bluuebunny/crossref_metadata_2025 huggingface dataset:
‘The Nation will always prevail’, Representation, participation and contestation in the Belgian Constitution of 1831
Authors: Maes Christophe , Deseure Brecht
Published: October 2020

The exact nature of the concept of sovereignty enshrined by the Belgian Constitution of 1831 has recently become the object of academic debate. This article takes a stand in this debate by analyzing the representative system instated by the constituent National Congress. It is argued that the congressmen attributed primacy to the legislative Chamber because it concentrated in its midst all the individual wills of the people in order to express the general will or the wish of the Nation. Importantly, though, parliament was not the only representative of the national will, neither was it considered completely self-contained. Parliament’s expression of the national will was subject to constant evaluation by public opinion. When the assembly failed to respond to popular grievances, other representatives were qualified to address the issue: the king could disband the Chamber or pronounce his veto when the national interest required it. The jury, assessing press or political related crimes, could correct oppressive governmental action. And if all of this failed – and only then – the nation could ultimately resist and take directly matters in its own hands. Thus, it is argued that the character of sovereignty in the Belgian state system was ultimately popular.
The Case for ‘Human Diplomacy’
Authors: Solana Javier
Published: October 2020

Apocalyptic predictions on the world’s future after COVID-19 are unfounded. Structures of global governance can be reinforced through greater subsidiarity; that is, by enhancing the participation of local authorities, by the involvement of civil society and the private sector and by regionalising initiatives, where appropriate. Furthermore, globalisation’s scope should be extended to comprise the shared governance of all global public goods and elements affecting human security. This essay outlines how this transformation could work for the four policy areas of global trade, food security, public health and climate change.
Understanding Diverse Model Projections of Future Extreme El Niño
Authors: Stevenson Samantha , Wittenberg Andrew T. , Fasullo John , Coats Sloan , Otto-Bliesner Bette
Published: October 2020

The majority of future projections in the Coupled Model Intercomparison Project (CMIP5) show more frequent exceedances of the 5 mm day−1 rainfall threshold in the eastern equatorial Pacific rainfall during El Niño, previously described in the literature as an increase in “extreme El Niño events”; however, these exceedance frequencies vary widely across models, and in some projections actually decrease. Here we combine single-model large ensemble simulations with phase 5 of the Coupled Model Intercomparison Project (CMIP5) to diagnose the mechanisms for these differences. The sensitivity of precipitation to local SST anomalies increases consistently across CMIP-class models, tending to amplify extreme El Niño occurrence; however, changes to the magnitude of ENSO-related SST variability can drastically influence the results, indicating that understanding changes to SST variability remains imperative. Future El Niño rainfall intensifies most in models with 1) larger historical cold SST biases in the central equatorial Pacific, which inhibit future increases in local convective cloud shading, enabling more local warming; and 2) smaller historical warm SST biases in the far eastern equatorial Pacific, which enhance future reductions in stratus cloud, enabling more local warming. These competing mechanisms complicate efforts to determine whether CMIP5 models under- or overestimate the future impacts of climate change on El Niño rainfall and its global impacts. However, the relation between future projections and historical biases suggests the possibility of using observable metrics as “emergent constraints” on future extreme El Niño, and a proof of concept using SSTA variance, precipitation sensitivity to SST, and regional SST trends is presented.
Evaluation of hygrothermal ageing in CFRP composite material using a non-destructive approach
Authors: Bagale Nilesh , Bhat M R
Published: October 2020

Hygrothermal (HT) ageing is a major concern for polymer composites in aircraft structures. An aircraft gets inspected after certain flying hours/cycles consuming man-hours, money and time. For economic inspection, non-contact, Non-destructive Evaluation (NDE) techniques can prove to be effective. This study presents NDE approaches using three such techniques, namely, X-ray radiography, ultrasound, and infrared thermography for evaluation of HT-ageing in Carbon Fiber Reinforced Polymer (CFRP) composites. For accelerating the ageing, specimens were subjected to a hot water environment up to more than 1000 hours at [Formula: see text]C. It’s influence on different NDE parameters through each technique was investigated. Building on the findings, the effectiveness of these techniques for the evaluation of HT-ageing in CFRP has been demonstrated.
Experimental method and evaluation for interlaminar shear properties of randomly oriented strand thermoplastic composites based on modified double-notch specimen and two dimensional digital image correlation
Authors: Murakami Takashi , Matsuo Tsuyoshi , Sumiyama Takuya
Published: October 2020

