Molybdenum oxynitride nanoparticles on nitrogen-doped CNT architectures for the oxygen evolution reaction

Transition metal-based electrocatalysts are considered the potential alternative to noble metal-based ones owing to their comparable electrocatalytic properties, durability, and low cost for the oxygen evolution reaction (OER). Herein, we report the partial nitridation of molybdenum oxide nanoparticles anchored on nitrogen-doped carbon nanotube (Mo-N-CNT) architectures for a highly active OER electrocatalyst. The molybdenum oxynitride nanoparticles are uniformly distributed on the surface of hierarchical N-CNT architectures, where nitrogen heteroatoms are incorporated through the thermal decomposition of carbon nitride. The modified surface chemistry can boost the electrocatalytic activity of Mo-N-CNT to show improved electrochemical behaviours for OER operation. The Mo-N-CNT achieves a current density of 10 mA cm^-2 with an overpotential of 344 mV, Tafel slope of 64 mV dec^-1, and current density retention of 79% during the oxidation in an alkaline electrolyte for 80 h. The enhanced electrocatalytic performance of Mo-N-CNT is attributed to the hierarchical N-CNT structure and nitridation of Mo oxides.

Boosting Redox-Active Sites of 1T MoS2 Phase by Phosphorus-Incorporated Hierarchical Graphene Architecture for Improved Li Storage Performances

Hybridizing and architecting two kinds of 2D nanomaterials are attractive for energy storage applications. Herein, the chemical and electronic coupling of redox active 1T MoS₂ phase with hierarchical phosphorus-doped graphene architecture (HMPGA) is accomplished by the strong interactions of 2D hybrid colloids. The spectroscopic analyses on the crystal structure, surface morphology, and composition confirm the efficient doping of phosphorus and the hybridization interaction of 1T MoS₂ with the phosphorus-incorporated graphene. The resulting HMPGA anode shows significant improvement in battery performances. The specific capacity is delivered to 1194 mAh g^-1 at 100 mA g^-1 with a cyclability of 93.3% over 600 cycles. This improvement is ascribed to the multicoupling effect arising from the abundant redox-actives sites of 1T MoS₂ phase boosted and stabilized by hierarchically architected, phosphorus-doped graphenes.

The effect of myocardial injury on the clinical course of snake envenomation in South Korea

CONTENT

This study investigated the incidence, progression and clinical course of myocardial injury-related snake envenomation in South Korea. In addition, this study evaluated whether antivenom guidelines are appropriate to control envenomation in patients with myocardial injury.

METHODS

The study included 198 patients who received antivenom after a snakebite, and they were divided into two groups according to evidence of myocardial injury (defined as elevated troponin I or ischemic change on electrocardiogram) at presentation. Data including serial troponin I, echocardiogram/coronary angiogram findings, the clinical course, and treatment were collected and analyzed.

RESULTS

The incidence of myocardial injury at presentation was 15.2%. The troponin I level was 0.11 (0.07-0.56) ng/ml at presentation and tended to decrease over 24 h. Echocardiograms revealed neither regional wall motion abnormalities nor left ventricular dysfunction in 15 of 17 patients, while two patients showed signs of coronary artery stenosis on echocardiograms and coronary angiograms. However, compared with patients without myocardial injury, patients with myocardial injury had a higher frequency of systemic envenomation complications, including bleeding, respiratory failure, hypotension, acute kidney injury, thrombocytopenia and venom-induced consumption coagulopathy (VICC). The patients with myocardial injury at presentation needed significantly more frequent and larger doses of antivenom than indicated by the initial severity of envenomation. Multivariate analysis showed that myocardial injury was associated with the need for additional antivenom administration after initial administration.

DISCUSSION AND CONCLUSION

Myocardial injury is not uncommon after snake envenomation in Korea. Although myocardial injury itself seems to be benign, the clinical course of patients with myocardial injury is complicated, and myocardial injury is associated with the need for additional antivenom administration. The optimal use of antivenom to control envenomation in patents with myocardial injury after snake envenomation in South Korea should be established.

