bluuebunny/crossref_metadata_2025 huggingface dataset:
Installation of roof-top solar PV modules and their impact on building cooling load
Authors: Kotak Y , Gago EJ , Mohanty P , Muneer T
Published: March 2014

It has been shown by many researchers that over a long term there has been a slow but steady rise of ambient temperature within the Indian sub-continent. Due to an increased economic prosperity there has been an accompanied increase in the urban heat island effect. Furthermore, urbanisation of large cities in India has also led to higher population densities. The above factors had the combined effect of a significant increase of cooling load of buildings. The high density of dwellings and other building construction has resulted in shading of walls. However, the flat roof spaces are exposed to an uninterrupted solar radiation regime and this in turn leads to generation of high sol-air temperatures which cause higher cooling loads. Presently, it has been argued that roof spaces are one of the major contributors to building cooling load. In this article, the reasons behind the phenomenal rise in the installation of air-conditioners in India are reviewed. The dual role of roof-top PV systems in electricity generation and reduction of building cooling load due to the shading they provide is then investigated. For this purpose, the CIBSE method to obtain sol-air temperature with solar radiation and outdoor ambient temperature has been used. Sol-air temperature for five key Indian locations (Delhi, Bhopal, Ahmedabad, Bhubaneswar and Chennai), based on the recently presented data by the NREL-India Meteorological Department consortium, were then obtained. A computer simulation routine was presently developed for solving the classical transient heat conduction problem with hourly sol-air temperature data and roof construction details provided to the routine. This program was executed to obtain the cooling load profile for each of the five Indian locations for the respective design day.

Practical application: The present work reviews the reasons behind the phenomenal rise in the installation of air-conditioners in India. The dual role of roof-top PV systems in electricity generation and reduction of building cooling load due to the shading they provide has been investigated. The computer simulation demonstrated that the energy required for roof-induced cooling load decreased between 73% and 90% after installation of the PV system. The method used in this work has the advantage that it enables the user to obtain cooling load estimates using a general transient heat conduction approach. Moreover, all software was developed within MS-Excel environment, this is also an additional advantage as the cost associated with purchase and training of proprietary building energy software can be prohibitive for many consultants who are based in developing countries.
A Model to Simulate Delay in Train Schedule Caused by Crowded Passengers
Authors: Toriumi Shigeki , Taguchi Azuma , Matsumoto Tetsuro
Published: March 2014

We propose a network flow model to study problems in commuting traffic in the railway network of the Tokyo Metropolitan area. Through this network, about seven million passengers commute, and about 7,500 trains transport them in morning rush hours. Trains are usually crowded and subject to delay caused by overcrowded passengers. In addition to the huge traffic volume, such facts intensify the situation that the commuters concentrate in commuting during short time period, traveling radial lines directing to the central district, and choosing a “better (higher speed)” train service. In order to relieve such conditions, not only investments in hardware but also soft approach are important to fully utilize the existing capacity of the network to average the number of passengers across the trains. Our model consists of a time–space network (or schedule-based network) and detailed traffic data on route choice of commuters. The former has been intensively studied to consider traffic problems where each vehicle service is operated according to a timetable. Using this network, every train services and actions of passengers can be represented by nodes and edges of the network. The latter is the questionnaire survey of commuting traffic in Metropolitan area being done in every five years. We use the survey conducted in 2005, which has about 140,000 respondents. Another important point of our model is that it is able to consider the whole railway network universally in one system.
The social meanings of mobile phones among South Africa’s ‘digital natives’: a case study
Authors: Chuma Wallace
Published: March 2014

The past decade has seen the mobile phone evolve and acquire additional meanings in Africa and elsewhere. From being the relatively expensive yuppie toy of the 1990s to becoming the basic necessity available on the market both as new and used today; from the voice-and-text only functions of yesteryear to the compact multimedia ‘package’ that usurps the roles of earlier technologies like the TV, radio and PC, the mobile phone has been key to the (re)shaping of society, just as its appropriation has been dialectically shaped by society. And yet most of the writing about new media in Africa focuses on the economic and technological aspects of use and access, the digital divide, and the potential of new media to help the development process and expand e-commerce, among others. All these aspects are important, but there is also scope for new research to explore the social character of the mobile device among different African communities. This article focuses on the social place of the mobile phone among a section of South African youth, namely University of Cape Town students. It employs a combination of online survey and qualitative interviews with selected undergraduate students. The article notes that the mobile phone has arguably become a key pivot around which youth culture is organised, while at the same time being appropriated and shaped creatively by the youth to address their varying interests. The study notes that although the mobile phone has not replaced traditional norms of socialisation as such, its presence has structured, and continues to structure youth’s social and academic lives.
Detection of Delta-like 1 ligand for the diagnosis of tuberculous meningitis: An effective and rapid diagnostic method
Authors: Peng Tao , Zhou Yan , Li Jinyi , Li Jinghong , Wan Wencui , Jia Yanjie
Published: March 2014

Objective

To investigate the diagnostic value of Delta-like 1 ligand (DLL1) in cerebrospinal fluid (CSF) and serum, in tuberculous meningitis (TBM).