A new interlaminar shear test method has been proposed based on the double-notch compression test method, in which the test specimen shape with a modified overlap length of the notches is proposed, and the interlaminar shear strain is measured by two-dimensional digital image correlation (2D-DIC) analysis. In order to obtain the interlaminar shear properties in the elastic and non-linear regions of randomly oriented strand thermoplastic composites, we adopted a 2D-DIC analysis system using a bi-telecentric lens, which can accurately measure the strain in a small field of view, and a test system including an interlaminar shear test jig, which can apply a compressive load to the end face of the specimen at high perpendicularity. It is necessary to provide an overlap of the double-notch of 1 mm or more in order to simultaneously obtain the strain in the elastic region and the non-linear region from the actual test results. When numerical analysis by finite element method (FEM) was carried out on four types of test specimen with different shapes used in this research, by using the interlaminar shear property data obtained from actual tests on the optimum test specimen, there was a high level of agreement with the 2D-DIC analysis results for the shear stress – strain diagrams and the interlaminar shear strain distribution. Therefore, the benefits of the test specimen shape and dimensions in the new test method and the validity of the interlaminar shear property values that can be obtained using this method have been confirmed.
Experimental and analytical model for the penetration and indentation prediction on BFRP laminates under low velocity impacts
Authors: Papa I , El Hassanin A , Langella T , Lopresto V
Published: October 2020

Low velocity impact tests at different impact energies were performed on basalt fibre reinforced plastic laminates, varying laminate thickness, stacking sequence, support dimensions and indenter diameter. A previous modified analytical model for the prediction of the indentation as a function of the impact energy, valid for carbon and glass fibre reinforced plastic laminates, was applied: a different behaviour was observed denoting an other damage mechanisms of the basalt fibre laminates. About the prediction of the penetration energy, the previous model largely applied in the literature showing the importance of the total fibre content was adopted, and a good agreement between the theoretical predictions and the experimental results was found. In analysing previous experimental data, in comparison to those of carbon fibre reinforced plastics, higher impact energy was found to be necessary to penetrate the basalt laminates whereas the indentation depth at the same impact energy was lower. A larger number of tests were carried out to validate a preliminary work done by the authors.
The politics of nonviolent mobilization: Campaigns, competition, and social movement resources
Authors: Edwards Pearce
Published: October 2020

Nonviolent resistance is considered one of the most effective methods of bringing about political change. Yet empirical research on how nonviolent campaigns emerge is limited. This article considers two sets of considerations which influence the strategic decision of a campaign to use nonviolent or violent methods: interactions with the state and campaign resources. Campaigns are concerned about the risk of repression from the state and are more likely to choose nonviolence when they believe the state will accommodate their demands. Open political competition signals likely accommodation. Campaigns’ nonviolent tactics are more effective when they possess social movement resources, though high levels of movement resources threaten the state. The argument implies political competition and social movement resources are associated with a higher likelihood of a campaign using nonviolence, though the relationship with social movement resources diminishes at high levels. Implications of the argument are tested on a sample of contentious campaigns from 1945 to 2006. Political competition and social movement resources are related as expected to the use of nonviolence. However, an extension shows these factors do not account for the advantage of nonviolent methods, particularly in triggering backlash protests, once a campaign is under way. An original ordinal measurement strategy for campaign methods suggests the intensity of violence and nonviolence are likewise unrelated to competition and resources.
Jordanian Student Nurses’ Attitudes towards the Care of Dying Patients
Authors: Al Qadire Mohammad
Published: October 2020

The purpose of the current inquiry is to measure Jordanian student nurses’ attitudes towards the care of dying patients using a cross-sectional survey. The sample of this study comprises 300 nursing students. Data was collected using the Frommelt’s Attitude Toward Care of the Dying Form B (FATCOD–B). Most of the students were female (72%) in their second year (40.3%). The mean total score of all FATCD-B items was 95.8 out of 150 (SD 8.7). Student nurses had low mean scores for their attitude towards care of the dying. Two approaches could be taken to improve this situation. First, research is needed to fully understand and explain students’ attitudes towards the care of dying patients. It might be more appropriate to utilize mixed research methods. The second is to integrate end-of-life care courses within the curricula of nursing programmes, currently the mainstay in improving students’ knowledge and attitudes toward care of the dying.
Effects of Self-selected Resistance Training on Physical Fitness and Psychophysiological Responses in Physically Inactive Older Women: A Randomized Controlled Study
Authors: Elsangedy Hassan Mohamed , Oliveira Gledson Tavares Amorim , Machado Daniel Gomes da Silva , Tavares Marília Padilha Martins , Araújo Andressa de Oliveira , Krinski Kleverton , Browne Rodrigo Alberto Vieira , Gregório da Silva Sérgio
Published: October 2020

This study aimed to investigate the effects of a 12-week self-selected resistance training (SSRT) program on physical fitness and psychophysiological responses among physically inactive older women. We randomly allocated 32 inactive older women (M age = 66.0 years, SD = 3.0) into either an SSRT (n = 16) or control group (n = 16). Participants performed SSRT three times per week over 12 weeks. We assessed maximal isotonic and isokinetic muscle strength, functional capacity, flexibility, cardiorespiratory fitness, and body composition at baseline and after the intervention. Affective responses and perceived exertion were evaluated after each exercise set throughout the training program. The SSRT group significantly improved their maximal muscle strength in all exercises (Cohen’s d ranging from 1.4-3.3; all p’s < .001), peak torque (knee flexors: d = 1.7; knee extensors: d = 1.6; all p < .001), flexibility (knee flexors: d = 1.7; single hip flexors: d = 1.6; all p < .001; bilateral hip flexors: d = 1.1, p = .001), fat-free mass (d = .9, p = .008), and cardiorespiratory fitness (d = .9, p = .014), compared to the control group. All components of functional capacity improved compared to the control group (Cohen’s d ranging from .8 to 5.5; all p’s ≤ .001). Participants perceived the exercise training sessions as pleasant and of low to moderate effort. Thus, a 12-week SSRT program was effective at improving physical fitness and inducing feelings of pleasure among inactive older women.
Voice and Mirroring in SLA: Top-Down Pedagogy for L2 Pronunciation Instruction
Authors: LaScotte Darren , Meyers Colleen , Tarone Elaine
Published: October 2020