Transport and Durability of Energy Storage Materials Operating at High Temperatures

Temperature is a state variable that significantly affects thermodynamic and kinetic performances and performance degradation of energy storage materials. In this Perspective, we address our recent progress in the energy storage performance and transporting phenomena of supercapacitors when temperatures are elevated to >100 °C. Electrodes include reduced graphene oxide film and foam and conductive metal organic frameworks; electrolytes include phosphoric-acid-doped polybenzimidazole and double networked ionogels. The electrochemical, thermal, and mechanical properties of electrodes and electrolytes are correlated with energy storage performance and degradation at high temperatures. We also address the fundamental understanding of ion transport of polymeric electrolytes and the emergence of nanoscale-confined fast mobile protons at elevated temperatures.

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air® App

BACKGROUND

In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently.

METHODS

All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated.

RESULTS

A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures.

CONCLUSIONS

VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.

Female reproductive factors and the risk of dementia: a nationwide cohort study

BACKGROUND AND PURPOSE

The aim was to investigate whether female reproductive factors are associated with dementia.

METHODS

In all, 4 696 633 post-menopausal women without dementia were identified using the Korean National Health Insurance System database. Data on reproductive factors were collected using a self-administered questionnaire. Dementia was determined using dementia diagnosis codes and anti-dementia drug prescription. Cox proportional hazards regression was conducted to assess the hazard ratio (HR) for dementia according to reproductive factors.

RESULTS

During a median follow-up of 5.74 years, there were 212 227 new cases of all-cause dementia (4.5%), 162 901 cases of Alzheimer's disease (3.5%) and 24 029 cases of vascular dementia (0.5%). The HR of dementia was 1.15 [95% confidence interval (CI) 1.03-1.16] for menarcheal age ≥17 years compared with menarcheal age 13-14 years, 0.79 (0.77-0.81) for menopausal age ≥55 years compared with menopausal age <40 years, and 0.81 (0.79-0.82) for fertility duration ≥40 years compared with fertility duration <30 years. Whilst being of parity one (HR 0.89, 95% CI 0.85-0.94) and breastfeeding <6 months (HR 0.92, 95% CI 0.88-0.95) was associated with lower risk of dementia, being of parity two or more (HR 1.04, 95% CI 0.99-1.05) and breastfeeding ≥12 months (HR 1.14, 95% CI 1.01-1.07) was associated with a higher risk of dementia than women without parity or breastfeeding history. Use of hormone replacement therapy and oral contraceptives independently reduced the dementia risk by 15% and 10%, respectively.

CONCLUSIONS

Female reproductive factors are independent risk factors for dementia incidence, with higher risk associated with shorter lifetime endogenous estrogen exposure.

Interfacially Polymerized Polyamide Interlayer onto Ozonated Carbon Nanotube Networks for Improved Stability of Sulfur Cathodes

Lithium-sulfur (Li-S) batteries are considered promising energy-storage devices owing to the high specific capacity and low cost of the S cathode. However, they suffer from capacity decay and poor coulombic efficiency arising from the dissolution of long-chain polysulfides and their shuttling. A facile and scalable method was developed to directly coat a thin (≈57.3 nm) and porous polyamide (PA) interlayer onto a S cathode by interfacial polymerization. This PA interlayer prevented the shuttling of polysulfides by creating a physical barrier and, through chemical interactions between the amide functionalities of PA and the polysulfides, allowing access to the S electrode by the Li ions. The resulting PA-coated cathode exhibited approximately 64.2 % capacity retention over 1000 cycles at 1 C with only 0.0358 % decay per cycle and a moderate capacity of 1008 mAh g^-1 at 0.1 C.

A systematic review of automated feeder detection software for locoregional treatment of hepatic tumors

PURPOSE

The purpose of this study was to perform a systematic review of current literature describing the efficacy and technical outcomes of transarterial liver therapies using automated feeder detection (AFD) software.

MATERIALS AND METHODS

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A structured search was performed in the PubMed, SCOPUS, and Embase databases of patients undergoing locoregional therapy of liver tumors utilizing AFD software. Demographic data, procedure data (including radiometrics) and tumor response rate were recorded. Where available, performance of AFD was compared to conventional digital subtraction angiography (DSA) and cone-beam CT (CBCT) without AFD.

