bluuebunny/crossref_metadata_2025 huggingface dataset:
Alirocumab Treatment and Achievement of Non‐High‐Density Lipoprotein Cholesterol and Apolipoprotein B Goals in Patients With Hypercholesterolemia: Pooled Results From 10 Phase 3 ODYSSEY Trials
Authors: Bays Harold E. , Leiter Lawrence A. , Colhoun Helen M. , Thompson Desmond , Bessac Laurence , Pordy Robert , Toth Peter P.
Published: September 2017

Background

Non‐high‐density lipoprotein cholesterol (non‐
HDL
‐C) and apolipoprotein (apo) B are better predictors of atherosclerotic cardiovascular disease risk than low‐density lipoprotein cholesterol alone.
US
and European lipid management guidelines support non‐
HDL
‐C and apoB as targets for lipid‐lowering therapy.

Methods and Results

This analysis evaluated the efficacy of alirocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, on non‐
HDL
‐C and apoB. Data were derived from 4983 patients enrolled in 10 randomized, placebo‐ or ezetimibe‐controlled Phase 3
ODYSSEY
trials. Primary end point for this pooled analysis was percent reduction in non‐
HDL
‐C and apoB at Week 24; secondary end points included the percentage of patients achieving guideline‐directed treatment goals (National Lipid Association guidelines: non‐
HDL
‐C <100 or <130 mg/dL for patients at very high and high cardiovascular risk, respectively; European Society of Cardiology/European Atherosclerosis Society guidelines: apoB <80 mg/dL for patients at very‐high cardiovascular risk). Data were grouped according to comparator, alirocumab starting dose, and concomitant statin use. Compared with controls, alirocumab produced significantly greater reductions in non‐
HDL
‐C and apoB at Week 24 (
P
<0.0001), an effect extending up to 78 weeks. More alirocumab‐treated patients achieved levels of non‐
HDL
‐C <100 mg/dL and apoB <80 mg/dL (
P
≤0.0001 versus control). By Week 24, >70% of alirocumab‐treated patients on background statin achieved non‐
HDL
‐C <100 or <130 mg/dL, and apoB <80 mg/dL. Safety was comparable across pooled groups and in line with previous reports.

Conclusions

Alirocumab produced significant, sustained reductions in non‐
HDL
‐C and apoB, allowing more patients to achieve lipid goals compared with placebo or ezetimibe and irrespective of maximally tolerated statin use.
Physical Activity Frequency and the Risk of Stroke: A Nationwide Cohort Study in Korea
Authors: Jeong Han‐Gil , Kim Do Yeon , Kang Dong‐Wan , Kim Beom Joon , Kim Chi Kyung , Kim Yerim , Yang Wookjin , Park Eun‐Sun , Lee Seung‐Hoon
Published: August 2017

Background

The current guideline recommends moderate‐ to vigorous‐intensity physical activity (
PA
) at least 40 min/day for 3 to 4 days/week. Although recent evidence has demonstrated that low‐dose
PA
could reduce cardiovascular mortality, the relationship between low‐dose
PA
and the risk of stroke remains uncertain.

Methods and Results

Using data from a nation‐wide sample cohort in Korea, we examined 336 326 individuals who received a general health examination between 2009 and 2010. Level of
PA
was assessed using a questionnaire for weekly
PA
frequencies regarding 3 intensity categories: light, moderate, and vigorous. Moderate‐ to vigorous‐intensity
PA
(
MVPA
) was classified into 4 frequency categories: none, 1 to 2, 3 to 4, or ≥5 times/week. Cox proportional hazard models were constructed to estimate the risk of stroke. During the average follow‐up of 3.6 years, 2213 stroke cases occurred.
MVPA
was none in 50%, 1 to 2 times/week in 20%, 3 to 4 times/week in 13%, and ≥5 times/week in 18% of the cohort. Individuals with
MVPA
1 to 2 times/week had a 16% reduced risk of stroke (adjusted hazard ratio, 0.84; 95% confidence interval, 0.73–0.96) compared with those with no
MVPA
. The population attributable fraction of no
MVPA
was 12%, which was the second most important risk factor for a stroke after hypertension.

Conclusions

Even 1 to 2 times a week of
MVPA
might be beneficial to prevent a first‐ever stroke in the general population, although a quantitative validation of the questionnaire is needed. From a public health perspective, we need to encourage inactive people to start exercising with more‐achievable goals.
Inspiratory Muscle Training Is Associated With Improved Inspiratory Muscle Strength, Resting Cardiac Output, and the Ventilatory Efficiency of Exercise in Patients With a Fontan Circulation
Authors: Laohachai Karina , Winlaw David , Selvadurai Hiran , Gnanappa Ganesh Kumar , d'Udekem Yves , Celermajer David , Ayer Julian
Published: September 2017

Background

Patients with a Fontan circulation have reduced exercise capacity and respiratory muscle strength. Inspiratory muscle training (
IMT
) improves exercise capacity and quality of life in adults with heart failure. We assessed whether 6 weeks of a home‐based program of
IMT
improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation.