There are two broad approaches to the research and teaching of second-language (L2) pronunciation—‘bottom-up’ and ‘top-down’—which roughly align with structural and communicative approaches to language teaching. A bottom-up approach, explicitly focusing on de-contextualised linguistic forms, is structuralist and predominated in the second half of the 20th century; a top-down approach to L2 pronunciation takes a more communicative orientation, defining the instructional goal not as acquiring a native-speaker accent, but rather as ‘intelligibility.’ In consideration of this pronunciation goal (i.e. intelligibility) and recent L2 acquisition theoretical frameworks emphasising the role of social and contextual factors in shaping interlanguage (IL) systems, we argue that a top-down approach is paramount to L2 pronunciation instruction. Drawing on variationist research on IL phonology and a brief recount of International Teaching Assistant pronunciation course programs in the US, we present the Mirroring Project as an effective top-down pedagogical approach for L2 pronunciation instruction.
Stability control of in-wheel motor driven vehicle based on extension pattern recognition
Authors: Hongbo Wang , Youding Sun , Hongliang Tan , Yongjie Lu
Published: October 2020

According to the characteristics that the torque of each wheel of the in-wheel motor driven vehicle is independent and controllable, the stability control of in-wheel motor driven vehicle based on extension pattern recognition method is proposed in this paper. The dynamic model of the vehicle is established by Matlab/Simulink and Carsim. Taking two-degree-of-freedom (2-DOF) vehicle model as reference model, the vehicle yaw rate and the sideslip angle as the control objectives. The differences between the actual values and the reference values of the yaw rate and the actual sideslip angle are used to define the vehicle stability status. The vehicle stability status is divided into four stability control patterns, which are the no control pattern, the yaw rate control pattern, the yaw rate and sideslip angle joint control pattern, and the sideslip angle control pattern, respectively. The extension pattern recognition algorithm is used to determine the vehicle control pattern. The fuzzy controllers of yaw rate and sideslip angle are designed to obtain the additional yaw moment. Besides, the optimal torque distribution method is proposed by taking the lowest total energy loss of four motors as the objective function. The feasibility and effectiveness of the proposed control strategy are verified by Matlab/Simulink and Carsim joint simulation platform and hardware-in-the-loop (HIL) test.
Finite time coverage tracking algorithm of maneuvering target by multiple mobile agents
Authors: Ma Longbiao , Yan Yongjie , Zhang Yang , Liu Yan , Tian Yungang
Published: October 2020

In this paper, a problem regarding how multiple mobile agents track a high-speed maneuvering target is considered. Due to the uncertainties of the target caused by the background noises, we use a dynamic non-uniform region to describe the location of target. Therefore, the cooperative tracking problem is transformed into a problem to cover a known dynamic non-uniform region. In order to capture the high-speed maneuvering target, the mobile agents with global sensing areas and limited actuation region are designed to track and cover the dynamic region. Also, the probability that the target appear in the circle is denoted by a probability density function and a performance index function is given to describe the effectiveness of covering a moving target. With observer-based estimation and dynamic formation control, a coverage tracking algorithm is proposed so that the group of agents catch the target by a coverage tracking policy in finite time.
Event-triggered H∞ control for networked control systems under denial-of-service attacks
Authors: Zhang Liruo , Nguang Sing Kiong , Yan Shen
Published: October 2020

This paper investigates the event-triggered H∞ control for networked control systems under the denial-of-service (DoS) attacks. First, a novel system model is established considering random, time-constraint DoS attacks. Second, an event-triggered scheme including an off-time is proposed to reduce the unnecessary occupation of network resources, with which a prescribed minimum inter-triggering time is guaranteed and Zeno problem is avoided. Third, sufficient conditions for the existence of an event-triggered controller which ensures the exponential stability of the closed-loop system with desired H∞ performance are formulated in linear matrix inequalities (LMIs). Finally, the effectiveness of the proposed method is examined by two illustrative examples, where a real communication network based on the ZigBee protocol is utilized.
Video-thoracoscopic left cardiac sympathetic denervation for long-QT syndrome
Authors: Lampridis Savvas , Antonopoulos Achilleas , Kakos Christos , Mitsos Sofoklis , Patrini Davide , Lawrence David R , Panagiotopoulos Nikolaos
Published: October 2020

Background

Congenital long-QT syndrome represents the most common cardiac channelopathy and manifests as potentially lethal ventricular arrhythmias. Prevention strategies include beta-blockade pharmacotherapy, implantable cardioverter-defibrillators, and left cardiac sympathetic denervation, which can increase the threshold for ventricular fibrillation. Herein, we report our experience with video-assisted thoracoscopic left cardiac sympathetic denervation.

