300 to 1500 K are obtained by using the CBS‐QB3 method in the high‐pressure limit and are corrected for tunneling and anharmonicity of rotation about the transitional bond. A total of 149 reactions are studied. From these reactions, a total of 52 group additivity values and 35 resonance corrections are derived. The general applicability of the group additivity method is demonstrated for a test set containing 25 reactions. At 300 K, rate coefficients are on average reproduced within a factor of 2.8. The mean absolute deviations on the Arrhenius parameters are 2 kJ mol−1 for the activation energy and 0.38 for log A in which A is the pre‐exponential factor.
Using Platelet Function Testing to Guide Antiplatelet Therapy
Authors: Linden Matthew D.
Published: October 2013

Clinical Development Phases I‐III Regulatory, Quality, Manufacturing

Platelets are subcellular fragments in blood whose activation is central to atherothrombosis and cardiovascular events. Platelet activation is complex, with multiple pathways of initiation and amplification involved. Antiplatelet drugs may target any of these pathways to diminish the propensity of platelets to become activated. The most well‐established antiplatelet drugs, aspirin and thienopyridines, target the thromboxane and adenosine diphosphate auto‐amplification pathways of platelet activation, respectively. These are very effective medicines, but response varies and residual on‐treatment platelet function is associated with poorer clinical outcomes. Alternative antiplatelet therapies are available and more are in development. Therefore, tailoring antiplatelet therapy to on‐treatment platelet activation is an appealing strategy and the subject of investigation. There are many different approaches to measuring platelet activation and response to stimulation with antiplatelet therapy, but there is very little agreement between them regardless of the cutoffs used. Therefore, selection of the appropriate platelet function test is important in assessing on‐treatment platelet activation for guided therapy. Recent research has shown that tailoring antiplatelet therapy can improve these laboratory measures of platelet activation, but clinical studies that assess cardiovascular benefit against potential for increased bleeding are required.
The Fall and Rise of Cangrelor
Authors: Leonardi Sergio , Ferlini Marco , Marino Marcello , Visconti Luigi Oltrona
Published: October 2013

Clinical Development Phases I‐III Regulatory, Quality, Manufacturing

The antagonism of the platelet P2Y12 receptor is essential for the treatment of patients undergoing percutaneous coronary intervention (PCI). Cangrelor is an intravenous P2Y12 receptor antagonist that being both reversible and very short acting has the potential to overcome some of the limitations of currently available oral agents like clopidogrel, prasugrel, and ticagrelor. Cangrelor has been studied in a large phase III program called Cangrelor versus standard therapy to acHieve optimal Management of Platelet InhibitiON (CHAMPION) that included three randomized controlled trials (RCTs): PCI, PLATFORM, and PHOENIX. The first two RCTs, conducted concurrently, were prematurely interrupted for futility. However, it was soon evident that unanticipated challenges in the ascertainment of PCI‐related myocardial infarction (MI) due to shorter‐than‐expected times to cardiac catheterization may have reduced the ability to detect cangrelor efficacy. While CHAMPION PCI and PLATFORM were ongoing, the universal definition of MI provided recommendations to address these challenges. Specifically, this consensus document recommended the presence of a rise and/or a fall of cardiac biomarkers to define MI. The universal MI definition enhanced by novel approaches to efficiently and accurately implement this definition was used to adjudicate MI in PHOENIX, which showed superiority of cangrelor over clopidogrel, with an effect that was mostly evident in MI. The development of cangrelor illustrates the critical importance of PCI‐related MI as end point, the challenges in its definition in patients undergoing a very early invasive management, and the role of the universal MI definition in overcoming these challenges.
Heparin‐Induced Thrombocytopenia: Pathophysiology, Diagnosis, and Treatment Monitoring
Authors: Kyriakou Elias S. , Kokori Styliani I. , Stylos Dimitrios A. , Kardoulaki Aikaterini P. , Tsantes Argyrios E.
Published: October 2013

