bluuebunny/crossref_metadata_2025 huggingface dataset:
Breastfeeding and Risk of Metabolic Syndrome in Children and Adolescents: A Systematic Review
Authors: Wisnieski Lauren , Kerver Jean , Holzman Claudia , Todem David , Margerison-Zilko Claire
Published: November 2017

Background:

The beneficial effect of breastfeeding on individual components of the metabolic syndrome in children and adolescents has been reported, but it is unknown if there is an association between being breastfed and metabolic syndrome as a whole.

Research aim:

This systematic review was performed to assess quality and strength of evidence for the association between being breastfed and the development of metabolic syndrome in children and adolescents.

Methods:

Articles were obtained from searches using PubMed and Embase databases, as well as from secondary searches through reference lists. Study quality was assessed using a three-level quality rating system.

Results:

Of 11 studies reviewed, 7 found a protective association between breastfeeding and metabolic syndrome and 4 found no association. There was no clear dose–response relationship between duration of breastfeeding and metabolic syndrome risk and insufficient evidence to demonstrate an added effect of being exclusively breastfed. The overall quality of the articles was moderate. In general, lower quality articles found no significant association, whereas higher quality articles found a significant association.

Conclusion:

Our review demonstrated a limited amount of high-quality research on the relationship between being breastfed and development of metabolic syndrome in children and adolescents. The evidence presented in this review suggests that being breastfed may be protective against metabolic syndrome, but further research with improvements in study design, such as improved measurement of breastfeeding and the use of prospectively collected data, will improve our understanding of this relationship.
Dielectric analysis of polypropylene (PP) and polylactic acid (PLA) blends reinforced with halloysite nanotubes
Authors: Rajan Krishna Prasad , Al-Ghamdi Ahmed , Thomas Selvin P , Gopanna Aravinthan , Chavali Murthy
Published: November 2017

Polypropylene (PP) and polylactic acid were blended in the ratio 80:20 by weight and compatibilized with 3 wt% of maleic anhydride-grafted-PP. The compatibilized blend was chosen as the base matrix for reinforcement with halloysite nanotubes (HNTs). The nanotube content varied from 0 to 10 wt%. Blend and the nanocomposites were prepared by melt mixing technique. Dielectric analysis of the base matrix and the nanocomposites was carried out using interdigitated electrode sensor in a DEA 288 Epsilon-dielectric analyser. The dielectric properties of the composites were measured at temperatures from 30 to 120°C at various frequencies ranging from 1 Hz to 1 kHz. Permittivity values slightly decreased as the HNT content increased from 0 to 2 wt%. It increased at 4 wt% of HNT and again slightly decreased at 6 wt% of HNT, and with further increase in HNT (HNT 8 and HNT 10) led to increase in permittivity values. Loss factor values decreased slightly as the HNT content in the composites increased from 0 to 4 wt%; but with further increase in HNT, the loss factor showed a sharp increase. Loss tangent (tan δ) values decreased up to 4 wt% of HNT (HNT 4) and then increased up to 8 wt% (HNT 8) of HNT and then decreased slightly (for HNT 10). Analysing the different dielectric properties, consistent properties were shown by 6 wt% of HNT similar to static and dynamic mechanical properties. The analysis showed that the composites can be utilized in microelectronic devices or in microelectronic packaging applications.
Titrating the Rig: How Paramedics Work in and on Their Ambulance
Authors: Corman Michael K.
Published: November 2017

In this article, I take readers inside of an ambulance and explore how paramedics work in and on their “apparatus unit” to make it a workable fit. This taken-for-granted work is important because much is at stake in the back of the ambulance, particularly in relation to quality of care and safety. I draw on data from an institutional ethnography into the socially organized work and work settings of paramedics, which included more than 200 hr of observations and more than 100 interviews with paramedics. The findings shed light on the situated work processes of paramedics as they orient and respond to their “apparatus unit” and enact quality and safety in practice. This article adds to the sociological literature on work and occupations as well as safety and quality in health care of an increasingly important group of health care and emergency services professional.
The Experience of Persons With Hematological Malignancy When Communicating With Health Care Professionals
Authors: Horinuki Fumika , Noguchi-Watanabe Maiko , Takai Yukari , Yamahana Reiko , Ohno Nobuhiro , Okada Sadamu , Mori Shin-ichiro , Yamamoto-Mitani Noriko
Published: November 2017

This study aimed to elucidate the experiences of Japanese persons with hematological malignancy (PHMs) in communicating with health care professionals (HCPs), from diagnosis to the end of life, as recalled by their families. We interviewed 14 bereaved families and analyzed the data using the basic techniques of grounded theory. We found that PHMs lived to the fullest possible when they experienced ownership of their illness process despite their disease. The ownership was made possible by active communication from HCPs: first, acknowledging the PHM’s way of life, including reaching out from the HCPs and appreciating sincerely PHMs’ hopes and will; and second, paving the way ahead, including giving prospects and offering choices. The study underlines that rather than just providing information about the disease, HCPs need to actively ask about and show respect for the PHM’s way of life. Only after achieving this can HCPs communicate possible future pathways with PHMs.
The Influence of Hypothetical Death Scenarios on Multidimensional End-of-Life Care Preferences
Authors: Dassel Kara B. , Utz Rebecca , Supiano Katherine , McGee Nancy , Latimer Seth
Published: November 2017

Background:

Differences in end-of-life (EOL) care preferences (eg, location of death, use of life-sustaining treatments, openness to hastening death, etc) based on hypothetical death scenarios and associated physical and/or cognitive losses have yet to be investigated within the palliative care literature.