Methods

We performed a retrospective review of the electronic medical records of all patients with congenital long-QT syndrome who underwent video-assisted thoracoscopic left cardiac sympathetic denervation at our institution.

Results

From September 2009 to May 2016, 6 patients with a mean age of 30.5 years (range 20–47 years) underwent video-assisted thoracoscopic left cardiac sympathetic denervation for medically refractory long-QT syndrome. All patients had an uneventful recovery and were discharged 1–3 days after the operation. At a median follow-up of 14 months (range 12–60 months), 4 patients had no cardiac events while 2 experienced 1 episode of arrhythmic syncope and 1 episode of appropriate implantable cardioverter-defibrillator shock. Following surgery, the mean annual cardiac events in the study cohort decreased from 2.13 to 0.33 ( p = 0.004) and the mean corrected QT interval reduced from 560 ms to 491 ms ( p = 0.006).

Conclusions

Video-assisted thoracoscopic left cardiac sympathetic denervation is a safe and effective therapy in patients with congenital long-QT syndrome who continue to suffer from recurrent life-threatening arrhythmias or frequent implantable cardioverter-defibrillator discharges despite maximum tolerated doses of beta blockers.
A Review of In Silico Tools as Alternatives to Animal Testing: Principles, Resources and Applications
Authors: Madden Judith C. , Enoch Steven J. , Paini Alicia , Cronin Mark T.D.
Published: October 2020

Across the spectrum of industrial sectors, including pharmaceuticals, chemicals, personal care products, food additives and their associated regulatory agencies, there is a need to develop robust and reliable methods to reduce or replace animal testing. It is generally recognised that no single alternative method will be able to provide a one-to-one replacement for assays based on more complex toxicological endpoints. Hence, information from a combination of techniques is required. A greater understanding of the time and concentration-dependent mechanisms, underlying the interactions between chemicals and biological systems, and the sequence of events that can lead to apical effects, will help to move forward the science of reducing and replacing animal experiments. In silico modelling, in vitro assays, high-throughput screening, organ-on-a-chip technology, omics and mathematical biology, can provide complementary information to develop a complete picture of the potential response of an organism to a chemical stressor. Adverse outcome pathways (AOPs) and systems biology frameworks enable relevant information from diverse sources to be logically integrated. While individual researchers do not need to be experts across all disciplines, it is useful to have a fundamental understanding of what other areas of science have to offer, and how knowledge can be integrated with other disciplines. The purpose of this review is to provide those who are unfamiliar with predictive in silico tools, with a fundamental understanding of the underlying theory. Current applications, software, barriers to acceptance, new developments and the use of integrated approaches are all discussed, with additional resources being signposted for each of the topics.
Operationalizing exposure diversity
Authors: Moe Hallvard , Hovden Jan Fredrik , Karppinen Kari
Published: October 2020

The concept of exposure diversity, the diversity of information that people actually access and use, has recently gained prominence in media policy debates. This aspect of media diversity, however, remains difficult to define, measure or implement in actual policy. In this article, we propose an empirical approach that operationalizes exposure diversity in terms of news and current affairs providers in the media repertoire of different social groups. This can be studied through cluster analysis of survey data on respondents’ combinations of use of different media providers and outlets. The article first discusses exposure diversity as a media policy aim. We then outline our proposal on how to take the debate a step further through empirical analysis of media repertoires, with an illustration of how such an analysis may be conducted using survey data from Norway.
Healing effects of a protein scaffold loaded with adipose-derived mesenchymal stem cells on radiation-induced vaginal injury in rats
Authors: Ye Mingxia , Yu Ling , She Yujia , Wang Shufang , Wang Min , Zhao Qingdong , Gu Chenglei , Bian Lihua , Wen Na , Gong Jing , Li Lian , Meng Yuanguang
Published: October 2020

Objectives

Cervical cancer, the most common female cancer after breast cancer, is typically treated using radiotherapy. However, pelvic radiotherapy can cause irreversible damage to the vagina, seriously affecting patients’ quality of life. In this study, protein scaffolds loaded with rat adipose-derived mesenchymal stem cells (ADSCs) were implanted into irradiated tissue to assess their healing potential.

Methods

We established a rat model of radiation-induced vaginal injury. Complexes (consisting of protein scaffolds loaded with ADSCs) were implanted into injury sites. Histological analysis were used to assess regeneration of the vaginal epithelium. RNA sequencing was used to study the therapeutic mechanism of the complexes.

Results

The complexes promoted vaginal epithelial cell regeneration, vaginal tissue repair and improved vaginal stenosis and contracture. Compared with rats transplanted with ADSCs, rats transplanted with complexes achieved better therapeutic effects.

Conclusions

Protein scaffold-ADSC complexes had a beneficial therapeutic effect on radiation-induced vaginal injury in rats and may serve as the basis of a novel therapeutic approach for radiation dermatitis.
Efficacy and safety of rituximab for minors with immune thrombocytopenia: a systematic review and meta-analysis
Authors: Qu Min , Zhou Jing , Yang Song-Jun , Zhou Ze-Ping
Published: October 2020

Objective

We reviewed relevant research on rituximab (RTX) treatment for pediatric immune thrombocytopenia (ITP) to elucidate the efficacy and safety of RTX.

