bluuebunny/crossref_metadata_2025 huggingface dataset:
Left ventricular global longitudinal strain predicts mortality and heart failure admissions in African American patients
Authors: Kansal Mayank M. , Mansour Ibrahim N. , Ismail Sahar , Bress Adam , Wu Grace , Mirza Omer , Marpadga Rahul , Gheith Hana , Kim Yoonsang , Li Yien , Cavallari Larisa , Stamos Thomas D.
Published: March 2017

Background

Several studies have demonstrated the importance of left ventricular (LV) global longitudinal strain (GLS) as a reliable prognostic indicator in patients with heart failure (HF). These studies have included few African American (AA) patients, despite the growing prevalence and severity of HF in this patient population.

Hypothesis

LV GLS predicts long‐term HF admission and all‐cause mortality in AA patients with chronic HF on optimal guideline‐directed medical therapy (GDMT).

Methods

We enrolled 207 AA adults, age 56 ± 14.5 years, with New York Heart Association (NYHA) class I through III HF on optimal GDMT from the University of Illinois HF clinic between November 2001 and February 2014. LV GLS was assessed by velocity vector imaging using 2‐, 3‐, and 4‐chamber views. Patients were followed for HF admissions and death for 3 ± 3.0 years. LV GLS value of −7.95 was used as the optimal cutoff point that maximizes sensitivity and specificity

Results

LV GLS < −7.95% was significantly associated with higher all‐cause mortality and HF admissions in Kaplan‐Meier survival curves (log‐rank P < 0.001). After incorporation in multivariate Cox proportional hazard models, GLS < −7.95% was found to be an independent predictor of all‐cause mortality (hazard ratio [HR] = 4.04; 95% confidence interval [CI]: 1.07‐15.32; P = 0.04] and HF admissions (HR = 3.86; 95% CI: 1.38‐10.77; P = 0.010).

Conclusions

In AA patients with chronic stable HF on GDMT, more impaired LV GLS (< −7.95%) is a strong and independent predictor of long‐term all‐cause mortality and HF admissions.
Heart Rhythm Society: expert consensus statements—part 2
Authors: Sennhauser Susie , Anand Rishi , Kusumoto Fred , Goldschlager Nora
Published: March 2017

One of the most important roles for professional societies in medicine is assembling multiple stakeholders and experts to develop documents that can help guide and define policies and strategies for best medical care. Each year the Heart Rhythm Society (HRS) develops several consensus documents that address critical clinical subjects that have been identified by input from HRS members and HRS committees. Over the past 5 years, HRS has produced documents with multiple professional societies from around the world, and although the topics chosen for exploration center around arrhythmia management, the reviews and recommendations made in the documents are important for clinical cardiologists and generalists who are not arrhythmia specialists. When an internist or other primary care provider identifies a patient who may be having symptoms from an arrhythmia, the referral first is made to the clinical cardiologist and only later, if necessary, does an arrhythmia specialist become involved. These expert consensus statements are developed for specific clinical questions regarding arrhythmia management where there is controversy or uncertainty, often with less data from randomized controlled trials to help guide recommendations, which must then be made by extrapolation of existing data, observational data, and expert opinion. In this 2‐part review, the consensus statements developed by the HRS over the past 5 years that pertain to adults are discussed in part 1; part 2 focuses on consensus statements that HRS has developed in conjunction with the Pediatric and Congenital Electrophysiology Society that address arrhythmia issues in children and adults with congenital heart disease.
The relationship between cardio‐ankle vascular index and subclinical atherosclerosis evaluated by cardiac computed tomographic angiography
Authors: Matsumoto Suguru , Nakanishi Rine , Luo Yanting , Kim Michael , Alani Anas , Nezarat Negin , Dailing Christopher , Budoff Matthew J.
Published: March 2017

Background

The cardio‐ankle vascular index (CAVI) is a new noninvasive index to evaluate arterial stiffness. We investigated whether CAVI can predict severity, extent, and burden of coronary artery disease by comparing results with cardiac computed tomographic angiography (CCTA).

Hypothesis

CAVI may predict the presence of subclinical atherosclerosis.

Methods

We prospectively enrolled 95 patients (66% male; mean age, 50 ± 16 years) who underwent both CCTA and CAVI consecutively. We evaluated if CAVI correlated with (1) severe stenosis (≥50%); (2) plaque extent, determined by a segment‐involvement score (SIS), defined by the total number of coronary artery segments containing any plaque; and (3) plaque burden, determined by a segment‐stenosis score (SSS), defined by the extent of obstruction of coronary luminal diameter in individual coronary artery segments.

Results

Bivariate analysis showed a statistically significant relationship not only between CAVI and SIS, but also between CAVI and SSS (r2 = 0.4, P < 0.0001 for SIS; r2 = 0.36, P < 0.0001 for SSS). Multivariable logistic analysis demonstrated that CAVI is significantly associated with SSS >5 (odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1‐7.8, P = 0.03) and SIS >5 (OR: 2.3, 95% CI: 1.1‐5.8, P = 0.02), but not severe stenosis (OR: 1.7, 95% CI: 0.9‐4.3, P = 0.13), after adjusting for age, sex, chest pain, hypertension, dyslipidemia, family history, diabetes, and current smoking.