Aim:

The purpose of this study was to explore the multidimensional EOL care preferences in relation to 3 different hypothetical death scenarios: pancreatic cancer (acute death), Alzheimer disease (gradual death), and congestive heart failure (intermittent death).

Design:

General linear mixed-effects regression models estimated whether multidimensional EOL preferences differed under each of the hypothetical death scenarios; all models controlled for personal experience and familiarity with the disease, presence of an advance directive, religiosity, health-related quality of life, and relevant demographic characteristics.

Setting/Participants:

A national sample of healthy adults aged 50 years and older (N = 517) completed electronic surveys detailing their multidimensional preferences for EOL care for each hypothetical death scenario.

Results:

The average age of the participants was 60.1 years (standard deviation = 7.6), 74.7% were female, and 66.1% had a college or postgraduate degree. Results revealed significant differences in multidimensional care preferences between hypothetical death scenarios related to preferences for location of death (ie, home vs medical facility) and preferences for life-prolonging treatment options. Significant covariates of participants’ multidimensional EOL care preferences included age, sex, health-related quality of life, and religiosity.

Conclusion:

Our hypothesis that multidimensional EOL care preferences would differ based on hypothetical death scenarios was partially supported and suggests the need for disease-specific EOL care discussions.
Self-Assessment Scores Improve After Simulation-Based Palliative Care Communication Skill Workshops
Authors: Brown Crystal E. , Back Anthony L. , Ford Dee W. , Kross Erin K. , Downey Lois , Shannon Sarah E. , Curtis J. Randall , Engelberg Ruth A.
Published: November 2017

Background:

We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This article reports findings from trainees’ self-assessments.

Aim:

To examine whether Codetalk resulted in improved self-assessed communication competence by trainees.

Design:

Trainees were recruited from the University of Washington and the Medical University of South Carolina. Internal medicine residents, medicine subspecialty fellows, nurse practitioner students, or community-based advanced practice nurses were randomized to Codetalk, a simulation-based workshop, or usual education. The outcome measure was self-assessed competence discussing palliative care needs with patients and was assessed at the start and end of the academic year. We used robust linear regression models to predict self-assessed competency, both as a latent construct and as individual indicators, including randomization status and baseline self-assessed competency.

Results:

We randomized 472 trainees to the intervention (n = 232) or usual education (n = 240). The intervention was associated with an improvement in trainee’s overall self-assessment of competence in communication skills ( P < .001). The intervention was also associated with an improvement in trainee self-assessments of 3 of the 4 skill-specific indicators—expressing empathy, discussing spiritual issues, and eliciting goals of care.

Conclusion:

Simulation-based communication training was associated with improved self-assessed competency in overall and specific communication skills in this randomized trial. Further research is needed to fully understand the importance and limitations of self-assessed competence in relation to other outcomes of improved communication skill.
Teaching Medical Students About “The Conversation”: An Interactive Value-Based Advance Care Planning Session
Authors: Lum Hillary D. , Dukes Joanna , Church Skotti , Abbott Jean , Youngwerth Jean M.
Published: November 2017

Background:

Advance care planning (ACP) promotes care consistent with patient wishes. Medical education should teach how to initiate value-based ACP conversations.

Objective:

To develop and evaluate an ACP educational session to teach medical students a value-based ACP process and to encourage students to take personal ACP action steps.

Design:

Groups of third-year medical students participated in a 75-minute session using personal reflection and discussion framed by The Conversation Starter Kit. The Conversation Project is a free resource designed to help individuals and families express their wishes for end-of-life care.

Setting and Participants:

One hundred twenty-seven US third-year medical students participated in the session.

Measurements:

Student evaluations immediately after the session and 1 month later via electronic survey.

Results:

More than 90% of students positively evaluated the educational value of the session, including rating highly the opportunities to reflect on their own ACP and to use The Conversation Starter Kit. Many students (65%) reported prior ACP conversations. After the session, 73% reported plans to discuss ACP, 91% had thought about preferences for future medical care, and 39% had chosen a medical decision maker. Only a minority had completed an advance directive (14%) or talked with their health-care provider (1%). One month later, there was no evidence that the session increased students’ actions regarding these same ACP action steps.