Methods and Results

Twenty‐three adolescent participants (aged 16±2 years) with a Fontan circulation underwent 6 weeks of
IMT
for 30 minutes daily. Respiratory muscle strength (maximal inspiratory pressure and expiratory pressure), lung function, and exercise capacity (cardiopulmonary exercise testing) were assessed. Fourteen of 23 participants also underwent exercise cardiac magnetic resonance imaging to examine the effects of
IMT
on cardiac output and systemic and pulmonary blood flow. Six weeks of
IMT
improved maximal inspiratory pressure by 36±24 cm H
2
O (61±46%) with no change in maximal expiratory pressure. Ventilatory efficiency of exercise improved after 6 weeks of
IMT
(from 34.2±7.8 to 32.2±5.6,
P
=0.04). In those who underwent exercise cardiac magnetic resonance imaging,
IMT
increased resting cardiac output (from 4.2±1.2 to 4.5±1.0 L/min,
P
=0.03) and ejection fraction (from 50.1±4.3 to 52.8±6.1%,
P
=0.03).

Conclusions

Six weeks of
IMT
is associated with improved inspiratory muscle strength, ventilatory efficiency of exercise, and resting cardiac output in young Fontan patients.
IMT
may be a simple beneficial addition to the current management of Fontan patients, potentially reducing exercise intolerance and long‐term morbidity and mortality.
Orobanche mlokosiewiczii (Orobanchaceae): a new species from the Greater Caucasus, and nomenclatural notes on similar species
Authors: PIWOWARCZYK RENATA , SÁNCHEZ PEDRAJA ÓSCAR , MORENO MORAL GONZALO , DENYSENKO-BENNETT MAGDALENA , GÓRALSKI GRZEGORZ , KWOLEK DAGMARA , KOSACHEV PETR , JOACHIMIAK ANDRZEJ J.
Published: September 2017

A new, probably endemic species, Orobanche mlokosiewiczii (Orobanchaceae) is described from Georgia, in the Greater Caucasus. The species grows near waterfalls, on slopes with thermo-hygrophilous subalpine tall herbaceous vegetation, and is exclusively parasitic of another endemic species: Aconitum cymbulatum. It is a graceful whitish or pale white-yellow plant, characterised by campanulate flowers and usually a very wide open throat of corolla. So far, for the Orobanche parasite on Aconitum (exlusively A. lycoctonum) only one species O. lycoctoni is known—occurring in the Cantabrian Mts. in Spain and in the Alps. A detailed description, diagnosis, illustrations, and comparison with possible related species (O. lycoctoni, O. krylowii, O. inulae, O. flava subsp. cicerbitae) are provided. We also present phylogenetic analysis, and nomenclatural notes about the above species, and a lectotype of O. inulae is designated. Moreover, inside the Orobanche sect. Orobanche, a new combination Orobanche subsect. Curvatae and a new series Orobanche ser. Krylowianae are proposed and their types are designated.
Three lectotypifications in Tephrosia Pers. (Fabaceae)
Authors: KRISHNARAJ MOOTHEDATHU VENUGOPALAN NAIR , MOHANAN NARAYANAN NAIR
Published: September 2017

The genus Tephrosia Persoon (1807: 328) is well delimited with ca. 350 species, mostly distributed in the tropical and sub-tropical regions of the world.(Cowie 2004,Schrire 2005,Mabberley 2008).In India, the genus is represented by 27 species and 1 variety (Sanjappa 1992,Krishnaraj et al. 2013).While studying the genus in India, we found that three nameswithin the genusTephrosia are not yet typified: T. hookeriana Wight &Arnott(1834: 212), T. barberi Drummond (1918:320) and T. canarensis Drummond (1918:319). The lectotypes are selected based on Art.9.2 of the Melbourne Code (McNeill et al. 2012). Herbarium acronyms followThiers (2016).
What really hampers taxonomy and conservation? A riposte to Garnett and Christidis (2017)
Authors: RAPOSO MARCOS A. , STOPIGLIA RENATA , BRITO GUILHERME RENZO R. , BOCKMANN FLÁVIO A. , KIRWAN GUY M. , GAYON JEAN , DUBOIS ALAIN
Published: September 2017

Responding to purported taxonomic anarchy, in an article published in the widely read journal Nature, Garnett & Christidis (2017) [hereafter GC] opined on the need for “standardized global species lists”, at the behest of conservationists, and proposed the construction of a judicial committee to “restrict … freedom of taxonomic action” and promote taxonomic stability. Here we reflect on this perspective and contest that the view of GC conflicts with some basic and indisputable principles underpinning the philosophy of science, most notably: it must be free. They appear to believe that taxonomic revisions should be based on political, economic and conservation concerns, and they treat species as fixed real entities, instead of refutable scientific hypotheses. In addition to such theoretical misconceptions, GC did not consider important practical aspects of what they term taxonomic anarchy, most significantly the participation of conservationists as authors of taxonomic works, and the importance of alternative management units, a well-established discussion in conservation biology.
Ultrastructure and morphometry of the egg of Psorophora albipes (Theobald, 1907) (Diptera: Culicidae)
Authors: MELLO CECILIA FERREIRA DE , SANTOS-MALLET JACENIR R. , GLEISER RAQUEL M. , ALENCAR JERONIMO
Published: September 2017