RESULTS

A total of 14 full-text manuscripts met inclusion criteria, comprising 1042 tumors in 604 patients (305 men, 156 women; mean age, 68.6±6.0 [SD] years), including 537 patients with hepatocellular carcinoma, 8 with metastases from neuroendocrine tumors, and 59 patients without reported etiology. Reported sensitivity of AFD ranged between 86% and 98.5%, compared to DSA alone (38% - 64%) or DSA in combination with CBCT (69% - 81%). Three studies reported tumor response by modified response evaluation criteria in solid tumors (mRECIST) guidelines, with complete response in the range of 60% - 69%.

CONCLUSION

AFD is a promising new technology for the identification of intrahepatic and extrahepatic tumor-feeding arteries and should be considered a useful adjunct to conventional DSA and CBCT in the treatment of liver tumors.

Two-Dimensional Metallic Niobium Diselenide for Sub-micrometer-Thin Antennas in Wireless Communication Systems

The state-of-the-art of the Internet of things (IoT) and smart electronics demands advances in thin and flexible radio frequency (RF) antennas for wireless communication systems. So far, nanostructured materials such as metals, carbon nanotubes, graphene, MXene, and conducting polymers have been investigated due to their noteworthy electrical conductivity. However, most antennas based on metallic materials are thick, which limits their application in miniaturized and portable electronic devices. Herein, we report two-dimensional (2D) metallic niobium diselenide (NbSe₂) for a monopole patch RF antenna, which functions effectively despite its sub-micrometer thickness, which is less than the skin depths of other metals. The as-fabricated antenna has an 855 nm thickness and a 1.2 Ω sq^-1 sheet resistance and achieves a reflection coefficient of -46.5 dB, a radiation efficiency of 70.6%, and omnidirectional RF propagation. Additionally, the resonance frequency of this antenna at the same thickness is reconfigured from 2.01 to 2.80 GHz, while decreasing its length and preserving its reflection coefficient of less than -10 dB. This approach offers a facile process to synthesize 2D metallic transition metal dichalcogenides for the rational design of flexible, miniaturized, frequency-tunable, and omnidirectional monopole patch RF antennas for body-centric wearable communication systems.

Redox Tuning in Crystalline and Electronic Structure of Bimetal-Organic Frameworks Derived Cobalt/Nickel Boride/Sulfide for Boosted Faradaic Capacitance

The development of efficient electrode materials is a cutting-edge approach for high-performance energy storage devices. Herein, an effective chemical redox approach is reported for tuning the crystalline and electronic structures of bimetallic cobalt/nickel-organic frameworks (Co-Ni MOFs) to boost faradaic redox reaction for high energy density. The as-obtained cobalt/nickel boride/sulfide exhibits a high specific capacitance (1281 F g^-1 at 1 A g^-1 ), remarkable rate performance (802.9 F g^-1 at 20 A g^-1 ), and outstanding cycling stability (92.1% retention after 10 000 cycles). An energy storage device fabricated with a cobalt/nickel boride/sulfide electrode exhibits a high energy density of 50.0 Wh kg^-1 at a power density of 857.7 W kg^-1 , and capacity retention of 87.7% (up to 5000 cycles at 12 A g^-1 ). Such an effective redox approach realizes the systematic electronic tuning that activates the fast faradaic reactions of the metal species in cobalt/nickel boride/sulfide which may shed substantial light on inspiring MOFs and their derivatives for energy storage devices.

P1882Association between acute hepatitis B flare and long-term clinical outcomes in patients with atrial fibrillation

Background

Relationship between AF and inflammation was shown in previous studies. However, there was limited data about the association between the acute hepatitis B flare (AVHF-B) and AF in the long-term follow-up.

Purpose

The aim of this study was to evaluate the association of AVHF-B and long-term clinical outcomes in patients with AF.

Methods

Our University echocardiography, electrocardiogram (ECG) and hepatitis B database were reviewed from 2008 to 2017 to identify patients with AF and AVHF-B. Patients were followed for a mean 26.4±0.9 months and were divided into two groups according to the absence or presence of AVHF-B with AF.