Conclusion:

A value-based ACP educational session using The Conversation Starter Kit successfully engaged medical students in learning about ACP conversations, both professionally and personally. This session may help students initiate conversations for themselves and their patients.
Patterns and Yearly Time Trends in the Use of Radiation Therapy During the Last 30 Days of Life Among Patients With Metastatic Rectal Cancer in the United States From 2004 to 2012
Authors: Becerra Adan Z. , Probst Christian P. , Fleming Fergal J. , Xu Zhaomin , Aquina Christopher T. , Justiniano Carla F. , Boodry Courtney I. , Swanger Alex A. , Noyes Katia , Katz Alan W. , Monson John R. , Jusko Todd A.
Published: November 2017

Purpose:

Although radiation therapy (RT) can provide palliative benefits for patients with metastatic rectal cancer, its role at the end of life remains unclear. The objective of this study was to assess sociodemographic and clinical factors associated with the use of RT during the last 30 days of life and to evaluate yearly time trends in RT utilization among stage IV patients with rectal cancer.

Methods:

The 2004 to 2012 National Cancer DataBase was queried for patients with metastatic rectal cancer who had a documented death during follow-up. A Bayesian multilevel logistic regression model was used to characterize predictive factors and yearly time trends associated with RT use in the last 30 days of life.

Results:

Among 10 431 patients who met inclusion criteria, 345 (3%) received RT during the last 30 days of life. Factors independently associated with RT use included older age, female sex, African American race, nonprivate insurance, higher comorbidity burden, and worse grade. The odds of RT use at the end of life decreased by 28% between 2007 and 2009 (odds ratio [OR] = 0.72, 95% Credible Interval (CI) = 0.58-0.93), but then increased by 16% from 2010 to 2012 (OR = 1.16, 95% CI = 1.13-1.33), relative to 2004 to 2006.

Conclusion:

Radiation therapy use for patients with metastatic rectal cancer is beneficial, and efforts to optimize its appropriate use are important. Several factors associated with RT use during the last 30 days of life included disparities in sociodemographic and clinical subgroups. Research is needed to understand the underlying causes of these inequalities and the role of predictive models in clinical decision-making.
What Did Latino Family Caregivers Expect and Learn From Education Intervention “Caregivers Like Me”?
Authors: Cruz-Oliver Dulce M. , Parikh Manas , Wallace Cara L. , Malmstrom Theodore K. , Sanchez-Reilly Sandra
Published: November 2017

Objective:

US Latinos historically have underutilized end-of-life (EOL) resources. This study reports the views of family caregivers before and after education intervention Caregivers Like Me geared to improve knowledge and attitudes regarding EOL resources among Latino caregivers.

Methods:

This is a qualitative substudy within a multicentered cross-sectional study design. Educational intervention was offered to family caregivers of Latino elders from 3 different communities, using an audiovisual presentation, including a case-based video telenovela and pre–posttest questionnaires with open-ended questions. This study pertains to the qualitative results for the open-ended questions before and after education intervention.

Results:

Participants (N = 145) were mostly females (79%) with a mean age of 56 ± 15 years and reported (92%) active learning from intervention. The pretest open-ended question on expected learning identified 2 themes, care for the sick and self-care. It included 5 subthemes and the most common one was how to help the sick. The posttest question on actual learning identified the same 2 themes and 4 subthemes that were similar but different from the pretest. Accepting help and knowledge of services available were the most common.

Conclusion:

The education intervention Caregivers Like Me was able to improve attitudes toward EOL care because participants who wanted to help their loved ones realized that they need to accept professional help and were made aware of the services available.
Patient Outcomes After Palliative Care Consultation Among Patients Undergoing Therapeutic Hypothermia
Authors: Pinto Priya , Brown Tartania , Khilkin Michael , Chuang Elizabeth
Published: November 2017

Objectives:

To compare the clinical outcomes of patients who did and did not receive palliative care consultation among those who experienced out-of-hospital cardiac arrest and underwent therapeutic hypothermia.

Methods:

We identified patients at a single academic medical center who had undergone therapeutic hypothermia after out-of-hospital cardiac arrest between 2009 and 2013. We performed a retrospective chart review for demographic data, hospital and critical care length of stay, and clinical outcomes of care.

Results:

We reviewed the charts of 62 patients, of which 35 (56%) received a palliative care consultation and 27 (44%) did not. Palliative care consultation occurred an average of 8.3 days after admission. Patients receiving palliative care consultation were more likely to have a do-not-resuscitate (DNR) order placed (odds ratio: 2.3, P < .001). The mean length of stay in the hospital was similar for patients seen by palliative care or not (16.7 vs 17.1 days, P = .90). Intensive care length of stay was also similar (11.3 vs 12.6 days, P = .55).