Conclusions

We demonstrated that CAVI had a significant relationship with subclinical coronary atherosclerosis evaluated by CCTA, especially in relation to plaque burden and plaque extent, but not severe stenosis. Thus, CAVI may reflect coronary atherosclerosis burden more than severity.
Trait dimensionality and population choice alter estimates of phenotypic dissimilarity
Authors: Carscadden Kelly A. , Cadotte Marc W. , Gilbert Benjamin
Published: March 2017

The ecological niche is a multi‐dimensional concept including aspects of resource use, environmental tolerance, and interspecific interactions, and the degree to which niches overlap is central to many ecological questions. Plant phenotypic traits are increasingly used as surrogates of species niches, but we lack an understanding of how key sampling decisions affect our ability to capture phenotypic differences among species. Using trait data of ecologically distinct monkeyflower (Mimulus) congeners, we employed linear discriminant analysis to determine how (1) dimensionality (the number and type of traits) and (2) variation within species influence how well measured traits reflect phenotypic differences among species. We conducted analyses using vegetative and floral traits in different combinations of up to 13 traits and compared the performance of commonly used functional traits such as specific leaf area against other morphological traits. We tested the importance of intraspecific variation by assessing how population choice changed our ability to discriminate species. Neither using key functional traits nor sampling across plant functions and organs maximized species discrimination. When using few traits, vegetative traits performed better than combinations of vegetative and floral traits or floral traits alone. Overall, including more traits increased our ability to detect phenotypic differences among species. Population choice and the number of traits used had comparable impacts on discriminating species. We addressed methodological challenges that have undermined cross‐study comparability of trait‐based approaches. Our results emphasize the importance of sampling among‐population trait variation and suggest that a high‐dimensional approach may best capture phenotypic variation among species with distinct niches.
Evaluation on Applicability to Electrical Insulating Material of Hydrocarbon‐Based Thermosetting Resin
Authors: YOSHIDA KEISUKE , KOZAKO MASAHIRO , ISHIBE SHINJI , HIKITA MASAYUKI , KAMEI NOBUHITO
Published: March 2017

This paper deals with dielectric properties of hydrocarbon‐based thermosetting resin to evaluate the applicability to electrical insulating materials. Moreover, higher withstand voltage, lower dielectric constant, and lower moisture absorption are required for the electrical insulating materials. One of the candidate polymer materials satisfying such demands is hydrocarbon‐based thermosetting resin, that is, polydicyclopentadiene (P‐DCP) and polytricyclopentadiene (P‐TCP). We measured the dielectric properties such as dielectric constant, dielectric loss, volume resistivity, and breakdown strength (BDS), and other properties such as moisture absorption, viscosity, mechanical strength, glass transition temperature, and coefficient of linear expansion of those specimens. It was found from the results in particular that P‐DCP and P‐TCP have the lower dielectric constant and the lower moisture absorption as compared with epoxy resin, while the volume resistivity and the BDS of P‐DCP and P‐TCP are not different to those of epoxy resin. As a result, it is elucidated that two kinds of hydrocarbon‐based thermosetting resin have a potential for application to an electrical insulating material.
Metabolic profiles in heart failure due to non‐ischemic cardiomyopathy at rest and under exercise
Authors: Mueller‐Hennessen Matthias , Sigl Johanna , Fuhrmann Jens C. , Witt Henning , Reszka Regina , Schmitz Oliver , Kastler Jürgen , Fischer Jenny J. , Müller Oliver J. , Giannitsis Evangelos , Weis Tanja , Frey Norbert , Katus Hugo A.
Published: March 2017

Aims

Identification of metabolic signatures in heart failure (HF) patients and evaluation of their diagnostic potential to discriminate HF patients from healthy controls during baseline and exercise conditions.

Methods

Plasma samples were collected from 22 male HF patients with non‐ischemic idiopathic cardiomyopathy and left ventricular systolic dysfunction and 19 healthy controls before (t0), at peak (t1) and 1 h after (t2) symptom‐limited cardiopulmonary exercise testing. Two hundred fifty‐two metabolites were quantified by gas chromatography‐mass spectrometry (GC‐MS) and liquid chromatography (LC)‐MS/MS‐based metabolite profiling.

Results

Plasma metabolite profiles clearly differed between HF patients and controls at t0 (P < 0.05). The metabolic signature of HF was characterized by decreased levels of complex lipids and fatty acids, notably phosphatidylcholines, cholesterol, and sphingolipids. Moreover, reduced glutamine and increased glutamate plasma levels, significantly increased purine degradation products, as well as signs of impaired glucose metabolism were observed. The metabolic differences increased strongly according to New York Heart Association functional class and the addition of three metabolites further improved prediction of exercise capacity (Q2 = 0.24 to 0.35). Despite a high number of metabolites changing significantly with exercise (30.2% at t1/t0), the number of significant alterations between HF and controls was almost unchanged at t1 and t2 (30.7 and 29.0% vs. 31.3% at t0) with a similar predictive group separation (Q2 = 0.50 for t0, 0.52 for t1, and 0.56 for t2, respectively).

Conclusions

Our study identified a metabolic signature of non‐ischemic HF with prominent changes in complex lipids including phosphatidylcholines, cholesterol, and sphingolipids. The metabolic changes were already evident at rest and largely preserved under exercise.
Construction and Functionalization of Heteroarenes by Use of Photoredox Catalysis
Authors: Boubertakh Oualid , Goddard Jean‐Philippe
Published: March 2017

The functionalization and the construction of heteroarenes with the aid of visible‐light photoredox catalysis have been investigated by a number of research groups. In this review, two different approaches are reported. In the first part, substitution of different heteroaryl derivatives is presented according to four classes of reactions: alkylation, perfluoroalkylation, C–X bond formation, and arylation. In the second part, construction of heteroaromatic cycles is reported according to the size and the structure of the ring. All of the processes deal with pure photoredox catalysis, and recent developments in dual catalysis are omitted.
Rumination induces a pattern of attention characterized by increased vigilance followed by avoidance of affective pain words
Authors: Brookes M.L. , Sharpe L. , Dear B.F.
Published: March 2017

Background

This study examined the effects of rumination on attentional processes in relation to an acute experimental pain task. In keeping with recent theory and research, it was hypothesized that we would identify a pattern of attentional bias characterized by enhanced initial vigilance followed by avoidance of pain‐related stimuli.