Clinical Development Phases I‐III Regulatory, Quality, Manufacturing

Heparin‐induced thrombocytopenia (HIT) without or with thrombosis (HIT‐T) constitutes an acquired immune prothrombotic state, occurring in patients under unfractionated heparin or rarely low molecular weight heparin treatment. Heparin binding to secreted platelet factor‐4 (PF4) generates PF4 neo‐epitopes, against which polyclonal IgG‐antibodies are produced. IgG‐Hep/PF4 complexes bind on specific platelet, monocyte and endothelial cell Fcγ surface receptors, causing platelet consumption (thrombocytopenia), cell activation, release of prothrombotic tissue factor‐bearing microparticles and thrombin generation. Mild to moderate thrombocytopenia and venous or arterial thrombosis are the two hallmarks of HIT. “4T” scoring‐system predicts HIT‐probability, while diagnosis is further confirmed via specific laboratory assays, which reveal either the presence of IgG antibodies against Hep/PF4 complex (immunological assays), or whether patient's serum can activate donor platelets in the presence of heparin (functional assays). HIT‐treatment imposes immediate heparin cessation and initial parenteral anticoagulation with alternative anticoagulants, such as direct thrombin inhibitors (DTIs: lepirudin, argatroban, bivalirudin, desirudin) or indirect FXa inhibitors (IXaIs: danaparoid, fondaparinux). Monitoring of DTIs and IXaIs (via activated partial thromboplastin time or modern assays such as hemoclot thrombin inhibitor and anti‐Xa activity, respectively) is essential especially in patients with renal or hepatic failure or in patients with HIT‐related consumptive coagulopathy, in order to avoid serious bleeding events or anticoagulant underdosing. Vitamin K antagonists, which are contraindicated during acute phase, are permitted only after platelet count has substantially recovered and must be continued for at least 30 days and 3 months in isolated HIT and HIT‐T, respectively, with target international normalized ratio (INR) between 2.0 and 3.0.
Coagulation Assays in Patients with New Oral Anticoagulants (NOACs): Why? When?
Authors: Samama Meyer Michel
Published: October 2013

Clinical Development Phases I‐III Regulatory, Quality, Manufacturing

Treatment with new oral anticoagulant drugs does not require laboratory monitoring. However, there are some clinical settings where the measurement of the anticoagulant activity can be useful, especially in urgent surgery or invasive procedure. Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are prolonged with good correlation with plasma drug concentration. The influence of rivaroxaban on PT is greater than that on aPTT, in contrast to dabigatran. Apixaban responses to PT and aPTT are weak. These tests are not specific and cannot detect low plasma concentrations. For direct Factor‐Xa inhibitors, the most appropriate test is a modified anti‐Xa chromogenic assay. A specific test unresponsive to heparins and fondaparinux has been developed. For dabigatran measurement, a modified thrombin clotting time, “Hemoclot,” has been well documented. The use of plasma calibrators allows an expression of the results in ng/ml of plasma. Expected peak concentration (2 to 4 h after drug intake) and trough concentration or Cmin—before a repeated administration—have been determined. More clinical work is warranted to determine possible adjustments of the drug according to its plasma concentration. Finally, the potential advantage of a punctual screening during long‐term treatment has not been investigated.
Biochemical markers of recombinant human insulin‐like growth factor‐I (rhIGF‐I)/rhIGF binding protein‐3 (rhIGFBP‐3) misuse in athletes
Authors: Guha Nishan , Erotokritou‐Mulligan Ioulietta , Nevitt Simon P. , Francis Michael , Bartlett Christiaan , Cowan David A. , Bassett E. Eryl , Sönksen Peter H. , Holt Richard I. G.
Published: October 2013