Conclusions:

Palliative care consultation was underutilized and utilized late in this cohort. Palliative consultation was associated with DNR orders but did not affect measures of utilization such as hospital and intensive care length of stay.
End-of-life Characteristics and Palliative Care Provision for Patients With Motor Neuron Disease
Authors: Cheng Hon Wai Benjamin , Chan Oi Man Iman , Chan Chun Hung Red , Chan Wan Hung , Fung Koon Sim , Wong Kar Yin
Published: November 2017

Motor neuron disease (MND) is a neurodegenerative disease and manifested as progressive decline in physical, respiratory, swallowing and communication function, and ultimately death. Traditional model of care was fragmented and did not match with multifacet needs of patients and carers. Furthermore, there could be lack of integrated care at end of life for patients with MND in most lower- and middle-income countries or in places with inadequate palliative care (PC) coverage. In view of this, a special workgroup for patients with MND, which includes neurologist, respiratory physician, rehabilitation specialist, and PC physician was formed in Hong Kong since year 2011. In various disease phase, each specialty team plays a leading role in coordinated care of patients with MND. From July 2011 to June 2017, a total of 52 patients with MND were referred for PC; 41 deceased patients with MND were included into data analysis. Major cause of death remains pneumonia (54.8%) and respiratory failure (40.5%). Most of the patients with MND (66.7%) died in acute ward and neurology units, with only 11.9% dying in PC units and hospices. The PC team plays a major role in advance care planning (ACP), and most patients had their ACP documented at second or third PC clinic visit (93.8%). Patients with MND often have limitations in mobility, swallowing difficulty, respiratory insufficiency requiring ventilator support, and various psychosocial needs. This highlighted the importance of early PC referral.
Monomethyl fumarate treatment impairs maturation of human myeloid dendritic cells and their ability to activate T cells
Authors: Mazzola Maria Antonietta , Raheja Radhika , Regev Keren , Beynon Vanessa , von Glehn Felipe , Paul Anu , Pierre Isabelle , Kivisakk Pia , Weiner Howard L , Gandhi Roopali
Published: November 2017

Background:

Dimethyl fumarate (DMF) and its active metabolite monomethyl fumarate (MMF) effectively lead to reduction in disease relapses and active magnetic resonance imaging (MRI) lesions. DMF and MMF are known to be effective in modulating T- and B-cell responses; however, their effect on the phenotype and function of human myeloid dendritic cells (mDCs) is not fully understood.

Objective:

To investigate the role of MMF on human mDCs maturation and function.

Methods:

mDCs from healthy controls were isolated and cultured in vitro with MMF. The effect of MMF on mDC gene expression was determined by polymerase chain reaction (PCR) array after in vitro MMF treatment. The ability of mDCs to activate T cells was assessed by in vitro co-culture system. mDCs from DMF-treated multiple sclerosis (MS) patients were analyzed by flow cytometry and PCR.

Results:

MMF treatment induced a less mature phenotype of mDCs with reduced expression of major histocompatibility complex class II (MHC-II), co-stimulatory molecules CD86, CD40, CD83, and expression of nuclear factor κB (NF-κB) subunits RELA and RELB. mDCs from DMF-treated MS patients also showed the same immature phenotype. T cells co-cultured with MMF-treated mDCs showed reduced proliferation with decreased production of interferon gamma (IFN-γ), interleukin-17 (IL-17), and granulocyte-macrophage colony-stimulating factor (GM-CSF) compared to untreated cells.

Conclusion:

We report that MMF can modulate immune response by affecting human mDC function.
Comparative assessment of patient outcomes with intraluminal or subintimal crossing of infrainguinal peripheral artery chronic total occlusions
Authors: Kondapalli Ananya , Jeon-Slaughter Haekyung , Lu Hua , Xu Hao , Khalili Houman , Prasad Anand , Armstrong Ehrin J , Brilakis Emmanouil S , Banerjee Subhash
Published: November 2017

This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications. A subintimal crossing technique was necessary in 388 lesions (27% overall in 1335 lesions; 34% ( n=351) in 1023 femoropopliteal lesions, and 12% ( n=37) in 312 infrapopliteal lesions, p<0.01) with a lower procedural ( p<0.01) and technical ( p<0.01) success than the intraluminal in both femoropopliteal and infrapopliteal interventions. There were no significant differences in procedural complications, major adverse cardiac events, or clinically driven target limb revascularization at 1 year between the two groups, except a higher residual dissection rate in the subintimal crossing group than the intraluminal group in femoropopliteal target vessels ( p = 0.04).
Race influences parent report of concerns about symptoms of autism spectrum disorder
Authors: Donohue Meghan Rose , Childs Amber W , Richards Megan , Robins Diana L
Published: November 2017

Racial differences in parent report of concerns about their child’s development to healthcare providers may contribute to delayed autism spectrum disorder diagnoses in Black children. We tested the hypotheses that compared to White parents, Black parents of children with autism spectrum disorder would report fewer concerns about autism symptoms and would be more likely to report concerns about disruptive behaviors. A sample of 18- to 40-month-old toddlers ( N = 174) with autism spectrum disorder and their parent participated. After screening positive for autism spectrum disorder risk, but prior to a diagnostic evaluation, parents completed free-response questions soliciting concerns about their child’s development. Parent responses were coded for the presence or the absence of 10 possible concerns, which were grouped into autism concerns (e.g. social and restricted and repetitive behavior concerns) or non-autism concerns (e.g. general developmental and disruptive behavior concerns). Compared to White parents, Black parents reported significantly fewer autism concerns and fewer social and restricted and repetitive behavior concerns. However, Black parents did not report significantly fewer non-autism concerns. Race did not influence parent report of disruptive behavior concerns. Lower reporting of autism concerns by Black parents may impact providers’ abilities to identify children who need further screening or evaluation.
Psychometric testing of the Turkish version of the Health Literacy for School-Aged Children Scale
Authors: Haney Meryem Ozturk
Published: November 2017