Method

Undergraduate students were randomized to a rumination condition, which received threat‐inducing information about the cold pressor task, or a distraction condition. Using the dot probe task, attentional biases to sensory and affective pain words were assessed at two presentation intervals (500 and 1250 ms).

Results

Those in the rumination condition did not show differences in attentional biases compared to the control group, however, they did respond more quickly to pain congruent trials compared to neutral/neutral trials when affective pain words were presented for 500 ms. In addition, those in the rumination group responded more slowly in congruent trials to neutral/neutral trials than affective/neutral trials indicating avoidance at 1250 ms. Although those in the rumination condition exhibited higher levels of distress and reported higher levels of pain when they withdrew their hands from the cold pressor task, the congruency biases did not predict these results.

Conclusion

These results suggest that experimentally manipulating rumination changes attentional processes consistent with the vigilance‐avoidance hypothesis.

Significance

The rumination manipulation led to increased worry about pain and induced to an attentional pattern of vigilance‐avoidance for affective pain words. The induction also led to more distress and pain. Rumination and worry appear to increase unhelpful patterns of attention and could be an appropriate focus of intervention.
A Voltammetric Electronic Tongue Based on Commercial Screen‐printed Electrodes for the Analysis of Aminothiols by Differential Pulse Voltammetry
Authors: Pérez‐Ràfols Clara , Gómez Ana , Serrano Núria , Díaz‐Cruz José Manuel , Ariño Cristina , Esteban Miquel
Published: March 2017

A voltammetric electronic tongue has been designed as a proof of concept for the analysis of aminothiols by differential pulse voltammetry and has been tested in ternary mixtures of cysteine (Cys), homocysteine (hCys) and glutathione (GSH). It consists of three screen‐printed electrodes of carbon, carbon nanofibers and gold cured at low temperature. A preliminary calibration study carried out separately for each aminothiol confirmed that, working at an optimal pH value of 7.4, every electrode produces differentiated responses for every analyte (cross‐response). As for the tongue, it was applied to calibration and validation mixtures of Cys, hCys and GSH and provided voltammograms that, baseline‐corrected, normalized and combined in different ways were submitted to partial least squares (PLS) calibration. The calibration models produced good predictions of the concentrations of all three analytes, which suggest that the proposed voltammetric tongue improves the performance of a previous design based on linear sweep voltammetric measurements under acidic conditions.
Experimental Analyses on Feasibility of Chemical‐Looping CoO/CoAl2O4 with Additive for Solar Thermal Fuel Production
Authors: Hong Hui , Zhang Hao , Han Tao , He Fengjuan , Jin Hongguang
Published: March 2017

Solar thermal fuel production from solar heat is considered an innovative technology for the utilization of solar energy. The process of solar‐heat‐driven hydrocarbon fuel reformation is a promising approach for solar thermal fuel production. Here, perspectives on the use of solar heat at approximately 673–723 K to drive dimethyl ether (DME) reformation with a looping material of (CoO+1.0 % PtO2)/CoAl2O4 are given for the production of solar thermal fuel, and the experimental results for the thermochemical reactivity and the stability of this looping material are discussed in particular. The experimental results indicate that the synthesized (CoO+1.0 % PtO2)/CoAl2O4 shows good reactivity at a solar thermal fuel production temperature of 673–723 K, at which the conversion rate is 80–95 %. Moreover, the looping material also shows a satisfactory stable redox stability over 16 cycles. To avoid the deactivation of the looping material by carbon deposition, H2O is introduced to accompany the solar‐driven reduction of (CoO+1.0 % PtO2)/CoAl2O4 with DME. Although the PtO2 additive is expensive and not “ideal”, the results obtained in this study may provide a starting point for solar thermal fuel production from mid‐temperature solar heat using the chemical‐looping combustion of DME.
Comparative Study of Ammonia‐fueled Solid Oxide Fuel Cell Systems
Authors: Okanishi T. , Okura K. , Srifa A. , Muroyama H. , Matsui T. , Kishimoto M. , Saito M. , Iwai H. , Yoshida H. , Saito M. , Koide T. , Iwai H. , Suzuki S. , Takahashi Y. , Horiuchi T. , Yamasaki H. , Matsumoto S. , Yumoto S. , Kubo H. , Kawahara J. , Okabe A. , Kikkawa Y. , Isomura T. , Eguchi K.
Published: March 2017

Several solid oxide fuel cell (SOFC) systems can be considered for the NH3 utilization. In this study, the catalytic activity and long‐term stability of the NH3 decomposition reactor with the Ni/Y2O3‐based catalysts and the autothermal NH3 cracker with the Co–Ce–Zr composite oxide catalyst were investigated. Moreover, the NH3 decomposition reactor and the autothermal NH3 cracker were combined with the SOFC stack and their performances of the stack were compared to those fueled with NH3 and H2/N2. The power output of each SOFC stack was over 200 W. Moreover, it was demonstrated that the direct NH3‐fueled SOFC stack was stable for 1,000 h at 770 °C without significant degradation.
Use of cancer antigen 125, cancer antigen 19‐9, and the neutrophil‐to‐lymphocyte ratio to diagnose mature cystic teratoma with torsion
Authors: Wang Yuan‐qiu , Xia Wei‐ting , Wang Fang , Zhuang Xin‐xin , Zheng Fei‐yun , Lin Feng
Published: March 2017

Objective

To determine the efficacy of serum levels of cancer antigen 125 (CA125) and cancer antigen 19‐9 (CA19‐9), and the neutrophil‐to‐lymphocyte ratio (NLR) for diagnosis of mature cystic teratoma (MCT) with torsion.