Insulin‐like growth factor‐I (IGF‐I) is reportedly misused by elite athletes, either alone or with growth hormone (GH). The GH‐2000 and GH‐2004 research groups previously developed a method for detecting GH misuse based on the GH‐sensitive markers IGF‐I and procollagen type III amino‐terminal propeptide (P‐III‐NP). Both markers increase in response to rhIGF‐I/rhIGF binding protein‐3 (rhIGFBP‐3) administration in recreational athletes. The aim of this pilot study was to assess the effect of rhIGF‐I/rhIGFBP‐3 administration on other serum markers of the GH‐IGF axis and on other bone and collagen markers. Twenty‐six female and 30 male recreational athletes were randomized to 28 days’ treatment with placebo or rhIGF‐I/rhIGFBP‐3 complex, followed by 56 days’ washout. GH‐IGF axis markers (IGFBP‐2, IGFBP‐3, acid‐labile subunit (ALS) and IGF‐II) and bone and collagen markers (procollagen type I carboxy‐terminal propeptide (PICP), type I collagen cross‐linked carboxy‐terminal telopeptide (ICTP) and osteocalcin) were measured using commercial immunoassays. In women in the high dose treatment group, mean IGF‐II decreased by 53% (P=0.0028) on Day 21. Mean IGFBP‐2 increased by 119% (P=0.0039) and mean ALS decreased by 40% (P=0.0022) on Day 21. There were no significant changes in IGFBP‐3, osteocalcin, ICTP or PICP. In men in the high dose group, mean IGF‐II decreased by 51% on Day 21 (P<0.0001). Mean IGFBP‐2 increased by 125% on Day 21 (P=0.0003). There were no significant changes in IGFBP‐3, ALS, osteocalcin, ICTP or PICP. Serum IGFBP‐2 and IGF‐II may be useful markers of rhIGF‐I/rhIGFBP‐3 administration in both women and men while ALS may also be a useful marker in women; these markers are now undergoing further evaluation. Copyright © 2013 John Wiley & Sons, Ltd.
THCCOOH concentrations in whole blood: Are they useful in discriminating occasional from heavy smokers?
Authors: Fabritius Marie , Favrat Bernard , Chtioui Haithem , Battistella Giovanni , Annoni Jean‐Marie , Appenzeller Monique , Dao Kim , Fornari Eleonora , Lauer Estelle , Mall Jean‐Frédéric , Maeder Philippe , Mangin Patrice , Staub Christian , Giroud Christian
Published: October 2013

Some forensic and clinical circumstances require knowledge of the frequency of drug use. Care of the patient, administrative, and legal consequences will be different if the subject is a regular or an occasional cannabis smoker. To this end, 11‐nor‐9‐carboxy‐Δ9‐tetrahydrocannabinol (THCCOOH) has been proposed as a criterion to help to distinguish between these two groups of users. However, to date this indicator has not been adequately assessed under experimental conditions. We carried out a controlled administration study of smoked cannabis with a placebo. Cannabinoid levels were determined in whole blood using tandem mass spectrometry. Significantly high differences in THCCOOH concentrations were found between the two groups when measured during the screening visit, prior to the smoking session, and throughout the day of the experiment. Receiver operating characteristic (ROC) curves were determined and two threshold criteria were proposed in order to distinguish between these groups: a free THCCOOH concentration below 3 µg/L suggested an occasional consumption (≤ 1 joint/week) while a concentration higher than 40 µg/L corresponded to a heavy use (≥ 10 joints/month). These thresholds were tested and found to be consistent with previously published experimental data. The decision threshold of 40 µg/L could be a cut‐off for possible disqualification for driving while under the influence of cannabis. A further medical assessment and follow‐up would be necessary for the reissuing of a driving license once abstinence from cannabis has been demonstrated. A THCCOOH level below 3 µg/L would indicate that no medical assessment is required. Copyright © 2013 John Wiley & Sons, Ltd.
Old dogs and new tricks: Defective peripheral regulatory T cell generation in aged mice
Authors: Lopes‐Carvalho Thiago , Coutinho António
Published: October 2013

Tolerance is a developmentally acquired property of the vertebrate immune system, in part ensured by regulatory CD4+ lymphocytes (Treg cells) expressing the Foxp3 transcription factor. Recent work has shown that thymic emigrants are the preferential source of peripherally generated Treg cells. A new report in this issue of the European Journal of Immunology [Eur. J. Immunol. 2013. 43: 2598–2604] describes a cell autonomous defect in Foxp3 induction in aged CD4+ cells in mice. Immune homeostasis becomes progressively less robust as ontogeny gives way to aging, and a key feature of senescence is thymic involution and the impaired T‐cell turnover that follows. In this Commentary, we discuss the implications of these recent findings for our understanding of the induction of tolerance to peripheral antigens in aging.
A Robust and General Protocol for the Lewis‐Base‐Catalysed Reaction of Alcohols and Alkyl Propiolates
Authors: Tejedor David , Álvarez‐Méndez Sergio J. , López‐Soria Juan M. , Martín Víctor S. , García‐Tellado Fernando
Published: October 2013