Methods

Patients with a definite diagnosis of central nervous system infection (TBM, viral meningitis/encephalitis or bacterial meningitis) were prospectively enrolled alongside patients with intracranial metastatic tumour and patients with no diagnosis (who served as controls). DLL1 content in CSF and serum was measured quantitatively by enzyme-linked immunosorbent assay; analyses were blinded.

Results

A total of 173 patients were enrolled: 62 with TBM; 38 with viral meningitis/encephalitis; 26 with bacterial meningitis; 17 with intracranial metastatic tumour; 30 with no diagnosis. CSF DLL1 content was highest for TBM; there were no differences in CSF DLL1 between the other groups. Serum DLL1 content was highest for the TBM and intracranial metastatic tumour groups, with significant differences between the TBM group and the viral meningitis/encephalitis, bacterial meningitis and nondiagnosed groups. There were no differences in serum DLL1 between the viral meningitis/encephalitis, bacterial meningitis and nondiagnosed groups, or between the TBM group and the tumour group.

Conclusion

As a new biomarker, DLL1 may be of great clinical importance in the diagnosis of TBM.
Ketamine
Authors: Bokor Gyula , Anderson Peter D.
Published: March 2014

Ketamine is a dissociative anesthetic and substance of abuse. Numerous effects can result from the abuse of ketamine. Death from acute direct toxicity is rare. Ketamine can alter numerous functions in the brain including color perception, memory, attention, cognition, reaction time, and sense of time and can produce psychological addiction. Chronic ketamine abuse can produce toxicity to the gastrointestinal and urinary tract. Gastrointestinal changes include epigastric pain, hepatic dysfunction, and impaired gallbladder activity. The most common urological condition from ketamine is cystitis but renal failure has been reported.
An Oasis in the Hospital
Authors: Williams Anne M. , Bulsara Caroline E. , Joske David J. L. , Petterson Anna S. , Nowak Anna K. , Bennett Kellie S.
Published: March 2014

Aims: The aim of this study was to explore and describe the experiences of persons attending a cancer support center, providing emotional support to cancer patients through self-selected complementary therapies offered free of charge through qualified volunteer therapists. A grounded theory methodology was used. Sources of data were 16 semistructured interviews with persons attending the center. Interviews were digitally recorded and transcribed verbatim. Analysis was conducted using the constant comparative method. Findings: The overarching theme that emerged in this study was the benefits attributed to attendance at the cancer support center. The center was described as an “oasis” in the hospital, and three aspects relating to this were identified: (a) facilitating comfort, (b) increasing personal control, and (c) helping make sense of the cancer experience. Conclusion: A drop-in center offering complementary therapies appeared to enable coping with the diagnosis and treatment of cancer by facilitating comfort and increasing perceptions of personal control. The center also helped some participants to make sense of their experience with cancer. This research has provided a unique insight into the ongoing emotional needs of cancer patients, and directions for further development and research into the provision of holistic care for patients within a hospital setting.
Handling Diversity with Absolute Civility
Authors: Kinra Rajeev
Published: March 2014

Despite many advances in recent scholarship, a good deal of Mughal cultural historiography—not to mention the popular memory of the Mughal era—is still dominated by attention to the patronage and liberal outlooks of two figures, the Emperor Jalal al-Din Muhammad Akbar (r. 1556–1605) and his great-grandson, Prince Dara Shukoh (1615–1659), both of whom are viewed as having been especially, even heroically, tolerant toward the non-Muslims in their midst. However, while both of these men are certainly worthy of the attention they have received, the emphasis on their individual contributions to the Mughal attitude of ‘universal civility’ (ṣulḥ-i kull) has in some ways obscured the broader cultures of everyday tolerance that pervaded Mughal life in the seventeenth century. This article aims to present a preliminary—though far from exhaustive—survey of evidence for this broader and continuing Mughal approach to handling India’s diversity in the post-Akbar period and to try and connect it, via the suggestive comments of several influential European commentators of the early Enlightenment, to the larger connected histories of tolerance in global early modernity.
Handling of Diversity in Early Modern India?
Authors: Fluechter Antje
Published: March 2014

The notion of plurality amongst the Indian population is one of the most prominent features of early modern German discourse on India. This article combines the concepts ‘diversity’ and ‘transculturality’ to analyse how German speaking mercenaries of the Dutch East India Company perceived this plurality. These mercenaries were a specific group of travellers, quite different from the well-known, erudite globetrotter. I analyse the group labels that mercenaries used to describe, understand and categorise India’s diverse population. The categories that the mercenaries used reflected their own understanding and fluidity of the terms nation, religion and social status. In contrast to the assumed relevance of religion and social status for early modern societies, the authors predominantly chose the term ‘nation’ for the different people in India. Moreover, their notion of a ‘nation’ did not imply a social hierarchy, but rather a juxtaposition. Based on this evidence, this article concludes that the organisation of diversity depended crucially on the individual author and his social position.
Identities and Narratives in Medieval Europe and in European Historical Research
Authors: Kintzinger Martin
Published: March 2014