The eggs of Psorophora albipes were studied using scanning electron microscopy (SEM) and described based on a morphometric analysis of the main structures observed. We used eggs from a female caught in the Poço das Antas Biological Reserve (REBIO-PA), located in the municipality of Silva Jardim, State of Rio de Janeiro, Brazil. The eggs have an elliptical outline with a mean length of 538.67 ± 69.89 μm and width of 157.66 ± 23.12 μm and a mean egg index of 3.42 ± 0.07 μm. The external coating of the eggs is regular, with elongated chorionic cells that vary in size, with a mean length of 13.02 µm and mean width of 6.47 µm. The cells mostly have a pentagonal shape, but some have an elliptical shape. The micropylar disc has a mean diameter of 19.8 μm, it has small irregularities in its outline, excavations at the edge with the center slightly raised and a micropyle with a diameter of 2.36 μm. Complete knowledge of the egg morphology of species through SEM is useful in correlating its fine structure with consistent non-discernible differences observed under a stereoscopic microscope, and can aid in species discrimination. SEM allows the construction of identification keys for mosquito eggs that should be useful for studies involving eggs recovered from ovitraps or debris/soil samples.
Utilizing Probabilistic Downscaling Methods to Develop Streamflow Forecasts from Climate Forecasts
Authors: Mazrooei Amirhossein , Sankarasubramanian A.
Published: September 2017

Statistical information from ensembles of climate forecasts can be utilized in improving the streamflow predictions by using different downscaling methods. This study investigates the use of multinomial logistic regression (MLR) in downscaling large-scale ensemble climate forecasts into basin-scale probabilistic streamflow forecasts of categorical events over major river basins across the U.S. Sun Belt. The performance of MLR is then compared with the categorical forecasts estimated from the traditional approach, principal component regression (PCR). Results from both cross validation and split sampling reveal that in general, the probabilistic categorical forecasts from the MLR model have more accuracy and exhibit higher rank probability skill score (RPSS) compared to the PCR probabilistic forecasts. MLR forecasts are also more skillful than PCR forecasts during the winter season as well as for basins that exhibit high interannual variability in streamflows. The role of ensemble size of precipitation forecasts in developing MLR-based streamflow forecasts was also investigated. Because of its simplicity, MLR offers an alternate, reliable approach to developing categorical streamflow forecasts.
Satellite Precipitation Characterization, Error Modeling, and Error Correction Using Censored Shifted Gamma Distributions
Authors: Wright Daniel B. , Kirschbaum Dalia B. , Yatheendradas Soni
Published: September 2017

Satellite multisensor precipitation products (SMPPs) have a variety of potential uses but suffer from relatively poor accuracy due to systematic biases and random errors in precipitation occurrence and magnitude. The censored, shifted gamma distribution (CSGD) is used here to characterize the Tropical Rainfall Measurement Mission Multisatellite Precipitation Analysis (TMPA), a commonly used SMPP, and to compare it against the rain gauge–based North American Land Data Assimilation System phase 2 (NLDAS-2) reference precipitation dataset across the conterminous United States. The CSGD describes both the occurrence and the magnitude of precipitation. Climatological CSGD characterization reveals significant regional differences between TMPA and NLDAS-2 in terms of magnitude and probability of occurrence. A flexible CSGD-based error modeling framework is also used to quantify errors in TMPA relative to NLDAS-2. The framework can model conditional bias as either a linear or nonlinear function of satellite precipitation rate and can produce a “conditional CSGD” describing the distribution of “true” precipitation based on a satellite observation. The framework is also used to “merge” TMPA with atmospheric variables from version 2 of the Modern-Era Retrospective Analysis for Research and Applications (MERRA-2) to reduce SMPP errors. Despite the coarse resolution of MERRA-2, this merging offers robust reductions in random error due to the better performance of numerical models in resolving stratiform precipitation. Improvements in the near-real-time version of TMPA are relatively greater than for the higher-latency research version.
Quantitative Micro-Raman Spectroscopy for Partial Pressure Measurement in Small Volumes
Authors: Karlen Sylvain , Gobet Jean , Overstolz Thomas , Haesler Jacques , Lecomte Steve
Published: September 2017

We demonstrate the quantitative capabilities of Raman confocal microscopy as a nondestructive method to measure the partial pressure of molecular gases in mm3 range sealed volume having an optical access. Thanks to a calibration procedure, we apply this technique for the characterization of the absolute nitrogen partial pressure inside buffered micro electromechanical system (MEMS) atomic vapor cells developed for atomic clocks. Our results are compared with measurements obtained by rubidium hyperfine frequency spectroscopy and a good agreement is demonstrated between the two methods, with a three-sigma detection limit below 10 mbar for a 1 h integration time, using a 33 mW 532 nm excitation laser. These results prove the potential of confocal micro-Raman spectroscopy as a simple and nondestructive method for small-scale pressure measurements.
Iraq and the material basis of post-conflict police reconstruction
Authors: Wozniak Jesse SG
Published: September 2017

