Number and size of stones in patients with asymptomatic and symptomatic gallstones and gallbladder carcinoma: A prospective study of 592 cases

The development of gallbladder carcinoma has been correlated with the presence of a single large gallstone in two retrospective studies. The objective of the present study was to determine the number and size of gallstones in patients with gallbladder carcinoma compared to asymptomatic and symptomatic female patients with gallstones. The following three groups of patients were included in this prospective trial: (A) 78 asymptomatic patients with gallstones; (B) 365 symptomatic patients with gallstones; and (C) 149 patients with gallbladder carcinoma. At the end of the operation, the resected gallbladder was opened and the number of stones counted. The maximum size of the stones was determined using calipers. Patients with gallbladder carcinoma were significantly older than patients in the other two groups (P <0.001). In the group with asymptomatic gallstones, there were significantly more patients with one single stone, whereas in the group with gallbladder carcinoma there were significantly more patients with multiple stones (more than 11; P <0.01). Patients with gallbladder carcinoma had significantly larger stones, regardless of the number of stones present (P <0.001). We postulate that the increase in the number and size of the stones among patients with gallbladder carcinoma could simply be an effect of aging or it could be a reflection of the long-term presence of stones in the gallbladder rather than some particular chemical or physical influence.     

Secondary Creep Analysis of FG Rotating Cylinder with Exponential,Linear and Quadratic Volume Reinforcement

Creep is an irreversible time-dependent deformation in which a material under constant mechanical stress and elevated temperature for a considerably prolonged period of time, starts to undergo permanent deformation. Creep deformation occurs in three stages namely, primary, secondary and tertiary. Out of these three stages, secondary or steady state creep is particularly an area of engineering interest as it has almost a constant creep rate. Creep deformation plays a significant role in understanding effective service life of an engineering component working under high temperature conditions as such components such as super-heater and re-heater tubes and headers in a boiler, jet engines operating at temperature as high as 1200 ∘C, usually experience a failure or rupture due to creep phenomenon. Design engineers keep a close attention on working stress conditions and elevated temperature under which an engineering component is expected to work as these conditions determine the onset of creep behavior in an engineering component. By recognizing the parameters of material response to creep behavior, engineers can analyse the useful service life and hazardous working conditions for an engineering components. Recognizing the creep phenomenon as high temperature design limitation, ASME Boiler and Pressure Vessel Code have provided guidelines on maximum allowable stresses for materials to be used in creep range. One of the criteria for determination of allowable stresses is 1% creep deformation of material in 100,000 h of service. Thus, the study of creep behavior in engineering components pertaining to high stress and temperature working conditions is very important as it affects the reliability and performance of the engineering components. The aim of our study is to understand the behavior of secondary creep deformation so that an advanced reinforced functionally graded material with better creep resistance, can be designed. In this paper, a secondary creep analysis of functionally graded (FG) thick-walled rotating cylinder under internal and external pressure is conducted. The novelty of the model intends to specify secondary creep stresses and strains by employing exponential, linear and quadratic volume reinforcement for SiCp ceramic in Al metal matrix in radial direction. This will help us to understand the effect of volume reinforcement in FG cylinder under internal/external pressure and rotating centrifugal body force by obtaining secondary creep stresses and strains. The response of the FG cylinder with isotropic material is analyzed and the solution for stress–strain rates in radial and tangential directions are obtained in closed form. Comparison of steady state creep stresses and strains under exponential, linear and quadratic volume reinforcement profiles are discussed and presented graphically.     

One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies

One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators. We analysed IPD of 1856 participants with PJI of the hip from 44 cohorts across four continents. The primary outcome was re-infection (recurrence of infection by the same organism(s) and/or re-infection with a new organism(s)). Hazard ratios (HRs) for re-infection were calculated using Cox proportional frailty hazards models. After a median follow-up of 3.7 years, 222 re-infections were recorded. Re-infection rates per 1000 person-years of follow-up were 16.8 (95% CI 13.6–20.7) and 32.3 (95% CI 27.3–38.3) for one-stage and two-stage strategies respectively. The age- and sex-adjusted HR of re-infection for two-stage revision was 1.70 (0.58–5.00) when compared with one-stage revision. The association remained consistently absent after further adjustment for potential confounders. The HRs did not vary importantly in clinically relevant subgroups. Analysis of pooled individual patient data suggest that a one-stage revision strategy may be as effective as a two-stage revision strategy in treating PJI of the hip.     

