Canadian French Translation and Validation of the Neck Dissection Impairment Index: A Quality of Life Measure for the Surgical Oncology Population.

BACKGROUND: Neck dissections (ND) are a routine procedure in head and neck oncology. Given the postoperative functional impact that some patients experience, it is imperative to identify and track quality of life (QoL) symptomatology to tailor each patient's therapeutic needs. To date, there is no validated French-Canadian questionnaire for this patient-population. We therefore sought to translate and validate the Neck Dissection Impairment Index (NDII) in Canadian French. METHODS: A 3-phased approach was used. Phase 1: The NDII was translated from English to Canadian French using a "forward and backward" translational technique following international guidelines. Phase 2: A cognitive debriefing session was held with 10 Canadian French-speaking otolaryngology patients to evaluate understandability and acceptability. Phase 3: The final version was administered prospectively to 30 patients with prior history of ND and 30 control patients. These patients were asked to complete the questionnaire 2 weeks after their first response. Test-retest reliability was calculated with Spearman's correlation. Internal consistency was elicited using Cronbach's alpha. RESULTS: NDII was successfully translated and validated to Canadian French. Cronbach's alpha revealed high internal consistency (0.92, lower 95% confidence limit 0.89). The correlation for test-retest validity were strong or very strong (0.61-0.91). CONCLUSION: NDII is an internationally recognized QoL tool for the identification of ND-related impairments. This validated Canadian French version will allow clinicians to adequately assess the surgery-related QoL effect of neck surgery in the French-speaking population, while allowing French institutions to conduct and/or participate in multisite clinical trials requiring the NDII as an outcome measure.

Validation of the Basic Empathy Scale in an Arabic-speaking population: The BES-Ar.

PURPOSE: The aim of this work was to test the psychometric properties of the Arabic version of the BES (Basic Empathy Scale) by establishing its factor structure, its internal consistency and construct validity in the general population. DESIGN AND METHODS: The BES was tested among 526 Tunisian adults. FINDINGS: The two-factor structure of the BES-20 was confirmed. Internal consistency and concurrent validity were very satisfactory. DISCUSSION: This scale will be useful for clinicians in various fields (mental health, psychiatry) in Arabic countries.

Patterns of alaryngeal voice adoption and predictive factors of vocal rehabilitation failure following total laryngectomy.

OBJECTIVE: We aimed to determine patterns of alaryngeal voice acquisition and predictive factors of vocal rehabilitation (VR) failure following total laryngectomy (TL) at a large Canadian tertiary care center. METHODS: All consecutive patients having undergone a TL between January 1st, 2011 and December 31st, 2019, at the Centre Hospitalier de l'Université de Montréal were included. RESULTS: One hundred and ninety-seven laryngectomized patients were identified. Successful VR was achieved in 86 (59.0%) patients, while 59 (41.0%) failed to use a method of alaryngeal voice as their principal means of communication at 1 year postoperatively. The use of tracheoesophageal puncture (TEP) was associated with higher VR success rates (70.6%) when compared with the artificial larynx (48.6%), and esophageal voice (18.8%). The only independent predictor of VR failure on multivariate analysis at all time points was a low socioeconomic status. CONCLUSION: Failure to adopt an alaryngeal voice following TL is highly prevalent, despite comprehensive and free speech language pathologist services being offered at our center. A low resort to TEP at our institution and a poor acceptability and accessibility of alternative VR methods may contribute to this trend. The challenges of VR may be further exacerbated by the barriers linked to a lower socioeconomic status, which in turn may contribute to reduced candidacy for TEP.

First Patient-to-Patient Intrahospital Transmission of Clade I Candida auris in France Revealed after a Two-Month Incubation Period.