Existing scientific literature on post-conflict police reconstruction is largely divided between two camps. The first, and most widely employed in practice, can be termed a neo-liberal model, which argues progress comes through technological and organizational sophistication delivered by Western officials. This neo-liberal model has been the guiding principle of the reconstruction of the Iraqi state and police force. However, many scholars have argued this model is woefully inadequate for post-conflict reconstruction and have instead developed an alternative approach which can be termed a reflexive model. Similar to what is known as fourth generation peacebuilding in the International Relations literature, the reflexive model stresses building relationships with local stakeholders and relying on indigenous knowledge to guide post-conflict reconstruction. Drawing from 48 intensive interviews, 87 qualitative surveys, and six months of ethnographic examination of an Iraqi police training academy, this article argues that both the neo-liberal and reflexive models suffer from ignoring the material basis of reconstruction. This article employs the term ‘material’ in the theoretical sense; while police reconstruction programs spend significant effort on reshaping the ideologies of police, few address the real conditions police face, from the necessary levels of funding and equipment in their training centers, to basic concerns such as adequate pay to draw qualified applicants and prevent corruption. This study examines how economic inequality affects the ‘other side’ of conflicts, the security sector. The central finding is that the material deprivation experienced by Iraqi police has resulted in an underqualified force consisting of uninterested officers whose capacity and skill deficits have fed directly into the rise of powerful non-state organizations such as the Islamic State. This article explicates a central underlying cause of the problem with the reconstruction of the Iraqi police specifically and the larger case of neo-liberal post-conflict police reconstruction generally.
India's development strategy: Regional imbalances and Jharkhand
Authors: Rangarajan C.
Published: August 2017

This Address besides discussing the theoretical issues in development outlines India's development strategy in the post Independence period. It points out that while planned development effort with state having a pervasive role had the beneficial effect of promoting an indegenous core sector but it also led to inefficient allocation of resources, uncompetitive production processes and reduction in India's share in world trade. Another important concern has been balanced regional development but the States in Eastern region especially Bihar, has not developed at the same pace as States in Western and Southern regions of the country. The Address also discusses role of financial institutions. It also points out towards the rich mineral resources in Jharkhand leading to enormous potential for growth in the State.
Responsibility and Laboratory Animal Research Governance
Authors: McLeod Carmen , Hartley Sarah
Published: September 2017

The use of animals in experiments and research remains highly contentious. Laboratory animal research governance provides guidance and regulatory frameworks to oversee the use and welfare of laboratory animals and relies heavily on the replacement, reduction, and refinement (3Rs) principles to demonstrate responsibility. However, the application of the 3Rs is criticized for being too narrow in focus and closing down societal concerns and political questions about the purpose of animal laboratory research. These critiques challenge the legitimacy of responsibility in laboratory animal research governance and call for new approaches. With the advent of the "Responsible Research and Innovation" (RRI) agenda, we investigate whether the notion of responsibility in the controversial area of animal research governance could be enhanced by examining the 3Rs through RRI. Our analysis reveals RRI has the potential to helpfully augment the 3Rs in three key ways: recognizing the need to include a broader range of experts and publics in animal research governance; emphasizing the importance for animal research scientists of taking societal, and not just role, responsibilities into account; and acknowledging the political questions animal research raises.
From Power Elites to Influence Elites: Resetting Elite Studies for the 21st Century
Authors: Wedel Janine R.
Published: September 2017

The dominant theory of elite power, grounded in Weberian bureaucracy, has analyzed elites in terms of stable positions at the top of enduring institutions. Today, many conditions that spawned these stable ‘command posts’ no longer prevail, and elite power thus warrants rethinking. This article advances an argument about contemporary ‘influence elites’. The way they are organized and the modus operandi they employ to wield influence enable them to evade public accountability, a hallmark of a democratic society. Three cases are presented, first to investigate changes in how elites operate and, second, to examine varying configurations in which the new elites are organized. The cases demonstrate that influence elites intermesh hierarchies and networks, serve as connectors, and coordinate influence from multiple, moving perches, inside and outside official structures. Their flexible and multi-positioned organizing modes call for reconsidering elite theory and grappling with the implications of these elites for democratic society.
Arthroscopic Knot Removal for Failed Superior Labrum Anterior-Posterior Repair Secondary to Knot-Induced Pain
Authors: Park Jung Gwan , Cho Nam Su , Kim Jung Youn , Song Jong Hoon , Hong Se Jung , Rhee Yong Girl
Published: September 2017

Background:

Studies on failed superior labrum anterior-posterior (SLAP) repair are increasing. However, the number of reports on treatment options for failed SLAP repair remains quite low, and the clinical results vary between different study groups.

Purpose:

To describe the clinical presentation of failed SLAP repair due to knot-induced pain and evaluate the efficacy of arthroscopic knot removal.

Study Design:

Case series; Level of evidence, 4.

Methods:

The authors retrospectively reviewed records of 11 patients (mean age, 24.6 ± 8.6 years; range, 17-43 years) with stable, healed SLAP lesions with knot-induced pain after arthroscopic fixation of unstable type II SLAP lesions. All patients demonstrated a positive compression-rotation test before knot removal. The mean follow-up duration after knot removal was 48.0 ± 37.4 months (range, 24-156 months). The mean duration between primary fixation and knot removal was 21.2 ± 14.7 months (range, 8-56 months).

Results:

Sharp pain (100%) and clicking (64%) were the most common symptoms. The knot was positioned on the glenoid side in 5 patients and the labral side in 6 patients. The knots on the glenoid side had associated humeral head cartilage damage. The mean University of California at Los Angeles score significantly improved from 15.2 points to 31.7 points after knot removal ( P = .003) Additionally, the mean Constant score greatly improved from a mean of 56.5 points to 89.8 points ( P = .003). At a mean of 3 weeks after surgery, we observed dramatic pain relief. Six weeks after surgery, the compression-rotation test was negative in all patients.