In medieval Europe from the late antiquity onwards up to about 1500, social and political identities were constructed by learned men in order to legitimise current developments and prevailing situations. According to this point of view, the older a tradition could be claimed, the better it was suited to explain their own reality. Ancient kings and heroes as well as legendary figures helped to construct a historically based identity which was defined by dynastic continuity. Conflicts and concurrences first emerged from the process of ranking different dynasties within a social hierarchy. The obligation to differ between Christian and non-Christian, antique as well as pagan traditions forced the narrative of a Christian Occident to be rebuilt. Contact with Muslims outside or even in Europe and with Jews in European cities finally led to open questions on how to behave and how to deal with one’s own identity.
Rule by Consensus
Authors: Schneidmüller Bernd
Published: March 2014

This article analyses specific characteristics of pre-modern rule in medieval central Europe. It becomes clear from the analysis that although the notion of monarchy implies a single ruler (mon-archia), it was actually the case, however, that in political practice, the kings and rulers of the Holy Roman Empire had to come to an arrangement with the elites and nobles. Therefore, the famous model developed by Max Weber regarding the three types of legitimate rule: legal, traditional and charismatic, fall short of encompassing the alterity and plurality of politics in the Middle Ages. Here, the concept of consensual rule is conceptualised through the use of additional case studies. These case studies more appropriately capture the fluid decision-making process in the Middle Ages through ongoing negotiation. Thus, the kings and emperors are clearly integrated into the framework of pre-modern oligarchies and therefore offer a counter-outline to the doctrine of divine right.
Governing Agrarian Diversities
Authors: Datta Rajat
Published: March 2014

In a country as large and diverse as India, governance meant a welter of institutional and customary arrangements, particularly in the agrarian sector. Globally, the early modern state’s fiscal well being depended on agriculture. In India, the demands of an expanding maritime commerce made this more complex. Contrary to prevalent views of the state as an economic predator, this article shows how the sixteenth-century initiated novel and creative techniques of agrarian governance, which enabled it to consolidate power, extract revenue and protect diversities at the same time. This was a new dispensation, which cannot be explained by seamless notions of the ‘medieval’. These new strategies of governance can only be understood in the frame of an early modernity, which was a shared global experience. For India, agrarian governance involved, inter alia—the consolidation of private property and transactions based on contractual obligations. These were some of the important ways in which the state facilitated the making of an early modern economy in sixteenth-century India.
A Clock for the Sultan
Authors: Burschel Peter
Published: March 2014

The contribution examines a gift-giving conflict which arose in Istanbul and which was recorded in the diary of the Habsburg envoy Hans Ludwig von Kuefstein at the turn of the year 1628/1629: the demand made by Ottoman dignitaries to increase the guest gifts for the Sultan and the rejection of this demand by the envoy. How should this conflict be interpreted? The contribution examines this question by contextualizing the conflict from a dual perspective—thereby disclosing the contours of two different approaches to gift-giving which had difficulty finding common ground. While the political economy of gift-giving in Western Europe was based upon personal obligation and internal bonds, the Ottoman Empire possessed the concept of a gift-giving duty which was intended solely to honour the office. The contribution thereby shows how the encounter of cultural strangeness can be discussed in specific situations. For this reason, the study should also be viewed as a micro-analytical history of diplomacy carried out from an intercultural perspective.
Gift-exchange as a Means of ‘Handling Diversity’
Authors: De Winter Wim
Published: March 2014

Historical intercultural interactions between Europeans and Japanese during the seventeenth century were characterised by a diversity of perceptions and attitudes within a dynamic yet stable continuum of relationships, in which people reached a certain degree of understanding in a daily context. This relational stability was fundamentally created through evolving cycles of gift-behaviour, which occurred on distinct social levels. Surpassing mere tribute, this proved to be a constitutive element of daily social life. Research based on early seventeenth century European travellers’ accounts, letters and journals, compared with a famous case from the end of that century, emphasises that this behaviour changed in some ways and persisted in others. Originally developing in a considerably spontaneous and dynamic manner, this tendency became more institutionalised and ritualised in later times, when a fixed protocol for dealing with diversity was established. This phenomenon can be analysed through anthropological theory, and should be compared to different historical contexts in a diachronic sense, in order to fully understand both the theoretical implications and particularities of this context. This includes a methodologically critical perspective as well as a reflection on how historians handle diversity.
Napsin-A, TTF-1, EGFR, and ALK Status Determination in Lung Primary and Metastatic Mucin-Producing Adenocarcinomas
Authors: Rossi Giulio , Cavazza Alberto , Righi Luisella , Sartori Giuliana , Bisagni Alessandra , Longo Lucia , Pelosi Giuseppe , Papotti Mauro
Published: March 2014