Candida auris is a recently described emerging pathogen in hospital settings. Five genetic clades have been delineated, with each clade being isolated from specific geographic regions. We here describe the first transmission between 2 patients (P0 and P1) of a clade I C. auris strain imported into our burn intensive care unit from the Middle East. The strains have been investigated with whole-genome sequencing, which validated the high similarity of the genomes between isolates from P0 and P1. We repeatedly screened the two patients and contact patients (i.e., other patients present in the same hospital ward at the time of the first positive sample from P0 or P1; n = 49; 268 tests) with fungal culture and a C. auris-specific quantitative PCR assay to assess transmission patterns. We observed that P1 developed C. auris colonization between 41 and 61 days after potential exposure to P0 contamination, despite three negative screening tests as recommended by our national authorities. This study illustrates that transmission of C. auris between patients can lead to long-term incubation times before the detection of colonization. The recommended screening strategy may not be optimal and should be improved in the light of our findings. IMPORTANCE While large outbreaks of C. auris in hospital settings have been described, few clear cases of direct transmission have been documented. We here investigated the transmission of C. auris clade I between two patients with a 41- to 61-day delay between exposure and the development of colonization. This may lead to changes in the recommendations concerning treatment of C. auris cases, as an incubation period of this length is one of the first to be reported.

PeakForest: a multi-platform digital infrastructure for interoperable metabolite spectral data and metadata management.

INTRODUCTION: Accuracy of feature annotation and metabolite identification in biological samples is a key element in metabolomics research. However, the annotation process is often hampered by the lack of spectral reference data in experimental conditions, as well as logistical difficulties in the spectral data management and exchange of annotations between laboratories. OBJECTIVES: To design an open-source infrastructure allowing hosting both nuclear magnetic resonance (NMR) and mass spectra (MS), with an ergonomic Web interface and Web services to support metabolite annotation and laboratory data management. METHODS: We developed the PeakForest infrastructure, an open-source Java tool with automatic programming interfaces that can be deployed locally to organize spectral data for metabolome annotation in laboratories. Standardized operating procedures and formats were included to ensure data quality and interoperability, in line with international recommendations and FAIR principles. RESULTS: PeakForest is able to capture and store experimental spectral MS and NMR metadata as well as collect and display signal annotations. This modular system provides a structured database with inbuilt tools to curate information, browse and reuse spectral information in data treatment. PeakForest offers data formalization and centralization at the laboratory level, facilitating shared spectral data across laboratories and integration into public databases. CONCLUSION: PeakForest is a comprehensive resource which addresses a technical bottleneck, namely large-scale spectral data annotation and metabolite identification for metabolomics laboratories with multiple instruments. PeakForest databases can be used in conjunction with bespoke data analysis pipelines in the Galaxy environment, offering the opportunity to meet the evolving needs of metabolomics research. Developed and tested by the French metabolomics community, PeakForest is freely-available at https://github.com/peakforest .

Drivers of functional diversity in the hyporheic zone of a large river.

The effects of regional (hydrogeology and geomorphology) and local (sediment and hydrology) characteristics on hyporheic assemblages were studied along a 40-km reach of a large gravel-bed river. Hyporheic water and fauna were sampled at the upstream and downstream positions of 15 large gravel bars. The resulting 30 stations varied in their sediment grain size, stability and direction of river-aquifer exchanges. The study concludes that at the 40-km (sector) scale, the longitudinal distribution of hyporheic fauna was controlled by 1) the hydrogeology of the valley (i.e. gaining vs loosing sectors) that modifies abundance and taxonomic richness of stygobites 2) current channel morphometry of the river (i.e. shape and location of meanders), and 3) historical changes (i.e. river incision) which modify abundance and richness of assemblages. At the local scale, we found that surface grain size and stability of the sediment evaluated by visual observation were poor predictors of hyporheos composition. In contrast, the local hydrology (i.e. downwellings, upwellings, low vertical exchanges) explained a large part of the abundance, taxonomic richness and composition of the hyporheic assemblages. Stations with low vertical exchanges were found poorly colonized, while the upwelling zones were rich in stygobites and downwelling areas harbor abundant and species-rich temporary hyporheos. It was also observed that functional diversity was controlled by the same parameters, with high relative abundances of stygobites in upwelling zones and POM feeders in downwelling zones. The heterogeneity of hydrological patterns, with alternation of upwellings and downwellings may represent the optimal spatial structure for hyporheic biodiversity conservation and resilience in rivers.

Assessment of surgical competence for neck dissection: a pilot study.

