bluuebunny/crossref_metadata_2025 huggingface dataset:
Distribution of magnetic field strength inside exciting coil of single sheet tester
Authors: Matsubara Ryo , Takahashi Yasuhito , Fujiwara Koji , Ishihara Yoshiyuki , Azuma Daichi
Published: November 2017

The double H-coil method was proposed to detect magnetic field strength on the surface of a specimen more accurately than the single H-coil method. In this paper, the distribution of magnetic field strength inside exciting coil of a single sheet tester (SST) is measured simultaneously by the single H-coil method using four separated H-coils. They are placed at different distances from the surface of the specimen and thereby enable us to evaluate the influence of the position of the H-coil on the measurement accuracy of magnetic properties. As a result, it was revealed that the magnetic field strength and specific total loss increase linearly as the distance of the H-coil from the surface of the specimen increases. However the increasing rate of the specific total loss is smaller than that of the magnetic field strength and within the range of required measurement reproducibility.
Analysis of soft magnetic materials by electron backscatter diffraction as a powerful tool
Authors: Schuller David , Hohs Dominic , Loeffler Ralf , Bernthaler Timo , Goll Dagmar , Schneider Gerhard
Published: November 2017

The current work demonstrates that electron backscatter diffraction (EBSD) is a powerful and versatile characterization technique for investigating soft magnetic materials. The properties of soft magnets, e.g., magnetic losses strongly depend on the materials chemical composition and microstructure, including grain size and shape, texture, degree of plastic deformation and elastic strain. In electrical sheet stacks for e-motor applications, the quality of the machined edges/surfaces of each individual sheet is of special interest. Using EBSD, the influence of the punching process on the microstructure at the cutting edge is quantitatively assessed by evaluating the crystallographic misorientation distribution of the deformed grains. Using an industrial punching process, the maximum affected deformation depth is determined to be 200 - 300 μm. In the case of laser cutting, the affected deformation depth is determined to be approximately zero. Reliability and detection limits of the developed EBSD approach are evaluated on non-affected sample regions and model samples containing different indentation test bodies. A second application case is the investigation of the recrystallization process during the annealing step of soft magnetic composites (SMC) toroids produced by powder metallurgy as a function of compaction pressure, annealing parameters and powder particle size. With increasing pressure and temperature, the recrystallized area fraction (e.g., grains with crystallographic misorientations < 3°) increases from 71 % (200 MPa, 800°C) to 90% (800 MPa, 800°C). Recrystallization of the compacted powder material starts at the particle boundaries or areas with existing plastic deformation. The progress of recrystallization is visualized as a function of time and of different particle to grain size distributions. Here, large particles with coarse internal grain structures show a favorable recrystallization behavior which results in large bulk permeability of up to 600 – 700 and lower amount of residual misorientations (>3°).
Permanent structural anisotropy in a hybrid fiber optical waveguide
Authors: Yang Xu , Scannell Garth , Jain Chhavi , Rodrigues Bruno Poletto , Schmidt Markus A. , Wondraczek Lothar
Published: November 2017

The shearing of a liquid with a one-dimensional molecular structure causes structural anisotropy through chain orientation. Here, we exploit this behavior to generate a hybrid fiber optical waveguide with tailored transversal anisotropy. Preferentially oriented chains of silver metaphosphate glass are obtained by pressure-assisted melt filling of silica micro-capillaries at several filling temperatures, pressures, internal capillary diameters, and filling times. Accurate control of the aforementioned parameters enables the adjustment of the degree of anisotropy within limits. Annealing of the waveguides induces volume shrinkage, which is taken as further evidence for the alignment of phosphate chains. These are the first steps towards a novel paradigm for producing glass-based fiber waveguides in which the transversal anisotropy is used to alter optical functionality.
Two-component additive manufacturing of nanothermite structures via reactive inkjet printing
Authors: Murray Allison K. , Isik Tugba , Ortalan Volkan , Gunduz I. Emre , Son Steven F. , Chiu George T.-C. , Rhoads Jeffrey F.
Published: November 2017

With an eye towards improving the safety of the deposition of energetic materials while broadening the scope of materials compatible with inkjet printing, this work demonstrates the use of combinatorial inkjet printing for the deposition of energetic materials. Two largely inert colloidal suspensions of nanoaluminum and nanocopper (II) oxide in dimethylformamide with polyvinylpyrrolidone were sequentially deposited on a substrate using piezoelectric inkjet printing. The materials were deposited in such a way that the aluminum and copper (II) oxide droplets were adjacent, and overlapping, to allow for in situ mixing of the components. The alternating deposition was repeated to create a sample with multiple layers of energetic materials. Energetic performance was subsequently tested on samples printed with 3, 5, and 7 layers of materials using a spark igniter. This ignition event was observed with a high speed camera and compared to representative samples printed with pre-mixed nanothermite. High speed thermal imaging supported a conclusion that the maximum reaction temperature of comparable samples printed with the dual nozzle technique was nominally 200 K less than the samples printed with a single nozzle. Scanning transmission electron microscopy images confirmed a claim that the material constituents were comparably mixed with the single and dual nozzle techniques. This work proves the feasibility of reactive inkjet printing as a means for depositing energetic materials from two largely inert suspensions. In doing so, it opens the doors for safer material handling and the development of a wide array of energetic materials that were previously deemed incompatible with inkjet printing.
Orientational cross correlations between entangled branch polymers in primitive chain network simulations
Authors: Masubuchi Yuichi , Pandey Ankita , Amamoto Yoshifumi , Uneyama Takashi
Published: November 2017