Results

Among 280 patients with AF, 100 (35.7%) patients had AVHF-B. Total any event rates were significantly higher in patients with AVHF-B compared to those without AVHF-B (P<0.001). Arrhythmias including AF, atrial tachycardia,APC, VT, and VPC also occurred in 54 (19.3%) patients, with a significantly higher incidence in patients with AVHF-B than in those without AVHF-B (P<0.001). In univariate analysis, CHA2DS2 VASc, Left atrial diameter (LAD), E/E' (the peak mitral flow velocity of the early rapid filling wave/early diastolic mitral annulus velocity) and AVHF-B were significantly associated with arrhythmic events and total any events including thromboembolic events, arrhythmic events, re-hospitalizations and mortality. In multivariate analysis, AVHF-B was independent risk factors for arrhythmic events (P=0.031) at the long-term follow-up.

Conclusion

The patients with AVHF-B were associated with higher arrhythmic events and total any events, suggesting more intensive medical therapy with close clinical follow-up will be required.

Acknowledgement/Funding

None

P3617Systolic blood pressure, glycemic control and clinical outcome in diabetic patients with acute myocardial infarction

Background

Recent blood pressure guidelines recommend intensive blood pressure control in diabetic patients with cardiovascular disease.

Purpose

We sought to investigate combined impact of intensive blood glucose lowering and blood pressure control on clinical outcome in diabetic patients with acute myocardial infarction (AMI) has not been fully investigated yet.

Method

Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database included 12,179 patients (9,046 men; mean age = 63.6±12.6 year-old) who were discharged alive. Among them, 3,430 (28.2%) had a diabetes mellitus (DM). MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations at 1 year. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.

Result

We determined cut-off value of discharge systolic blood pressure (SBP) to predict 1-year MACCE in DM and non-DM patients. Discharge SBP of less than 130mmHg was associated with a lower MACCE at 1 year compared to SBP level of 130mmHg or greater (10.8% versus 15.4%; log-rank p=0.001) in DM patients, whereas discharge SBP cut-off level was 140mmHg to discriminate 1-year MACCE in non-DM patients (6.4% versus 8.5%, log-rank p=0.045). In DM patients, there were no significant difference in 1-year MACCEs between patients with HbA1c less than 7% versus 7% or greater (12.0% versus 10.7%; log-rank p=0.325). DM patients were categorized into 4 groups; discharge SBP <130mmHg and HbA1c <7% (Group 1); discharge SBP <130mmHg and HbA1c ≥7% (Group 2); discharge SBP ≥130mmHg and HbA1c <7% (Group 3); discharge SBP ≥130mmHg and HbA1c ≥7% (Group 4). Intensive BP control was associated lower 1-year MACCEs in patients with good glycemic control (Group 1 & 3; 10.7% versus 16.7%; log-rank p=0.009). However, in patients with poor glycemic control, intensive BP control did not improve 1-year MACCEs (Group 2 & 4; 10.6% versus 11.1%; log-rank p=0.761).

Conclusion

Strict BP control is more important than glycemic control to improve short-term clinical outcome in DM patients with AMI. However, in patients with poor glycemic control, strict BP control did not improve clinical outcome.

P3583Optimal procedural strategy to improve clinical outcome in primary percutaneous coronary intervention

Background

Current guideline recommends potent antiplatelet agents and transradial intervention. However, it is uncertain whether routine use of IVUS, thrombus aspiration and glycoprotein IIB-IIIA inhibitor is beneficial for improving clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI).

Purpose

The aim of this study was to investigate optimal procedural strategy to improve clinical outcome.

Methods

A total of 6,046 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were analyzed from the Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database. MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.