BACKGROUND: Progressive implementation of the milestone competence-based curriculum has created a need for new objective and validated means to assess resident surgical proficiency. A previous systematic review of the literature by our group has highlighted a shortage of tools assessing surgical competence in oncologic procedures in otolaryngology - head and neck surgery. METHODS: We developed a procedure-specific assessment tool for neck dissection using a modified Delphi method. The 2-part design was modelled on the previously validated Objective Structured Assessment of Technical Skills checklist. The tool was then validated through a 1-year multicentric prospective study in collaboration with the residents and faculty from our academic centre. Additionally, we developed an online survey to assess the acceptability by residents and staff before and after the validation studies. RESULTS: A total of 29 evaluations were completed throughout the 2016-2017 academic year. Acceptability ranked high for both residents and staff, with a single discrepancy in responses regarding a potential formative as opposed to summative use of the tool. Validation study results showed significantly higher checklist scores among senior residents than junior residents, as well as a significant score progression over time (p < 0.05). Trends in scores on the task-specific tool correlated highly to results obtained on a validated global rating scale (p < 0.05). CONCLUSION: The first tool assessing surgical competence in oncologic otolaryngology - head and neck surgery has been developed and shows promising validity.

Bloodstream Infections Caused by Magnusiomyces capitatus and Magnusiomyces clavatus: Epidemiological, Clinical, and Microbiological Features of Two Emerging Yeast Species.

Magnusiomyces clavatus and Magnusiomyces capitatus are emerging yeasts with intrinsic resistance to many commonly used antifungal agents. Identification is difficult, and determination of susceptibility patterns with commercial and reference methods is equally challenging. For this reason, few data on invasive infections by Magnusiomyces spp. are available. Our objectives were to determine the epidemiology and susceptibility of Magnusiomyces isolates from bloodstream infections (BSI) isolated in Germany and Austria from 2001 to 2020. In seven institutions, a total of 34 Magnusiomyces BSI were identified. Identification was done by internal transcribed spacer (ITS) sequencing and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Antifungal susceptibility was determined by EUCAST broth microdilution and gradient tests. Of the 34 isolates, M. clavatus was more common (n = 24) than M. capitatus (n = 10). BSI by Magnusiomyces spp. were more common in men (62%) and mostly occurred in patients with hemato-oncological malignancies (79%). The highest in vitro antifungal activity against M. clavatus/M. capitatus was observed for voriconazole (MIC50, 0.03/0.125 mg/L), followed by posaconazole (MIC50, 0.125/0.25 mg/L). M. clavatus isolates showed overall lower MICs than M. capitatus. With the exception of amphotericin B, low essential agreement between gradient test and microdilution was recorded for all antifungals (0 to 70%). Both species showed distinct morphologic traits on ChromAgar Orientation medium and Columbia blood agar, which can be used for differentiation if no MALDI-TOF MS or molecular identification is available. In conclusion, most BSI were caused by M. clavatus. The lowest MICs were recorded for voriconazole. Gradient tests demonstrated unacceptably low agreement and should preferably not be used for susceptibility testing of Magnusiomyces spp.

Development, translation, and preliminary validation of the neck dissection assessment tool.

BACKGROUND: The objective was to develop an assessment tool to evaluate residents' competency for neck dissection and provide preliminary evidence of feasibility, reliability, and validity. METHODS: Six surgeons developed a neck dissection assessment tool using a modified Delphi method and evaluated 58 neck dissections from six junior and six senior otolaryngology residents. RESULTS: The assessment tool uses a double checklist: a previously validated global rating scale (GRS) and a task-specific checklist (TSC). Use of the instrument appeared feasible and the average scores on the GRS and TSC differed significantly between junior and senior residents. The Pearson correlation coefficient between both checklists was 0.87. Intraclass correlation (ICC) for inter-rater reliability was 0.69 for the GRS, and 0.80 for the TSC. CONCLUSION: This study provides preliminary evidence of feasibility, reliability, and validity for the first neck dissection assessment tool and provides a foundation for further psychometric analysis and research.

Does spatial heterogeneity of hyporheic fauna vary similarly with natural and artificial changes in braided river width?