Methods

A retrospective medical record review was conducted of data for women who had undergone surgery for ovarian MCT at the First Affiliated Hospital of Wenzhou Medical University, China, between January 1, 2008, and January 1, 2015. Patients with torsion and a control group who underwent surgery on the same days were identified. Clinical characteristics and the serum levels of CA125, CA19‐9, and the NLR were assessed.

Results

The serum levels of CA125, CA19‐9, and the NLR were higher in the torsion group (n=68) than in the control group (n=120; P≤0.001 for all). Receiver operating characteristic analysis indicated that the area under the curve for the combined use of CA125, CA19‐9, and NLR was 0.978 (95% confidence interval 0.954–1.000; P<0.001). This combination had a diagnostic sensitivity of 93.9% and a specificity of 98.3%. Moreover, levels of these inflammatory markers were significantly increased among patients with large tumor diameters (P<0.01 for all).

Conclusion

The combined measurement of CA125, CA19‐9, and the NLR provided an efficient method for the diagnosis of MCT with torsion.
Determining the optimal protocol for preparing an acellular scaffold of tissue engineered small‐diameter blood vessels
Authors: Pu Lei , Wu Jian , Pan Xingna , Hou Zongliu , Zhang Jing , Chen Wenmin , Na Zhuhui , Meng Mingyao , Ni Haiyan , Wang Liqiong , Li Yaxiong , Jiang Lihong
Published: March 2017

Although detergent‐based decellularization protocols have been widely used to obtain a natural extracellular matrix (ECM) scaffold in tissue engineering, some key challenges still exist. To achieve an optimum natural decellularized scaffold for the construction of tissue‐engineered small‐diameter blood vessels (TEBV), porcine carotid arteries (PCAs) were decellularized by combining sodium dodecyl sulfate (SDS), sodium deoxycholate (SDC) and Triton X‐100 (Triton) in different concentrations. Tissue samples were processed and their histological, biochemical and biomechanical characteristics were investigated. Results showed that only two methods 0.5% (SDS + SDC) and 1% (SDS + SDC) could completely remove of the cellular contents and preserve the native ECM architecture. Furthermore, 1% (SDS + SDC) based methods acquire preferable porosity and suitable mechanical strength. Residual Triton in the ECM scaffold holds intensive cytotoxity. In conclusion, 1%(SDS + SDC) based method can obtain a superior PCAs scaffold for the construction of TEBV. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 619–631, 2018.
Equimatchable Regular Graphs
Authors: Akbari Saieed , Ghodrati Amir Hossein , Hosseinzadeh Mohammad Ali , Iranmanesh Ali
Published: March 2017

A graph is called equimatchable if all of its maximal matchings have the same size. Kawarabayashi, Plummer, and Saito showed that the only connected equimatchable 3‐regular graphs are K4 and K3, 3. We extend this result by showing that for an odd positive integer r, if G is a connected equimatchable r‐regular graph, then . Also it is proved that for an even r, a connected triangle‐free equimatchable r‐regular graph is isomorphic to one of the graphs C5, C7, and .
The effect of excitation wavelength and metallic nanostructure on SERS spectra of C60
Authors: Sinwani Miri , Muallem Merav , Tischler Yaakov R.
Published: March 2017

Understanding the mechanisms of surface‐enhanced Raman scattering (SERS) phenomena is essential for advancing next‐generation Raman‐based chemical and biological sensors. SERS studies typically examine the excitation wavelength dependence for a given nanostructure morphology. However, more comprehension of the SERS mechanisms can be gained by investigating the combined excitation wavelength and metal morphology dependencies. Here, using a thin Au film with tapered boundaries as the Raman enhancing surface, we investigate the SERS mechanisms exhibited along the sloped region of the sample. The tapered boundaries provide controllably different Au morphologies from densified thin film to nano‐island to nanoparticle structures. A layer of Fullerene C60 was thermally evaporated uniformly across the Au film. The excitation wavelength of 532 nm generated similar SERS spectra across the Au surface, which closely matched the regular Raman scattering spectrum, thus indicating enhancement of the normal Raman modes of C60. In contrast, an excitation wavelength of 784 nm generated different SERS spectra across the boundary whose intensity from the tapered Au film surface was 10 times higher than the SERS signal from the Au thin film region. The spectral differences observed with 784‐nm excitation are indicative of an electromagnetic mechanism controlled by near field interactions of local surface plasmon resonances. Using the configuration of tapered Au films can enable fast determination of the most enhancing Au nanostructure for a given laser excitation and provide an in‐depth insight into the enhancement mechanisms associated with a particular analyte molecule, as shown here for C60. Copyright © 2017 John Wiley & Sons, Ltd.
Thermodynamic CoO–Co3O4 crossover using Raman spectroscopy in magnetic octahedron‐shaped nanocrystals
Authors: Rivas‐Murias Beatriz , Salgueiriño Verónica
Published: March 2017

