bluuebunny/crossref_metadata_2025 huggingface dataset:
Lower mean blood glucose during short‐term intensive insulin therapy is associated with long‐term glycemic remission in patients with newly diagnosed type 2 diabetes: Evidence‐based recommendations for standardization
Authors: Liu Liehua , Liu Juan , Xu Lijuan , Ke Weijian , Wan Xuesi , Li Hai , He Xiaoying , Wang Liangjiao , Cao Xiaopei , Xiao Haipeng , Li Yanbing
Published: November 2017

Aims/Introduction

Optimal glycemic targets during short‐term intensive insulin therapy in patients with newly diagnosed type 2 diabetes are not standardized. The present study was carried out to determine the optimal glycemic targets during therapy by analyzing the impacts of glucose levels on therapeutic outcomes.

Materials and Methods

A total of 95 individuals with newly diagnosed type 2 diabetes were enrolled. Short‐term intensive insulin therapy was carried out using an insulin pump to achieve and maintain glycemic targets (fasting blood glucose ≤6.0 mmol/L, 2‐h postprandial blood glucose ≤7.8 mmol/L) for 14 days, with daily eight‐point capillary blood glucose profiles recorded. Patients were followed up for 1 year after discharge.

Results

In most participants, the mean blood glucose and glycemic excursion parameters during the therapy were controlled within the normal range. Mean blood glucose was independently associated with amelioration of acute insulin response (r = −0.25, P = 0.015) and 1‐year remission (odds ratio 0.12, 95% confidence interval 0.034–0.426), but negatively associated with more level 1 hypoglycemia (r = −0.34, P = 0.001), although major hypoglycemia was rare. Among mean blood glucose tertiles, patients in the middle (68.7%) and lower (75.0%) tertiles had a higher 1‐year remission rate compared with the upper tertile (32.3%, both P < 0.001), whereas only the middle tertile did not have increased hypoglycemia compared with the upper tertile (8.1 ± 5.4 vs 7.2 ± 3.9 events/person, P = 0.48).

Conclusions

Stricter glycemic control during short‐term intensive insulin therapy produced more remission despite self‐manageable hypoglycemia. Based on glycemic parameters in the middle mean tertile, we propose new glycemic targets that are approximately 0.4 mmol/L lower than current the targets, as long‐term benefit outweighs short‐term risks.
Laryngeal chondronecrosis after radiation therapy in a dog
Authors: Bertran J. , Martinez M. , Breit M. , McLoughlin M. A. , Ham K. L. , Warry E. , Wavreille V.
Published: November 2017

A 5‐year‐old pug presented with a soft tissue swelling on the ventral neck and moderate stridor with associated respiratory effort. This patient received hypofractionated radiotherapy for metastatic upper lip mast cell tumour and to the submandibular lymph nodes 6 months before presentation. Oral examination showed moderate elongation of the soft palate, stage III laryngeal collapse with only the right laryngeal saccule mildly everted and exuberant pale epiglottal and left pharyngeal mucosa. Staphylectomy, resection of the epiglottal mucosa and left arytenoid lateralisation were performed. One day after surgery, temporary tracheostomy was performed after respiratory distress due to the severe laryngeal and pharyngeal oedema. A third oral exam showed pale and redundant caudal pharyngeal mucosa obstructing the rima glottis, soft and collapsible arytenoid cartilage with pale mucosa and bilateral everted laryngeal saccules. Permanent tracheostomy was elected and laryngeal cartilage biopsies were taken. Histologic diagnosis showed cartilage necrosis and abundant tissue oedema. The patient was euthanased 1 week later.
Treatment of pathologic peri‐implant pockets
Authors: Renvert Stefan , Polyzois Ioannis
Published: November 2017

Peri‐implant and periodontal pockets share a number of anatomical features but also have distinct differences. These differences make peri‐implant pockets more susceptible to trauma and infection than periodontal pockets. Inadequate maintenance can lead to infections (defined as peri‐implant mucositis and peri‐implantitis) within peri‐implant pockets. These infections are recognized as inflammatory diseases, which ultimately lead to the loss of supporting bone. Diagnostic and treatment methods conventionally used in periodontics have been adopted to assess and treat these diseases. Controlling infection includes elimination of the biofilm from the implant surface and efficient mechanical debridement. However, the prosthetic supra‐structure and implant surface characteristics can complicate treatment. Evidence shows that when appropriately managed, peri‐implant mucositis is reversible. Nonsurgical therapy, with or without the use of antimicrobials, will occasionally resolve peri‐implantitis, but for the majority of advanced lesions this approach is insufficient and surgery is indicated. The major objective of the surgical approach is to provide access and visualize the clinical situation. Hence, a more informed decision can be made regarding whether to use a resective or a regenerative surgical technique. Evidence shows that following successful decontamination, surgical treatment to regenerate the bone can be performed, and a number of regenerative techniques have been proposed. After treatment, regular maintenance and good oral hygiene are essential for a predictable outcome and long‐term stability.
Engine Performances With Advanced Common Rail Injector Design
Authors: Zimmermann Kilian , Haefeli Richard , Ganser Marco
Published: November 2017

This paper presents the application of the Ganser CRS common rail injectors with the proprietary poppet valve, the state of the art hydraulic switching device for common rail injectors. Due to its unique design, the combustion process is optimized by stable and rapid injection rate profiles, which are allowing for reliable multiple injection driving strategies to further reduce the fuel consumption and in-cylinder emissions. Due to its flexible characteristics, the poppet valve is applicable in numerous fields. Two applications are specifically presented in this paper.