Although it has not been frequently discussed, contributions of the orientational cross-correlation (OCC) between entangled polymers are not negligible in the relaxation modulus. In the present study, OCC contributions were investigated for 4- and 6-arm star-branched and H-branched polymers by means of multi-chain slip-link simulations. Owing to the molecular-level description of the simulation, the segment orientation was traced separately for each molecule as well as each subchain composing the molecules. Then, the OCC was calculated between different molecules and different subchains. The results revealed that the amount of OCC between different molecules is virtually identical to that of linear polymers regardless of the branching structure. The OCC between constituent subchains of the same molecule is significantly smaller than the OCC between different molecules, although its intensity and time-dependent behavior depend on the branching structure as well as the molecular weight. These results lend support to the single-chain models given that the OCC effects are embedded into the stress-optical coefficient, which is independent of the branching structure.
Experimental setup for the growth of solid crystals of inert gases for particle detection
Authors: Guarise M. , Braggio C. , Calabrese R. , Carugno G. , Dainelli A. , Khanbekyan A. , Luppi E. , Mariotti E. , Poggi M. , Tomassetti L.
Published: November 2017

Low energy threshold detectors are necessary in many frontier fields of the experimental physics. In this work, we present a novel detection approach based on pure or doped matrices of inert gases solidified at cryogenic temperatures. The small energy release of the incident particle can be transferred directly (in pure crystals) or through a laser-driven ionization (in doped materials) to the electrons of the medium that are then converted into free electrons. The charge collection process of the electrons that consists in their drift within the crystal and their extraction through the solid–vacuum interface gives rise to an electric signal that we exploit for preliminary tests of charge collection and crystal quality. Such tests are carried out in different matrices of neon and methane using an UV-assisted apparatus for electron injection in crystals.
Enhanced optical coupling and Raman scattering via microscopic interface engineering
Authors: Thompson Jonathan V. , Hokr Brett H. , Kim Wihan , Ballmann Charles W. , Applegate Brian E. , Jo Javier A. , Yamilov Alexey , Cao Hui , Scully Marlan O. , Yakovlev Vladislav V.
Published: November 2017

Spontaneous Raman scattering is an extremely powerful tool for the remote detection and identification of various chemical materials. However, when those materials are contained within strongly scattering or turbid media, as is the case in many biological and security related systems, the sensitivity and range of Raman signal generation and detection is severely limited. Here, we demonstrate that through microscopic engineering of the optical interface, the optical coupling of light into a turbid material can be substantially enhanced. This improved coupling facilitates the enhancement of the Raman scattering signal generated by molecules within the medium. In particular, we detect at least two-orders of magnitude more spontaneous Raman scattering from a sample when the pump laser light is focused into a microscopic hole in the surface of the sample. Because this approach enhances both the interaction time and interaction region of the laser light within the material, its use will greatly improve the range and sensitivity of many spectroscopic techniques, including Raman scattering and fluorescence emission detection, inside highly scattering environments.
Effect of surface curvature on diffusion-limited reactions on a curved surface
Authors: Eun Changsun
Published: November 2017

To investigate how the curvature of a reactive surface can affect reaction kinetics, we use a simple model in which a diffusion-limited bimolecular reaction occurs on a curved surface that is hollowed inward, flat, or extended outward while keeping the reactive area on the surface constant. By numerically solving the diffusion equation for this model using the finite element method, we find that the rate constant is a non-linear function of the surface curvature and that there is an optimal curvature providing the maximum value of the rate constant, which indicates that a spherical reactant whose entire surface is reactive (a uniformly reactive sphere) is not the most reactive species for a given reactive surface area. We discuss how this result arises from the interplay between two opposing effects: the exposedness of the reactive area to its partner reactants, which causes the rate constant to increase as the curvature increases, and the competition occurring on the reactive surface, which decreases the rate constant. This study helps us to understand the role of curvature in surface reactions and allows us to rationally design reactants that provide a high reaction rate.
Accuracy of trajectory surface-hopping methods: Test for a two-dimensional model of the photodissociation of phenol
Authors: Xie Weiwei , Domcke Wolfgang
Published: November 2017