A general and practical protocol for the tertiary‐amine‐catalysed synthesis of β‐alkoxyacrylates from primary, secondary, and tertiary alcohols is described. Of the currently used catalysts, DABCO proved to be the best one for this process. Three factors seem to influence the outcome of the reaction: (1) the nucleophilic strength of the catalyst, (2) the electrophilicity of the intermediate ammonium acrylate, and (3) the pKa/nucleophilicity of the alcohol/alkoxide nucleophile. Reactivity tuning enables the transformation of a range of tertiary alcohols into the corresponding β‐alkoxyacrylate derivatives. Differences in the reactivity of different types of alcohol allow the selective transformation of diols containing two different hydroxy groups into the corresponding monoprotected derivatives. This protocol will aid other synthetic organic chemists to easily prepare such vinyl ethers under atom‐economic, efficient, and bench‐friendly reaction conditions.
Bayesian spatial interpolation as an emerging cognitive radio application for coverage analysis in cellular networks
Authors: Sayrac Berna , Galindo‐Serrano Ana , Jemaa Sana Ben , Riihijärvi Janne , Mähönen Petri
Published: October 2013

Coverage prediction is one of the most important aspects of cellular network optimisation for mobile operators due to the highly competitive market conditions and the obligations towards the regulatory authorities. Although wireless communications research is considerably diversifying, including new areas, problems and concepts with a notable pace, cellular coverage still remains as a core subject of research for operators because of the obligation to adapt to the continuously evolving wireless ecosystem, with new radio access technologies/architectures, emerging applications and innovative cellular concepts. This paper presents the application of a powerful mathematical tool coming from spatial statistics, Bayesian kriging, to construct a radio environment map (REM) for the purpose of cellular coverage prediction as an emerging application of cognitive radio techniques in cellular networks. The proposed approach provides an efficient alternative to the conventional manual coverage prediction on the basis of drive tests, which are expensive, polluting and slow solutions for obtaining the ‘ground‐truth’ information. Bayesian kriging‐based REMs allow to estimate the coverage situation in those regions where the operator lacks direct information. Our approach can be directly used by operators for the cellular network coverage optimisation. We evaluate the accuracy of the proposed REM construction approach for a long term evolution network with two mesh sizes using highly realistic data sets. Results show that the Bayesian kriging interpolation technique has a good accuracy for cellular coverage prediction, and this accuracy is directly related with the mesh size. Copyright © 2013 John Wiley & Sons, Ltd.
Initial Preparation and Characterization of Single Step Fabricated Intermediate Temperature Solid Oxide Fuel Cells (IT‐SOFC)
Authors: Sivasankaran V. , Combemale L. , Pera M. C. , Caboche G.
Published: October 2013

In this study, facile tape casting process has been successfully carried out to fabricate an unit anode supported intermediate temperature solid oxide fuel cell (IT‐SOFC) with four different layers: a composite cathode which is a mix of La0.6Sr0.4Co0.2Fe0.8O3 (LSCF48) and Gd0.1Ce0.9O1.9 (GDC10), GDC10 as thin electrolyte layer, NiO‐GDC10 without pore former as thin anode functional layer (AFL), and anode support layer of NiO‐GDC10 with carbon pore former. The multi‐layer was sintered once to produce an unit planar cell. An OCV of 1.002 V at 500 °C, and maximum power density of 466 mW cm–2 at 648 °C are obtained. These results indicate negligible leakage of fuel through electrolyte. Furthermore scanning electron microscope (SEM) revealed crack free dense electrolyte. The single step sintering process gives an unit planar cell, which exhibits good performance without use of sintering aids, co‐pressing, and lamination of green tape.
The faces of pain: A cluster analysis of individual differences in facial activity patterns of pain
Authors: Kunz M. , Lautenbacher S.
Published: October 2013

Background

There is general agreement that facial activity during pain conveys pain‐specific information but is nevertheless characterized by substantial inter‐individual differences. With the present study we aim to investigate whether these differences represent idiosyncratic variations or whether they can be clustered into distinct facial activity patterns.

Methods

Facial actions during heat pain were assessed in two samples of pain‐free individuals (n = 128; n = 112) and were later analysed using the Facial Action Coding System. Hierarchical cluster analyses were used to look for combinations of single facial actions in episodes of pain. The stability/replicability of facial activity patterns was determined across samples as well as across different basic social situations.