This study aimed to assess the validity and reliability of the Turkish version of the Health Literacy for School-Aged Children (HLSAC-T) scale. This study was a cross-sectional and methodological design. The sample consisted of 563 sixth and ninth grade students in Izmir, Turkey. Data were collected with the socio-demographic characteristics questionnaire, HLSAC-T, and Turkish version of the Adolescent Lifestyle Profile. Cronbach’s α for the scale was .77 and item-total correlations were between .49 and .61 ( p < .001). The model fit indices were determined to be the root mean square error of approximation at .035, the goodness of fit index at .99, and the comparative fit index at .99. The concordance validity and convergent validity were supported and the discriminant validity suggested that the scale successfully discriminated students who cared about healthy lifestyle from the students who did not. The HLSAC-T showed an adequate reliability and validity for determining the subjective health literacy of Turkish school-aged children. The results showed promise that the scale could be translated into other languages.
Flutter performance optimization of steel truss girder with double-decks by wind tunnel tests
Authors: Li Yongle , Tang Haojun , Wu Bing , Zhang Jingyu
Published: November 2017

To improve the flutter stability of a long-span suspension bridge with double-decks, aerodynamic optimization on the upper and lower bridge decks is studied, and a series of countermeasures are considered, including slotted deck, wind fairings, porosity of guardrail, and horizontal and vertical stabilizers. Wind tunnel tests were performed to measure the critical flutter wind speed of the bridge and find effective aerodynamic countermeasures for improvement of the flutter stability. The results show that double-vertical stabilizers symmetrically installed at the two sides of the bottom of the lower deck with the distance of 9.32 or 11.55 m to the center efficiently improve the flutter performance of the original section at −3°, 0°, and 3° angles of attack simultaneously, while other common aerodynamic measures can hardly achieve this effect alone. The composite measure which consists of two central stabilizers installed on the top of the upper and lower decks, respectively, is promise and superior to the single measure. The combination of wind fairing and central stabilizer on the top of the lower deck is also an effective countermeasure. The results can provide the reference information for flutter optimization of the long-span steel truss girder suspension bridge with double-deck in the future.
Ethnography for a new global political economy? Marcus (1995) revisited, through the lens of Tsing and Nash
Authors: Gagnon Terese
Published: November 2017

In 1995 George Marcus wrote on the ‘emergence of multi-sited ethnography’, contrasting ethnography in the world and ethnography of the world. He seemed to anticipate that with increasing globalization, technological advances, and new economic conditions, multi-sited methods would become the hallmark of ethnography for the nascent age. More than two decades later, I reflect on Marcus’s forecast. Anna Tsing has written perhaps the first monograph to fulfill Marcus’s ‘follow the thing’ model, as a style of ethnography of the world, while June Nash exemplifies his description of ethnography in the world system. Here I compare the merits and challenges of the two ethnographic styles through their works. I consider whether Marcus’s prediction has proven true. I conclude that both approaches are still relevant and, in fact, necessary complements to one another, just as post-capitalist and classic Marxist theories, far from being mutually exclusive, are vital tools for describing and understanding the world.
Effects of triglyceride gasoline blends on combustion and emissions in a common rail direct injection diesel engine
Authors: Lakshminarayanan Arunachalam , Olsen Daniel B , Cabot Perry E
Published: November 2017

This study presents the combustion and emission results using a blend of unrefined triglycerides (straight vegetable oils) and regular unleaded gasoline in a compression ignition engine typically used in farming machinery. Most farm equipment is powered by diesel engines. A sizable cost of producing a crop on a farm can be attributed to fuel—diesel in such cases. Farmers and researchers have been interested in the use of alternative fuels, especially triglycerides, which could potentially bring down the fuel cost portion of the farm input costs. One of the major drawbacks of using unrefined triglycerides is poor cold flow properties due to high density and viscosity. To overcome this, the triglycerides can be blended with gasoline to lower the density and viscosity. This blend has been used in existing diesel engines without the need for any modification to the engine or its control system. The experiments were conducted on a 4.5-L Tier 3 engine. The fuel used was a blend of unrefined canola triglyceride and regular unleaded gasoline (10% by volume). Measurements include mass fraction burned combustion pressure, fuel consumption and pollutant emissions. The fuel consumption of TGB10 was lower than most straight vegetable oils found in the literature, but higher than diesel. The peak pressure of TGB10 was slightly higher than diesel and occurred earlier than diesel. The brake-specific NOx was lower than diesel at lower and no load points. Particulate matter emissions of TGB10 were higher than diesel at rated speed. Total hydrocarbon emissions were generally higher than diesel. CO emissions were lower than diesel except at low or no load points where they were significantly higher.
The enemy within: The dangers of Chantal Mouffe’s figure of the adversary to the democratic task of agonistic planning
Authors: Yamamoto Arata D
Published: November 2017