Heterogeneity of hyporheic fauna is associated with geomorphological features and related vertical water exchanges. Constrictions on river floodplain are known to induce groundwater inputs and increase stygobite fauna. Two floodplain constrictions were studied in a large braided river (the Drôme River): one linked to a natural process (valley narrowing), another to an artificial river regulation (early 20th embankment). Spatial distribution of hyporheic organisms were sampled upstream and downstream of the two constrained sections, at 9 stations, 3 positions (left and right sides, centre of the braided strip), 3 replication points and at a depth of 50 cm in the river sediment. The spatial heterogeneity in community composition was higher near the banks than at the centre of the braided strip, no matter the width of the strip. The artificial constriction induced a decrease in spatial heterogeneity of the benthic fraction of the hyporheic fauna, but no changes were detected for the stygofauna. The natural valley narrowing reduced width and thickness of the alluvium and induced an inflow of groundwater resulting in an increase in stygofauna abundance. Natural floodplain narrowing linked to geology thus control the distribution of stygobite species, while artificial constrictions only modify the spatial distribution of the benthic fraction of the hyporheic fauna.

Proposal for a chemically consistent way to annotate ions arising from the analysis of reference compounds under ESI conditions: A prerequisite to proper mass spectral database constitution in metabolomics.

Nowadays, high-resolution mass spectrometry is widely used for metabolomic studies. Thanks to its high sensitivity, it enables the detection of a large range of metabolites. In metabolomics, the continuous quest for a metabolite identification as complete and accurate as possible has led during the last decade to an ever increasing development of public MS databases (including LC-MS data) concomitantly with bioinformatic tool expansion. To facilitate the annotation process of MS profiles obtained from biological samples, but also to ease data sharing, exchange, and exploitation, the standardization and harmonization of the way to describe and annotate mass spectra seemed crucial to us. Indeed, under electrospray (ESI) conditions, a single metabolite does not produce a unique ion corresponding to its protonated or deprotonated form but could lead to a complex mixture of signals. These MS signals result from the existence of different natural isotopologues of the same compound and also to the potential formation of adduct ions, homomultimeric and heteromultimeric ions, fragment ions resulting from "prompt" in-source dissociations. As a joint reflection process within the French Infrastructure for Metabolomics and Fluxomics (MetaboHUB) and with the purpose of developing a robust and exchangeable annotated MS database made from pure reference compounds (chemical standards) analysis, it appeared to us that giving the metabolomics community some clues to standardize and unambiguously annotate each MS feature was a prerequisite to data entry and further efficient querying of the mass spectral database. The use of a harmonized notation is also mandatory for interlaboratory MS data exchange. Additionally, thorough description of the variety of MS signals arising from the analysis of a unique metabolite might provide greater confidence on its annotation.

Discovery of a new species of the genus Stygepactophanes from a groundwater-fed spring in southern France (Crustacea, Copepoda, Harpacticoida, Canthocamptidae).

A new species of the genus Stygepactophanes Moeschler & Rouch, 1984 (Copepoda, Harpacticoida, Canthocamptidae) is established to accommodate a small canthocamptid population collected from a spring system in the "Parc du Mercantour", Var catchment, southern France. The population analysed in the present study is defined by a set of morphological characters of the female, namely a very large maxilliped, a rudimentary mandibular palp, P1 with 3-segmented exopod and 2-segmented endopod, a falcate terminal claw of the P1 endopod, dorsal seta of caudal rami inserted on the inner margin, and anal operculum not overreaching the insertion of the caudal rami, thus supporting its assignment into the genus Stygepactophanes. The new species Stygepactophanesoccitanus shows marked differences with the nominotypical species of the genus that was originally described by monotypy with the species Stygepactophanesjurassicus Moeschler & Rouch, 1984. The main diagnostic traits of S.jurassicus are the absence of the P5 and a falcate outer terminal claw of P1 endopod. Stygepactophanesjurassicus also shows a reduced armature of the antennal exopod, bearing one seta, 1-segmented P2-P4 endopods, a reduced armature of P2-P4 exopodal segments 3 (3,4,4 armature elements, respectively), P6 bearing only one long seta, a rounded short and smooth anal operculum. Conversely the female of S.occitanus Galassi & Fiers, sp. n. has a well-developed P5, with rudimentary intercoxal sclerite, together with a falcate outer terminal claw of P1 endopod, antennal exopod bearing two elements, P4 endopod 1-segmented versus 2-segmented in P2-P3, P2-P4 exopodal segment 3 with five armature elements, P6 with three setae of different lengths, rounded anal operculum, bearing 3-4 strong spinules. According to our present knowledge, S.occitanus Galassi & Fiers, sp. n. is assigned to the genus Stygepactophanes as the most conservative solution, waiting for the male to be discovered. The genus Stygepactophanes represents a distinct lineage within the harpacticoid family Canthocamptidae that colonised southern European groundwater, the genus being known only from the saturated karst in Switzerland and a fissured saturated aquifer in southern France. Both species of the genus are stygobites and narrow endemics, the nominotypical species being known from the type locality Source de la Doux in Délemont (Switzerland), and S.occitanus Galassi & Fiers, sp. n. described herein from a spring system of the Var catchment (France).