Drive for muscularity and drive for thinness: the impact of pro-anorexia websites

In recent years, websites that stress the message of thinness as the ideal and only choice have surfaced on the internet. The possibility that pro-anorexia websites may reinforce restrictive eating and exercise behaviors is an area of concern. In addition, friends may be influencing one another to view these websites, further contributing to drive for thinness in women and drive for muscularity in men. Three hundred male and female undergraduate psychology students responded to questionnaires assessing: internalization of pro-anorexia website content, internalization of general media content, influence of friends to view pro-anorexia websites, peer influence, drive for muscularity, and drive for thinness. Results showed internalization of pro-anorexia website content was positively correlated with drive for thinness in women, and negatively correlated with drive for muscularity in men. Internalization of pro-anorexia website content was found to be related to both drive for thinness in women and drive for muscularity in men.     

Flowering in bursting bubbles with viscoelastic interfaces

The lifetime of bubbles, from formation to rupture, attracts attention because bubbles are often present in natural and industrial processes, and their geometry, drainage, coarsening, and rupture strongly affect those operations. Bubble rupture happens rapidly, and it may generate a cascade of small droplets or bubbles. Once a hole is nucleated within a bubble, it opens up with a variety of shapes and velocities depending on the liquid properties. A range of bubble rupture modes are reported in literature in which the reduction of a surface energy drives the rupture against inertial and viscous forces. The role of surface viscoelasticity of the liquid film in this colorful scenario is, however, still unknown. We found that the presence of interfacial viscoelasticity has a profound effect in the bubble bursting dynamics. Indeed, we observed different bubble bursting mechanisms upon the transition from viscous-controlled to surface viscoelasticity-controlled rupture. When this transition occurs, a bursting bubble resembling the blooming of a flower is observed. A simple modeling argument is proposed, leading to the prediction of the characteristic length scales and the number and shape of the bubble flower petals, thus paving the way for the control of liquid formulations with surface viscoelasticity as a key ingredient. These findings can have important implications in the study of bubble dynamics, with consequences for the numerous processes involving bubble rupture. Bubble flowering can indeed impact phenomena such as the spreading of nutrients in nature or the life of cells in bioreactors.

When residing in Newtonian fluids, bubble rupture proceeds with features that are shown in Fig. 1. Different dynamics are observed depending on the capillary number, Ca=u η/γ, where u is the experimentally measured characteristic retraction speed of the film, η is the liquid viscosity, and γ is the surface tension between the liquid and gas, and the Reynolds number, Re=ρuRbubble/η, where ρ is the liquid density, and Rbubble is the bubble radius (1–7). Fig. 1 A–D report observed bubble ruptures in the different regimes previously discussed in the literature: 1) for Re≪1, viscous forces are larger than inertial and surface forces, resulting in a very slow hole opening (8) (Fig. 1A); 2) when Re>1, the hole opens up much more quickly (9), and a toroidal rim (Fig. 1B) is subjected to an azimuthal instability, which leads to fingering and, possibly, jetting (Fig. 1 B–D), depending on the corresponding Ca value. If Ca≫1, the rim is stable and folds upward (10); otherwise, inertial instabilities break it into pieces with a characteristic length scale, d=Rbubbleh, where h is the film thickness (11).Open in a separate windowFig. 1.Bubble bursting dynamics. (A) Low Re. (B and C) High Ca and high Re. (D) Low Ca and high Re. (E) Low Ca and high Re with intermediate interfacial viscoelasticity (20 mg/mL of BSA). (F) Low Ca and high Re with high interfacial viscoelasticity (50 mg/mL of BSA). (G) Bubble rupture as functions of time for different concentrations of BSA. Increasing the concentration of BSA leads to an increase in the surface viscoelasticity, and the bubble bursting dynamics change. The concentration of 20 mg/mL is identified as the limit above which flowering occurs. The number of petals, 10 at 20 mg/mL, decreases to 5 when the concentration of BSA is increased to 50 mg/mL. The bursting time (from the puncture to complete film retraction) increases when BSA is added, and it changes from 1.5 ms at 0.1 mg/mL to 2.7 ms at 50 mg/mL.Here, we report evidence of the effect of surface viscoelasticity in bubble rupture dynamics. Surface viscoelasticity is adjusted by adding a surface-active material to the bulk and modulating its concentration and chemistry. We chose bovine serum albumin (BSA) proteins (12, 13), as they are known to form highly viscoelastic surface layers. At low concentrations, BSA molecules are adsorbed at the air/water interface with their major axis parallel to the surface. No protein denaturation occurs, and the molecules retain their globular conformation. As the concentration of BSA increases, a primary monolayer achieves full surface coverage, and a secondary monolayer appears, extending into the aqueous phase (14, 15). Adsorbed protein molecules are connected by interprotein contacts forming an interconnected network within the adsorbed layers (16). Upon compression, globular proteins, such as BSA, respond as deformable spheres, thereby being capable of storing elastic energy (yielding high storage moduli) (17). Many examples can be found in the literature in which the addition of surfactants to the protein solution can drastically change surface properties, giving an unlimited variety of model systems to achieve desired surface properties with a straightforward tuning of the surfactant concentration (18).