Trajectory surface hopping (TSH) methods have been widely used for the study of nonadiabatic molecular dynamics. In the present work, the accuracy of two TSH algorithms, Tully’s fewest switching algorithm and an algorithm based on the Landau-Zener formula, has been critically evaluated in comparison with exact nonadiabatic quantum dynamics calculations for a model of the photoinduced hydrogen-atom dissociation reaction in phenol. The model consists of three electronic states (S0, 1ππ*, 1πσ*) and two nuclear degrees of freedom (the OH stretching coordinate and CCOH dihedral angle) and displays two successive conical intersections (1ππ*/1πσ* and 1πσ*/S0). Considering instantaneous photoexcitation from different vibrational levels of the S0 state to the 1ππ* state, we examined the time-dependent electronic population dynamics as well as the branching ratio of the two dissociation channels. The results of fully converged trajectory calculations are compared with the results of exact quantum wave-packet calculations. It is found that both TSH algorithms describe the dynamics at the 1πσ*/S0 conical intersection, which is accessed with high excess energy, with good accuracy. The 1ππ*/1πσ* conical intersection, on the other hand, is accessed with little excess energy so tunneling effects as well as wave-packet interference effects which cannot be reproduced with classical trajectory calculations become relevant. Overall, the performance of the fewest-switching and Landau-Zener surface-hopping algorithms for the photodissociation of phenol is very similar. The populations of the adiabatic S1 and S2 states are found to exhibit fast oscillations which reflect nonadiabatic electronic transitions driven by coherent dynamics in the OH stretching mode. These electronic population oscillations are qualitatively reproduced by both TSH algorithms.
Picosecond amplification images the energy transfer between two laser beams
Authors: Tracy Samantha
Published: November 2017

Observing an amplified picosecond pulse, plasma physicists determine the spatial pattern of polarization changes to understand the scattering of intense laser beams in plasma photonics applications.
Microfluidic assay analyzes initiation of adaptive immune response
Authors: Tracy Samantha
Published: November 2017

New microfluidic measurement approximates the strength of the TCR-pMHC receptor-ligand interaction by measuring the reduction in T-cell speed when flowing past immobilized pMHC.
New sensitivity record reached for electron paramagnetic resonance spectroscopy
Authors: Kim Meeri
Published: November 2017

Researchers employ superconducting circuit-based technology to achieve state-of-the-art sensitivity level.
French activists to the (radical) right and the (radical) left: are they different or similar?
Authors: Stockemer Daniel
Published: November 2017

This research aims at detecting commonalities and differences between right-wing and left-wing activists. Based on 44 interviews with members of the French National Front (FN) and 88 Attac activists, I find that Attac activists are individuals with high amounts of civic skills that have been politically socialised until the age of 25. Somewhat different, my interview research indicates that the socialisation mechanisms of FN members, as well as their social and educational backgrounds are diverse. Pertaining to the activists’ values, the two groups expose values at the opposite end of the political spectrum. Whereas left-wing activists respond to globalisation and neo-liberalism by highlighting national and international solidarity and participatory democracy, the radical right-wing members respond to the same phenomena by propagating nationalism, authoritarianism and protectionist policies. Finally, I find that left-wing activists are driven by instrumental and ideological considerations, whereas right-wing activists are motivated by ideology as well as identity processes.
Successful Present, Successful Future? Assessment of a Nonbinary Model of Successful Aging
Authors: Manierre Matthew
Published: November 2017

Purpose

Though many models of successful aging exist, there is a need for assessments of the empirical validity of these models and their measures. This study tests the validity of the multidimensional model of successful aging presented by Young and colleagues.

Design and Methods

Expanding on an earlier validation study, this analysis uses 1,211 respondents from the Americans’ Changing Lives (ACL) study to determine predictive and discriminant validity. Respondents were surveyed in 1986, 1989, and 1994, providing an opportunity to assess if a baseline 5-point successful aging scale is associated with present and future outcomes. Validators include self-report items and interviewer recorded observations. In addition, a survival analysis of 24 years of ACL mortality data is conducted to confirm that baseline successful aging decreases risk of all-cause mortality.

Results

Results illustrate that, in some cases as far as 8 years in the future, low successful aging scores correspond with higher risk of future hospitalization and depressive episodes, interviewer observed difficulty moving around, low self-rated health, and decreased life satisfaction. Lowest scorers also had a 356% higher risk of mortality compared to individuals with the highest scores.

Implications

These findings provide further evidence that Young and colleagues’ successful aging construct is empirically valid and could be applied in future research and practice. Most respondents had middling scores, suggesting that future analyses should be cautious about concealing heterogeneity by operationalizing successful aging as a binary outcome.
Joking about cancer as an avoidance strategy among US adults
Authors: Carcioppolo Nick , John Kevin K , Jensen Jakob D , King Andy J
Published: November 2017

Findings from years of research on fear appeals suggest that individuals with low efficacy utilize avoidance strategies when they perceive a significant threat—a process called fear control. Some research suggests that joking could be an avoidance strategy. The current study identifies conditions in which people are more likely to joke about colorectal cancer and explores how this behavior may be associated with screening avoidance. Older adults (N = 209) recruited from eight different worksites completed a survey measuring fear appeal constructs and enactment of colorectal cancer-related joking. Results of a moderated mediation analysis suggest that men were more likely to joke about colorectal cancer than women, particularly if they perceived significant threat but had limited self-efficacy, signifying fear control. Results support prior fear appeal research, suggesting that an increase in joking behavior concerning colorectal cancer may be indicative of screening avoidance, and describe belief-based mechanisms that explain differences between biological sex and joking.
Giant molecular cloud collisions as triggers of star formation. VI. Collision-induced turbulence
Authors: Wu Benjamin , Tan Jonathan C , Nakamura Fumitaka , Christie Duncan , Li Qi
Published: November 2017