Conclusion:

The most common symptom of knot-induced pain after SLAP repair was persistent sharp pain followed by clicking. The knot appears to be a cause of pain in failed SLAP repairs, and arthroscopic knot removal can provide dramatic pain relief and significant improvement of clinical outcomes.
A Novel Approach for Meniscal Regeneration Using Kartogenin-Treated Autologous Tendon Graft
Authors: Huang He , Xu Hongyao , Zhao Jianning
Published: September 2017

Background:

The meniscus is one of the most commonly injured parts of the body, and meniscal healing is difficult.

Hypothesis:

Kartogenin (KGN) induces tendon stem cells (TSCs) to differentiate into cartilage cells in vitro and form meniscus-like tissue in vivo. A damaged meniscus can be replaced with a KGN-treated autologous tendon graft.

Study Design:

Controlled laboratory study.

Methods:

In the in vitro experiments, TSCs were isolated from rabbit patellar tendons and cultured with various concentrations of KGN, from 0 to 1000 µM. The effect of KGN on the chondrogenesis of TSCs in vitro was investigated by histochemical staining and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). The in vivo experiments were carried out on 6 New Zealand White rabbits by removing a meniscus from the rabbit knee and implanting an autologous tendon graft treated with KGN or saline. The meniscus formation in vivo was examined by histological analysis and immune staining.

Results:

The proliferation of TSCs was promoted by KGN in a concentration-dependent manner. Both histochemical staining and qRT-PCR showed that the chondrogenic differentiation of TSCs was increased with KGN concentration. After 3 months of implantation, the tendon graft treated with KGN formed a meniscus-like tissue with a white and glistening appearance, while the saline-treated tendon graft retained tendon-like tissue and appeared yellowish and unhealthy. Histochemical staining showed that after 3 months of implantation, the KGN-treated tendon graft had a structure similar to that of normal meniscus. Many cartilage-like cells and fibrocartilage-like tissues were found in the KGN-treated tendon graft. However, no cartilage-like cells were found in the saline-treated tendon graft after 3 months of implantation. Furthermore, the KGN-treated tendon graft was positively stained by both anti–collagen type I and type II antibodies, but the saline-treated tendon graft was not stained by collagen type II.

Conclusion:

The findings indicated that KGN can induce the differentiation of TSCs into cartilage-like cells in vitro and in vivo. The results suggest that KGN-treated tendon graft may be a good substitute for meniscal repair and regeneration.

Clinical Relevance:

This study revealed the direct effects of KGN on the chondrogenic differentiation of TSCs in vitro and in vivo. A KGN-treated autologous tendon graft induced formation of a meniscus-like tissue in vivo. This study provides a new cartilage regenerating technology for the treatment of damaged meniscus.
Investigating tool performance and wear when simulating bandsawing of nickel-based superalloy under interrupted orthogonal turning condition
Authors: Khan Fahd N , Haider Julfikar , Persson Martin
Published: September 2017

The manufacturing industries still face the most challenging job at hand to machine nickel-based superalloy, Inconel 718, efficiently and economically. In contrast to the extensive research efforts in secondary machining processes such as turning, milling and drilling, very little or no attention is paid on bandsawing of Inconel 718. This article presents an experimental investigation of machining Inconel 718 using carbide-tipped bandsaw teeth in a custom-made experimental facility. Cutting forces were measured during the bandsawing operation using a dynamometer, and the wear modes and mechanisms in the bandsaw teeth were investigated in a scanning electron microscope. Three different feeds or depths of cut (10, 20 and 30 μm) were employed with a cutting speed of 30 m/min during the machining tests. At smaller feed or depth of cut (10 μm), abrasive wear, adhesive wear and some degree of plastic deformation were identified as the governing mechanisms of tool wear. The higher depth of cut (30 μm) could cause cracking, chipping or premature failure of the carbide tip in bandsaw tooth. Strong welding of workpiece material to the cutting edge formed a built-up edge, which would impair the bandsawability due to the modification of the cutting edge. The higher depth of cut significantly improved the machining performance due to the reduction in specific cutting energy. However, it was not recommended to apply higher depth of cut as there were obvious possibilities of premature tooth failure. Machining force and specific cutting energy results along with chip characteristics were correlated with the tool performance and tool wear. The results of this investigation would be helpful for bandsaw manufacturers and end users to get a fundamental understanding of the bandsawability of Inconel 718 with the carbide-tipped bandsaw.
Infectious complications in HIV-infected kidney transplant recipients
Authors: Ailioaie O , Arzouk N , Valantin MA , Tourret J , Calin RO , Turinici M , Mircescu G , Barrou B
Published: September 2017

Renal transplantation is now a viable alternative for dialysis in HIV-infected patients who achieve good immunovirological control with current antiretroviral therapy regimens available. However, there are few studies that analyze the incidence of post-transplant infections in this population. In this study, a retrospective analysis of data files of 24 HIV-infected kidney transplant (KT) recipients was undertaken, matched to 21 non-infected controls. All patients received induction with anti-interleukin-2 antibodies and were followed in the Pitié-Salpêtrière Hospital in Paris, France. The rate of incidence of post-transplant infections was 23.58 and 26.98/100 patient-years, in HIV-infected and HIV-negative groups (relative risk [RR]: 0.90; 95% confidence interval [CI]: 0.58–1.39; p = 0.63). In HIV-infected KT recipients, bacterial infections were the most frequent (67.7%), followed by viral (14.7%) and fungal and parasitic infections (8.8%). Similar trends were seen in the control group. Incidence of opportunistic infections was similar in HIV-infected KT recipients and controls (38.2 vs. 26.5%; p = 0.44). There were three post-transplant HIV reactivations in two patients, secondary to poor adherence to medication. HIV status did not influence survival, but infections increased the risk of unfavorable outcome. Incidence of post-transplant infections was similar in HIV-infected KT recipients and controls. Infections, but not HIV status, had adverse effects on patient and graft survival.
Study of the Safety of Extracorporeal Cardiac Shock Wave Therapy: Observation of the Ultrastructures in Myocardial Cells by Transmission Electron Microscopy
Authors: Liu Bing , Zhang Yunhe , Jia Na , Lan Ming , Du Ling , Zhao Dachun , He Qing
Published: September 2017