The first application of the poppet valve is the common rail retrofit of a V16 GE® 7FDL locomotive engine with a power output of 4000HP. In this retrofit project, the existing mechanical fuel injection system is replaced by a common rail system. The injector design is such that no changes to the cylinder head are required. The injector includes an integrated accumulator for maximized and constant injection pressures during the whole injection process. Each cylinder bank is equipped with its own slim rail attached to the engine structure and a dedicated high pressure pump, allowing for a freely configurable injection event up to 1600bar. The resulting significant reduction of fuel consumption over the locomotive duty cycle as well as emissions reductions are discussed in detail in this paper.

The poppet valve is also successfully applied in the field of micro pilot injection for new dual fuel engines, in the marine and power-gen sectors, as a second application of this injector design principle. On these engines, the micro pilot injection quantity to ignite the gas is typically 0.5–2% of the total energy input. This maximized diesel fuel substitution is possible because of the accurate switching characteristics of the poppet valve at smallest injection quantities. With the application of the proprietary Wave Dynamics and Dampening System (WDD) [1] and injector-integrated accumulators, the rail can be replaced completely by so-called jumper lines, while maintaining a slim outer shape on the overall injector size.
Using LES to Simulate Cycle-to-Cycle Variability During the Gas Exchange Process
Authors: Ameen Muhsin M. , Yang Xiaofeng , Kuo Tang-Wei , Som Sibendu
Published: November 2017

In spark ignition (SI) engines, high efficiencies are typically obtained near limits of stable operation which may result in high cycle-to-cycle variations (CCV). Traditional computational fluid dynamics (CFD) tools like Reynolds-averaged Navier-Stokes simulations (RANS) may not predict the CCV in engines. Higher fidelity CFD tools like large-eddy simulations (LES) have been shown to capture these CCV. In this paper, LES of a motored transparent combustion chamber (TCC) engine is performed to simulate the CCV introduced during the gas exchange process. A grid convergence study is performed, and it is shown that using a 1 mm in-cylinder grid size leads to similar flowfield statistics as compared to using a 0.5 mm in-cylinder grid size. The phase-averaged mean and root mean square (RMS) flowfields predicted by LES are validated comprehensively using particle image velocimetry (PIV) measurements. The validation is performed for 4 different crank angles, corresponding to the intake, compression, expansion and exhaust strokes, and for three different measurement planes. It is shown that LES is able to accurately predict the mean velocities, whereas the RMS velocity magnitudes are under-predicted. The inaccuracy in the RMS velocities are largest during the intake stroke, whereas good agreement with the measurements is observed during the expansion and exhaust strokes. A similarity index analysis provides a quantitative measure of the number of cycles that are required to be simulated to capture the flowfield statistics. This analysis is applied to both the PIV dataset and CFD dataset. It is shown that approximately 20 cycles are sufficient to obtain converged mean and RMS flowfields from the simulations, whereas the PIV measurements require approximately 40 cycles. Faster convergence for the LES results is because the simulations do not take into account additional uncertainties in the rpm, plenum pressures, boundary temperatures and so on, which are present in the experiments.
A Study of Injection Strategy to Achieve High Load Points for Gasoline Compression Ignition (GCI) Operation
Authors: Cung Khanh , Ciatti Stephen
Published: November 2017

Many studies have shown that gasoline compression ignition (GCI) can replace conventional diesel combustion (CDC) by achieving high efficiency and low smoke and toxic gaseous emissions simultaneously. This is due to the low cetane number of gasoline that results in long ignition delay, allowing very advanced injection timing. This gives even longer time for fuel-air mixing, thus resulting in locally lean combustion that produces low particulate matter (PM). However, GCI operation faces challenges at high engine load condition. At high load conditions, large amounts of fuel injected early for premixed combustion can lead to high combustion noise from premixed combustion. Meanwhile, more fuel late injected late leads to poor mixing, hence higher smoke. Multiple injections can offer the flexibility in controlling the in-cylinder fuel stratification level. In this study, moderate to high engine loads of 8 to 14 bar BMEP were accomplished by utilizing an optimal multiple injection scheme. Injection timing of pilot, main, and post injections was investigated individually for its effect on the emission and engine performance. A moderate level of exhaust gas recirculating (EGR) was used to achieve low temperature combustion (LTC) condition. While higher EGR reduced NOx significantly due to lower combustion temperature, it affected the maximum boost that could be acquired by the turbocharger due to the reduction in exhaust enthalpy. During the engine load/speed sweep, calculations of combustion, thermodynamics, gas exchange, and mechanical efficiencies were analyzed to identify factor that needs to be improved for GCI operation. This study also demonstrates the importance of injection strategy including high injection pressure to attain high load points with low smoke and low noise.
CFD Simulations of the Effect of Water Injection Characteristics on TSCI: A New, Load-Flexible, Advanced Combustion Concept
Authors: Rahimi Boldaji Mozhgan , Sofianopoulos Aimilios , Mamalis Sotirios , Lawler Benjamin
Published: November 2017

Homogeneous Charge Compression Ignition (HCCI) combustion has the potential for high efficiency with very low levels of NOx and soot emissions. However, HCCI has thus far only been achievable in a laboratory setting due to the following challenges: 1) there is a lack of control over the start and rate of combustion, and 2) there is a very limited and narrow operating range. In the present work, the injection of water directly into the combustion chamber was investigated to solve the aforementioned limitations of HCCI. This new advanced combustion mode is called Thermally Stratified Compression Ignition (TSCI).