We investigate collisions between giant molecular clouds (GMCs) as potential generators of their internal turbulence. Using magnetohydrodynamic (MHD) simulations of self-gravitating, magnetized, turbulent GMCs, we compare kinematic and dynamic properties of dense gas structures formed when such clouds collide compared to those that form in non-colliding clouds as self-gravity overwhelms decaying turbulence. We explore the nature of turbulence in these structures via distribution functions of density, velocity dispersions, virial parameters, and momentum injection. We find that the dense clumps formed from GMC collisions have higher effective Mach number, greater overall velocity dispersions, sustain near-virial equilibrium states for longer times, and are the conduit for the injection of turbulent momentum into high density gas at high rates.
Convergent and Divergent Signaling in PAMP-Triggered Immunity and Effector-Triggered Immunity
Authors: Peng Yujun , van Wersch Rowan , Zhang Yuelin
Published: November 2017

Plants use diverse immune receptors to sense pathogen attacks. Recognition of pathogen-associated molecular patterns (PAMPs) by pattern recognition receptors localized on the plasma membrane leads to PAMP-triggered immunity (PTI). Detection of pathogen effectors by intracellular or plasma membrane–localized immune receptors results in effector-triggered immunity (ETI). Despite the large variations in the magnitude and duration of immune responses triggered by different PAMPs or pathogen effectors during PTI and ETI, plasma membrane–localized immune receptors activate similar downstream molecular events such as mitogen-activated protein kinase activation, oxidative burst, ion influx, and increased biosynthesis of plant defense hormones, indicating that defense signals initiated at the plasma membrane converge at later points. On the other hand, activation of ETI by immune receptors localized to the nucleus appears to be more directly associated with transcriptional regulation of defense gene expression. Here, we review recent progress in signal transductions downstream of different groups of plant immune receptors, highlighting the converging and diverging molecular events.
The Effect of ICU Out-of-Hours Admission on Mortality: A Systematic Review and Meta-Analysis*
Authors: Galloway Megan , Hegarty Aoife , McGill Sarah , Arulkumaran Nishkantha , Brett Stephen J , Harrison David
Published: November 2017

Objectives:

Organizational factors are associated with outcome of critically ill patients and may vary by time of day and day of week. We aimed to identify the association between out-of-hours admission to critical care and mortality.

Data Sources:

MEDLINE (via Ovid) and EMBASE (via Ovid).

Study Selection:

We performed a systematic search of the literature for studies on out-of-hours adult general ICU admission on patient mortality.

Data Extraction:

Meta-analyses were performed and Forest plots drawn using RevMan software. Data are presented as odds ratios ([95% CIs], p values).

Data Synthesis:

A total of 16 studies with 902,551 patients were included in the analysis with a crude mortality of 18.2%. Fourteen studies with 717,331 patients reported mortality rates by time of admission and 11 studies with 835,032 patients by day of admission. Admission to ICU at night was not associated with an increased odds of mortality compared with admissions during the day (odds ratio, 1.04 [0.98–1.11]; p = 0.18). However, admissions during the weekend were associated with an increased odds of death compared with ICU admissions during weekdays (1.05 [1.01–1.09]; p = 0.006). Increased mortality associated with weekend ICU admissions compared with weekday ICU admissions was limited to North American countries (1.08 [1.03–1.12]; p = 0.0004). The absence of a routine overnight on-site intensivist was associated with increased mortality among weekend ICU admissions compared with weekday ICU admissions (1.11 [1.00–1.22]; p = 0.04) and nighttime admissions compared with daytime ICU admissions (1.11 [1.00–1.23]; p = 0.05).

Conclusions:

Adjusted risk of death for ICU admission was greater over the weekends compared with weekdays. The absence of a dedicated intensivist on-site overnight may be associated with increased mortality for acute admissions. These results need to be interpreted in context of the organization of local healthcare resources before changes to healthcare policy are implemented.
Cervical morbidity in Alsace, France: results from a regional organized cervical cancer screening program
Authors: Baldauf Jean-Jacques , Fender Muriel , Bergeron Christine , Marrer Emilie , Velten Michel , Pradat Pierre , Arbyn Marc
Published: November 2017

In 1994, a pilot program of cervical cancer screening was introduced in the Alsace region, France. Women aged 25–65 years were proposed to have one Pap smear every 3 years. The objective was to assess cervical morbidity in Alsace before the human papillomavirus vaccinated population reaches the age of screening. Data on cervical lesions and cancers were collected by EVE for the period September 2008 to August 2011 from existing medical services and cytopathology laboratories in Alsace. Cytological and histological data were completed with data from the two cancer registries covering the region (Bas-Rhin and Haut-Rhin). Cancer incidence rates were computed for the target population (truncated to 25–64 years) and were age standardized according to the world reference population. World standardized incidence rates for the whole female population were obtained from the two cancer registries. During 2008–2011, 565 153 smears were performed in 498 913 women aged 25–64 years, representing an average of 1.13 smears/woman and 1.62 smears/screened woman. The overall screening coverage was 70.1% over the 3-year period. Histologically confirmed high-grade lesions were found in 2303 women (0.5%). Moreover, 215 cervical cancers were reported among women aged 25–64 years (crude and standardized truncated incidence rate of 10.6 and 10.0/100 000 women-years, respectively). The overall screening coverage of 70% at 3 years is higher than the national rate (57%), and the overall cancer incidence of 5.5/100 000 is below the national French level. The EVE database will be useful to assess trends in cervical morbidity over time and to further assess the effect of screening as well as of human papillomavirus vaccination.
Melanocytic Matricoma With Consumption of the Epidermis: An Atypical Histologic Attribute or a Malignant Variant?
Authors: Winslow Caroline Y. , Camacho Ivan , Nousari Carlos H.
Published: November 2017