Results

During the primary PCI, potent antiplatelet agents such as prasugrel and ticagrelor were used in 2342 (38.4%). PCI was performed through transradial approach in 1490 (25.2%). Thrombus aspiration and intravascular ultrasound (IVUS) examination was done in 2204 (36.1%) and 1079 (18.1%), respectively. Glycoprotein IIB-IIIA inhibitor was administered in 1295 (21.7%). Among them, potent antiplatelet agents, transradial intervention, IVUS, and thrombus aspiration significantly reduced MACCEs at 1 year. Glycoprotein IIB-IIIA inhibitor was not effective to improved clinical outcome. In Cox-proportional hazards model, potent antiplatelet agents (hazard ratio 0.82, 95% confidence interval 0.67–0.99; p=0.045) and transradial intervention (hazard ratio 0.61, 95% confidence interval 0.47–0.78; p<0.001) was an independent predictor of MACCEs after adjusting for confounding variables. Combined use of potent antiplatelet agents and transradial intervention (hazard ratio 0.54; 95% confidence interval 0.37–0.80; p=0.002) substantially reduced MACCEs at 1 year.

Conclusion

Among evidence based procedures during the primary PCI, combined use of potent antiplatelet agents and transradial intervention was optimal procedural strategy to improve clinical outcome.

P6253Electrocardiographic characteristics for prediction of irreversible fulminant hepatitis in patients with acute hepatic failure

Background

There was limited data about the association between the electrocardiographic characteristics and irreversible fulminant hepatitis (IFH) in patients with acute hepatic failure (AHF) in the long-term follow up.

Purpose

The aim of this study was to analysis the electrocardiographic characteristics for prediction of IFH in patients with AHF.

Methods

Our University echocardiography, electrocardiogram (ECG) and viral hepatitis database were reviewed from 2008 to 2017 to identify patients with AHF. Patients were followed for a mean 32.0±0.8 months and were analyzed to find out the predictors for IFH.

Results

Among 202 patients with AHF, 23 (11.4%) patients had IFH. In our study, there are 118 (58.7%) viral hepatitis patients (hepatitis A, 83 patients, 41.3%; hepatitis B, 19 patients, 9.5%; hepatitis C, 15 patients, 7.5%) and alcoholic hepatitis patients (83 patients, 41.3%). Based on the ROC curve, we set the corrected QT interval (QTc) cutoff value of 425 msec for prediction of IFH, which gave a sensitivity of 66.7% and a specificity of 66.0% (P=0.002). In univariate analysis, age, QTc, diabetes mellitus (DM), heavy alcoholics, labile INR, hemoglobin, albumin, total bilirubin, sodium, and c-reactive protein were significantly associated with IFH. In multivariate analysis, age, QTc, DM, heavy alcoholics, and total bilirubin were independent risk factors for IFH at the long-term follow-up.

Conclusion

Longer QTc (>425msec) in patients with AHF was associated with higher IFH, suggesting close clinical and electrocardiographic follow-up will be required.

Acknowledgement/Funding

None

Rational Design of Carbon Nanomaterials for Electrochemical Sodium Storage and Capture

Electrochemical sodium storage and capture are considered an attractive technology owing to the natural abundance, low cost, safety, and cleanness of sodium, and the higher efficiency of the electrochemical system compared to fossil-fuel-based counterparts. Considering that the sodium-ion chemistry often largely deviates from the lithium-based one despite the physical and chemical similarities, the architecture and chemical structure of electrode materials should be designed for highly efficient sodium storage and capture technologies. Here, the rational design in the structure and chemistry of carbon materials for sodium-ion batteries (SIBs), sodium-ion capacitors (SICs), and capacitive deionization (CDI) applications is comprehensively reviewed. Types and features of carbon materials are classified into ordered and disordered carbons as well as nanodimensional and nanoporous carbons, covering the effect of synthesis parameters on the carbon structure and chemistry. The sodium storage mechanism and performance of these carbon materials are correlated with the key structural/chemical factors, including the interlayer spacing, crystallite size, porous characteristics, micro/nanostructure, morphology, surface chemistry, heteroatom incorporation, and hybridization. Finally, perspectives on current impediment and future research directions into the development of practical SIBs, SICs, and CDI are also provided.