A 3-D CFD model was developed using CONVERGE CFD coupled with detailed chemical kinetics to gain a better understanding of the underlying phenomena of the water injection event in a homogeneous, low temperature combustion strategy. The CFD model was first validated against previously collected experimental data. The model was then used to simulate TSCI combustion and the results indicate that injecting water into the combustion chamber decreases the overall unburned gas temperature and increases the level of thermal stratification prior to ignition. The increased thermal stratification results in a decreased rate of combustion, thereby providing control over its rate. The results show that the peak pressure and gross heat release rate decrease by 37.8% and 83.2%, respectively, when 6.7 mg of water were injected per cycle at a pressure of 160 bar. Finally, different spray patterns were simulated to observe their effect on the level of thermal stratification prior to ignition. The results show that symmetric patterns with more nozzle holes were generally more effective at increasing thermal stratification.
Numerical evidence of fluctuating stripes in the normal state of high-
T
c
cuprate superconductors
Authors: Huang Edwin W. , Mendl Christian B. , Liu Shenxiu , Johnston Steve , Jiang Hong-Chen , Moritz Brian , Devereaux Thomas P.
Published: November 2017

Numerics converging on stripes

The Hubbard model (HM) describes the behavior of interacting particles on a lattice where the particles can hop from one lattice site to the next. Although it appears simple, solving the HM when the interactions are repulsive, the particles are fermions, and the temperature is low—all of which applies in the case of correlated electron systems—is computationally challenging. Two groups have tackled this important problem. Huang
et al.
studied a three-band version of the HM at finite temperature, whereas Zheng
et al.
used five complementary numerical methods that kept each other in check to discern the ground state of the HM. Both groups found evidence for stripes, or one-dimensional charge and/or spin density modulations.

Science
, this issue p.
1161
, p.
1155
Osteoblasts remotely supply lung tumors with cancer-promoting SiglecFhighneutrophils
Authors: Engblom Camilla , Pfirschke Christina , Zilionis Rapolas , Da Silva Martins Janaina , Bos Stijn A. , Courties Gabriel , Rickelt Steffen , Severe Nicolas , Baryawno Ninib , Faget Julien , Savova Virginia , Zemmour David , Kline Jaclyn , Siwicki Marie , Garris Christopher , Pucci Ferdinando , Liao Hsin-Wei , Lin Yi-Jang , Newton Andita , Yaghi Omar K. , Iwamoto Yoshiko , Tricot Benoit , Wojtkiewicz Gregory R. , Nahrendorf Matthias , Cortez-Retamozo Virna , Meylan Etienne , Hynes Richard O. , Demay Marie , Klein Allon , Bredella Miriam A. , Scadden David T. , Weissleder Ralph , Pittet Mikael J.
Published: November 2017

A bona fide portrayal of tumor growth

Bone has a well-established role in advanced cancer. It provides a supportive microenvironment for the growth of metastatic cells that escape the primary tumor, which ultimately leads to loss of bone mass. Engblomet al.show that bone may also contribute to early-stage tumorigenesis through a mechanism that leads to an increase in bone mass (see the Perspective by Zhang and Lyden). In mouse models of lung adenocarcinoma, primary tumor cells remotely activated bone-resident cells called osteoblasts, which have a bone-building function. The activated osteoblasts in turn triggered production of a certain type of neutrophil that infiltrates the primary tumor and promotes its growth. Patients with early-stage lung cancer were also found to have an increase in bone density, consistent with the findings in mice.

Science, this issue p.eaal5081; see also p.1127
Follicular bronchiolitis in an HIV-infected individual on combination antiretroviral therapy with low CD4+ cell count but sustained viral suppression
Authors: Rasmussen Line D , Pedersen Court , Madsen Helle D , Laursen Christian B
Published: November 2017

A 36-year-old Danish man, living in Asia, was diagnosed withPneumocystispneumonia (PCP) and HIV in 2013 (CD4+ count: 6 cells/µL; viral load: 518 000 copies/mL). He initiated combination antiretroviral therapy. Later that year, he was also diagnosed with granulomatosis with polyangiitis and was treated with prednisolone. Despite complete viral suppression and increasing CD4+ count (162 cells/µL), he was readmitted with PCP in April 2015. Subsequently, he returned to Denmark (CD4+ count: 80 cells/µL, viral suppression). Over the following months, he developed progressive dyspnoea. Lung function tests demonstrated severely reduced lung capacity with an obstructive pattern and a moderately reduced diffusion capacity. High resolution computer tomography revealed minor areas with tree-in-bud pattern and no signs of air trapping on expiratory views. Lung biopsy showed lymphocytic infiltration surrounding the bronchioles with sparing of the alveolar septa. He was diagnosed with follicular bronchiolitis. The patient spontaneously recovered along with an improvement of the immune system.
Individual and partnership factors associated with anticipated versus actual partner notification following STI diagnosis among men who have sex with men and/or with transgender women in Lima, Peru
Authors: Braun Hannan M , Segura Eddy R , Lake Jordan E , Gandhi Monica , Rios Jessica , Villaran Manuel V , Sanchez Jorge , Lama Javier R , Clark Jesse L
Published: November 2017

Objectives

A detailed understanding of intentions and practices related to partner notification (PN) following STI diagnosis can improve control strategies. We assessed participant-level and partner-level factors guiding notification behaviour among men who have sex with men and/or with transgender women (MSM-TW) in Lima, Peru, including discordances between anticipated and actual notification.