Melanocytic matricoma is a recently described cutaneous adnexal tumor composed of matrical and supramatrical cells admixed with pigmented dendritic melanocytes, thought to recapitulate the anagen bulb of the hair follicle. We report a case of a 75-year-old white man, which demonstrates consumption of the epidermis that is defined as thinning of the epidermis with attenuation of the basal and suprabasal layers and loss of the normal rete architecture in areas of direct contact with neoplastic cells. It has been associated with aggressive histologic features in melanoma and likely represents an early phase of ulceration due to attenuation. Epidermal consumption has not been previously reported in nonmelanocytic tumors and it is uncertain whether this atypical histologic feature represents a sign of malignant behavior in this rare tumor.
Florid Granuloma Annulare–Like Reaction in Regional Lymph Nodes After “Regression” of Red Pigment in Tattoos
Authors: Carter Michael D. , Trites Jonathan , McNeil Shelly A. , Walsh Noreen N. M. , Bullock Martin J.
Published: November 2017

A healthy 50-year-old woman had a tattoo performed on the posterior aspect of her neck and another on the dorsum of her left foot. Several weeks later, she noted redness, tenderness, and intense pruritis at both tattoo sites. Treatment with cephalexin and hydrocortisone cream was instituted, without success. Within a few months, the red, but not black, pigment had disappeared from both tattoos and was replaced by pale areas of scarring. Persistently enlarged left supraclavicular and suboccipital lymph nodes were excised 7 and 10 months after receipt of the tattoos, respectively. The nodes were pigmented on gross examination, and on microscopy, a granuloma annulare–like reaction was observed. Normal lymphoid tissue was seen to be replaced by large palisading granulomas with central degenerative change, abundant stromal mucin, and scattered deposits of tattoo pigment. Histochemical stains, tissue culture, and serological studies revealed no evidence of infection. There are rare reports of granuloma annulare–like reactions in tattoos, and these are believed to represent delayed-type hypersensitivity reactions. Our case is unique in the observation of this reaction pattern in regional lymph nodes, and it expands the spectrum of complications known to be associated with tattoos.
Eccrine-Centric Melanocytic Nevus
Authors: Fertig Raymond M. , Berghoff Adar , Cervantes Jessica , Darwin Evan , Jukic Drazen
Published: November 2017

Benign melanocytic neoplasms present with a diverse array of well-known histopathologic patterns. It is imperative to recognize the benign patterns to render accurate diagnoses. We describe here an interesting and hitherto not described low-power architectural pattern of a benign melanocytic lesion: eccrine-centric melanocytic nevus. The patient was a 50-year-old African American woman who noticed a new mole on her foot that began as a dark speck but quickly grew larger. The lesion was excised to exclude the possibility of melanoma. Upon review of the specimen, the lesion was noted to demonstrate a distinctive pattern consistent with a melanocytic nevus of possible congenital onset. Remarkably, the ducts of eccrine glands were increased in density and the nests of melanocytes were found solely in a peri-eccrine distribution without melanocytes in any other locations (ie, interstitial, perifollicular). Additionally, all melanocytes in the nevus were rather heavily pigmented. Although this pattern demonstrated no atypical features that would cause one to consider it malignant to the trained eye, this presentation could implicate a metastatic disease (well-delineated nests in the dermis without concomitant interstitial component) and it is important to recognize.
Immunohistochemical and Fluorescence In Situ Hybridization Analysis of MYC in a Series of 17 Cutaneous Angiosarcomas: A Single-Center Study
Authors: Requena Celia , Rubio Luis , Lavernia Javier , Machado Isidro , Llombart Beatriz , Sanmartín Onofre , Traves Víctor , Guillén Carlos , Cruz Julia
Published: November 2017

Cutaneous angiosarcoma (AS) is an uncommon, aggressive sarcoma whose incidence is rising because of the increasing use of radiation therapy, especially in breast cancer. The few studies on the relevance of prognostic factors, such as MYC status in cutaneous AS, have reported inconclusive findings, with some authors reporting MYC amplification only in postirradiation and lymphedema-associated AS and others reporting evidence of MYC amplification in idiopathic AS. We analyzed 17 cases of cutaneous AS (6 idiopathic AS, 10 postirradiation AS, and 1 lymphedema-associated AS) treated at our institute between 2000 and 2015. Follow-up data were available in all cases. We compared the presence/absence of MYC amplification by fluorescence in situ hybridization (FISH) and immunohistochemical (IHC) MYC overexpression in the different AS subtypes. We also investigated potential associations between MYC amplification and prognosis. MYC amplification was observed by FISH in 6 of 14 informative cases. The positive cases were all secondary AS (5 postirradiation AS and 1 lymphedema-associated AS). IHC detected MYC overexpression in 8 of 15 informative cases (7 secondary AS and 1 idiopathic AS). In conclusion, MYC amplification and MYC overexpression were detected almost exclusively in secondary AS. No associations were found between MYC amplification/overexpression and prognosis. We found MYC amplification or overexpression in a similar proportion of the patients who died and who were still alive at the end of the study. In the group of 9 patients who died, MYC was detected by FISH in 4 cases and by IHC in 5. The corresponding figures in the group of 6 patients still alive were 2 by FISH and 3 by IHC.
Bupivacaine as an Adjunct to Lidocaine in Mohs Micrographic Surgery: A Prospective Randomized Controlled Trial
Authors: Chen Peggy , Smith Harvey , Vinciullo Carl
Published: November 2017