Results

Cluster analyses revealed four distinct activity patterns during pain, which stably occurred across samples and situations: (I) narrowed eyes with furrowed brows and wrinkled nose; (II) opened mouth with narrowed eyes; (III) raised eyebrows; and (IV) furrowed brows with narrowed eyes. In addition, a considerable number of participants were facially completely unresponsive during pain induction (stoic cluster). These activity patterns seem to be reaction stereotypies in the majority of individuals (in nearly two‐thirds), whereas a minority displayed varying clusters across situations.

Conclusion

These findings suggest that there is no uniform set of facial actions but instead there are at least four different facial activity patterns occurring during pain that are composed of different configurations of facial actions. Raising awareness about these different ‘faces of pain’ might hold the potential of improving the detection and, thereby, the communication of pain.
Use of Magnetic Nanoparticles and a Microplate Reader with Fluorescence Detection to Detect C‐reactive Protein
Authors: Yang Jian‐Ying , Lin Yi‐Jyun , Su Mei‐Yu , Li Wen‐Jie , Liu Mine‐Yine
Published: October 2013

Two approaches based on magnetic nanoparticles (MNPs) have been compared to analyze C‐reactive protein (CRP). Both the non‐eluted and eluted MNP‐1°Ab‐CRP‐2°Ab/FITC bioconjugates were measured by a microplate reader with fluorescence detection. The linear ranges for the non‐elution and elution methods were 10‐200 and 0.1‐2.0 μg/mL, respectively. The concentration limits of detection for the nonelution and elution methods were 2.91 and 0.04 μg/mL, respectively. The non‐ elution method gave better precision and recovery than the elution method, and also showed comparable results to that of ELISA assay. The non‐elution method is simple and only needs minute volumes of sample and buffer. There is no need to dissociate the fluorescence probes from the bioconjugates, and the fluorescence signals can be directly measured on the MNP‐1°Ab‐CRP‐2°Ab/FITC bioconjugates. Meanwhile, samples with high CRP concentrations are not necessarily to be diluted before analysis.
Vacuum Ultraviolet and Soft X‐ray Photoelectron Spectroscopy of Liquid Beams Using a Hemispherical Photoelectron Spectrometer with a Multistage Differential Pumping System
Authors: Nishizawa Kiyoshi , Ohshimo Keijiro , Suzuki Toshinori
Published: October 2013

We present photoelectron spectroscopy of liquid beams using a high‐resolution hemispherical photoelectron spectrometer with a multistage differential pumping system developed in our laboratory. Intense soft X‐ray synchrotron radiation (500‐1200 eV) at SPring‐8 and a relatively large detection solid angle (1.5 × 10−2 π sr) of the spectrometer enable highly efficient measurements of X‐ray photoelectron spectra of liquids. Vacuum ultraviolet photoelectron spectroscopy using the same spectrometer provides sufficiently high spectral resolution to resolve rotational isomers of gas‐phase molecules.
Tips and troubleshooting for transpapillary metal stenting for distal malignant biliary obstruction
Authors: Hamada Tsuyoshi , Isayama Hiroyuki , Nakai Yousuke , Kogure Hirofumi , Yamamoto Natsuyo , Koike Kazuhiko
Published: October 2013

Endoscopic placement of a self‐expandable metal stent (SEMS) has become a mainstream treatment to relieve non‐resectable distal malignant biliary obstructions—its longer patency and cost‐effectiveness were demonstrated in comparison with plastic biliary stents in several randomized controlled trials. Despite advances in ERCP devices and SEMSs themselves to enable safe and effective biliary drainage via a SEMS, several significant aspects of the endoscopic placement of SEMS must be considered; otherwise, SEMS‐related complications and early SEMS dysfunction may occur. Also, SEMS dysfunction, including occlusion and migration, occurs at a certain frequency in the long term, and appropriate reintervention is necessary to preserve the quality of life of the patient. Here, we present tips for endoscopic transpapillary SEMS placement for distal malignant biliary obstruction and reintervention for SEMS dysfunction.
Synthesis of Bicyclic N‐Methylpyrazoline and Pyrazole Derivatives from α,β‐Unsaturated Ketones and N,N‐Dimethylhydrazine: An Illustration of Reductive Cyclization
Authors: Panda A. K. , Das U. , Quail J. W. , Dimmock J. R.
Published: October 2013