Search for a Dark Matter-Induced Annual Modulation Signal in NaI(Tl) with the COSINE-100 Experiment

We present new constraints on the dark matter-induced annual modulation signal using 1.7 years of COSINE-100 data with a total exposure of 97.7 kg yr. The COSINE-100 experiment, consisting of 106 kg of NaI(Tl) target material, is designed to carry out a model-independent test of DAMA/LIBRA's claim of WIMP discovery by searching for the same annual modulation signal using the same NaI(Tl) target. The crystal data show a 2.7  cpd/kg/keV background rate on average in the 2-6 keV energy region of interest. Using a χ-squared minimization method we observe best fit values for modulation amplitude and phase of 0.0092±0.0067  cpd/kg/keV and 127.2±45.9  d, respectively.

Surface-Modified Sulfur Nanorods Immobilized on Radially Assembled Open-Porous Graphene Microspheres for Lithium-Sulfur Batteries

The assembly of two-dimensional conductive nanomaterials into hierarchical complex architectures precisely controlling internal open porosity and orientation, external morphology, composition, and interaction is expected to provide promising hosts for high-capacity sulfur cathodes. Herein, we demonstrate rod-like nanosulfur (nS) deposited onto radially oriented open-porous microspherical reduced graphene oxide (rGO) architectures for improved rate and cyclic capabilities of lithium-sulfur (Li-S) batteries. The combined chemistry of a spray-frozen assembly and ozonation drives the formation of a radially oriented open-porous structure and an overall microspherical morphology as well as uniform distribution and high loading of rod-like nS. Moreover, an optimum composition and strong bonding of the rGO/nS hybrid enables the optimization of redox kinetics for high sulfur utilization and high-rate capacities. The resulting rGO/nS hybrid provides a specific capacity and first-cycle Coulombic efficiency of 1269.1 mAh g^-1 and 98.5%, respectively, which are much greater than those of ice-templated and physically mixed rGO/nS hybrids and radially oriented open-porous rGO/bulk sulfur with the same hybrid composition. A 4C capacity of 510.3 mAhg^-1 and capacity decay of 0.08% per cycle over 500 cycles (70.9% of the initial capacity over 300 cycles) also support the synergistic effect of the rod-like nS strongly interacting with the radially oriented open-porous rGO microspheres.

First Direct Search for Inelastic Boosted Dark Matter with COSINE-100

A search for inelastic boosted dark matter (IBDM) using the COSINE-100 detector with 59.5 days of data is presented. This relativistic dark matter is theorized to interact with the target material through inelastic scattering with electrons, creating a heavier state that subsequently produces standard model particles, such as an electron-positron pair. In this study, we search for this electron-positron pair in coincidence with the initially scattered electron as a signature for an IBDM interaction. No excess over the predicted background event rate is observed. Therefore, we present limits on IBDM interactions under various hypotheses, one of which allows us to explore an area of the dark photon parameter space that has not yet been covered by other experiments. This is the first experimental search for IBDM using a terrestrial detector.

Abstract P3-03-31: Is sentinel lymph node biopsy necessary in all patients with early breast cancer?

Background and objectives : Since the results of the American College of Surgeons Oncology Group Z0011 published, the criteria for applying axillary lymph node (ALN) dissection was relaxed among early breast cancer patients who were scheduled for breast conserving surgery, adjuvant chemotherapy therapy, and adjuvant radiation therapy. SLNB criteria may be established if pathologic nodal status can be predicted. The aim of this study was to develop a nomogram for preoperative prediction of axillary node metastasis.

Methods: The records of 1650 patients with T1, T2 primary invasive breast cancer who were treated between January 2013 and September 2016 were selected from the medical database of Yonsei University (Seoul, South Korea). Those whom a preoperative diagnosis of axillary node metastases were excluded. Two nomogram that predicted three or more axillary metastasis and one or more axillary metastasis were developed using a binary logistic regression model with a training cohort. Internal validation was carried out adopting bootstrap method by validation cohort 500 times resampling.

Result: A total of 82 (4.8%) patients had three or more ALNs metastasis. Three hundred seventy five (17.4%) patients had one or more ALNs metastasis. Axillary metastasis was associated with Preoperative ALN suspicious image findings, clinical tumor size, Number of neoplastic foci, estrogen receptor status, Ki-67 expression, tumor marker. The nomogram was developed based on the clinical and statistically significant predictors. It had good discrimination performance (AUC 0.79, 95% CI, 0.73–0.85), (AUC 0.71, 95% CI, 0.67–0.74) and calibration fit.