Methods

Prospective clinical trials of RTX for the treatment of pediatric ITP were collected by searching the PubMed, Cochrane Library, Web of Science, and OVID: EMBASE databases and ClinicalTrials.gov. We examined rates of overall response (OR), complete response (CR), partial response (PR), sustained response (SR), relapse (R), and adverse drug reaction (ADR). The Methodological Index for Nonrandomized Studies scale was used, and sensitivity analyses were performed.

Results

For five studies, including 100 patients, the pooled OR, CR, PR, SR, R, and ADR rates were 52% (95% CI: 0.36–0.77, I2 = 78%), 52% (95% CI: 0.41–0.67, I2 = 45%), 18% (95% CI: 0.10–0.33, I2 = 33%), 43% (95% CI: 0.29–0.63, I2 = 0%), 25% (95% CI: 0.06–0.96, I2 = 52%), and 30% (95% CI: 0.15–0.58, I2 = 64%), respectively.

Conclusion

There is evidence, albeit low quality, that RTX may be a better second-line therapy than splenectomy for children with ITP; however, its efficacy and safety need to be validated by further high-quality clinical trials, such as randomized controlled trials.
Therapeutic effect of concentrated growth factor preparation on skin photoaging in a mouse model
Authors: Zhou Rongrong , Wang Miao , Zhang Xudong , Chen Aifen , Fei Yanghonghong , Zhao Qiming , Guo Danjing , Chen Hui , Zheng Shusen
Published: October 2020

Objective

To establish a nude mouse model of photoaging and study the therapeutic effect of a concentrated growth factor preparation (CGF) on skin photoaging.

Methods

CGF was prepared from blood from Sprague–Dawley rats. A skin photoaging nude mouse model was developed using UV irradiation combined with the photosensitizer, 8-methoxypsoralen. Mice were divided randomly into seven groups (n = 6 per group): normal control, photoaging, mock treatment, saline treatment, CGF treatment, Filoca 135HA treatment, and plasma skin regeneration system irradiation (the latter two were positive controls). Body weight and skin appearance were observed and pathological changes were determined by hematoxylin and eosin staining. Fiber elasticity was evaluated by Weigert staining. Expression levels of proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase 1 (MMP1) were determined by immunohistochemistry.

Results

A mouse model with typical features of photoaging skin was successfully developed. CGF significantly improved the skin appearance, wrinkle scores, pathological changes, and fiber elasticity, and increased PCNA and decreased MMP1 expression levels in photoaging mice, comparable to the two positive controls.

Conclusion

CGF can improve the symptoms of skin photoaging in mice, suggesting that it may have applications in the treatment of skin aging in humans.
Association of lower extremity function with nutritional status and number of drugs in patients with chronic heart failure
Authors: Morimoto Yosuke , Kawano Hiroaki , Miyanaga Kei , Yano Yudai , Fukushima Takuya , Kozu Ryo , Eishi Kiyoyuki , Maemura Koji
Published: October 2020

Objective

This study was performed to investigate the physical performance parameters, including lower extremity function parameters, that may be risk factors for falls in patients with chronic heart failure.

Methods

Seventy patients with stable chronic heart failure were included in this retrospective cross-sectional study. The five-repetition sit-to-stand test (5STS) time, Controlling Nutritional Status (CONUT) score, and number of drugs were assessed.

Results

Simple linear regression analysis revealed that the 5STS time was positively correlated with age, the CONUT score, and the number of drugs but was negatively associated with the handgrip force, quadriceps force, and quadriceps muscle thickness. Multiple linear regression analysis showed a significant association between the 5STS time and the CONUT score, quadriceps force, and number of drugs.

Conclusion

The muscle strength, nutritional status, and number of drugs should be evaluated to prevent lower extremity weakness in patients with stable chronic heart failure.
Toward a theory of musical intelligence
Authors: Sternberg Robert J.
Published: October 2020

This article presents an effort toward a theory of musical intelligence through a somewhat novel combination of Howard Gardner’s theory of multiple intelligences with Robert J. Sternberg’s theory of successful intelligence. In particular, musical intelligence involves creative, analytical, practical, and wisdom-based aspects. These components apply to both musical composition and performance and can apply as well to musical understanding and scholarship. In performance, for example, performers devise creative interpretations of composers’ music, analyze their interpretations to ensure they are historically and musically defensible, perform the music in a way that is practical in reaching their audience, and do good in providing their listeners with enjoyment and sometimes new ways of thinking about the world.
The comprehensive lower limb amputee socket survey: Reliability and validity of the persian version
Authors: Rouhani Naeimeh , Esfandiari Elham , Babaee Taher , Khosravi Mobina , Moradi Vahideh , Balouchkayvan Behrad , Pezham Hamid
Published: October 2020

Background:

The Comprehensive Lower limb Amputee Socket Survey (CLASS) is a self-reported measure developed to assess prosthetic socket fit in individuals with lower limb amputation.