Methods

Men newly diagnosed with gonorrhoea, chlamydia and/or syphilis between 2012 and 2014 reported recent partners’ characteristics, anticipated PN practices, and actual PN outcomes following diagnosis. Generalised estimating equation Poisson regression analyses assessed factors guiding PN outcomes.

Results

Participants (n=150) predominantly identified as homosexual (70%) and moderno (versatile sexual role, 55%); 55% of partners (n=402) were casual. Among all sexual partners, 35% were notified of the STI diagnosis, though only 51% of predicted PN occurred and 26% of actual notifications were unanticipated. 47% of participants notified no partners, while 24% notified all partners. PN was more common with stable versus casual (adjusted prevalence ratio (aPR), 95% CI: 0.53, 0.39 to 0.73) or commercial (aPR, 95% CI: 0.38, 0.12 to 1.21) partners, and among participants who perceived PN as normative among their peers (aPR, 95% CI: 1.96, 1.37 to 2.82). A trend towards greater notification following condom-protected intercourse was observed (aPR, 95% CI: 1.33, 0.98 to 1.81). PN frequency did not differ by type of STI diagnosed.

Anticipated notification predicted actual notification (aPR, 95% CI: 1.67, 1.19 to 2.33) only imperfectly: 81 (54%) participants’ PN practices did not match their anticipated behaviour. Successful notification despite anticipated silence (40 participants, 63 partners) was associated with stable partnerships and a normative perception of PN. Non-notification despite intention (43 participants, 73 partners) frequently occurred among participants reporting exclusively oral sex with the partner or with partners identified as activo (insertive role).

Conclusions

Anticipated notification imperfectly reflects actual PN behaviour. Future interventions to improve PN among MSM-TW in Peru need to acknowledge partnership contexts.
Galileon string measure and other modified measure extended objects
Authors: Vulfs T. O. , Guendelman E. I.
Published: November 2017

We show that it is possible to formulate string theory as a “Galileon string theory”. The Galileon field [Formula: see text] enters in the definition of the integration measure in the action. Following the methods of the modified measure string theory, we find that the final equations are again those of the sigma-model. Moreover, the string tension appears again as an additional dynamical degree of freedom. At the same time, the theory satisfies all requirements of the Galileon higher derivative theory at the action level while the equations of motion are still of the second-order. A Galileon symmetry is displayed explicitly in the conformal string worldsheet frame. Also, we define the Galileon gauge transformations. Generalizations to branes with other modified measures are discussed.
Applying Sutureless Encircling Number 41 Band and Transscleral Chandelier-Assisted Laser Retinopexy for Scleral Buckling Procedure
Authors: Gomaa Amir Ramadan , Elbaha Samir Mohamed
Published: November 2017

Purpose. To assess the outcome of sutureless encirlcing number 41 band and transscleral laser retinopexy in uncomplicated rhegmatogenous retinal detachment (RRD), using a wide-angle viewing system (WAVS) and chandelier endoillumination.Methods. Prospective intervention study included 30 eyes of 30 patients presenting with RRD of recent onset indicated for SB. All cases were treated by sutureless encircling number 41 band and transscleral laser retinopexy. Visualization was provided by the Resight WAVS and a single 27-gauge chandelier endoillumination. Anatomical and visual outcomes were evaluated.Results. The mean age of our group was 49.8 ± 12.3 years, and the mean duration of RD was 7 (0–50) days. Twenty-four eyes (80.0%) were phakic while the remaining 6 eyes (20%) were either pseudophakic or aphakic. The primary retinal reattachment rate was 83.3% (25 out of 30 eyes). LogMAR visual acuity improved from 1.3 (0.30–2.0) preoperatively to 1.0 (0.40–1.60) at first month (p=0.002) and to 0.70 (0.20–1.92) at third month (p<0.001).Conclusion. Sutureless encircling number 41 band with chandelier-assisted transscleral laser retinopexy is a safe and effective technique for managing uncomplicated RRD. It provides a high primary success rate while eliminating the complications of cryotherapy, sutures, and broad buckles.
Pomegranate Juice Prevents the Formation of Lung Nodules Secondary to Chronic Cigarette Smoke Exposure in an Animal Model
Authors: Husari Ahmad , Hashem Yasmine , Zaatari Ghazi , El Sabban Marwan
Published: November 2017