The reaction of N,N‐dimethylhydrazine with α,β‐unsaturated keto precursors such as 2‐benzylidenecyclohexanone, 2,6‐bis(benzylidene)cyclohexanone, and 3,5‐bis(benzylidene)‐1‐methyl‐4‐piperidone hydrochloride provided bicyclic N‐methylpyrazoles instead of hydrazones or any Michael addition products. The crystal structure of a representative pyrazole is reported. The proposed mechanism for the formation of the bicyclic N‐methylpyrazole 1 is outlined.
Utility of the Pfitzinger Reaction in the Synthesis of Novel Quinoline Derivatives and Related Heterocycles
Authors: Gök Derviş , Kasımoğulları Rahmi , Cengiz Mustafa , Mert Samet
Published: October 2013

2‐(2‐Amino‐3,5‐dinitrophenyl)‐2‐oxoacetic acid (2) was obtained from hydrolysis of 5,7‐dinitroisatin (1) in alkaline media. A novel quinoxaline derivative (3) was synthesized from the reaction of the same compound (1) with o‐phenylenediamine. Reacting 2 with ethyl 3‐oxo‐3‐phenylpropanoate yields 6,8‐dinitro‐2‐phenylquinoline‐3,4‐dicarboxylic acid (4). Then, 4 was converted into new quinoline‐diacylchloride, quinoline‐ester, quinoline‐dicarboxamide, pyridazine, and pyrroledione derivatives (5, 6a, 6b, 6c, 6d, 7a, 7b, 7c, 7d, 8, 9, 10a, 10b, 10c, 10d, 11a, 11b, 12) with SOCl2, alcohols, amines, and hydrazines, respectively. The structures of synthesized compounds were clarified by 1H NMR, 13C NMR, IR, mass and elemental analysis methods.
Value of diffusion‐weighted and gadolinium‐enhanced MRI for the diagnosis of pelvic recurrence from colorectal cancer
Authors: Colosio Alban , Soyer Philippe , Rousset Pascal , Barbe Coralie , Nguyen Francis , Bouché Olivier , Hoeffel Christine
Published: October 2013

Purpose

To prospectively assess the added value of gadolinium‐enhanced and diffusion‐weighted (DWI) MRI for the diagnosis of pelvic recurrence from colorectal cancer (CRC).

Materials and Methods

Fifty‐two patients with suspected pelvic recurrence from CRC underwent pelvic MRI with T2‐weighted (“T2”), gadolinium‐enhanced fat‐suppressed T1‐weighted (“gadolinium”) and DWI MR sequences. Three readers (senior radiologist: R1, two residents: R2, R3) scored the likelihood of recurrence on “T2,” “T2 + DWI,” and “T2 + Gadolinium.”

Results

Twenty‐seven patients had 42 sites of pelvic recurrence. On “T2,” R1 achieved AUC of .95, sensitivity 88.4%, specificity 95.2%. For R2, these figures were .89, 81.4%, 90.5%, for R3 .90, 83.7%, 76%. Both Gadolinium injection and DWI significantly improved AUCs for residents but not for the senior radiologist: up to .988 (R2, P = 0.006) and to .98 (R3, P = 0.01) with DWI and to .96 (R2, P = 0.04), .98 (R3, P = 0.01) after gadolinium. All readers achieved slightly better AUCs with “T2 + DWI” than with “T2+Gadolinium” but not significantly (P = 0.68, P = 0.11, P = 0.3; respectively).

Conclusion

For diagnosis of pelvic recurrence from CRC, both DWI and gadolinium‐enhanced MRI significantly increase diagnostic performances compared with “T2” MRI for residents. DWI may be helpful in patients with contra‐indications to intravenous administration of gadolinium. J. Magn. Reson. Imaging 2014;40:306–313. © 2013 Wiley Periodicals, Inc.
Apparent diffusion coefficient (ADC) measurement in endometrial carcinoma: Effect of region of interest methods on ADC values
Authors: Inoue Chie , Fujii Shinya , Kaneda Sachi , Fukunaga Takeru , Kaminou Toshio , Kigawa Junzo , Harada Tasuku , Ogawa Toshihide
Published: October 2013

Purpose

To investigate the influence of different‐shaped regions of interest (ROIs) on tumor apparent diffusion coefficient (ADC) measurements and interobserver variability in endometrial carcinoma.