Objective:

To assess the reliability and validity of the Persian version of the CLASS.

Study Design:

Cross-sectional and repeated-measures.

Methods:

We evaluated the translation and back translation of the CLASS and made the required changes according to expert committee feedback. Then, we recruited 124 participants with unilateral lower limb amputation (89.5% men). Internal consistency was analyzed with Cronbach’s alpha and test–retest reliability using intra-class correlation coefficients. Convergent construct validity was assessed by comparing the CLASS scores with the Persian version of the Trinity Amputation and Prosthesis Experience Scales (TAPES) scores. In addition, known groups construct validity was assessed by comparing CLASS scores between groups with different causes and levels of amputation.

Results:

Cronbach’s alpha coefficient represented a very good internal consistency for all domains of the Persian CLASS (ranged from 0.86 to 0.92). The intra-class correlation coefficient for test–retest reliability for the Persian CLASS was good to excellent (ranged from 0.73 to 0.97). There was a significant correlation between the subscales of the Persian CLASS and satisfaction subscales of the Persian TAPES (p < 0.001). There was significant difference between comfort subscale of the Persian CLASS scores by level of amputation.

Conclusion:

The Persian CLASS is a reliable and valid measure for evaluating prosthetic socket fit.
Introducing a Safety Net: The Effects of Neoliberal Policy on Welfare, Poverty, and the Net Social Wage during the Greek Crisis
Authors: Missos Vlassis
Published: October 2020

The combined effects of internal devaluation and fiscal consolidation policies implemented in Greece between 2010 and 2019 are reflected in substantial levels of income contraction and unequal distribution of the financial burden. Neoliberal policy responses are examined through a safety net that allocates scarce fiscal resources to persons in extreme need, subject to high primary budget surplus targets. The safety net operates in this manner when social pressure upon the worker class intensifies. Further, the essay explores two supplementary aspects. First, a modified measure of poverty using the conventional approach of differentiated income poverty lines is considered. Second, net social wage variations are examined. Results indicate Greek workers have suffered substantially and that neoliberal policies have placed disproportionate burdens on persons most in need.
Assessing Young Students’ Design Thinking Disposition and Its Relationship With Computer Programming Self-Efficacy
Authors: Tsai Meng-Jung , Wang Ching-Yeh
Published: October 2020

To explore the role of design thinking in contemporary computer literacy education, this study aimed to examine the relationship between young students’ design thinking disposition and their computer programming self-efficacy. To assess students’ design thinking disposition, this study developed the Design Thinking Disposition Scale (DTDS) with a sample of 350 junior high school students who had computer programming experience in a STEAM course. A principle axis factor analysis with the promax rotation method was used to verify the DTDS’s construct under the four dimensions: empathize, define, ideate and prototype. The Cronbach’s alpha reliability was .90 for the overall scale. Correlation analyses results showed that all the four dimensions were significantly correlated with computer programming self-efficacy assessed by CPSES. A significant regression model was found in which the three factors, ideate, prototype and define, significantly predicted the overall computer programming self-efficacy. Meanwhile, except for the ideate subscale, no gender difference was found in the young students’ design thinking dispositions. The students’ self-directed programming learning experience was shown to benefit their design thinking disposition. The DTDS can be applied to design-thinking-embedded computer literacy curricula such as makers, STEAM, or robotics education. Several further studies are also suggested.
Childhood Maltreatment and Anhedonic Symptoms: Test of a Dual-risk Model in Emerging Adults
Authors: Cohen Joseph R. , McNeil Shiesha , Menon Suvarna V.
Published: October 2020

Anhedonia, defined as deficits in positive affect and approach related behaviors, remains an understudied trauma response. As anhedonic responses to interpersonal violence are associated with a more severe course of psychopathology that is more difficult to treat, an increased focus on risk factors for anhedonia is necessary. The present study sought to address this gap in the literature by testing a theoretical model that highlights two transdiagnostic pathways leading to anhedonic responses in emerging adults attending college. Specifically, our study examined how childhood maltreatment subtypes (a) uniquely associate with depressive and post-traumatic stress (PTS) manifestations of anhedonia and (b) how temperament (i.e., anticipatory positive affect) and distress (i.e., negative mood) explain these relations. At baseline, a racially diverse sample of 462 emerging adults (AgeMean = 19.45; 75.5% female; 45.5% White) completed self-report forms on childhood abuse and neglect, anticipatory positive affect, negative mood, and anhedonia. Individuals completed measures of temperament and psychological distress again 6-weeks, and 12-weeks later. Latent growth curve models were utilized to test our model. Consistent with hypotheses, deficits in anticipatory positive affect uniquely explained the relation between neglect and depressive/PTS anhedonic symptoms. Meanwhile, negative mood mediated the relation between abuse and both forms of anhedonia. These findings support the theory that two separate risk pathways lead to anhedonia. Support for our model suggests that distinguishing between pathways for anhedonic responses may be the key to a more targeted, transdiagnostic, trauma-informed approach for treating and preventing these deleterious, treatment-resistant, internalizing symptoms.
Empowerment of Patients in the Process of Rehabilitation
Authors: Wang Lan , Dong Jie , Gan Hong-Bin , Wang Tao
Published: October 2020