This work describes the effect of the laser power and the exposure time on a sample of octahedron‐shaped nanocrystals of cobalt(II) oxide using Raman spectroscopy. Above a certain value of the laser power and exposure time, CoO rock salt sample evolves clearly to the oxidized Co3O4 normal spinel material because of the energy transfer and consequent local heating induced by the applied laser. The analysis of this thermodynamic CoO–Co3O4 crossover in octahedron‐shaped nanocrystals by means of the Raman spectroscopy has been performed. Copyright © 2017 John Wiley & Sons, Ltd.
Mapping the distribution of nodal metastases in papillary thyroid carcinoma: Where exactly are the nodes?
Authors: Goyal Neerav , Pakdaman Michael , Kamani Dipti , Caragacianu Diana , Goldenberg David , Randolph Gregory W.
Published: March 2017

Objective

To characterize nodal disease of patients presenting with papillary thyroid carcinoma (PTC)

Study Design

Retrospective chart review.

Methods

PTC patients who underwent thyroidectomy and/or neck dissection (revision/primary) from 2004 to 2009 at a tertiary‐care hospital were reviewed. Preoperative computed tomography (CT) scan and ultrasonography were utilized to identify macroscopic, clinically apparent nodal metastasis (cN+). Demographic data, type of surgery, nodal disease, and primary tumor information were recorded.

Results

Of 416 patients reviewed, 35% had cN+ on initial presentation (IP); of these, 88% and 50% had central (CND) and lateral nodal disease (LND), respectively. The presence of ectopic nodal (END) metastases (nodal disease outside typical CND or LND locations) was absent on IP but occurred in 9% of patients with nodal recurrence. END was typically found in the retropharyngeal area but also was noted in the sublingual region, subcutaneous location, axilla, and chest wall. Extrathyroidal extension (ETE) was found in 8.9% without nodal disease, 33.1% with nodal disease, and 57.1% with END (P < 0.0001). Primary tumor size greater than 4 cm (P = 0.05) was associated with nodal disease.

Conclusion

This report represents a large series describing characteristics of the primary PTC tumor and associated nodal disease not only in the central and lateral neck but also in the ectopic locations. Our results suggest that a significant proportion of patients will have nodal disease in the central compartment on IP, especially younger patients. ETE and tumor size are associated with macroscopic nodal disease (including END). Nine percent of the patients with nodal recurrence had ectopic nodes occurring in various locations, most commonly in the retropharynx. CT scan can assist with identification and surgical planning of recurrent nodal disease.

Level of Evidence

4. Laryngoscope, 127:1959–1964, 2017
Minimum lymph node yield in elective level I–III neck dissection
Authors: Pou Jason D. , Barton Blair M. , Lawlor Claire M. , Frederick Christopher H. , Moore Brian A. , Hasney Christian P.
Published: March 2017

Objectives/Hypothesis

Unlike lymphadenectomy at other sites, there is no discrete lymph node count defining an adequate neck dissection. The purpose of this study was to determine the minimum lymph node yield (LNY) of an elective level I–III neck dissection required to reliably capture any positive nodes present in these nodal basins.

Study Design

Retrospective single‐institution analysis.

Methods

All patients with the diagnosis of head and neck squamous cell carcinoma who underwent elective level I–III neck dissection between 2004 and 2015 at our institution were analyzed. Preoperatively, patients had no clinical or radiographic evidence of lymphadenopathy. Patients with unknown number of lymph nodes on pathology report were excluded. Age, gender, race, history of radiation, tumor subsite, stage, surgeon, LNY, and number of positive nodes were recorded; bilateral neck dissections were reported separately.

Results

One hundred eighteen level I–III neck dissections met criteria and were included in the study. Mean LNY was 21.15, and metastatic disease was present in 24.5% of cases, with 8.4% of cases being N2. The highest portion of positive lymph nodes was present in the group with 18 to 24 lymph nodes (36%), which was significantly higher than the group with <18 (14.89%) (P = .044).

Conclusions

Although there is no accepted minimum for LNY in level I–III neck dissection, at least 18 nodes may be considered an adequate LNY. Such a yield reliably allows for capture of occult disease within these nodal basins.

Level of Evidence

4. Laryngoscope, 127:2070–2073, 2017
Still equivalent for dose calculation in the Monte Carlo era? A comparison of free breathing and average intensity projection CT datasets for lung SBRT using three generations of dose calculation algorithms
Authors: Zvolanek Kristina , Ma Rongtao , Zhou Christina , Liang Xiaoying , Wang Shuo , Verma Vivek , Zhu Xiaofeng , Zhang Qinghui , Driewer Joseph , Lin Chi , Zhen Weining , Wahl Andrew , Zhou Su‐Min , Zheng Dandan
Published: March 2017

Purpose

Inhomogeneity dose modeling and respiratory motion description are two critical technical challenges for lung stereotactic body radiotherapy, an important treatment modality for small size primary and secondary lung tumors. Recent studies revealed lung density‐dependent target dose differences between Monte Carlo (Type‐C) algorithm and earlier algorithms. Therefore, this study aimed to investigate the equivalence of the two most popular CT datasets for treatment planning, free breathing (FB) and average intensity projection (AIP) CTs, using Type‐C algorithms, and comparing with two older generation algorithms (Type‐A and Type‐B).