BACKGROUND

In Mohs micrographic surgery (MMS), the standard local anesthetic agent used is lignocaine with adrenaline. However, MMS can be prolonged; thus reinjections of local anesthetics are often required.

OBJECTIVE

Is 0.5% bupivacaine with 1:200,000 epinephrine a useful adjunctive treatment when compared with the use of 1% lidocaine with 1:100,000 epinephrine in MMS for the nose?

METHODS

Participants undergoing MMS received 2.5 mL of 1% lidocaine with 1:100,000 epinephrine before commencement of Stage 1. At the end of Stage 1, participants were randomized sequentially to either 2.5 mL 0.5% bupivacaine with 1:200,000 epinephrine (Group A) or 2.5 mL of 1% lidocaine with 1:100,000 epinephrine (Group B). Effectiveness of anesthesia was assessed using 30 G needle to 5 points of the wound before further stage or repair.

RESULTS

Fifty-one patients were randomized, 26 to Group A, and 25 to Group B. No differences between the 2 groups in size of defect and time lapse between time of injection and time of testing were observed. Seven of 25 were tested positive in Group B. Zero of 26 tested positive in Group A (p = .003, 95% confidence interval: 10%–46%).

CONCLUSION

Adjunctive use of 0.5% bupivacaine with 1:200,000 epinephrine is effective in prolonging anesthesia in MMS.
Is BMI a valid measure of obesity in postmenopausal women?
Authors: Banack Hailey R. , Wactawski-Wende Jean , Hovey Kathleen M. , Stokes Andrew
Published: November 2017

Objective:

Body mass index (BMI) is a widely used indicator of obesity status in clinical settings and population health research. However, there are concerns about the validity of BMI as a measure of obesity in postmenopausal women. Unlike BMI, which is an indirect measure of obesity and does not distinguish lean from fat mass, dual-energy x-ray absorptiometry (DXA) provides a direct measure of body fat and is considered a gold standard of adiposity measurement. The goal of this study is to examine the validity of using BMI to identify obesity in postmenopausal women relative to total body fat percent measured by DXA scan.

Methods:

Data from 1,329 postmenopausal women participating in the Buffalo OsteoPerio Study were used in this analysis. At baseline, women ranged in age from 53 to 85 years. Obesity was defined as BMI ≥ 30 kg/m2 and body fat percent (BF%) greater than 35%, 38%, or 40%. We calculated sensitivity, specificity, positive predictive value, and negative predictive value to evaluate the validity of BMI-defined obesity relative BF%. We further explored the validity of BMI relative to BF% using graphical tools, such as scatterplots and receiver-operating characteristic curves. Youden's J index was used to determine the empirical optimal BMI cut-point for each level of BF% defined obesity.

Results:

The sensitivity of BMI-defined obesity was 32.4% for 35% body fat, 44.6% for 38% body fat, and 55.2% for 40% body fat. Corresponding specificity values were 99.3%, 97.1%, and 94.6%, respectively. The empirical optimal BMI cut-point to define obesity is 24.9 kg/m2 for 35% BF, 26.49 kg/m2 for 38% BF, and 27.05 kg/m2 for 40% BF according to the Youden's index.

Conclusions:

Results demonstrate that a BMI cut-point of 30 kg/m2 does not appear to be an appropriate indicator of true obesity status in postmenopausal women. Empirical estimates of the validity of BMI from this study may be used by other investigators to account for BMI-related misclassification in older women.
Initial investigation into the optimal dose ratio of conjugated estrogens and bazedoxifene: a double-blind, randomized, placebo-controlled phase 2 dose-finding study
Authors: Pickar James H. , Lavenberg Joanne , Pan Kaijie , Komm Barry S.
Published: November 2017

Objective:

The aim of the study was to explore dose-related endometrial effects of conjugated estrogens/bazedoxifene (CE/BZA).

Methods:

In this randomized, double-blind, phase 2 study, 408 nonhysterectomized, symptomatic (with hot flushes [HFs]) postmenopausal women received ≥1 dose of CE 0.3 or 0.625 mg alone or with BZA 5, 10, or 20 mg/d; placebo; BZA 5 mg/d alone; or CE 0.625 mg with medroxyprogesterone acetate 2.5 mg/d for 84 days. The primary outcome was endometrial thickness on transvaginal ultrasound. HF frequency and severity based on diaries were key secondary outcomes.