Background. Cigarette smoke (CS) induces an oxidative stress, DNA damage, and lung cancer. Pomegranate juice (PJ) possess potent antioxidant activity attributed to its polyphenols. We investigated whether PJ supplementation would prevent the formation of lung nodules, attenuate mitotic activity, and reduce hypoxia‐inducible factor‐1α (HIF‐1α) expression secondary to CS exposure in an animal model. Methods. Mice were divided into: Control group, CS group, CS + PJ group, and PJ‐only group. CS and CS + PJ were exposed to CS, 5 days per week, for a total of 5 months. Animals were then housed for additional four months. CS + PJ and PJ groups received PJ throughout the experiment period while others received placebo. At the end of the experiment, the incidence of lung nodules was assessed by (1) histological analysis, (2) mitotic activity [measurement of PHH3 antibodies], and (3) measurement of HIF‐1α expression. Results. The incidence of lung nodules was significantly increased in CS. CS exposure significantly increased PHH3 and HIF‐1α expression. PJ supplementation attenuated the formation of lung nodules and reduced PHH3 and HIF‐1α expression. Conclusion. PJ supplementation significantly decreased the incidence of lung cancer, secondary to CS, prevented the formation of lung nodules, and reduced mitotic activity and HIF‐1α expression in an animal model.
Blocking the Feedback Loop between Neuroendocrine Differentiation and Macrophages Improves the Therapeutic Effects of Enzalutamide (MDV3100) on Prostate Cancer
Authors: Wang Chao , Peng Guang , Huang Hai , Liu Fei , Kong De-Pei , Dong Ke-Qin , Dai Li-He , Zhou Zhe , Wang Kai-Jian , Yang Jun , Cheng Yan-Qiong , Gao Xu , Qu Min , Wang Hong-Ru , Zhu Feng , Tian Qin-Qin , Liu Dan , Cao Li , Cui Xin-Gang , Xu Chuan-Liang , Xu Dan-Feng , Sun Ying-Hao
Published: November 2017

Purpose: Androgen deprivation therapy (ADT), including enzalutamide, induces resistance in prostate cancer; ADT resistance is associated with neuroendocrine differentiation (NED) and tumor-associated macrophages (TAM). This study aimed to investigate the association between enzalutamide-induced NED and TAMs and its mechanism.

Experimental Design: The association between enzalutamide-induced NED and TAMs was investigated by IHC using prostate cancer tissues, enzalutamide-resistant mouse xenografts, and a coculture system. The underlying mechanisms were assessed using in vitro cytokine antibody arrays, ELISAs, chromatin immunoprecipitation, and other methods. An orthotopic prostate cancer mouse model was established to evaluate the in vivo effects of combined IL6 receptor (IL6R) and high mobility group box 1 (HMGB1) inhibition on enzalutamide resistance.

Results: High CD163 expression was observed in ADT-treated prostate cancer or castration-resistant prostate cancer (CRPC) tissues with high levels of neuron-specific enolase (NSE) and chromogranin A (CHGA) and in enzalutamide-resistant xenografts, indicating the crucial roles of NED and TAMs in enzalutamide resistance. Specifically, enzalutamide-induced HMGB1 expression facilitated TAM recruitment and polarization and drove NED via β-catenin stabilization. HMGB1-activated TAMs secreted IL6 to augment enzalutamide-induced NED and directly promote HMGB1 transcription via STAT3. Finally, inhibition of the IL6/STAT3 pathway by tocilizumab combined with HMGB1 knockdown inhibited enzalutamide-induced resistance in an orthotopic prostate cancer mouse model.

Conclusions: Enzalutamide elevates HMGB1 levels, which recruits and activates TAMs. Moreover, IL6 secreted by HMGB1-activated TAMs facilitates the enzalutamide-induced NED of prostate cancer, forming a positive feedback loop between NED in prostate cancer and TAMs. The combined inhibition of IL6R and HMGB1 may serve as a new treatment for enzalutamide resistance in patients with advanced or metastatic prostate cancer. Clin Cancer Res; 24(3); 708–23. ©2017 AACR.
A Retrospective Review of the Diagnostic and Management Challenges of Mirizzi Syndrome at the Singapore General Hospital
Authors: Seah Wei Ming , Koh Ye Xin , Cheow Peng Chung , Chow Pierce K.H. , Chan Chung Yip , Lee Ser Yee , Ooi London L.P.J. , Chung Alexander Y.F. , Goh Brian K.P.
Published: November 2017

Background: Mirizzi syndrome (MS) occurs when gallstone impaction in Hartmann’s pouch results in extrinsic obstruction of the common bile duct, and fistulation may occur. Methods: We retrospectively reviewed electronic records of patients surgically treated for MS from November 2001 to June 2012. Patient presentations, diagnostic methods, treatments and complications were recorded. Results: Sixty-four patients were grouped according to a classification proposed by Beltran et al. [World J Surg 2008; 32: 2237–2243]. Forty-three (66.2%), 18 (27.7%) and 3 (4.6%) patients were classified as types I, II, and III respectively. Magnetic-resonance-cholangiopancreaticography was the most sensitive imaging modality, suggesting MS in 24 (88.9%), followed by CT scan (40%) and ultrasonography (11.4%). Forty-four underwent Endoscopic-retrograde-cholangiopancreaticography and 29 (65.9%) suggested the presence of MS. MS was accurately diagnosed pre-operatively in 48 (73.8%) patients. In type I, 40 (93.0%) patients underwent cholecystectomy, while 3 required hepaticojejunostomy. In type II, 12 (66.7%) underwent cholecystectomy and 5 (27.8%) required hepatico-enteric anastomosis. In type III, 1 underwent cholecystectomy and 2 (66.7%) required hepatico-enteric anastomosis. Laparoscopic cholecystectomy was attempted in 20 (30.8%) patients and 13 (65.0%) required conversion. Twenty-nine (44.6%) underwent intra-operative-cholangioscopy, 30 (46.2%) underwent intra-operative-cholangiogram and 41 (63.1%) underwent intra-operative T-tube placement. Six (9.2%) experienced intra-operative complications, 12 (18.5%) experienced post-operative complications and 10 (15.4%) experienced late complications. Conclusion: MS is a challenging condition and multimodal diagnostic approach has the greatest yield in achieving accurate pre-operative diagnosis. If suspicion is high, a trial of laparoscopic dissection with low threshold for open conversion is recommended.
Molecular Ultrasound Imaging of Junctional Adhesion Molecule A Depicts Acute Alterations in Blood Flow and Early Endothelial Dysregulation
Authors: Curaj Adelina , Wu Zhuojun , Rix Anne , Gresch Oliver , Sternkopf Marieke , Alampour-Rajabi Setareh , Lammers Twan , van Zandvoort Marc , Weber Christian , Koenen Rory R. , Liehn Elisa A. , Kiessling Fabian
Published: November 2017