Sealing porous anodic layers on AA2024-T3 with a low viscosity benzoxazine resin for corrosion protection in aeronautical applications.

In this paper, a 4-ethylphenol-para-phenylenediamine (4EP-pPDA) benzoxazine has been applied and cured on previously anodized AA2024-T3 substrates. The porous surface oxide layers obtained from sulfo-tartaric anodizing appeared to be highly impregnated by the benzoxazine resin, sealing the anodic films. Through rheological, morphological and chemical characterization, the curing process has been identified to be the key step for the impregnation to occur, related to the low viscosity of the 4EP-pPDA benzoxazine attained during thermal curing. Moreover, the typical surface porosity of the anodic layer reappeared after curing, offering a good anchoring to possible top coats. Finally, high and enduring barrier properties of this hybrid organic-inorganic layer have been highlighted through Electrochemical Impedance Spectroscopy (EIS) and correlated with recent results obtained by Molecular Dynamics Simulations (MDS). These barrier properties appeared to be strongly influenced by the curing process parameters, as has been assessed using alternative curing cycles limiting their duration and lowering the curing temperature. Consequently, adapting the curing process enables the optimization of the barrier properties of the system while respecting the dependence of the mechanical properties of the AA2024-T3 substrate on thermal treatment at high temperatures.

Do thermal infrared (TIR) remote sensing and direct hyporheic measurements (DHM) similarly detect river-groundwater exchanges? Study along a 40 km-section of the Ain River (France).

Water exchanges through the hyporheic zone are crucial to many ecological processes in streams. One major challenge for river managers is to find a practical method for localizing these exchanges using rapid data acquisition techniques. This work compares spatially continuous data, acquired by Thermal Infrared (TIR) techniques, with discrete data collected in surface water and in the hyporheic zone (DHM), at sites of expected water exchanges (gravel bars). Forty gravel bars, distributed along a 40 km-sector of the Ain River were sampled at upstream- and downstream-bar positions (80 sites) in order to reveal hyporheic exchanges. At each site, 4 physico-chemical parameters were measured at 0, -20 and -50 cm beneath the sediment surface. The field collections of TIR high-resolution images were conducted concomitantly, at low flow and high surface-water temperatures. Among the 80 sites selected for field measurements, 14 were identified as upwellings (groundwater inputs) and 66 as downwelling sites. From those 14 upwellings, 13 were also identified with TIR. The 44 additional sites identified with TIR corresponded to small-sized cold-water patches situated along the gravel bars or to groundwater discharge sites located between the bars (19 lateral seeps). Nevertheless, the DHM method documented on downwelling exchanges (infiltration of surface water), which were not captured by TIR images, and may represent hyporheic hotspots especially for benthic invertebrates. Along the studied sector of the Ain River, these downwelling zones were much more numerous than upwelling ones. Both methods in combination provide a rather complete picture of water exchange along rivers and are needed to evaluate the potential as refuges zones during critical dry periods.

A new groundwater species of Pseudoniphargus (Amphipoda: Pseudoniphargidae) fromAlgeria.