Results:

CE 0.625 mg alone increased endometrial thickness compared with placebo (mean 5.5 vs 2.95 mm, P < 0.001); BZA countered this in a dose-related manner such that average thickness with the addition of BZA 5, 10, and 20 mg was 5.99, 4.33, and 3.54 mm, respectively. On average, endometrium was significantly less thick with CE 0.625 mg/BZA 20 mg than CE 0.625 mg (P < 0.001) and CE 0.3 mg/BZA 20 mg versus CE 0.3 mg (2.94 vs 3.92 mm, P < 0.05); endometrial thickness was similar to placebo with CE 0.625 mg/BZA 20 mg. Lower BZA doses failed to reduce endometrial thickness relative to the same dose of CE alone. Regimens containing CE 0.625 mg reduced HF frequency and severity versus placebo; CE 0.3 mg with BZA 10 or 20 mg was ineffective.

Conclusions:

BZA ≥20 mg is needed to counter endometrial growth resulting from treatment with CE 0.3 or 0.625 mg. CE 0.3 mg inadequately controls HFs if given with BZA 20 mg.
Associations of consuming specific fruit and vegetable subgroups with LDL-C status in early postmenopausal Chinese women
Authors: Chung Gary K.K. , Yu Ruby H.Y. , Ho Stella S.Y. , Woo Jean , Ho Suzanne C.
Published: November 2017

Objective:

Aging and menopausal changes contribute to increased cardiovascular risks in postmenopausal women. This study examined the associations of total and specific fruit and vegetable consumption with low-density lipoprotein cholesterol (LDL-C) status, a critical cardiovascular risk factor, in early postmenopausal Chinese women.

Methods:

A total of 508 postmenopausal Hong Kong Chinese women aged 50 to 64 years were recruited into a cohort study on cardiovascular risks. Sociodemographic characteristics, medical conditions, use of medications, and lifestyle factors were obtained via structured interviews. Dietary intake was assessed using a validated food frequency questionnaire. LDL-C and total cholesterol concentrations were determined using biochemical enzymatic techniques and categorized according to the Adult Treatment Panel III classification.

Results:

Ordinal logistic regression analysis showed that women with total fruit and vegetable intake in the highest quartile were 33% less likely (odds ratio [OR] = 0.67; 95% CI, 0.44-1.03) to have a worse LDL-C status than those with lower intake after adjustments. The intakes of total vegetables (OR = 0.63; 95% CI, 0.41-0.96) and vegetable subgroups in the highest quartiles, including darkgreen leafy vegetables (OR = 0.60; 95% CI, 0.41-0.89) and corn and tubers (OR = 0.62; 95% CI, 0.40-0.96), were significantly inversely associated with LDL-C status. Further adjustment for total cholesterol did not attenuate the associations.

Conclusions:

A daily consumption of vegetables equivalent to about four servings or more might be beneficial for LDL-C control in early Chinese postmenopausal women. In particular, darkgreen leafy vegetables, as well as corn and tubers, deserve greater advocacy for their ability to improve lipid profiles and hence cardiovascular health.
Age-related changes in luteal dynamics: preliminary associations with antral follicular dynamics and hormone production during the human menstrual cycle
Authors: Baerwald Angela , Vanden Brink Heidi , Hunter Caitlin , Beuker Denae , Lim Hyun , Lee Chel Hee , Chizen Donna
Published: November 2017

Objective:

The aim of the study was to test the hypothesis that the development of luteal phase dominant follicles (LPDFs) as women age is associated with abnormal luteal function.

Methods:

Luteal and antral follicle diameter were quantified in ovulatory women of midreproductive age (MRA; 18-35 y; n = 9) and advanced reproductive age (ARA; 45-55 y; n = 16) every 1 to 3 days during one complete interovulatory interval. Blood was drawn at each visit and assayed for progesterone, estradiol, inhibin A, follicle-stimulating hormone, and luteinizing hormone. Luteal diameter and hormone profiles were compared within MRA and ARA women with versus without LPDFs.

Results:

Luteal growth and regression profiles were similar in MRA women with typical versus no LPDFs (13.9, 14.8 mm; P > 0.1); however, luteal phase estradiol and progesterone were greater in MRA women with typical (91.1 ng/L, 8.81 μg/L) versus no (48.8 ng/L, 7.32 μg/L) LPDFs, respectively (LPDF effect, P < 0.1). In the ARA group, mean luteal diameter was lowest in women with atypical LPDFs (12.3 mm), greatest in those with typical LPDFs (16.0 mm), and moderate in those with no LPDFs (13.6 mm), (P < 0.1). Reduced luteal growth in ARA women with atypical versus typical and/or no LPDFs occurred simultaneously to greater luteal phase estradiol (199 vs 69.0, 78.4 ng/L) lower progesterone (7.38 vs 10.7, 13.8 ug/L), and lower inhibin A (36.3, 35.6, 51.2) (P < 0.1).