Chantal Mouffe’s agonistic pluralism calls for the mediation of antagonism. In planning theory, increasingly influential agonistic planning theory has taken inspiration from Mouffe’s neo-Schmittian radical democratic theory and promoted as its democratic task the transformation of antagonistic relation between friends and enemies into agonistic ones between adversaries. To accomplish this democratic task, however, I argue that it is not enough to transform antagonism into agonism and that agonism must also be prevented from transforming into antagonism. To this end, I first consider how Carl Schmitt’s formulation of the political as the friend–enemy concept is presupposed in his understanding of the state and is linked directly to his decisionist theory of sovereignty. Transforming antagonism into agonism could thus potentially compromise the effectiveness of sovereign decisions and the unity of social order, and I argue that the mediation of antagonism should be considered to involve the mediation between friends and enemies as well as the mediation between chaos and order. Yet the Mouffean figure of the adversary cannot adequately address the latter. With Bauman and Norval, I draw attention to Zygmunt Bauman’s figure of the stranger in the mediation between chaos and order and, with Sandercock, to a possible complementarity between Mouffe-inspired agonistic planning theory and Sandercock’s postmodern therapeutic planning theory. This complementarity is then examined through a number of empirical planning literature on agonistic and therapeutic planning practices, and I conclude by calling for the recognition of both the Mouffean figure of the adversary and Bauman’s figure of the stranger in implementing the democratic task of agonistic planning theory.
Comparison of CTA and DSA in the diagnosis of superior mesenteric artery dissecting aneurysm
Authors: Jia Zhongzhi , Huang Youhua , Shi Hongjian , Tang Liming , Shi Haifeng , Qian Liulan , Jiang Guomin
Published: November 2017

Objective

To compare computed tomography arteriography (CTA) and digital subtraction arteriography (DSA) in the diagnosis of superior mesenteric artery dissecting aneurysm (SMADA).

Methods

All SMADA patients who underwent CTA and DSA at one of two medical centers between May, 2007 and April, 2017 were identified. The accuracy of CTA and DSA for the depiction of morphologic characteristics of SMADA was analyzed.

Results

Fourteen patients (12 men; mean age, 55.1 ± 6.4 years) were included in this study. The mean diameter of the dissecting aneurysm was 3.78 ± 1.53 mm on CTA and 3.81 ± 1.54 mm on DSA ( p = 0.96). The luminal stenosis was 0.52 ± 0.27 on CTA and 0.35 ± 0.23 on DSA ( p = 0.09). The thrombosed false lumen was visualized on CTA in 79% (11/14) of patients but in no patients on DSA ( p < 0.001). The entry points of the dissection were visualized on CTA in 64.3% (9/14) of patients and on DSA in 100% (14/14) of patients ( p = 0.041); CTA and DSA did not visualize re-entry points in any patients. The intimal flap was visualized on CTA in 71.4% (10/14) of patients and on DSA in 78.6% (11/14) of patients ( p > 0.05). Branch vessel involvement was visualized in 7.1% (1/14) of patients on CTA but in no patients on DSA ( p > 0.05).

Conclusions

CTA can be used in place of DSA for the diagnosis of SMADA. Although CTA may exaggerate the degree of luminal stenosis and is weak in depicting the entry points of SMADA, this modality more accurately depicts the thrombosed false lumen and branch vessel involvement.
A corpus-based investigation of techno-optimism and propositional certainty in the National Intelligence Council’s ‘Future Global Trends Reports’ (2010–2035)
Authors: McKeown Jamie
Published: November 2017

This article reports the findings from a study of discursive representations of the future role of technology in the work of the US National Intelligence Council (NIC). Specifically, it investigates the interplay of ‘techno-optimism’ (a form of ideological bias) and propositional certainty in the NIC’s ‘Future Global Trends Reports’. In doing so, it answers the following questions: To what extent was techno-optimism present in the discourse? What level of propositional certainty was expressed in the discourse? How did the discourse deal with the inherent uncertainty of the future? Overall, the discourse was pronouncedly techno-optimist in its stance towards the future role of technology: high-technological solutions were portrayed as solving a host of problems, despite the readily available presence of low-technology or no-technology solutions. In all, 75.1% of the representations were presented as future categorical certainties, meaning the future was predominantly presented as a known and closed inevitability. The discourse dealt with the inherent uncertainty of the subject matter, that is, the future, by projecting the past and present into the future. This was particularly the case in relation to the idea of technological military dominance as a guarantee of global peace, and the role of technology as an inevitable force free from societal censorship.
Plant immunity and symbiosis signaling mediated by LysM receptors
Authors: Desaki Yoshitake , Miyata Kana , Suzuki Maruya , Shibuya Naoto , Kaku Hanae
Published: November 2017