Objective—

The junctional adhesion molecule A (JAM-A) is physiologically located in interendothelial tight junctions and focally redistributes to the luminal surface of blood vessels under abnormal shear and flow conditions accompanying atherosclerotic lesion development. Therefore, JAM-A was evaluated as a target for molecularly targeted ultrasound imaging of transient endothelial dysfunction under acute blood flow variations.

Approach and Results—

Flow-dependent endothelial dysfunction was induced in apolipoprotein E–deficient mice (n=43) by carotid partial ligation. JAM-A expression was investigated by molecular ultrasound using antibody-targeted poly(n-butyl cyanoacrylate) microbubbles and validated with immunofluorescence. Flow disturbance and arterial remodeling were assessed using functional ultrasound. Partial ligation led to an immediate drop in perfusion at the ligated side and a direct compensatory increase at the contralateral side. This was accompanied by a strongly increased JAM-A expression and JAM-A–targeted microbubbles binding at the partially ligated side and by a moderate and temporary increase in the contralateral artery (≈14× [
P
<0.001] and ≈5× [
P
<0.001] higher than control, respectively), both peaking after 2 weeks. Subsequently, although JAM-A expression and JAM-A–targeted microbubbles binding persisted at a higher level at the partially ligated side, it completely normalized within 4 weeks at the contralateral side.

Conclusions—

Temporary blood flow variations induce endothelial rearrangement of JAM-A, which can be visualized using JAM-A–targeted microbubbles. Thus, JAM-A may be considered as a marker of acute endothelial activation and dysfunction. Its imaging may facilitate the early detection of cardiovascular risk areas, and it enables the therapeutic prevention of their progression toward an irreversible pathological state.
Old for people, new for science: a previously undescribed species of harvested Vellozia (Velloziaceae) endemic to the Chapada Diamantina National Park, Bahia (Brazil)
Authors: CONCEIÇÃO ABEL A. , SOUZA JUMARA M. , CARNEIRO JOSEANE S. , MENEZES NANUZA L.
Published: November 2017

The overharvesting of a plant can disturb population dynamics, threatening the species (Ticktin 2004, Rolland et al. 2011). This is especially true for narrowly restricted ones (IUCN 2017), such as the ‘candombá’, endemic to the Chapada Diamantina National Park (CDNP), northeastern Brazil. The extent of occurrence of the candombá is less than 200 km2 (Conceição et al. 2017), and the plant has been traditionally used to ignite fires in wood stoves (Ministério do Meio Ambiente 2007, Oliveira et al. 2013, 2015), with this use continuing today.
The effect of prestress force magnitude on the natural bending frequencies of the eccentrically prestressed glass fibre reinforced polymer composite beams
Authors: Orlowska Anita , Graczykowski Cezary , Galezia Adam
Published: November 2017

This paper studies the effect of prestress force magnitude on natural frequencies and dynamic behaviour of eccentrically prestressed glass fibre reinforced polymer composite beams, including the theoretical background, numerical results and experimental verification. The term prestress indicates the initial tensile stress applied to the fibres embedded in selected external layers of the composite material. First, the paper presents the theoretical background of the finite element method modelling of prestressed composites. Then, the results of numerical simulations conducted for a five-layered glass-epoxy composite beam are presented. The natural frequencies corresponding to three initial bending modes are analyzed for different prestressing force levels and for different fibre volume content. Finally, the results are verificated by experimental modal analysis conducted on three different glass-epoxy composite specimens of various mechanical parameters. Both the numerical results obtained from finite element method and the experimental results obtained from experimental modal analysis reveal that the first bending frequency increases and the two subsequent bending frequencies decrease due to the prestressing force. The comparison of numerical and experimental data confirms the effect and allows to quantify the influence that the prestress force has on the natural frequencies of composites, which is an interesting and practically relevant phenomenon.
Integrating what and for whom? Financialisation and the Thames Tideway Tunnel
Authors: Loftus Alex , March Hug
Published: November 2017

The Thames Tideway Tunnel (TTT), often referred to as the Thames super sewer, is currently one of the largest infrastructure projects underway in any European city. Costing an estimated £4.2 billion, the sewer connects London’s Victorian sewerage network with the Thames Wastewater Treatment Works at Beckton. The latter facility has been described as the UK’s Water–Energy–Food nexus poster child, for its combination of desalination facilities, green energy generation and wastewater treatment. While physically connected to the Beckton plant, the TTT is, paradoxically, designed with an apparent disregard for the water–energy nexus. If the Beckton plant represents a nexus-based vision of integration – what Macrorie and Marvin (2016) refer to as Mode 2 Urban Integration – the TTT harks back to a view of urban integration carried from the Victorian era through to the present moment. What unites the two projects, and what undergirds the transformation of the hydrosocial cycle, is a financial model more focused on the extraction of rents from Thames Water’s consumers. Thames Water’s dismissal of genuinely integrated alternatives appears guided more by the financialisation of the urban integrated ideal than by what is needed to respond to London’s broader environmental needs. Contesting the project, therefore, will involve slicing through the various claims to integration, going beyond the many proposals for evidence-based alternatives, and capturing the transformations being wrought by finance’s entry into infrastructure provision.
Intergroup relations in a super-diverse neighbourhood: The dynamics of population composition, context and community
Authors: Bynner Claire
Published: November 2017