Pulmonary mucin-producing adenocarcinomas may be indistinguishable on conventional histology from a metastasis, as thyroid transcription factor-1 (TTF-1) expression often is lacking and KRAS mutations are widely present even in extrapulmonary sites. Few data have been reported on the diagnostic role of napsin-A and epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene alterations in this challenging differential diagnosis. Seventy-seven surgically resected cases, including 53 primary and 24 metastatic tumors from different sites, were evaluated for napsin-A, TTF-1, and ALK by immunohistochemistry and for EGFR mutations by direct sequencing. Overall, napsin-A expression in primary lung mucin-producing adenocarcinomas was 36% (8% mucinous, 17% colloid, 87.5% solid, and 100% signet ring cell) and TTF-1 expression reached an overall figure of 42% (12.5% mucinous, 33% colloid, 87.5% solid, and 100% signet ring cell). Metastatic mucinous adenocarcinomas did not react with napsin-A or with TTF-1. All primary and metastatic tumors lacked EGFR mutations, while a single case of signet ring cell lung adenocarcinoma showed ALK expression and rearrangement at fluorescent in situ hybridization analysis. Napsin-A has a lower sensitivity compared with TTF-1 in primary mucin-producing adenocarcinomas of the lung. However, both antibodies have an absolute specificity, being always negative in metastatic mucinous adenocarcinomas. EGFR mutations and ALK translocation or expression are exceedingly rare in mucin-producing adenocarcinomas of the lung, resulting unnecessary as diagnostic tool in this setting.
Limited-Open Achilles Tendon Repair Using Locking Sutures Versus Nonlocking Sutures
Authors: Demetracopoulos Constantine A. , Gilbert Susannah L. , Young Elizabeth , Baxter Josh R. , Deland Jonathan T.
Published: March 2014

Background:

Several limited-open Achilles tendon repair techniques that use locking or nonlocking sutures have been developed, but direct comparisons of in vitro mechanical properties have not yet been reported in the literature. It was our hypothesis that loads applied to the repaired Achilles tendon would be better resisted by limited-open techniques that use locking stitches compared with limited-open repairs that use nonlocking stitches.

Methods:

The Achilles tendons of 31 fresh-frozen cadaver lower limbs were incised 4 cm proximal to the calcaneal insertion. Tendons were then repaired using 1 of 2 limited-open Achilles tendon repair tools, one using 3 nonlocking sutures and the other using a combination of locking and nonlocking sutures. Repaired specimens were cycled to 1000 cycles from 20 to 100 N and from 20 to 190 N followed by a single load to failure test. Nonparametric analyses were performed to compare the number of cycles to gapping and total load to failure between the 2 repair techniques.

Results:

During cyclic loading, more cycles occurred prior to detection of 2-mm and 9.5-mm gaps in the locking suture construct compared with the nonlocking suture construct ( P = .012 and P = .005, respectively). There was no difference in the number of cycles to a gap of 5 mm ( P = .053). The locking suture construct also resisted a significantly greater load to failure compared with the nonlocking suture construct ( P < .001; median 385.0 and 299.6 N, respectively).

Conclusion:

Limited-open repair techniques using locking sutures provided greater construct strength under both cyclic and ultimate loads compared with a repair technique that used only nonlocking sutures.

Clinical Relevance:

Limited-open Achilles tendon repairs using locking sutures are better able to resist forces simulating early accelerated rehabilitation than repairs using nonlocking sutures.
Modification of the Weil/Maceira Metatarsal Osteotomy for Coronal Plane Malalignment During Crossover Toe Correction
Authors: Klinge Stephen A. , McClure Philip , Fellars Todd , DiGiovanni Christopher W.
Published: March 2014

Background:

Metatarsophalangeal joint (MPJ) instability, which often involves the second ray, may result in dorsal translation and coronal drift of the proximal phalanx, with subsequent crossover of the first and second toe. After traditionally described soft tissue and osteotomy procedures are used to treat this deformity, coronal plane malalignment may persist, but few additional surgical options have been described to address this problem.

Methods:

We present a retrospective series of 5 patients who underwent a supplemental technique to augment coronal plane MPJ realignment. All patients underwent preplanned concomitant procedures. Crossover angulation of the second MPJ, amount of coronal translation required, and overall first-second ray alignment were compared pre- and postoperatively.

Results:

Depending on the severity of refractory deformity after soft tissue release and decompressive metatarsal osteotomy, 1.5 to 4.5 mm of coronal plane metatarsal head translation was required to achieve 3 to 20 degrees of overall valgus correction at the MPJ and complete correction of the crossover toe deformity. All patients were satisfied and had good function at last follow-up, a mean of 10.2 months, although 3 patients exhibited some level of second MPJ stiffness. One patient ended up with a component of residual floating toe deformity that was considered more of an incomplete correction of dorsal MPJ subluxation rather than any technical complication of this translational osteotomy modification designed to primarily correct coronal plane malalignment. A second patient had asymptomatic angular malalignment through partial (coronal plane) malrotation of the metatarsal osteotomy before it had healed.

Conclusions:

We have found this technique modification to be a very effective and simple means of treating recalcitrant lesser MPJ coronal plane malalignment when traditional soft tissue and bony techniques fail to fully restore anatomic MPJ position.