Plants possess the ability to recognize microbe-associated molecular patterns (MAMPs) and PAMPs through the PRRs, and initiate pattern-triggered immunity. MAMPs are derived from cell-envelope components, secreted materials and cytosolic proteins from bacteria, oomycetes or fungi, and some MAMPs play a similar function in the innate immunity in mammals. Chitin is a representative fungal MAMP and triggers defense signaling in a wide range of plant species. The chitin receptors CEBiP and CERK1 on the plasma membrane have LysM (lysin motif) in their ectodomains. These molecules play an important role for the defense responses in rice and Arabidopsis, strictly recognizing the size and acetylated form of chitin oligosaccharides. However, related LysM receptors also play major roles for the signaling in root nodule and arbuscular mycorrhizal symbiosis. This review summarizes current knowledge on the molecular mechanisms of the defense and symbiosis signaling mediated by LysM receptors, including the activation steps of chitin-induced defense signaling downstream of LysM receptors.
Leriche syndrome: The inferior mesenteric artery saves the lower extremity
Authors: Assaad Mahmoud , Tolia Sunit , Zughaib Marcel
Published: November 2017

Leriche syndrome presents as a triad of claudication, erectile dysfunction, and decreased distal pulses. This syndrome is a well-recognized entity in the current literature; however, our case report illustrates that even with a severe ostial lesion of the inferior mesenteric artery, the vessel was able to provide perfusion to bilateral lower extremities. The patient presented with symptoms of progressive pain in his right leg that limited his physical activity and he also complained of paresthesia, pallor, and cold skin with black discoloration of his toes bilaterally. Diagnostic testing confirmed Leriche syndrome and he successfully underwent surgical revascularization.
Indigenous Memes and the Invention of a People
Authors: Frazer Ryan , Carlson Bronwyn
Published: November 2017

Scholars have become increasingly interested in the political work of Internet memes. While this research has delivered critical insights into how memes are implicated in both progressive and reactionary politics, there endures a lack of critical work on the ways in which Indigenous people engage with memes to deconstruct colonial power relations and produce alternative political arrangements. This article offers a reading of a set of memes produced and published by Australian Aboriginal activist Facebook page Blackfulla Revolution. We consider the ways in which memes are entangled in the achievement of an anti-colonial politics. More specifically, drawing Deleuze and Guattari’s notion of assemblage, this article offers two levels of analysis. The first analysis focuses on the memes as a text that works to challenge the founding national myth of “peaceful” British settlement. Through the careful narrative of the memes, we see how the colonial assemblage works through “making missing” Indigenous people. And while the material practices and expressive justifications of Australian colonialism might have varied over time, the assemblage has ultimately not changed in nature. For the second analysis, we read the subsequent user engagement with the memes. The sequence of memes, from this second view, contributes “to the invention of a people,” as Deleuze has said. Those excluded from the colonial assemblage and those who recognize it as violence are called forth to engage in movement against it.
Explaining the Relationship between Social Trust and Value Similarity: The Case of Estonia
Authors: Beilmann Mai , Lilleoja Laur
Published: November 2017

The article is dedicated to explaining why value similarity fosters generalised social trust in high-trust societies. Previous findings by Beilmann and Lilleoja suggest that value similarity is more important in generating individual-level social trust in countries where the overall levels of social trust are higher, while in countries with a low level of social trust, congruity of the personal value structure with the country-level value structure tends to be coupled with lower trustfulness on the part of individuals. The article explores the meso-level indicators that could explain this relationship. The relationship between social trust and human values was examined in a sample of 2,051 people in Estonia, using data from the European Social Survey, round 7. The results suggest that when differences in socio-economic factors are controlled for, value similarity remains a significant factor in fostering generalised social trust in Estonian society. However, its direct effect is relatively low when compared with predictors such as trust in certain institutions, economic well-being, and ethnicity. Trust in the legal system and the police plays a particularly important role in fostering generalised social trust in a high-trust society wherein people believe that other people in general treat them honestly and kindly.
Bringing about Penal Climate Change: The Role of Social and Political Trust and of Perceptions about the Aims for Punishment in Lowering the Temperature of Punitiveness
Authors: Sööt Mari-Liis , Rootalu Kadri
Published: November 2017

The paper presents a study demonstrating that social and political trust are good predictors of punitive attitudes. People who have low generalised social trust and low political trust would impose longer sentences on offenders. Awareness of the aims behind punishment is a strong predictor of systematically severe punitive attitudes – those for whom the aims for punishment revolve around the protection of society (rather than focusing on reforming the offender) are more punitive. The study indicates that penal attitudes are best altered in a trusting environment, and that attempts to achieve a shift away from harsh ones should be targeted principally at the most punitively minded groups in the relevant society. The assumption is that in an environment where penal attitudes towards offenders are milder, major changes in crime policy such as introduction of individualised penalties, reduction in prison terms and population would be more easily achieved.
Corruption as Presented in the Lithuanian Internet Media
Authors: Dobryninas Aleksandras , Gilaitis Mindaugas
Published: November 2017

The article focuses on content analysis of corruption-related publications released by Lithuanian Internet media. The authors present findings from structural and semantic analysis of the online publications on corruption issues that appeared during 2015 via two influential Internet portals: DELFI.lt and Lrytas.lt. These findings are interpreted in the context of official statistical data surrounding anti-corruption activity in the country and in light of results from corruption‑related diagnostic surveys. The analysis reveals a tendency toward ‘virtual criminalisation’ of corruption in the Internet-media publications examined and, a result of such a criminal-justice framing, an absence of focus on preventive and education‑oriented anti-corruption measures.
Changes in the Estonian Cannabis Debate
Authors: Paimre Marianne
Published: November 2017