Extracorporeal cardiac shock wave therapy (CSWT) has been used to treat patients with severe coronary heart disease and cardiac failure with good results; however, the safety of this treatment is still controversial. Its safety in clinical setting and on microstructures has been confirmed, but the influence of shock wave on the ultrastructures of myocardial cells is not clear. In this study, 12 Sprague-Dawley rats were randomly divided into control (NC) and CSWT therapy (NC+SW) groups. The heart rate, blood pressure, serum troponin I (TNI), and cardiac ultrasound were evaluated, and the myocardial inflammatory responses and fibrosis changes were compared. The samples were observed by transmission electron microscopy to evaluate the changes in myocardial tissue ultrastructure. The CSWT had no significant influence on rat hemodynamics indices and serum TNI, did not affect left ventricular function, and did not cause myocardial inflammatory response and fibrosis changes. The scores of myocardial ultrastructure damage in the NC and NC+SW groups were 1.39 ± 0.982 and 2.42 ± 1.009, respectively ( P = .103). The CSWT did not cause significant additional damage to myocardial ultrastructures. The safety of CWST has been preliminarily proved at the clinical, microstructure, and ultrastructure levels, but its long-term safety needs further exploration.
Multi-targeted ethnography and the Challenge of Engaging New Audiences and Publics
Authors: O’Dell Tom
Published: September 2017

This article focuses upon and problematizes the manner in which anthropologists and ethnologists have traditionally striven to communicate and share the knowledge they have gained through fieldwork. It does so by presenting and discussing the concept of multi-targeted ethnography, a move which implies a switch in perspectives that emphasizes distributive rather than accumulative modes of the ethnographic endeavor. In so doing, the objective of this text is to illuminate and discuss how multi-targeted ethnography might be understood, framed, and developed in relation to the broader array of audiences that ethnography is increasingly expected to engage. As part of this argument, the text points to a need to more actively reflect upon how scholars can engage the audiences their work is intended for, to not only establish understanding, answer questions, and deliver solutions to existing problems but even point to underlying questions that may elude clear-cut answers and be in need of open discussion and contestation.
An Improved Measure of Cognitive Salience in Free Listing Tasks
Authors: Robbins Michael C. , Nolan Justin M. , Chen Diana
Published: September 2017

A new free-list measure of cognitive salience, B′, is presented, which includes both list position and list frequency. It surpasses other extant measures by being normed to vary between a maximum of 1 and a minimum of 0, thereby making it useful for comparisons irrespective of list length or number of respondents. An illustration of its properties, uses, and computation is provided with the aid of examples drawn from free lists of foods elicited from a sample of migrants from the Republic of the Marshall Islands.
The burden of oral cancer in sub-Saharan Africa
Authors: Hille Jos , Johnson Newell W
Published: September 2017

Objectives:

To describe incidence and mortality rates of oral and of oropharyngeal cancers in sub-Saharan Africa using available sources and to discuss shortcomings.

Methods:

Incidence and mortality rates were obtained from GLOBOCAN online (IARC 2012) and the pathology-based South African National Cancer Registry (SA-NCR). Descriptions of oral and of oropharynx cancers for the four main geographical regions were derived from the literature. For South Africa, the incidence by ethnic group of lip and intra-oral cancer over the period 1988–2012 could be calculated from SA-NCR. The age distributions for intraoral and for oropharynx cancer in both genders in South Africa were compared for the period 1996–2002.

Results:

Age standardized incidence rates and mortality rates of lip and of oral cancer in sub-Saharan Africa varied substantially, depending on the regions, the mix of carcinogenic substances consumed in each country and the quality of the cancer registry data. African islands in the Indian Ocean and the Southern and Eastern African countries report the highest rates; these are generally reported to be much lower in West African countries. Available data are now old: not beyond 2010. Up until that time, in the Republic of South Africa, there appears to have been a slight decline in oral cancer rates, except in Black females, but a rise this millennium in cancer of the oropharynx, especially in Coloureds (mixed-race). At least until 2002, the Human Immunodeficiency Virus infection (HIV) pandemic had little or no stimulating influence on the incidence rates of oral squamous carcinoma in South Africa, although Kaposi’s sarcoma has been a major burden in the past. Asian and mixed-race South African females had the highest levels of oral squamous cell carcinomas in the <45 year age group.