Materials and Methods

Sixty‐nine patients (age range, 32–92 years; mean, 61 years) were evaluated in this retrospective study. Patients had undergone magnetic resonance (MR) examinations including diffusion‐weighted imaging (DWI) using a 3.0‐T MR system. Two readers measured tumor ADCs using four ROI methods: freehand ROI; square ROI; round ROI; and five small, round ROIs. Minimum and mean ADCs were obtained. The interclass correlation coefficient (ICC) was statistically analyzed to assess measurement reliability. Repeated‐measures analysis of variance was used for comparisons of ADCs measured with each ROI method.

Results

ICCs were 0.93 (minimum ADC) / 0.93 (mean ADC) for freehand ROIs, 0.94/0.95 for square ROIs, 0.94/0.95 for round ROIs, and 0.95/0.96 for five small, round ROIs. All ROI methods indicated excellent correlations. Each minimum ADC was significantly different except between square ROI and round ROI (P < 0.001). Mean ADCs showed significant differences only between freehand ROI and the other ROI methods (P < 0.001).

Conclusion

ROI shape has no marked influence on ICC in endometrial carcinoma. Compared with minimum ADCs, mean ADCs are suggested to provide more stable results regardless of the ROI method. J. Magn. Reson. Imaging 2014;40:157–161. © 2013 Wiley Periodicals, Inc.
Multiparameter MRI analysis of the time course of induced muscle damage and regeneration
Authors: Feng Shu , Chen Daniel , Kushmerick Martin , Lee Donghoon
Published: October 2013

Purpose

To test the ability of different magnetic resonance imaging (MRI) modalities to discriminate the time course of damage and regeneration in a model of acute, toxin‐induced muscle damage.

Materials and Methods

We analyzed the time course of tissue and cellular changes in mouse lower limb musculature following localized injection of myotoxin by T2, magnetization transfer (MT), and diffusion‐weighted MRI. We also used T1‐weighted imaging to measure leg muscle volume. In addition, postmortem histological analysis of toxin‐injected muscles was compared to uninjected controls.

Results

The damages detected by the MRI modalities are transient and recover within 3 weeks. Muscle water diffusivity and edema measured by leg volume increased within the first hours after injection of the toxin. The rate constant for volume increase was 0.65 ± 0.11 hr−1, larger than the increase in T2 (0.045 ± 0.013 hr−1) and change in MT ratio (0.028 ± 0.021 hr−1). During repair phase, the rate constants were much smaller: 0.022 ± 0.004 hr−1, 0.013 ± 0.0019 hr−1 and 0.0042 ± 0.0016 hr−1 for volume, T2, and MT ratio, respectively. Histological analyses confirmed the underlying cellular changes that matched the progression of MR images.

Conclusion

The kinetics of change in the MRI measurements during the progression of damage and repair shows MRI modalities can be used to distinguish these processes. J. Magn. Reson. Imaging 2014;40:779–788. © 2013 Wiley Periodicals, Inc.
Clinical application of the Provox NiD voice prosthesis: A longitudinal study
Authors: Lewin Jan S. , Portwood Martha A. , Wang Yijia , Hutcheson Katherine A.
Published: October 2013

Objectives/Hypothesis

To evaluate the indications, complications, and device life of the Provox NiD in a large cohort at a tertiary US cancer center.

Study Design

Longitudinal retrospective cohort study.

Methods

We reviewed the records of patients who used the NiD prosthesis (2005–2011) for general indicators, device life, and complications.

Results

One hundred eighty‐six patients who used the NiD were included (median follow‐up: 21.4 months). The NiD was placed at initial fit in 41 (22%) patients, whereas 145 (78%) tried an NiD after using another type of prosthesis. Most patients used the NiD similarly to an indwelling device. Median NiD device life was significantly longer than that of other nonindwelling prostheses (45 vs. 29 days, P = .0061), and did not significantly differ from that of standard indwelling devices (45 vs. 50 days, P = .4263). Thirty‐eight percent (71 of 189) of NiD users had a history of early leakage (<8 weeks) using a different prosthesis before trying the NiD. Among patients with a pre‐existing history of early leakage, almost 90% of NiD prostheses outperformed the device life of other products.

Conclusions

The NiD prosthesis offers satisfactory device life on a par with indwelling prostheses in our cohort of NiD users. Coupled with favorable published airflow characteristics and satisfactory tracheoesophageal voice, these data suggest that the NiD offers a durable, low‐cost prosthetic alternative in contemporary practice. A unique indication for NiD may be improved device life in some patients with a history of early leakage.