There is now an extensive literature demonstrating that experiences of migration and diversity differ significantly between and across local geographies. Three broad explanations for differences in local outcomes have been put forward (Robinson, 2010): first, population composition – the characteristics of individuals living in the neighbourhood; second, context – the social and physical environment; and third, community – socio-cultural histories and collective identities. Few studies examine the linkages between all three explanations and their relative importance. This article applies all three explanations to intergroup relations in a super-diverse context. It draws on data from a mixed methods case study of a neighbourhood in Glasgow, Scotland where long-term white and ethnic minority communities reside alongside Central and Eastern European migrants, refugees and other recent arrivals. The evidence comprises local statistics and documentary evidence, participant observation and qualitative and walk-along interviews with residents and local organisations. The findings highlight the different ways in which people respond to super-diversity, and the importance of the neighbourhood context and the material conditions for intergroup relations. The article thus demonstrates the ambiguities that arise from applying the dynamics of population composition, context and community to neighbourhood analysis, with implications for the study of neighbourhoods more widely.
Trial-Based Functional Analysis Informs Treatment for Vocal Scripting
Authors: Rispoli Mandy , Brodhead Matthew , Wolfe Katie , Gregori Emily
Published: November 2017

Research on trial-based functional analysis has primarily focused on socially maintained challenging behaviors. However, procedural modifications may be necessary to clarify ambiguous assessment results. The purposes of this study were to evaluate the utility of iterative modifications to trial-based functional analysis on the identification of putative reinforcement and subsequent treatment for vocal scripting. For all participants, modifications to the trial-based functional analysis identified a primary function of automatic reinforcement. The structure of the trial-based format led to identification of social attention as an abolishing operation for vocal scripting. A noncontingent attention treatment was evaluated using withdrawal designs for each participant. This noncontingent attention treatment resulted in near zero levels of vocal scripting for all participants. Implications for research and practice are presented.
The scientization of the world polity: International organizations and the production of scientific knowledge, 1950–2015
Authors: Zapp Mike
Published: November 2017

While recent concepts from the sociology of science stress novel sites of knowledge production (e.g. government, industry), they ignore international organizations’ (IOs) growing research capacity. Conversely, prevailing theories of IOs stress their regulative and normative influence in national policymaking, equally neglecting their scientific work. Using bibliometric data for a large sample of 1325 international organizations, this work examines, for the first time, the evolution of scientific output from international intergovernmental research organizations, intergovernmental organizations, and nongovernmental organizations in the period 1950–2015. The analysis finds a striking increase in scientific activity since the late 1980s and particularly since the early 2000s across organizational types, sectors (e.g. law, nutrition), research fields (e.g. life science, social sciences), output formats (e.g. articles, books), and geographic areas. Indeed, some of these organizations are among the most productive science producers worldwide. Additional analyses of IOs’ research collaborations suggest strong cross-organizational diversity reflecting wider trends of scientific internationalization and integration. The article argues that IOs’ scientization requires a thorough revision of theories of institutional change in science and research systems and of theories about the nature and role of IOs. These organizations reflect, and, indeed, spearhead, wider trends of the rationalization of social order and evidence-based global governance.
An Ecobehavioral Analysis of Child Academic Engagement: Implications for Preschool Children Not Responding to Instructional Intervention
Authors: Greenwood Charles R. , Beecher Constance , Atwater Jane , Petersen Sarah , Schiefelbusch Jean , Irvin Dwight
Published: November 2017

A gap exists in the information needed to make intervention decisions with preschool children who are unresponsive to instructional intervention. Multi-Tiered System of Supports/Response to Intervention (MTSS/RTI) progress monitoring is helpful in indicating when an intervention change is needed but provides little information on what to change. Ecobehavioral observation data may provide this support through information on a child’s academic and other behaviors, given the opportunity to learn. We sought to investigate this hypothesis and develop benchmarks for decision making. Teachers ( N = 39) and two representative age-cohorts of preschool children ( N = 117, 51% boys) were observed using an ecobehavioral, momentary time sample observation system (the Code for Interactive Recording of Children’s Learning Environments [CIRCLE]). Results provided insights into the content and amount of academic instruction children received, the responsiveness of children to instruction, and how context/teacher and child behaviors relationships were moderated by children’s level of Get Ready to Read (GRTR) literacy and Individualized Education Plan (IEP) status risk. Implications are discussed.
Noncardiovascular Disease and Critical Care Delivery in a Contemporary Cardiac and Medical Intensive Care Unit
Authors: Goldfarb Michael , van Diepen Sean , Liszkowski Mark , Jentzer Jacob C. , Pedraza Isabel , Cercek Bojan
Published: November 2017

Background:

Noncardiovascular comorbidities and critical illness are increasing in cardiovascular intensive care units (CICUs). There are limited data comparing critical care delivery, resource utilization, and costs between contemporary CICUs and medical intensive care units (MICUs).