Methods

Twenty patients (twenty‐one lesions) were planned using a Type‐A algorithm on the FB CT. Lung was contoured separately on FB and AIP CTs and compared. Dose comparison was obtained between the two CTs using four commercial dose algorithms including one Type‐A (Pencil Beam Convolution – PBC), one Type‐B (Analytical Anisotropic Algorithm – AAA), and two Type‐C algorithms (Voxel Monte Carlo – VMC and Acuros External Beam – AXB). For each algorithm, the dosimetric parameters of the target (PTV, Dmin, Dmax, Dmean, D95, and D90) and lung (V5, V10, V20, V30, V35, and V40) were compared between the two CTs using the Wilcoxon signed rank test. Correlation between dosimetric differences and density differences for each algorithm were studied using linear regression and Spearman correlation, in which both global and local density differences were evaluated.

Results

Although the lung density differences on FB and AIP CTs were statistically significant (P = 0.003), the magnitude was small at 1.21 ± 1.45%. Correspondingly, for the two Type‐C algorithms, target and lung dosimetric differences were small in magnitude and statistically insignificant (P > 0.05) for all but one instance, similar to the findings for the older generation algorithms. Nevertheless, a significant correlation was shown between the dosimetric and density differences for Type‐C and Type‐B algorithms, but not for the Type‐A algorithm.

Conclusions

With the capability to more accurately model inhomogeneity, Monte Carlo (Type‐C) algorithms are sensitive to respiration‐induced local and global tissue density changes and exhibit a strong correlation between dosimetric and density differences. However, FB and AIP CTs may still be considered equivalent for dose calculation in the Monte Carlo era, due to the small magnitude of lung density differences between these two datasets.
Energy and field size dependence of a silicon diode designed for small‐field dosimetry
Authors: Yarahmadi Mehran , Wegener Sonja , Sauer Otto A.
Published: March 2017

Purpose

To investigate the energy dependence/spectral sensitivity of silicon diodes designed for small‐field dosimetry and obtain response factors (RFs) for arbitrary photon spectra using Monte Carlo (MC) simulations.

Methods

The EGSnrc user‐code DOSRZnrc was used to calculate the dose deposition in water and in the active volume of a stereotactic diode field detector (SFD). Then, the RFs of the SFD were calculated for several circular field sizes and energies at 5 cm depth in water. Several low‐energy photon spectra (mean energy 55 to 200 keV), as well as Co‐60 radiation (mean energy 1.25 MeV) and a 6 MV Elekta Synergy beam (mean energy 2.9 MeV), in 10 × 10 cm2 field size were used to validate the MC calculations, using a simple beam model. The RFs of the SFD detector for a 6 MV Elekta Synergy linac photon beam in different field sizes were calculated. These were also measured with EBT3 Gafchromic film and the SFD detector.

Results

For the reference field size, differences between measured and calculated RFs were less than 5% at mean energies below 1 MeV and less than 1% at energies above 1 MeV. The calculated RFs for a 6 MV Elekta Synergy linac photon beam as a function of different field sizes showed a good agreement between the measurements and previously reported results. This agreement was within 2% for all considered field sizes.

Conclusion

While at high photon energies, the change of response of the SFD is marginal, whereas it is extreme at low energies. Therefore, it is desirable to benchmark response calculations also in the low‐energy domain. Our results, with a simple beam model and geometry, indicate that a validation of the simulations by experimental results is achievable. The present work provides a comprehensive table that can be used to calculate SFD detector response factors depending on both, field size and photon energy.
Performance evaluation of 18F radioluminescence microscopy using computational simulation
Authors: Wang Qian , Sengupta Debanti , Kim Tae Jin , Pratx Guillem
Published: March 2017

Purpose

Radioluminescence microscopy can visualize the distribution of beta‐emitting radiotracers in live single cells with high resolution. Here, we perform a computational simulation of 18F positron imaging using this modality to better understand how radioluminescence signals are formed and to assist in optimizing the experimental setup and image processing.

Methods

First, the transport of charged particles through the cell and scintillator and the resulting scintillation is modeled using the GEANT4 Monte‐Carlo simulation. Then, the propagation of the scintillation light through the microscope is modeled by a convolution with a depth‐dependent point‐spread function, which models the microscope response. Finally, the physical measurement of the scintillation light using an electron‐multiplying charge‐coupled device (EMCCD) camera is modeled using a stochastic numerical photosensor model, which accounts for various sources of noise. The simulated output of the EMCCD camera is further processed using our ORBIT image reconstruction methodology to evaluate the endpoint images.

Results

The EMCCD camera model was validated against experimentally acquired images and the simulated noise, as measured by the standard deviation of a blank image, was found to be accurate within 2% of the actual detection. Furthermore, point source simulations found that a reconstructed spatial resolution of 18.5 μm can be achieved near the scintillator. As the source is moved away from the scintillator, spatial resolution degrades at a rate of 3.5 μm per μm distance. These results agree well with the experimentally measured spatial resolution of 30–40 μm (live cells). The simulation also shows that the system sensitivity is 26.5%, which is also consistent with our previous experiments. Finally, an image of a simulated sparse set of single cells is visually similar to the measured cell image.