Level of Evidence

4. Laryngoscope, 124:1585–1591, 2014
Decreasing incidence of nasal adenocarcinoma in Wycombe woodworkers
Authors: Rourke Thomas , Grover Sharon , Wager Nadia , Capper John
Published: October 2013

Objectives/Hypothesis

The association between adenocarcinoma of the ethmoid sinuses and woodworkers was identified in the 1960s. Working conditions were poor, and epidemiological studies suggested the carcinogenic agent was hardwood dust created during furniture production. The objectives of this article were to describe the declining incidence of this disease in High Wycombe woodworkers between 1965 and 2012 and to explore the potential reasons for this occurrence.

Study Design

Prospective case series performed at Wycombe General Hospital.

Methods

Data were collected for all cases of nasal adenocarcinoma presenting in woodworkers to Wycombe General Hospital between 1965 and 2012. Statistical analysis was performed by calculating the Spearman rank correlation coefficient when comparing different variables from the data.

Results

A total of 105 reported cases of nasal adenocarcinoma were identified among woodworkers working in High Wycombe. Between 1965 and 2012, there was a statistically significant reduction in the incidence of the disease. Statistical analysis suggests that the declining incidence is not solely due to the reducing numbers of workers in the industry. Further analysis suggests a significant relationship between the individuals' ages at which diagnosis was made and the year in which they were diagnosed. Importantly, diagnoses made since 1980 were increasingly among people in their retirement years.

Conclusions

This article describes a statistically significant overall reduction in the incidence of nasal adenocarcinoma in Wycombe woodworkers. This is thought to not solely be due to declining numbers of workers within the industry but also improvements in working conditions following government legislation.

Level of Evidence

4 Laryngoscope, 124:1078–1082, 2014
Aircraft wind measurements to assess a coupled WRF‐CALMET mesoscale system
Authors: Gioli Beniamino , Gualtieri Giovanni , Busillo Caterina , Calastrini Francesca , Gozzini Bernardo , Miglietta Franco
Published: October 2013

Long term aircraft observations of wind magnitude along an ∼250 km flight track in central Italy, performed over 1.5 years, are compared with the output of an existing mesoscale prognostic‐diagnostic (WRF‐CALMET) model chain aimed at assessing wind potential maps at regional scale. Aircraft measurements are used to evaluate model performance along spatial and temporal transects at moderate altitude from the ground (∼75 m), where observational frameworks are rarely available. Spatial wind analysis was capable of assessing overall model performance, while highlighting some limitations: the implemented models have better performance in inland areas with respect to coastal areas, while they are capable of representing diurnal variability in all regions correctly. Overall agreement is within 3% in the cold season and 16% in the warm season, while the greatest differences, above 30%, are obtained in coastal areas in the summer. The hypothesis supporting these results is that summer sea breeze regimes that develop consistently from the coast through the interior land are not entirely resolved from mesoscale modelling. Finally, the model performance and limitations related to complex orography are highlighted. This study demonstrates the added value that may derive from aircraft wind measurements as an additional observational framework for applied meteorology studies.
Intraoral anastomosis of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate
Authors: Landes Constantin , Cornea Petruta , Teiler Anna , Ballon Alexander , Sader Robert
Published: October 2013

In this report, we present a case of a prelaminated radial forearm flap in reconstruction of a large persistent cleft palate with transoral single arterial and three venous anastomoses. A 17‐years‐old female patient presented a large cleft palate defect and complete dentition, dysmelia of both arms and bilateral thumb aplasia. A radial flap was prelaminated using oral mucosa 5 days prior to transplantation. Five days after flap prelamination, the facial artery and vein, submandibular vein, and a venous branch to the masseter muscle behind the buccinator muscle fibers were exposed through an intraoral incision lateral to the inferior right mucogingival junction. The radial artery, its bilateral accompanying veins, and the cephalic vein of transplanted flap were anastomosed transorally to the facial vessels, submandibular vein, and masseter branch. The vessel pedicle ran through the palatoglossal arch dorsal to the second upper molar. Good flow and flap perfusion were evinced, and further‐on successful healing was achieved. The case encourages similar treatment in comparable situations avoiding facial nerve hazard and extraoral scars. © 2013 Wiley Periodicals, Inc. Microsurgery 34:229–232, 2014.