Conclusion:Our nomogram might help predict the ALN metastasis in breast cancer patients. Patients with a low probability of ALN metastasis could be spared SLNB.

Citation Format: Yoon KH, Lee KB, Lee H, Lee J, Kim JY, Park HS, Park S, Kim SI, Cho YU, Park B-W. Is sentinel lymph node biopsy necessary in all patients with early breast cancer? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-31.

Abstract OT2-01-03: A prospective pilot study of simultaneous robotic assisted nipple sparing mastectomy and immediate reconstruction

Endoscopic breast surgery was expected to be an adequate technique to complete cancer clearance and preservation of the patient's body image. However, this technique has limitations including incomplete internal movements and unstable vision of a two dimensional camera due to inflexible endoscopic instruments especially during the skin flap formation. High resolution, ten-fold image magnification, and three-dimensional optics of robotic surgery help overcome the limitations of endoscopic surgery, and thus robotic surgery has been adopted in a wide range of intracorporeal procedures including breast surgery. However, few studies have evaluated feasibility and safety of robotic assisted nipple sparing mastectomy (RANSM) and immediate breast reconstruction (IBR) for the treatment of breast cancer. There were not any investigation to assess patients' satisfaction of cosmetic effect after performing RANSM and IBR. This study is aim to verify the feasibility and the safety of RANSM and IBR and to analyze cosmetic effect of the procedure and satisfaction of patients. The target number of enrollments is 15 patients. Patients who are diagnosed with early breast cancer or BRCA 1/2 mutation carriers are enrolled. Female patients over 20 years old who are candidates to preserve nipple areolar complex and considered to perform reconstruction with implants are prospectively collected. Written informed consents are mandatory. Patients who are considered the high possibility of postoperative radiation therapy according to preoperative stage are not included in this study. We exclude patients who want to undergo other methods of breast reconstruction than breast reconstruction with implants. Patients will undergo RANSM and IBR through a single axillary skin incision simultaneously. Regular follow-up at 1 month and 6 months after RANSM and IBR is scheduled to record recovery of a patient, amount of a drain, date of drain removal, and postoperative complications. Patient satisfaction questionnaire will be completed on the last follow-up day. To evaluate the safety of robotic assisted surgery, the oncologic safety (margin status of nipple areolar complex), postoperative recovery of a patient, and postoperative complications are investigated. We compare preoperative and postoperative 6 month photographs of patients and estimate the surgical outcome by objective indicators to evaluate the cosmetic grading by plastic surgeons. Patients' satisfaction are assessed by questionnaire (BREAST-Q) at the 6-month visit.

Citation Format: Lee J, Park HS, Kim JH, Lee DW, Song SY, Lew DH, Kim JY, Kim SI, Cho YU, Lee H, Lee KB, Yoon KH. A prospective pilot study of simultaneous robotic assisted nipple sparing mastectomy and immediate reconstruction [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-01-03.

Revealing molecular-level surface redox sites of controllably oxidized black phosphorus nanosheets

Bulk and two-dimensional black phosphorus are considered to be promising battery materials due to their high theoretical capacities of 2,600 mAh g^-1. However, their rate and cycling capabilities are limited by the intrinsic (de-)alloying mechanism. Here, we demonstrate a unique surface redox molecular-level mechanism of P sites on oxidized black phosphorus nanosheets that are strongly coupled with graphene via strong interlayer bonding. These redox-active sites of the oxidized black phosphorus are confined at the amorphorized heterointerface, revealing truly reversible pseudocapacitance (99% of total stored charge at 2,000 mV s^-1). Moreover, oxidized black-phosphorus-based electrodes exhibit a capacitance of 478 F g^-1 (four times greater than black phosphorus) with a rate capability of ~72% (compared to 21.2% for black phosphorus) and retention of ~91% over 50,000 cycles. In situ spectroelectrochemical and theoretical analyses reveal a reversible change in the surface electronic structure and chemical environment of the surface-exposed P redox sites.