Level of Evidence:

Level IV, retrospective case series.
Advancements in Induced Pluripotent Stem Cell Technology for Cardiac Regenerative Medicine
Authors: Suh Carol Y. , Wang Zelun , Bártulos Oscar , Qyang Yibing
Published: March 2014

Cardiovascular diseases remain the leading causes of morbidity and mortality in the developed world. Cellular-based cardiac regenerative therapy serves as a potential approach to treating cardiovascular diseases. Although various cellular types have been tested, induced pluripotent stem cells (iPSCs) are regarded as a promising cell source for therapy. In this review, we will highlight some of the advances in generating iPSCs and differentiation to cardiac cells. We will also discuss the progress in modeling cardiovascular diseases using iPSCs-derived cardiac cells. As we continue to make progress in iPSC and cardiac differentiation technology, we will come closer to the application of cardiac regenerative medicine.
Characteristic analysis of pitch-resistant hydraulically interconnected suspensions for two-axle vehicles
Authors: Ding Fei , Han Xu , Zhang Nong , Luo Zhen
Published: March 2014

This paper proposes a new method to investigate the characteristics of pitch-resistant hydraulically interconnected suspension (HIS) systems for two-axle vehicles in the pitch plane. The equations of motion for the mechanical and hydraulic coupled system are developed, in which the hydraulic strut forces are derived using the impedance transfer matrix method. The stiffness and damping matrices of the coupled systems are described in a manner similar to the generalized form of uncoupled conventional suspension (UCS) systems. The additional properties of HIS systems are explicitly described via hydraulic physical parameters. Based on the generalized form, (1) the accumulators of HIS systems can be functionally equivalent to a combined system with tandem bump and pitch-angular springs; (2) the direction damper valves (DDVs), which are located at the outlets of actuator cylinders, function like uncoupled tandem dampers; (3) the pitch damper valves (PDVs), which are fitted on the hose to connect the accumulators, alter the mode damping similar to the accumulators changing the mode stiffness; (4) the opposite installation corresponding to the schematic of front piston-rod-upward and rear piston-rod-downward produces higher mode stiffness and damping than the other installations. The dynamic responses are studied between the vehicles with HIS and UCS. Moreover, the damping coefficients are evaluated with the modal analysis method. The obtained results indicate that (1) the top and bottom DDVs mainly affect the vehicle body’s pitch motion and bounce vibration, respectively, (2) the PDVs are able to alter the load distribution among wheel stations, and (3) damping parameters can be designed to minimize the vehicle body’s pitch motion.
Vibration suppression using integrated topology optimization of host structures and damping layers
Authors: Zhang Xiaopeng , Kang Zhan
Published: March 2014

It is often desirable to simultaneously optimize the damping and stiffness distribution in the design of shell structures incorporating damping material layers for achieving the best vibration mitigation performance. This paper investigates the integrated topology optimization of host structures and damping layers for reducing the vibration level in the presence of harmonic excitations. Therein, the global damping matrix is a nonproportional one due to distributed damping effects. For an efficient frequency response analysis of the system with nonproportional damping, reduced-order equations are obtained by using lower-order eigenvectors of the undamped system, and then the method of complex mode superposition is employed for solving the dynamic equations in the state space. In the optimization model, the vibration amplitudes at specified positions are taken as the objective function. The relative densities of the elements are considered as design variables, and an artificial damping material model relating the local damping properties to the elemental density variables is employed. The Rational Approximation of Material Properties model is adopted to avoid localized modes in low-density areas during the optimization process. Numerical examples are presented to illustrate the effectiveness and efficiency of the proposed framework.
A case of atypical diffuse feline fibrotic lung disease
Authors: Le Boedec Kevin , Roady Patrick J , O’Brien Robert T
Published: March 2014

An 11-year-old cat presented for respiratory distress and weight loss. Thoracic radiographs were interpreted as a diffuse bronchointerstitial pattern with bronchiectasis and a mild ventral alveolar pattern on the lateral views. Computed tomography revealed a severe diffuse reticular pattern, relatively hyperattenuating in subpleural regions, with diffuse traction bronchiectasis and some degree of honeycombing. Despite the absence of basal predominance, this pattern was considered to be suggestive of usual interstitial pneumonia (UIP). Other differentials (other types of interstitial lung disease, infectious pneumonitis, neoplasia, or early edema or hemorrhage) were considered less likely based on history and other test results. The cat was discharged without any treatment, and euthanased 5 months later. Post-mortem histological analysis of the lung revealed end-stage lung, with extensive fibrosis that was more severe in subpleural regions, fibroblastic foci and honeycombing, suggestive of UIP. A probable diagnosis of idiopathic pulmonary fibrosis (IPF) was made. The diffuse distribution of the lesions was atypical compared with previous tomographic and histologic descriptions of IPF in cats. This case report suggests a heterogeneity of the pulmonary fibrotic disorders in cats that warrants further investigation for better characterization and classification.
Competitive synergy through practicing triple bottom line sustainability: Evidence from three hospitality case studies
Authors: Boley B. Bynum , Uysal Muzaffer
Published: March 2014