Conclusion:

The quality of cancer registry data in sub-Saharan Africa is variable, unreliable and out of date, suggesting gross under-ascertainment. Records of all causes of death are poor, which can result in both under- and over-attribution of cancer mortality. Improvements of the necessary resources for cancer registration and death certification deserve a high priority.
Analyzing the Clinical Outcomes of a Rapid Mass Conversion From Rosuvastatin to Atorvastatin in a VA Medical Center Outpatient Setting
Authors: Naville-Cook Chad , Rhea Leroy , Triboletti Mark , White Christina
Published: September 2017

Background: Medication conversions occur frequently within the Veterans Health Administration. This manual process involves several pharmacists over an extended period of time. Macros can automate the process of converting a list of patients from one medication to a therapeutic alternative. Objectives: To develop a macro that would convert active rosuvastatin prescriptions to atorvastatin and to create an electronic dashboard to evaluate clinical outcomes. Methods: A conversion protocol was approved by the Pharmacy & Therapeutics Committee. A macro was developed using Microsoft Visual Basic. Outpatients with active prescriptions for rosuvastatin were reviewed and excluded if they had a documented allergy to atorvastatin or a significant drug-drug interaction. An electronic dashboard was created to compare safety and efficacy endpoints pre- and postconversion. Primary endpoints included low-density lipoprotein (LDL), creatine phosphokinase (CPK), aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase. Secondary endpoints evaluated cardiovascular events, including the incidences of myocardial infarction, stroke, and stent placement. Results: The macro was used to convert 1520 patients from rosuvastatin to atorvastatin over a period of 20 hours saving $5760 in pharmacist labor. There were no significant changes in LDL, AST, ALT, or secondary endpoints ( P > .05). There was a significant increase in alkaline phosphatase ( P = .0035). Conclusions: A rapid mass medication conversion from rosuvastatin to atorvastatin saved time and money and resulted in no clinically significant changes in safety or efficacy endpoints. Macros and clinical dashboards can be applied to any Veterans Health Administration facility.
Rituximab-based first-line treatment of cGVHD after allogeneic SCT: results of a phase 2 study
Authors: Malard Florent , Labopin Myriam , Yakoub-Agha Ibrahim , Chantepie Sylvain , Guillaume Thierry , Blaise Didier , Tabrizi Reza , Magro Leonardo , Vanhove Bernard , Blancho Gilles , Moreau Philippe , Gaugler Béatrice , Chevallier Patrice , Mohty Mohamad
Published: September 2017

Key Points

The addition of rituximab to corticosteroid and CsA is safe and effective for first-line treatment of cGVHD. Resistance of PD-L1hi B cells to anti-CD20 depletion may lead to the suppression of activated Tfh cells and cGVHD control.
The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC): experiences from a successful ERS Clinical Research Collaboration
Authors: Chalmers James D. , Crichton Megan , Goeminne Pieter C. , Loebinger Michael R. , Haworth Charles , Almagro Marta , Vendrell Montse , De Soyza Anthony , Dhar Raja  , Morgan Lucy , Blasi Francesco , Aliberti Stefano , Boyd Jeanette , Polverino Eva
Published: September 2017

In contrast to airway diseases like chronic obstructive pulmonary disease or asthma, and rare diseases such as cystic fibrosis, there has been little research and few clinical trials in bronchiectasis. Guidelines are primarily based on expert opinion and treatment is challenging because of the heterogeneous nature of the disease.

In an effort to address decades of underinvestment in bronchiectasis research, education and clinical care, the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) was established in 2012 as a collaborative pan-European network to bring together bronchiectasis researchers. The European Respiratory Society officially funded EMBARC in 2013 as a Clinical Research Collaboration, providing support and infrastructure to allow the project to grow.

EMBARC has now established an international bronchiectasis registry that is active in more than 30 countries both within and outside Europe. Beyond the registry, the network participates in designing and facilitating clinical trials, has set international research priorities, promotes education and has participated in producing the first international bronchiectasis guidelines. This manuscript article the development, structure and achievements of EMBARC from 2012 to 2017.

Educational aims

To understand the role of Clinical Research Collaborations as the major way in which the European Respiratory Society can stimulate clinical research in different disease areas

To understand some of the key features of successful disease registries

To review key epidemiological, clinical and translational studies of bronchiectasis contributed by the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) project in the past 5 years

To understand the key research priorities identified by EMBARC for the next 5 years
Diagnosis of primary ciliary dyskinesia: summary of the ERS Task Force report
Authors: Kuehni Claudia E. , Lucas Jane S.
Published: September 2017

Key points

Primary ciliary dyskinesia (PCD) is a genetically and clinically heterogeneous disease characterised by abnormal motile ciliary function.

There is no “gold standard” diagnostic test for PCD.

The European Respiratory Society (ERS) Task Force Guidelines for diagnosing PCD recommend that patients should be referred for diagnostic testing if they have several of the following features: persistent wet cough; situs anomalies; congenital cardiac defects; persistent rhinitis; chronic middle ear disease with or without hearing loss; or a history, in term infants, of neonatal upper and lower respiratory symptoms or neonatal intensive care admission.

The ERS Task Force recommends that patients should be investigated in a specialist PCD centre with access to a range of complementary tests: nasal nitric oxide, high-speed video microscopy analysis and transmission electron microscopy. Additional tests including immunofluorescence labelling of ciliary proteins and genetic testing may also help determine the diagnosis.