Conclusions

Our simulation methodology agrees with experimental measurements taken with radioluminescence microscopy. This in silico approach can be used to guide further instrumentation developments and to provide a framework for improving image reconstruction.
Can diffusion tensor imaging and tractography represent cross‐sectional area of lumbar multifidus in patients with LUMBAR spine disease?
Authors: Oh Jeehae , Jung Joon‐Yong , Ko Young Jin
Published: March 2017

Introduction: Cross‐sectional area (CSA) is a useful measurement to evaluate the lumbar multifidus, but it cannot reflect the morphological characteristics of the entire muscle. Recently, diffusion tensor imaging (DTI) and tractography (DTT) have been used to assess 3‐dimensional muscle structures both qualitatively and quantitatively. In this study we investigate the correlation between CSA and multifidus volume and the clinical utility of DTI and DTT. Methods: Twenty‐eight lumbar multifidi from 14 subjects with lumbar spine disease were analyzed. We conducted correlation analysis between CSA from conventional magnetic resonance images and DTI‐derived parameters, including muscle volume, fractional anisotropy (FA), and mean diffusivity (MD); we performed morphological assessment using DTT. Results: Multifidus volume had a strong positive correlation with CSA (r = 0.760, P < 0.001). Neither FA nor MD correlated with CSA. Multifidi spanning fewer vertebral segments were smaller in volume. Discussion: DTT can be a valuable tool to visualize and quantify the lumbar multifidus in lumbar spine disease. Muscle Nerve 57: 200–205, 2018
Ultrasound Verification Of Safe Needle Examination Of The Rhomboid Major Muscle
Authors: Cushman Daniel , Henrie Michael , Vernon Scholl Linda , Ludlow Monica , Teramoto Masaru
Published: March 2017

Introduction: Palpation of a thoracic rib is a common method for reducing the risk of pneumothorax during electromyographic examination of the rhomboid major muscle, but its accuracy is unknown. Methods: Two physicians palpated healthy subjects to attempt to identify the center of a rib located beneath the rhomboid major muscle. The identified location was examined with ultrasonography to examine its accuracy and the subject's anatomical depths. Results: Forty‐four subjects (88 ribs) were studied. Palpation demonstrated a 66.3% accuracy rate, with significantly more incorrect palpations seen with greater muscle thickness (P = 0.004) and body mass index (P = 0.037), but not adipose thickness, age, or skin thickness (P > 0.05). Discussion: Palpation of the ribs in an attempt to avoid inadvertent pneumothorax while examining the rhomboid major may be inaccurate, primarily in patients with large muscle bulk. We suggest a brief ultrasound evaluation before electromyography to gauge correct needle depth. Muscle Nerve 57: 61–64, 2018
Understanding Tetrahydropyranyl as a Protecting Group in Peptide Chemistry
Authors: Sharma Anamika , Ramos‐Tomillero Iván , El‐Faham Ayman , Nicolas Ernesto , Rodriguez Hortensia , de la Torre Beatriz G. , Albericio Fernando
Published: March 2017

Tetrahydropyranyl (Thp) is recognized as a useful protecting group for alcohols in organic synthesis. It has several advantages, including low cost, ease of introduction, general stability to most non‐acidic reagents, it confers good solubility, and the ease with which it can be removed if the functional group it protects requires manipulation. However, little attention has been paid to Thp in peptide chemistry. Provided here is a concise analysis of the Thp protection of various amino acid functionalities (OH, SH, NH and COOH) and its application to peptide synthesis. Thp is a useful moiety for the side‐chain protection of serine, threonine and cysteine and is suitable for the Fmoc/tBu solid‐phase peptide synthesis strategy. The immobilized version of 3,4‐dihydro‐2H‐pyran, the so‐called Ellman resin, is also discussed as a useful solid support for anchoring the side chains of serine, threonine and tryptophan residues.
Thiamine Assays—Advances, Challenges, and Caveats
Authors: Edwards Katie A. , Tu‐Maung Nicole , Cheng Krystal , Wang Binbin , Baeumner Antje J. , Kraft Clifford E.
Published: March 2017

Thiamine (vitamin B1) is essential to the health of all living organisms and deficiency has long been associated with diseases in animals such as fish, birds, alligators, and domesticated ruminant mammals. Thiamine is also implicated in several human diseases including Alzheimer's, diabetes, dementia, depression and, most notably, Wernicke–Korsakoff syndrome and Beriberi disease. Yet, highly sensitive and specific detection of thiamine remains an analytical challenge, as pM to nm levels of thiamine need to be detected in environmental and human samples, respectively, various phosphorylated variants need to be discriminated, and rapid on‐site detection would be highly desirable. Furthermore, appropriate sample preparation is mandatory, owing to the complexity of the relevant sample matrices including fish tissues, ocean water, and body fluids. This Review has two objectives. First, it provides a thorough overview of analytical techniques published for thiamine detection over the last 15 years. Second, it describes the principles of analytical approaches that are based on biorecognition and may open up new avenues for rapid and high‐throughput thiamine analysis. Most notably, periplasmic binding proteins, ribozymes, and aptamers are of particular interest, as they function as bioaffinity recognition elements that can fill an important assay technology gap, owing to the unavailability of thiamine‐specific commercial antibodies. Finally, the authors provide brief evaluations of key outcomes of the major assay concepts and suggest how innovative techniques could help develop sensitive and specific thiamine analytical test systems.
Acute Care Management of the HIV‐Infected Patient: A Report from the HIV Practice and Research Network of the American College of Clinical Pharmacy
Authors: Durham Spencer H. , Badowski Melissa E. , Liedtke Michelle D. , Rathbun R. Chris , Pecora Fulco Patricia
Published: March 2017

Objective

Patients infected with human immunodeficiency virus (HIV) admitted to the hospital have complex antiretroviral therapy (ART) regimens with an increased medication error rate upon admission. This report provides a resource for clinicians managing HIV‐infected patients and ART in the inpatient setting.