This study advances the discussion of sustainability within the hospitality literature through the introduction of the concept of triple bottom line (TBL) sustainability and the potential synergistic benefits to competitiveness hospitality firms can achieve from practicing it. TBL sustainability transitions a firm’s attention away from solely focusing on short-term profits to a concentration on the firm’s long-term environmental, social, and economic performance. The study suggests that this transition to practicing TBL sustainability can result in “competitive synergy” for hospitality firms. The term “competitive synergy” is used to describe the phenomenon of when the anticipated benefits (e.g. reduced energy costs) from focusing on sustainability coalesce with the unanticipated benefits (e.g. increased employee job satisfaction) to make hospitality firms more competitive. One interviewee describes this synergy as a “resonant harmonic” because of the multiple benefits gained that were not part of the original motivations for engaging in sustainability. In an attempt to demonstrate industry examples of competitive synergy, three hospitality case studies practicing TBL sustainability are presented. These cases studies range from a small boutique hotel in Floyd, VA (Hotel Floyd), to a Caribbean resort in the Dominican Republic (Puntacana), and even to one of the world’s largest hotel groups (InterContinental). Findings from the interviews highlight the many tangential benefits discovered from implementing sustainable initiatives aimed at environmental, social, and economic sustainability.
Clinical Characteristics and Medical Costs in Patients With Diabetic Amputation and Nondiabetic Patients With Nonacute Amputation in Central Urban Hospitals in China
Authors: Wang Aihong , Xu Zhangrong , Mu Yiming , Ji Linong
Published: March 2014

The objective was to analyze the clinical characteristics, amputation level, final outcome of amputation, and medical cost between diabetic amputation and nonacute amputation in China central urban hospitals. For year 2010, amputation data from 19 central municipal general hospitals located in different big cities in China were retrospectively analyzed according to a standardized protocol. A total of 308 amputation patients were recruited. The patients were divided into diabetic amputation group (n = 174) and nonacute amputation group (n = 134). A total of 27.3% of the amputated patients or 56.5% of the nonacute patients were diabetic patients. Compared with nonacute amputation, patients with diabetic amputation were older (65.4 ± 11.6 vs 55.4 ± 19.6 years, P = .000), with higher systolic blood pressure (136.7 ± 19.7 vs 132.0 ± 20.3 mm Hg, P = .044), higher fasting blood glucose level (8.3 ± 3.7 vs 5.9 ± 2.3 mmol/L, P = .000), lower triglycerides (TG; 1.3 ± 0.7 vs 1.6 ± 1.0 mmol/L, P = .014), and lower high-density lipoprotein cholesterol (HDL-C; 1.0 ± 0.4 vs 1.2 ± 0.3 mmol/L, P = .001). Minor amputation was more common in the patients with diabetic foot disease than those with nonacute foot disease (55.7% vs 20.1%; χ2 = 40.519, P = .000). There were significant differences in days of hospital stay (33.5 vs 22.0 days) and medical cost (US$5932 vs US$4101) between the 2 groups. The patients with diabetic amputation were older with higher blood glucose, higher blood pressure, lower TG level, and lower HDL-C level. Most of them required minor amputation. More diabetic patients underwent repeated amputation. Their hospital stay was longer with significantly higher medical costs.
Effect of Daptomycin on Local Interleukin-6, Matrix Metalloproteinase-9, and Metallopeptidase Inhibitor 1 in Patients With MRSA-Infected Diabetic Foot
Authors: Ambrosch Andreas , Halevy Daniel , Fwity Boushra , Brin Thomas , Lobmann Ralf
Published: March 2014

Infection is a major cause of the diabetic foot syndrome that is promoted by the increased burden of multiresistant germs like methicillin-resistant Staphylococcus aureus (MRSA). Maximizing positive outcome for serious MRSA infections requires an aggressive treatment approach and careful monitoring of the healing process. Therefore, we examined 8 patients with MRSA-infected diabetic foot syndrome of Wagner classification grade 2 or 3 (corresponding to the Texas classification stage 2 or 3) during antibiotic treatment with daptomycin. We documented the wound size and obtained samples of wound secretion for analyses of proinflammatory interleukin-6 (IL-6), protease (matrix metalloproteinase-9 [MMP-9]), and antiprotease (metallopeptidase inhibitor 1 [TIMP-1]) activity. During the course of anti-MRSA therapy, we observed a decrease in the concentration of local IL-6 within the first 3 days followed by a decrease of MMP-9 and an increase of TIMP-1. Finally, a reduction of wound size was documented. The present data show that efficient antimicrobial treatment with daptomycin has a number of beneficial effects on wound healing at the molecular level in MRSA-infected diabetic foot ulcers.
Veterans Healthcare Administration providers’ attitudes and perceptions regarding pragmatic trials embedded at the point of care
Authors: Weir Charlene R , Butler Jorie , Thraen Iona , Woods Patricia A , Hermos John , Ferguson Ryan , Gleason Theresa , Barrus Robyn , Fiore Louis
Published: March 2014

Background

The Veterans Healthcare Administration (VA) is implementing an adaptation of a pragmatic trial program, Point of Care Research (POC-R). The goal of POC-R is to embed research into clinical practice, contributing to a Learning Healthcare System. Provider acceptance and participation in POC-R is essential to its successful implementation. The purpose of this study is to evaluate provider’s perceptions and beliefs regarding the POC-R program.