The article analyses the discussion of cannabis regulation in the Estonian media. In the past five years, there has been a noticeable shift in discussion of drug policies in some Western countries and regions (the US, Canada, Latin America, etc.) from a punitive focus towards a more liberal approach. The Global Commission on Drug Policy recommends that countries put an end to civil and criminal penalties for drug use and possession. In this context, the article examines how the Estonian press has reacted to the situation. Which approach to cannabis (continuing to ban it vs. advocating legalisation) prevails in opinion pieces? What are the main arguments both for and against its legalisation? The media could play a prominent role in determining public opinion about illicit drugs and shaping relevant public policies. Hence, the author looks also at how the coverage has changed over time. A content analysis of 57 opinion articles, editorials, comments, interviews, and summaries of public speeches was carried out to study the political debate surrounding cannabis in 2009 and 2015, both years in which it was high on the media agenda. The content analysis was complemented by the method of close reading. The findings indicate that press coverage of cannabis has become more tolerant towards ‘softer’ drug policies. The chorus of ‘voices’ has become more complex, which reflects development of the drug-politics discourse. While the 2009 debate was launched by pro-legalisation lawyers and the discussion involved various professional experts (among them medical doctors, lawyers, and specialists in drug prevention), cannabis more often made headlines in 2015 because of work by civil activists, columnists, writers, etc. A strong dichotomy between traditional law-enforcement discourse and cannabis-legalisation and harm-reduction discourses has emerged. The author expresses the opinion that a shift in the global drug-policy debate alongside softened media coverage may pave the way for changes in the national drug policy.
The Survival of Retributivism in our Modern Knowledge-based World
Authors: Ginter Jaan
Published: November 2017

The article discusses the development of theories of punishment in modern, more and more knowledge-based society. Are any changes foreseeable in how we rationalise expending scarce public resources on inflicting grievances on those fellow members of our society who have behaved in a manner not approved by general society? Adherents to retributivism strive to justify criminal punishment by simply referring to the punishment as the consequence that the criminal plainly deserves and stating that there is no need to present any utilitarian justifications for applying punishments. There is already mounting evidence from research suggesting that certain objective circumstances cause predisposition of certain persons to commit crimes, and some research suggests that there are several treatments that may in some cases be more suitable in place of criminal punishments. The paper presents an attempt to appraise whether these novel approaches leave any room for retributivist ideas. The article suggests that the more the science is able to understand why certain persons commit criminal offences and is able to find opportunities to treat these conditions, the less need there will be to think of punishments as just deserts, as what simply must be applied, without looking for any other utilitarian justification.
ОЦЕНКА ИНФОРМАТИВНОСТИ И ОТБОР ПРИЗНАКОВ ПРИ ИДЕНТИФИКАЦИИ ОБЪЕКТОВ НА ЦИФРОВЫХ ИЗОБРАЖЕНИЯХ МИКРОСКОПИЧЕСКИХ ПРЕПАРАТОВ, ОКРАШЕННЫХ ПО МЕТОДУ ЦИЛЯ-НИЛЬСЕНА
Authors: Narkevich Artem Nikolaevich , Vinogradov Konstantin Anatol’evich , Koretskaya Mikhaylovna Nataliya , Kataeva Alina Vladimirovna , Zhurbenko Ekaterina Olegovna
Published: November 2017

Цель. Оценка информативности и осуществление отбора признаков для классификации объектов, на цифровых изображениях микроскопических препаратов, окрашенных по методу Циля-Нильсена с помощью методов Шеннона и Кульбака, а также сравнение результатов их применения.Материалы и методы. Использовались данные о 343 687 объектах, выделенных на цифровых изображениях микроскопических препаратов: 6 708 объектов – кислотоустойчивые микобактерии, 336 979 – иные объекты. Анализ объектов производился по 240 цветовым и морфометрическим признакам, оценка информативности которых осуществлялась с помощью методов Шеннона и Кульбака. Оценка качества отбора признаков осуществлялась с применением наивного Байесовского классификатора.Результаты. Наибольшую информативность по методу Шеннона имели цветовые признаки объектов и соотношения их размеров, а наибольшая доля верно классифицированных объектов (84,6%) была достигнута при включении в классификационную модель 6 признаков с наибольшей информативностью по методу Шеннона. Наибольшую информативность по методу Кульбака имели радиальные размеры объектов и их соотношения, а наибольшая доля верно классифицированных объектов (78,0%) была достигнута при включении в классификационную модель 14 признаков с наибольшей информативностью по методу Кульбака.Заключение. Методы Шеннона и Кульбака могут применяться для снижения признакового пространства при классификации объектов. Метод Шеннона позволяет в большей мере сократить количество признаков, обеспечивая при этом наибольшую долю верной классификации объектов.