The management and appropriate treatment of peritoneal dialysis (PD) patients is an ongoing challenge in current health care. We believe that health education—consisting of knowledge, skills, and self-awareness—is a useful mechanism for patient empowerment. Patients should have an awareness of their disease, and as health care providers, PD nurses have the role of focusing their patients on preventive care, rather than of simply training patients. An empowerment program is a valuable intervention for improving the self-management of patients. It can both improve quality of life and assist in rehabilitation.
30 Years of Peritoneal Dialysis Development: The past and the Future
Authors: Krediet Raymond T.
Published: October 2020

A review is given of 30 years of development in peritoneal dialysis (PD). After a short description of the first 20 years, the main emphasis is put on the last 10 years. Subjects discussed are the increasing use of PD in high-risk populations, peritonitis and other catheter-related problems, adequacy of dialysis and nutrition, patient outcomes in comparison with hemodialysis, and peritoneal membrane changes with time on PD. Topics that have emerged during the last decade and the challenges for the next decennium are discussed. The great importance of quality assurance in fast-growing PD populations and of prevention of long-term membrane alterations are emphasized.
Various Obstacles to Peritoneal Dialysis Development in Japan: Too Much Money? Too Much Fear?
Authors: Kawaguchi Yoshindo
Published: October 2020

At 31 December 2005, the number of patients on maintenance dialysis in Japan was 257,765, with 9599 patients having started dialysis that year. Kidney transplant cases in Japan number about 1000 annually. Thus, almost all end-stage renal disease patients in Japan are likely to live on dialysis for the remainder of their lives. For various reasons, peritoneal dialysis has a lower penetration rate among Japanese dialysis patients, and work to educate patients and nephrologists about PD needs to be done.
Peritoneal Fibrosis Intervention
Authors: Kaneko Kayo , Hamada Chieko , Tomino Yasuhiko
Published: October 2020

Peritoneal fibrosis (PF) is invariably observed in patients undergoing long-term peritoneal dialysis (PD). The condition is thought to occur in response to a variety of insults, including bioincompatible dialysates (acidic solution, high glucose, glucose degradation products, or a combination), peritonitis, uremia, and chronic inflammation. Recently, the pathophysiologic mechanisms that contribute to the fibrosing process have been intensively studied. Transforming growth factor-β has been shown to be a key mediator of PF. Loss of the mesothelial cell layer has been identified in several studies and shown to correlate with submesothelial thickening and vasculopathy. An association has also been identified between increased submesothelial thickness in the peritoneal membrane and increased solute transport, suggesting a relationship between PF and loss of ultrafiltration capacity. Thus, to maintain long-term PD and improve quality of life for patients, it is important to develop interventions for prevention and treatment of PF.

Several strategies for peritoneal fibrosis intervention have been reported, including developing biocompatible dialysate, targeting mediators responsible for inflammation and fibrosis, and reconstituting the peritoneum using mesothelial or bone marrow–derived cells. Recent experimental trials in animal models and clinical studies are presented in this review.
Glycosaminoglycans and Proteoglycans: Overlooked Entities?
Authors: Yung Susan , Tak Mao Chan
Published: October 2020

♦ Background

By virtue of their high net negative charge, glycosaminoglycans and proteoglycans play pivotal roles in biologic processes such as cell–cell and cell–matrix interactions, sequestration of growth factors, activation of chemokines and cytokines, and permselectivity of basement membranes.

♦ Methods

The present article reviews the putative roles of glycosaminoglycans and proteoglycans in the peritoneal cavity during normal peritoneal homeostasis and chronic inflammation, the latter induced by constant exposure of the peritoneum to non-physiologic peritoneal dialysis (PD) solutions.

♦ Results

Glycosaminoglycans have been identified in the mesothelial glycocalyx, a slippery, non-adhesive layer that protects the peritoneal membrane from abrasion and infection. Dermatan sulfate proteoglycans can neutralize the activity of transforming growth factor β1 and can thus play an essential role in modulating peritoneal fibrosis. Heparan sulfate proteoglycans play a crucial role in the sequestration of growth factors; they also modulate selective permeability of proteins across the peritoneal cavity. Reduced expression of perlecan, a heparan sulfate proteoglycan of the basement membrane, is observed in peritoneal biopsies obtained from established PD patients, consequent to prolonged exposure to the elevated glucose concentrations in conventional PD solutions. Supplementation of PD fluids with glycosaminoglycans has been shown to be beneficial to both the structural and functional integrity of the peritoneum.