Methods

Provider focus groups and interviews were conducted at seven VA medical facilities involving 62 providers. A semi-structured script was used that included descriptions of four use cases and targeted questions regarding perceptions, concerns, and attitudes about the POC-R program. Sessions were audio-taped, de-identified, transcribed, and analyzed using systematic qualitative techniques to create response categories and overarching themes.

Results

The emergent themes were as follows: (1) POC-R is a valuable component of evidence-based practice, providing an opportunity to base clinical practice on more generalizable evidence as well as providing tools to improve local practice; (2) POC-R highlights the tension between the need for autonomy of practice and compliance with protocols; (3) POC-R may create increased time and burden resulting from added research responsibilities; (4) concern about the scientific validity and reliability of results; (5) potential for a negative impact on the provider–patient relationship; and (6) uncertainty regarding what constitutes equipoise, given differences in provider knowledge and preferences. Despite substantive concerns, barriers were generally felt to be solvable. Implementation should include provider education, careful attention to workflow for all arms of the study, inclusion of the entire team, and adequate oversight.

Limitations

The study design is qualitative with limited implications for causal inference. Participants are from the VA and may not be representative of other clinicians.

Conclusion

VA providers are supportive of the importance and value of pragmatic trials in general and of POC-R in particular. However, providers have significant concerns regarding the burden, ethics, and evidence regarding equipoise. Results are discussed in terms of implementation recommendations.
A green and black tea extract benefits urological health in men with lower urinary tract symptoms
Authors: Katz Aaron , Efros Mitchell , Kaminetsky Jed , Herrlinger Kelli , Chirouzes Diana , Ceddia Michael
Published: March 2014

Objectives:

The objective of this study was to examine the effects of a green and black tea extract blend [AssuriTEA Men’s Health (AMH)] in men with lower urinary tract symptoms (LUTS).

Methods:

In this randomized, double-blind, placebo-controlled study, 46 men aged 30–70 with an American Urologic Association symptom score (AUAss) of at least 8 and up to 24 were randomized to 500 mg AMH, 1000 mg AMH, or placebo daily for 12 weeks. Measurements were taken at baseline (BL), week 6 and week 12 for AUAss, simple uroflowmetry, postvoid residual volume (PVR), C-reactive protein (CRP), Short-Form 36 Health Survey (SF-36), and International Index of Erectile Function (IIEF).

Results:

A total of 40 subjects completed the study. AUAss decreased 34.5% from BL to week 12 in the 1000 mg AMH group ( p = 0.008). At week 12, CRP increased in the 500 mg AMH ( p = 0.003) and placebo ( p = 0.012) groups from their BL levels but not in the 1000 mg group. Average urine flow (Qmean) increased in the 500 mg ( p = 0.033) and 1000 mg AMH ( p = 0.002) groups versus placebo. PVR decreased in the 1000 mg AMH group ( p = 0.034) from BL at week 6. Treatment group effects were observed for the physical functioning and sexual desire domains of the SF-36 and IIEF ( p = 0.051 and p = 0.005 respectively). AMH was well tolerated.

Conclusions:

Oral administration of AMH improved LUTS and quality of life in as little as 6 weeks.
Prevalence of Freestyle Biomechanical Errors in Elite Competitive Swimmers
Authors: Virag Bonnie , Hibberd Elizabeth E. , Oyama Sakiko , Padua Darin A. , Myers Joseph B.
Published: March 2014

Background:

Poor freestyle stroke biomechanics is a suggested risk factor for shoulder pain and pathology, but this has not been proven in biomechanical or clinical studies. Furthermore, the prevalence of these theoretical errors has not been identified, which would help coaches, athletic trainers, and researchers determine the most appropriate errors to focus on and develop interventions.

Hypothesis:

The majority of swimmers will present with at least 1 freestyle stroke error.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

Stroke biomechanics for 31 swimmers from a collegiate swimming team were captured using underwater/above-water cameras. Each video was evaluated for biomechanical errors: a dropped elbow during the pull-through phase, a dropped elbow during the recovery phase, an eyes-forward head-carrying angle, incorrect hand position during hand entry, incorrect hand entry angle, incorrect pull-through pattern, and inadequate body roll. Error prevalence was calculated, and relationships among the errors were evaluated using chi-square statistics.

Results:

A dropped elbow during the pull-through phase (61.3%) and a dropped elbow during the recovery phase (53.2%) had the highest prevalence. A dropped elbow during the recovery phase was significantly associated with a thumb-first hand entry angle ( P = 0.027) and incorrect hand entry position ( P = 0.009). An eyes-forward head-carrying angle was associated with an incorrect pull-through pattern ( P = 0.047).

Conclusion:

Biomechanical errors potentially detrimental to the shoulder are prevalent among swimmers. Many of the errors were interrelated, suggesting that one error may lead to other errors.