Educational aims

This article is intended for primary and secondary care physicians interested in primary ciliary dyskinesia (PCD),i.e.those who identify patients for testing, and those involved in diagnosing and managing PCD patients. It aims:

to inform readers about the new European Respiratory Society Task Force Guidelines for diagnosing patients with PCD

to enable primary and secondary care physicians to: identify patients who need diagnostic testing; understand the diagnostic tests that their patients will undergo, the results of the tests and their limitations; and ensure that appropriate care is subsequently delivered.
Link between bedrock lithology and sedimentary systems in Lake Erhai Basin, southwest China, with respect to source to sink
Authors: Zhu Xiu , Zhu Hongtao , Zeng Hongliu , Liu Qianghu
Published: August 2017

Lake Erhai and its adjacent areas at one time constitute one complete source-to-sink (S2S) system. According to analyses of modern S2Ss, however, the S2S of Lake Erhai Basin can be divided into three subsystems — western (S2S-W), eastern (S2S-E), and northern (S2S-N). Among these three subsystems, significant differences have been found to exist in bedrock lithology (source area) and sedimentary bodies (sink area). The bedrocks (source area) of S2S-E consist mainly of carbonate rocks, and sediments are transported by small rivers and deposited on the eastern bank of the lake, forming small ([Formula: see text]) alluvial fans (sink area). Bedrocks of S2S-W involve metamorphic rocks and a few granitic and carbonate rocks. Sediments are transported by extensive streams (Cangshan 18 streams) and deposited along the western bank of the lake, forming a large ([Formula: see text]) sediment belt. In S2S-N (axial source), bedrocks are composed mainly of the clastic rocks. Sediments are transported by large rivers (the Miju and Lushi Rivers) and are deposited on the northern bank of the lake, forming a large delta ([Formula: see text]). Studies of the modern S2S reveal that different S2Ss can exist in the same basin (sag) and that these S2Ss are likely to differ significantly in catchment area, sedimentary body area, sedimentation response, etc., because of controlling factors such as bedrock lithology, tectonic activity, paleomorphology, basin boundaries, and transport channel, among others. Therefore, more attention should be paid to the distinguishing characteristics of S2Ss in further study of the ancient S2S systems.
Clinical staging models: From general medicine to mental disorders
Authors: Scott Jan , Henry Chantal
Published: September 2017

Revisions of international classification systems for mental disorders have focused on improving the reliability of diagnostic criteria. However, the uncertain validity of the current diagnostic categories means that they do not always fulfil their key purposes, namely to guide treatment and predict outcomes. This is especially true when traditional diagnostic approaches are applied to adolescents and young adults with emerging illnesses. A clinical staging model, similar to those used in general medicine, could improve diagnosis in psychiatry and aid treatment decision-making, especially if applied to individuals aged about 15–25 years, which is the peak age range for the onset of severe mental disorders. Staging models may offer a new framework for the development of interventions with high benefit and low risk, and for research into neurobiological and psychosocial risk factors. However, this approach is not without controversy: some experts oppose its introduction, some argue that it represents a transdiagnostic model, and some suggest it is only viable if disorder-specific models are used.

Learning Objectives

• Gain awareness of some limitations of current approaches to psychiatric diagnosis

• Review the basic principles of clinical staging models used in general medicine

• Understand current research on the use of staging models in psychiatry, and attempts to apply these models to bipolar disorders
Trends in the Prevalence of Intraoperative Adverse Events at Two Academic Hospitals After Implementation of a Mandatory Reporting System
Authors: Wanderer Jonathan P. , Gratch David M. , Jacques Paul St. , Rodriquez Luis I. , Epstein Richard H.
Published: August 2017

BACKGROUND:

Anesthesia information management systems (AIMSs) have been effectively used to improve quality in anesthesia care, and have enabled the development of mandatory quality assurance (QA) reporting systems for adverse events (AEs). While this approach has been shown to increase event reporting over time, the long-term effect of such a system on quality is unknown. We investigated the trends in AE reporting over time after implementing AIMS-based mandatory reporting systems at 2 academic medical centers.

METHODS:

At Thomas Jefferson University Hospital, AEs were retrieved after implementation of a mandatory QA process in 2013. These AEs were categorized as preventable and unpreventable. The rates of overall preventable and unpreventable AEs were analyzed over time. At Vanderbilt University Medical Center, the rates of AEs were analyzed after establishing a mandatory QA process in 2002. Data were binned by quarter, and trends over time were analyzed using the Mann-Kendall test.

RESULTS:

At Thomas Jefferson University Hospital, over a period of 2 years after implementation of a mandatory QA process, the documented AE rate decreased from 1.23% to 0.64% (P < .0001). This decrease occurred primarily in the group of preventable AEs, which declined from 1.01% to 0.52% (P = .014). The rate of unpreventable AEs was unchanged, from 0.22% to 0.12% (P = .12). At Vanderbilt University Medical Center, over a 7-year period after implementation, the AE rate decreased from 4.20% to 1.36% (P < .0001).

CONCLUSIONS:

After implementation of a mandatory QA process at 2 academic medical centers, documented AE rates decreased significantly. The decrease observed in preventable AEs, with unchanged rates of unpreventable AEs, demonstrates that mandatory reporting of intraoperative AEs was followed by a reduction in preventable intraoperative AEs. If our findings are replicated at other institutions and are shown to have a stronger trend compared with institutions where the implementation was not conducted, or there was a change from preimplementation trends, adding mandatory perioperative outcomes reporting in the AIMS may represent a valuable method to improve the overall safety of anesthesia.