Methods

A survey of the authors was conducted to evaluate common issues that arise during an acute hospitalization for HIV‐infected patients. After a group consensus, a review of the medical literature was performed to determine the supporting evidence for the following HIV‐associated hospital queries: admission/discharge orders, antiretroviral hospital formularies, laboratory monitoring, altered hepatic/renal function, drug‐drug interactions (DDIs), enteral administration, and therapeutic drug monitoring.

Results

With any hospital admission for an HIV‐infected patient, a specific set of procedures should be followed including a thorough admission medication history and communication with the ambulatory HIV provider to avoid omissions or substitutions in the ART regimen. DDIs are common and should be reviewed at all transitions of care during the hospital admission. ART may be continued if enteral nutrition with a feeding tube is deemed necessary, but the entire regimen should be discontinued if no oral access is available for a prolonged period. Therapeutic drug monitoring is not generally recommended but, if available, should be considered in unique clinical scenarios where antiretroviral pharmacokinetics are difficult to predict. ART may need adjustment if hepatic or renal insufficiency ensues.

Conclusions

Treatment of hospitalized patients with HIV is highly complex. HIV‐infected patients are at high risk for medication errors during various transitions of care. Baseline knowledge of the principles of antiretroviral pharmacotherapy is necessary for clinicians managing acutely ill HIV‐infected patients to avoid medication errors, identify DDIs, and correctly dose medications if organ dysfunction arises. Timely ambulatory follow‐up is essential to prevent readmissions and facilitate improved transitions of care.
Sample Clean‐up Strategies for ESI Mass Spectrometry Applications in Bottom‐up Proteomics: Trends from 2012 to 2016
Authors: Tubaon Ria Marni , Haddad Paul R. , Quirino Joselito P.
Published: March 2017

Bottom‐up proteomics is a mass spectrometric (MS)‐based approach for the characterization of peptides obtained from in‐solution protein digestion. MS is favored over other methods for peptide and protein analysis because of its better sensitivity and high throughput. Inorganic ions and surfactants present in the sample or produced during tryptic digestion are detrimental in MS analysis and affect the proteome data, thus sample preparation for removal of these unwanted components has become essential. Here, we review 48 research papers on strategies for removal of salts and surfactants (in particular, SDS) prior to ESI‐MS analysis in bottom‐up proteomics from 2012 to 2016. The strategies were mostly based on SPE and membrane‐based filter‐aided sample preparation for salt and SDS removal, respectively. Some known limitations of SPE and filter‐aided sample preparation procedures are that they can be time consuming, laborious, and require the use of organic solvents before a concentrated extract suitable for analysis is obtained. The development of faster analytical methods by reducing the sample preparation time and thereby, increasing sample throughput, and in a solvent‐less and membrane‐less operation, is a significant contribution to proteome research.
A series of novel side chain liquid crystalline polysiloxanes containing cyano‐ and cholesterol‐terminated substituents: Where will the structure‐dependence of terminal behavior of the side chain reappear?
Authors: Yao Wenhuan , Gao Yanzi , Zhang Cuihong , Li Chenyue , Li Fasheng , Yang Zhou , Zhang Lanying
Published: March 2017

A series of polysiloxane side chain liquid crystal polymers with strong polarity cyano substitution‐terminated achiral side chains and cholesterol‐terminated chiral side chains was successfully synthesized via thiol‐ene click chemistry. 1H‐NMR, FT‐IR, and thermogravimetric analysis were used to confirm their chemical structures and thermal stabilities. Their phase transition behaviors and phase structures were systematically investigated by a combination of analysis methods such as differential scanning calorimetry, polarized optical microscopy, and X‐ray. Results revealed that attributing to the decisive role of the polarity interaction, all the polymers only developed a monolayer interdigitated SmA phase in which the period arrangement was determined by the cyano‐terminated side chains, the increased content of cholesterol‐terminated chiral side chains (Xchol) just expanded the distance between neighboring molecules within a layer. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 1765–1772
Single domain antibodies for the knockdown of cytosolic and nuclear proteins
Authors: Böldicke Thomas
Published: March 2017

Single domain antibodies (sdAbs) from camels or sharks comprise only the variable heavy chain domain. Human sdAbs comprise the variable domain of the heavy chain (VH) or light chain (VL) and can be selected from human antibodies. SdAbs are stable, nonaggregating molecules in vitro and in vivo compared to complete antibodies and scFv fragments. They are excellent novel inhibitors of cytosolic/nuclear proteins because they are correctly folded inside the cytosol in contrast to scFv fragments. SdAbs are unique because of their excellent specificity and possibility to target posttranslational modifications such as phosphorylation sites, conformers or interaction regions of proteins that cannot be targeted with genetic knockout techniques and are impossible to knockdown with RNAi. The number of inhibiting cytosolic/nuclear sdAbs is increasing and usage of synthetic single pot single domain antibody libraries will boost the generation of these fascinating molecules without the need of immunization. The most frequently selected antigenic epitopes belong to viral and oncogenic proteins, followed by toxins, proteins of the nervous system as well as plant‐ and drosophila proteins. It is now possible to select functional sdAbs against virtually every cytosolic/nuclear protein and desired epitope. The development of new endosomal escape protein domains and cell‐penetrating peptides for efficient transfection broaden the application of inhibiting sdAbs. Last but not least, the generation of relatively new cell‐specific nanoparticles such as polymersomes and polyplexes carrying cytosolic/nuclear sdAb‐DNA or –protein will pave the way to apply cytosolic/nuclear sdAbs for inhibition of viral infection and cancer in the clinic.