Clinical Relevance:

These errors highlight the need for proper stroke instruction and evaluation to decrease the risk of shoulder injury in competitive swimmers.
Bodies Transformed: Negotiations of Identity in Chalcolithic Cyprus
Authors: Lorentz Kirsi O.
Published: March 2014

This paper focuses on how the human body, and the dead body in particular, was used to create social categories and identities in prehistoric Cyprus. Specifically, it explores how a particular condition, such as death, was integrated into social processes, and how the treatment of dead bodies both created and reinforced social categories and identities. The material the paper focuses on is the mortuary evidence from Chalcolithic Cyprus (3800–2300 BC). In particular, it argues that the extensive, intentional manipulation of dead bodies and human remains visible in Cypriot Chalcolithic cemeteries was aimed at integrating the individual to communal, collective wholes on the occasion of death and during the time period that followed.
Kinetics of martensite formation in plain carbon steels: Critical assessment of possible influence of austenite grain boundaries and autocatalysis
Authors: van Bohemen S. M. C. , Sietsma J.
Published: March 2014

The kinetics of the martensitic transformation in Fe–0·80C has been determined from dilatometry data and shows no significant variation when the cooling rate is changed by two orders of magnitude. All kinetic data can be adequately simulated by the Koistinen and Marburger (KM) equation using a specific start temperature TKM and rate parameter αm. This finding supports the suggestion that the transformation is athermal, and moreover, the absence of a time dependence strongly indicates that autocatalytic nucleation does not contribute to the transformation kinetics in plain carbon steels on measurable time scales. Furthermore, dilatometry experiments with different austenitising conditions were conducted to examine the effect of the prior austenite grain size on the overall kinetics of martensite formation. The present results indicate that the progress of martensite formation beyond a fraction f = 0·15 is independent of the prior austenitising treatment. It is therefore concluded that austenite–austenite grain boundaries have no significant effect on the overall nucleation and growth of athermal martensite, which is consistent with a model proposed by Ansell and co-workers.
Electropulsed steels
Authors: Qin R. S. , Rahnama A. , Lu W. J. , Zhang X. F. , Elliott-Bowman B.
Published: March 2014

With appropriate electropulsing parameters, the microstructure of steels can be manipulated towards a state that possesses favourable physical, mechanical and chemical properties. This work demonstrates the application of designed electropulsing to pearlitic steel, transformation induced plasticity steel, austenite stainless steel and clean steel in order to generate novel microstructures that are difficult to achieve by other conventional thermomechanical processes. The principles for the design of electropulsing processing have been discussed. The method is particularly suitable for fabrication of the advanced multiphase and multicomponent alloys.
p57 regulates T-cell development and prevents lymphomagenesis by balancing p53 activity and pre-TCR signaling
Authors: Matsumoto Akinobu , Takeishi Shoichiro , Nakayama Keiichi I.
Published: March 2014

Key Points

Ablation of p57 in T cells blocks differentiation at an early developmental stage as a result of excessive activation of E2F. Additional ablation of E2F1 or p53 normalizes p57-deficiency phenotypes, but loss of both p57 and p53 eventually results in thymic lymphoma.
Gene mutations and treatment outcome in chronic lymphocytic leukemia: results from the CLL8 trial
Authors: Stilgenbauer Stephan , Schnaiter Andrea , Paschka Peter , Zenz Thorsten , Rossi Marianna , Döhner Konstanze , Bühler Andreas , Böttcher Sebastian , Ritgen Matthias , Kneba Michael , Winkler Dirk , Tausch Eugen , Hoth Patrick , Edelmann Jennifer , Mertens Daniel , Bullinger Lars , Bergmann Manuela , Kless Sabrina , Mack Silja , Jäger Ulrich , Patten Nancy , Wu Lin , Wenger Michael K. , Fingerle-Rowson Günter , Lichter Peter , Cazzola Mario , Wendtner Clemens M. , Fink Anna M. , Fischer Kirsten , Busch Raymonde , Hallek Michael , Döhner Hartmut
Published: March 2014

Key Points

Independent prognostic impact of biological markers, notably TP53 and SF3B1 mutations, in CLL patients requiring therapy. NOTCH1 mutation as a predictive factor for reduced benefit from the addition of rituximab to FC chemotherapy.
RETRACTED ARTICLE: Exemestane blocks mesothelioma growth through downregulation of cAMP, pCREB and CD44 implicating new treatment option in patients affected by this disease
Authors: Nuvoli Barbara , Germoni Sabrina , Morosetti Carlotta , Santoro Raffaela , Cortese Giancarlo , Masi Serena , Cordone Iole , Galati Rossella
Published: March 2014

Background

Recent evidence suggests that aromatase may be involved in the pathogenesis of malignant mesothelioma. Here, we evaluated the effect of exemestane, an inhibitor of aromatase, in the treatment of mesothelioma using in vitro and in vivo preclinical models.

Results

We show a significant reduction of cell proliferation, survival, migration and block of cells in S phase of cell cycle in mesothelioma cells upon exemestane treatment. Moreover, we find that CD44, which is involved in mesothelioma cells migration, was modulated by exemestane via cAMP and pCREB. Most importantly, in mice mesothelioma xenograft exemestane causes a significant decrease in tumor size and the association pemetrexed/exemestane is more effective than pemetrexed/cisplatin.

Conclusion

The preclinical mesothelioma model suggests that exemestane might be beneficial in mesothelioma treatment.