Intensive sampling performed in the area of Oum El Bouaghi (Northeastern Algeria) yielded a new species of the stygobiont amphipod Pseudoniphargus, P. djemoi, in wells located in the plain of Tamlouka. The new species belongs to a group that shares the display of a uropod 3 exopod extremely elongate and upcurved in the male, whereas its peduncle is only moderately elongate. This cluster of species appears scattered across the southern Iberian Peninsula, Northern Morocco and the Canary Islands. This discovery increases the number of described species of the stygobiont amphipod genus Pseudoniphargus in north Africa to eight. A key to the species of Pseudoniphargus living in Continental Africa and Mediterranean Islands is provided.

Optical Fibre NO2 Sensor Based on Lutetium Bisphthalocyanine in a Mesoporous Silica Matrix.

In this article, we describe a NO2 sensor consisting of a coating based on lutetium bisphthalocyanine (LuPc2) in mesoporous silica. The sensor exploits the absorption spectrum change of this material which strongly and reversibly decreases in contact with NO2. NO2 is measured by following the amplitude change in the reflected spectrum of the coating deposited on the tip of a silica fibre. As diffusion of NO2 in LuPc2 is slow, the response time could be slow. To reduce it, the active molecules are dispersed in a mesoporous silica matrix deposited by a sol-gel process (Evaporation Induced Self Assembly) avoiding the formation of large crystals. Doing so, the response is fairly fast. As the recovery is slow at room temperature, the recovery time is reduced by exposure to UV light at 365 nm. This UV light is directly introduced in the fibre yielding a practical sensor sensitive to NO2 in the ppm range suitable for pollution monitoring.

Decreasing Revision Surgery in FAMM Flap Reconstruction of the Oral Cavity: Traditional Versus Modified Harvesting Technique.

OBJECTIVE: To compare the surgical and functional outcomes between two harvesting techniques for the inferiorly based facial artery musculomucosal (FAMM) flap for oral cavity and oropharynx reconstructions. METHODS: Multicenter retrospective chart review. RESULTS: We reviewed 55 cases of FAMM flap, including 29 traditional cases and 26 performed using the modified harvesting method. The overall rate of surgical re-intervention in the traditional group was 31% (n = 9 of 29) and 15% (n = 4 of 26) in the modified group (P = 0.196). The specific re-intervention rate for pedicle sectioning was 27% (n = 8 of 29) in the traditional group versus 0% (n = 0 of 26) in the modified group. The overall rate of complications was 21%. Nine out of 10 dentate patients in the traditional group and four out of five in the modified group needed tooth extraction. There was no difference between the two groups in terms of tracheostomy duration (P = 0.338) and time to first oral intake (P = 0.629). Speech and feeding outcomes were similar among groups (P = 0.922; P = 0.700, respectively). Dental rehabilitation was achieved in 67% and 78% of patients in the traditional and modified groups, respectively. CONCLUSION: The FAMM flap offers a low morbidity approach to reconstruct the oral cavity. The modified approach to harvesting the flap is a safe and effective technique, with similar functional results and equally low morbidity profile as the traditional technique. It has the added advantage of lower rates of secondary surgical interventions. LEVEL OF EVIDENCE: 4. Laryngoscope, 1802-1805, 2018.

Ecology-based evaluation of groundwater ecosystems under intensive agriculture: A combination of community analysis and sentinel exposure.

Ecological criteria are needed for a comprehensive evaluation of groundwater ecosystem health by including biological components with the physical and chemical properties that are already required by European directives. Two methodological approaches to assess the ecological status of groundwater ecosystems were combined in two alluvial plains (the Ariège and Hers Rivers, southwestern France) varying in agriculture intensity (from grassland to crop rotation including maize and sunflower, and to maize monoculture). In the first approach, the composition of invertebrate assemblages (only obligate-groundwater crustaceans, i.e. stygobionts) sampled in 28 wells differing in their land use contexts was analysed. Abundance, species richness, and assemblage composition significantly changed with agricultural land use or urbanization around the wells. In the second approach, we tested an in situ exposure of sentinel organisms to quantify their response to the environmental pressures. The epigean and native amphipod species Gammarus cf. orinos was used as the sentinel species. Amphipods (30 individuals in each of 10 wells) were exposed for one week to the in situ conditions at two seasons with contrasted concentrations of pollutants. The Ecophysiological Index (EPI) synthetizing the survival rates and energetic storage decreased in wells with low oxygen and high nitrate concentrations, but only during the highest contamination period. Atrazine-related compounds negatively impacted sentinel health whatever the season. The combination of these two approaches may have major applications for orientating groundwater ecosystem management.