Conclusions:

The development of LPDFs as women age was associated with reduced luteal growth, greater estradiol, lower progesterone, and lower inhibin A. These findings provide preliminary evidence that variations in antral folliculogenesis contribute to luteal insufficiency during the menopausal transition.
Risk factors associated with intensity of climacteric symptoms in Brazilian middle-aged women: a population-based household survey
Authors: Lui-Filho Jeffrey Frederico , Pedro Adriana Orcesi , Baccaro Luiz Francisco , Costa-Paiva Lucia
Published: November 2017

Objective:

To determine the factors associated with the intensity of climacteric somatovegetative, psychological, and urogenital symptoms among middle-aged women in the Metropolitan Region of Campinas, Brazil.

Methods:

A cross-sectional population-based household survey was conducted with 749 women aged 45 to 60 years. The dependent variable was the intensity of menopausal symptoms assessed using the Menopause Rating Scale. The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and gynecological background.

Results:

The mean age of the women was 52.5 ± 4.4 years, and the mean age at onset of menopause was 46.5 ± 5.8 years. The intensity of menopausal symptoms was defined using the subscale scores of the median Menopause Rating Scale. Poisson multiple regression for somatovegetative, psychological, and urogenital symptoms showed several associated factors of each subscale, though some factors were common. Factors associated with moderate to severe climacteric symptoms in all the subscales of the Menopause Rating Scale were self-perception of health as “fair”/“poor”/“very poor” (P < 0.01), depression/anxiety (P < 0.01), and osteoarticular diseases (P < 0.01).

Conclusions:

The severity of climacteric symptoms in the different Menopause Rating Scale domains was related to a broad set of factors. Each Menopause Rating Scale subscale had its own set of factors, but some were common. Presence of chronic diseases, depression or anxiety, and worst self-perception of health were highlighted. A better understanding of these factors may help to not only reduce the effect of climacteric symptoms on the quality of life of middle-aged women, but also identify groups of women who need multidisciplinary health care.
Negative-Pressure Wound Therapy for Ludwig’s Angina: A Case Series
Authors: Nanda Nainika , Zalzal Habib G. , Borah Gregory L.
Published: November 2017

Negative-pressure wound therapy (NPWT) is a well-established therapeutic approach for various complex wound classes. There is currently limited information on the use of NPWT for the scope of head and neck wounds. However, NPWT has been used successfully in some cases, including malignancy, infection, and trauma. In West Virginia, the incidence of dental-related infections leading to Ludwig’s Angina is high due to lack of access to dental care. Our case series describes the application of vacuum-based therapy in conjunction with antibiotic therapy for quick, effective closure of deep tissue infections before definitive complex wound repair via graft and flap reconstructions. Over a period of 3 months, 2 patients with submental infections extending to the lateral neck demonstrated clean, efficient wound closure with NPWT for less than 14 days while hospitalized at West Virginia University Medicine. Outpatient follow-up with these patients demonstrated excellent cosmetic outcomes with minimal contracture or hypertrophy of healing tissue. NPWT promotes wound healing through decreased edema, improved perfusion, and increased granulation of tissue based on our findings. Our series encourages the use of NPWT for initial closure of complex wounds secondary to deep neck infections.
Laparoscopic Harvest of the Rectus Abdominis for Perineal Reconstruction
Authors: Agochukwu Nneamaka , Bonaroti Alisha , Beck Sandra , Liau James
Published: November 2017

The rectus abdominis is a workhorse flap for perineal reconstruction, in particular after abdominoperineal resection (APR). Laparoscopic and robotic techniques for abdominoperineal surgery are becoming more common. The open harvest of the rectus abdominis negates the advantages of these minimally invasive approaches. (Sentence relating to advantages of laparoscopic rectus deleted here.) We present our early experience with laparoscopic harvest of the rectus muscle for perineal reconstruction. Three laparoscopic unilateral rectus abdominis muscle harvests were performed for perineal reconstruction following minimally invasive colorectal and urological procedures. The 2 patients who underwent APR also had planned external perineal skin reconstruction with local flaps. (Sentence deleted here to shorten abstract.) All rectus muscle harvests were performed laparoscopically. Two were for perineal reconstruction following laparoscopic APR, and 1 was for anterior vaginal wall reconstruction. This was done with 4 ports positioned on the contralateral abdomen. The average laparoscopic harvest time was 60–90 minutes. The rectus muscle remained viable in all cases. One patient developed partial necrosis of a posterior thigh fasciocutaneous flap after cancer recurrence. There were no pelvic abscesses, or abdominal wall hernias. Laparoscopic harvest of the rectus appears to be a cost-effective, reliable, and reproducible procedure for perineal with minimal donor-site morbidity. Larger clinical studies are needed to further establish the efficacy and advantages of the laparoscopic rectus for perineal reconstruction.
Chikungunya Virus Infections Among Infants—Who Classification Not Applicable
Authors: van Keulen Veronique , Huibers Minke , Manshande Meindert , van Hensbroek Michaël Boele , van Rooij Linda
Published: November 2017

Chikungunya virus caused an epidemic on Curaçao in 2014–2015. Infants are highly at risk for clinical syndromes as sepsis-like illness and central nervous system disease. Clinical recognition is important if laboratory test, polymerase chain reaction and enzyme-linked immunosorbent assay are not available. The World Health Organization created criteria for identification of probable Chikungunya virus. None of the studied infants met these criteria. We believe the criteria suggested by World Health Organization should be modified for infants.