♦ Conclusions

Recent advances in the field of glycobiology have revealed a multitude of biologic processes that are controlled or influenced by glycosaminoglycans and proteoglycans. Altered synthesis of these macromolecules during PD has serious implications for the peritoneal transport of proteins, host defense, wound healing, inflammation, and fibrosis.
Rational Choice of Peritoneal Dialysis Catheter
Authors: Dell'Aquila Roberto , Chiaramonte Stefano , Rodighiero Maria Pia , Spano’ Emilia , Di Loreto Pierluigi , Kohn Catalina Ocampo , Cruz Dinna , Polanco Natalia , Kuang Dingwei , Corradi Valentina , Massimo De Cal , Ronco Claudio
Published: October 2020

The peritoneal catheter should be a permanent and safe access to the peritoneal cavity. Catheter-related problems are often the cause of permanent transfer to hemodialysis (HD) in up to 20% of peritoneal dialysis (PD) patients; in some cases, these problems require a temporary period on HD. Advances in connectology have reduced the incidence of peritonitis, and so catheter-related complications during PD have become a major concern.

In the last few years, novel techniques have emerged in the field of PD: new dialysis solutions, better connectology, and cyclers for automated PD. However, extracorporeal dialysis has continued to improve in terms of methods and patient survival, but PD has failed to do so. The main reason is that peritoneal access has remained problematical.

The peritoneal catheter is the major obstacle to widespread use of PD. Overcoming catheter-related problems means giving a real chance to development of the peritoneal technique. Catheters should be as efficient, safe, and acceptable as possible.

Since its introduction in the mid-1960s, the Tenckhoff catheter has not become obsolete: dozens of new models have been proposed, but none has significantly reduced the predominance of the first catheter. No convincing prospective data demonstrate the superiority of any peritoneal catheter, and so it seems that factors other than choice of catheter are what affect survival and complication rates. Efforts to improve peritoneal catheter survival and complication rates should probably focus on factors other than the choice of catheter. The present article provides an overview of the characteristics of the best-known peritoneal catheters.
Can we Overcome the Predestined Poor Survival of Diabetic Patients? Perspectives from Pre- and Post-Dialysis
Authors: Kim Yong-Lim
Published: October 2020

Although the survival of diabetic peritoneal dialysis (PD) patients has improved, it is still much worse than the survival of nondiabetic patients. Diabetes has its own risks for cardiovascular disease (CVD), such as increased levels of advanced glycation end-products, carbonyl and oxidative stress, and low-grade inflammation. An independent, graded association has been observed between a reduced glomerular filtration rate and the risk of CVD events in chronic kidney disease (CKD). Both CKD and diabetes synergistically lead to a high risk of CVD. It seems that the poor survival of diabetic PD patients is predestined at the initiation of dialysis because of multiple pre-existing risk factors and comorbid diseases, particularly CVD.

Recently, several trials were successful in improving the survival of patients with diabetic CKD. Tight control of glucose, blood pressure management using angiotensin converting-enzyme inhibitors or angiotensin II receptor blockers, and use of statins, antioxidants, or peroxisome proliferator-activated receptor gamma agonists may improve the survival of diabetic PD patients. However, simple correction of a single CVD risk factor is not likely to be effective. New PD solutions such as those low in glucose degradation products or those with icodextrin may also be effective in reducing the risk of CVD in diabetic PD patients. Therefore, multifactorial interventions—including diet control, early referral, and choice of an optimal PD solution—may improve the survival of diabetic PD patients.
Peritoneal Dialysis in Patients with Diabetes: Are the Benefits Greater than the Disadvantages?
Authors: Kuriyama Satoru
Published: October 2020

Diabetic nephropathy has been increasing in prevalence in recent years, and it is now the dominant cause of end-stage renal disease (ESRD) worldwide. Because diabetes is frequently associated with multiple complications, nephrologists must be alert to the selection of dialysis modality so as to reduce the accompanying risks. The present review addresses whether the benefits of peritoneal dialysis are greater than its disadvantages in diabetic patients. The answer is quite positive: for most diabetic patients, peritoneal dialysis offers multiple benefits.
Body Composition Analysis Techniques in Adult and Pediatric Patients: How Reliable are They? How Useful are they Clinically?
Authors: Woodrow Graham
Published: October 2020

Complex abnormalities of body composition occur in peritoneal dialysis (PD). These abnormalities reflect changes in hydration, nutrition, and body fat, and they are of major clinical significance. Clinical assessment of these body compartments is insensitive and inaccurate. Frequently, simultaneous changes of hydration, wasting, and body fat content can occur, confounding clinical assessment of each component. Body composition can be described by models of varying complexity that use one or more measurement techniques. “Gold standard” methods provide accurate and precise data, but are not practical for routine clinical use. Dual energy X-ray absorptiometry allows for measurement of regional as well as whole-body composition, which can provide further information of clinical relevance. Simpler techniques such as anthropometry and bioelectrical impedance analysis are suited to routine use in clinic or at the bedside, but may be less accurate. Body composition methodology sometimes makes assumptions regarding relationships between components, particularly in regard to hydration, which may be invalid in pathologic states. Uncritical application of these methods to the PD patient may result in erroneous interpretation of results. Understanding the foundations and limitations of body composition techniques allows for optimal application in clinical practice.
Tuberculous and Fungal Peritonitis in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis
Authors: Sing Leung Lui , Tak Mao Chan , Kar Neng Lai , Lo Wai Kei
Published: October 2020

Tuberculous and fungal infections are two relatively uncommon but important causes of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). The clinical features, diagnosis, and management of these two special forms of CAPD-related peritonitis are highlighted in this article.