Perioperative practices in thyroid surgery: An international survey.

BACKGROUND: Perioperative practices in thyroid surgery vary from one specialty, institution, or country to the next. We evaluated the preoperative, intraoperative, and postoperative practices of thyroid surgeons focusing on preoperative ultrasound, vocal cord evaluation, wound drains, and hospitalization duration, among others. METHODS: A survey was sent to 7 different otolaryngology and endocrine/general surgery associations. RESULTS: There were 965 respondents from 52 countries. Surgeon-performed ultrasound is practiced by more than one third of respondents. Otolaryngologists perform preoperative and postoperative vocal cord evaluation more often than endocrine/general surgeons (p < .001). Sixty percent of respondents either never place drains or place drains <50% of the time in thyroid lobectomies (43% for total thyroidectomies). Outpatient thyroid surgery is most frequently performed by surgeons in the United States (63%). CONCLUSION: This epidemiologic study is the first global thyroid survey of its kind and clearly demonstrates the variability and evolving trends in thyroid surgery. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1296-1305, 2017.

Mechanistic study of competitive releases of H2O, NH3 and CO2 from deprotonated aspartic and glutamic acids: Role of conformation.

The aims of this study were to highlight the impact of minor structural differences (e.g. an aminoacid side chain enlargement by one methylene group), on ion dissociation under collision-induced dissociation conditions, and to determine the underlying chemical mechanisms. Therefore, we compared fragmentations of deprotonated aspartic and glutamic acids generated in negative electrospray ionization. Energy-resolved mass spectrometry breakdown curves were recorded and MS3 experiments performed on an Orbitrap Fusion for high-resolution and high-mass accuracy measurements. Activated fragmentations were performed using both the resonant and non-resonant excitation modes (i.e., CID and HCD, respectively) in order to get complementary information on the competitive and consecutive dissociative pathways. These experiments showed a specific loss of ammonia from the activated aspartate but not from the activated glutamate. We mainly focused on this specific observed loss from aspartate. Two different mechanisms based on intramolecular reactions (similar to those occurring in organic chemistry) were proposed, such as intramolecular elimination (i.e. Ei-like) and nucleophilic substitution (i.e. SNi-like) reactions, respectively, yielding anions as fumarate and α lactone from a particular conformation with the lowest steric hindrance (i.e. with antiperiplanar carboxyl groups). The detected deaminated aspartate anion can then release CO2 as observed in the MS3 experimental spectra. However, quantum calculations did not indicate the formation of such a deaminated aspartate product ion without loss of carbon dioxide. Actually, calculations displayed the double neutral (NH3+CO2) loss as a concomitant pathway (from a particular conformation) with relative high activation energy instead of a consecutive process. This disagreement is apparent since the concomitant pathway may be changed into consecutive dissociations according to the collision energy i.e., at higher collision energy and at lower excitation conditions, respectively. The latter takes place by stabilization of the deaminated aspartate solvated with two residual molecules of water (present in the collision cell). This desolvated anion formed is an α lactone substituted by a methylene carboxylate group. The vibrational excitation acquired by [(D-H)-NH3]-during its isolation is enough to allow its prompt decarboxylation with a barrier lower than 8.4kJ/mol. In addition, study of glutamic acid-like diastereomers constituted by a cyclopropane, hindering any side chain rotation, confirms the impact of the three-dimensional geometry on fragmentation pathways. A significant specific loss of water is only observed for one of these diastereomers. Other experiments, such as stable isotope labeling, need to be performed to elucidate all the observed losses from activated aspartate and glutamate anions. These first mechanistic interpretations enhance understanding of this dissociative pathway and underline the necessity of studying fragmentation of a large number of various compounds to implement properly new algorithms for de novo elucidation of unknown metabolites.