Methods:

All CICU (n = 6967; 22 748 patient-days) and MICU (n = 10 892; 39 211 patient-days) admissions to Cedars-Sinai Medical Center, a tertiary care academic medical center, between January 2011 and December 2016 were reviewed. Both the CICU and MICU admitted patients for primary cardiovascular or medical conditions during the study period, but not for postoperative surgical care.

Results:

Patients admitted to the CICU were more frequently older, male, and had more preexisting cardiac disease ( P < .0001). More than one-fifth (21.4%) of CICU patients had a noncardiovascular primary admission diagnosis, compared to 89.2% of MICU patients. Cardiovascular intensive care unit patients had lower Acute Physiology and Chronic Health Evaluation III scores (51.1 [19.9] vs 61.1 [24.9], P < .0001) and shorter median hospital length of stay ( P < .001), but not in-unit stay, as compared to MICU patients. Mechanical ventilation, vasopressors, inotropes, renal replacement therapy, and/or blood transfusion were required in 35.0% of CICU patients compared with 62.2% of MICU patients ( P < .0001). The unit mortality rate was lower for CICU than MICU patients (4.8% vs 13.0%, P < .0001), as was the hospital mortality rate (9.3% vs 21.6%, P < .0001). The standardized mortality ratio was 0.73 for the CICU and 0.86 for the MICU. There was no difference in the mean direct cost of care per patient-day between the CICU and MICU ($4011 USD [376] vs $3990 USD [214], P = .77).

Conclusions:

The burden of noncardiovascular diseases and the requirement for critical care therapies are high in contemporary CICU patients but remain lower compared to the MICU population. Our findings support the growing complexity of care in tertiary CICUs. Further studies are required to explore the association between critical care delivery and outcomes in this evolving population.
An investigation on the effect of surface treatment of bamboo fiber-filled PMMA composite
Authors: Chang Qiuxiang , Zhao Haojie , He Runqin
Published: November 2017

Polymeric composites have steadily gained importance in recent years for industrial applications. The increase in use calls for a better understanding of their behavior under different working environments. Friction and wear are considered two important parameters that govern tribological behavior. In this study, the friction and wear characteristics of bamboo fiber-Polymethyl methacrylate (PMMA) and MoS2 filler in PMMA composites were experimentally investigated at varied loads and sliding velocities. From this investigation, it was found that the addition of MoS2 in PMMA composite system showed least coefficient of friction and highest wear resistance.
Government Formation and Political Discussions in Twitter: An Extended Model for Quantifying Political Distances in Multiparty Democracies
Authors: Guerrero-Solé Frederic , Lopez-Gonzalez Hibai
Published: November 2017

The retweet overlap network (RON) method has proved to be successful in quantifying the distances between political parties in multiparty democracies. These distances are frequently used in political science to explain the formation of coalitions and governments. This article explores how data collected from Twitter can be related to ideological similarities between political parties, drawing on an extended development of the RON method that calculates the overlaps between the communities of retweeters of the most influential users in a political discussion. The method is applied to two conversations in Twitter during the last two General Elections in Spain in 2015 and 2016. Our results are consistent with the dynamics and the outcomes of the bargaining processes after both elections and support the Spanish President’s statement on the reasonableness of a government of the Popular Party, the Spanish Socialist Workers’ Party, and the Citizens–Party of the Citizenry after the Spanish General Elections in 2016. This work links quantitative analysis of the overlaps of the parties’ communities of retweeters with the theories of coalition and government formation. It contributes to the exploration of Twitter metrics that can be used as new indicators of the support for coalitions in multiparty democracies.
Roll aerodynamic characteristics study of an unmanned aerial vehicle based on circulation control technology
Authors: Chen Kun , Shi Zhiwei , Zhu Jiachen , Wang Haiyang , Fu Junquan
Published: November 2017

To explore the control efficiency of circulation flow control technology, a circulation control actuator with an independent gas source has been designed and applied in roll attitude control of a small unmanned aerial vehicle. The circulation control devices are arranged at the two ends of the wing on an unmanned aerial vehicle scale model, the changes in aerodynamic force and aerodynamic moment caused by turning on the actuator are measured in a wind tunnel, and the flow field characteristics are analysed using particle image velocimetry technology. The flight control effect of the roll attitude is verified via a flight test. Experimental and flight test results show that the control of roll attitude can be achieved by turning on the circulation control actuator on one side, and the maximum efficiency that the circulation control generates is equivalent to 8° aileron deflection with production of a favorable yaw moment to achieve a coordinated turn. The circulation control actuator can increase lift and reduce drag when opened on both sides simultaneously. The maximum lift-to-drag ratio of the UAV increased from 5 to 9, and this approach can also suppress flow separation and delay stall at high angles of attack. The aileron or trailing edge flaps can be replaced with circulation control actuators, and the circulation control technology can also be applied to aerodynamic performance improvement and flight control in other types of aircraft.
Book Review: Anna-Lucia Mackay, The Four Mindsets: How to Influence, Motivate and Lead High Performance Team
Authors: Karambelkar Mohan
Published: November 2017

Anna-Lucia Mackay, The Four Mindsets: How to Influence, Motivate and Lead High Performance Team, 2015, Milton: John Wiley and Sons, 264 pp. ISBN: 9780730324782. Reprint 2017, New Delhi, 264 pp., ₹299. ISBN: 978-81-265-6427-9