bluuebunny/crossref_metadata_2025 huggingface dataset:
Everyday intervention
Authors: Lloyd John B.
Published: October 2018

This article addresses the question of whether God intervenes in the regular workings of the physical world, either unprompted or in response to prayer. Its focus is on intervention that is not in the ordinary sense miraculous. It is proposed that, because humans undeniably have the ability to intervene and change the course of events, it is perverse and illogical to hold that the Creator cannot do likewise. But perhaps God chooses not to exercise his prerogative to intervene. Would not such intervention abrogate the God-given autonomy of the created world that makes its workings helpfully predictable and also accessible to scientific enquiry? Indeed, is it not unseemly for God to interfere with the day-to-day workings of the world? Jesus’ teaching about God’s nature suggests a nuanced approach, that of parenthood: one that includes the option to intervene, but is considerate and restrained. God’s intervention in response to prayer is the consistent premise of the Old and New Testaments, and it is probably unwise to put much store on human ability to discern what is and is not fitting for God to do. The validity and legitimacy of intercessory prayer are affirmed.
Sacred bones, stones, stories: St Albans and Bethel
Authors: Walton Kevin
Published: October 2018

The interpretation of both scripture and ancient sacred buildings is complex, but the comparison is illuminating. Both show traces of development through time but form a coherent unity. Both have human and cultural interest but are set within an overriding theological purpose. Both show evidence of theological differences, and both face questions of authenticity in interpretation. These issues are discussed with respect to the shrine of Bethel in the book of Genesis, and of St Alban in St Albans Cathedral, England.
New directions in adult baptism: Baptism in a secular culture
Authors: Carswell W. John
Published: October 2018

In this article I argue that the rise of secular culture demands a new approach to baptism, especially the baptism of adult converts for whom the claims of Christianity may be entirely unfamiliar and who will in consequence need extensive preparation to make the sacrament sensible and the Christian life meaningful. Towards that end, I review work done on the subject in the Church of Scotland and commend the Roman Catholic Rites of Christian Initiation of Adults (RCIA) as a model for the development of a full catechumenate.
Doctor–patient relationship mediates the effects of shared decision making on health-related quality of life among women living with breast cancer
Authors: Kugbey Nuworza , Oppong Asante Kwaku , Meyer-Weitz Anna
Published: October 2018

Decreased quality of life is a major challenge among women living with breast cancer due to treatment effects and other psychosocial comorbidities. However, shared decision making and doctor–patient relationship have been linked to improved quality of life, but the mechanism linking shared decision making and quality of life is poorly understood. This study therefore examined both the direct and indirect influences of shared decision making on quality of life through doctor–patient relationship among 205 women living with breast cancer in Ghana with a mean age of 52.49 years. Using a cross-sectional design, participants were administered questionnaires which measured quality of life, doctor–patient relationship, and shared decision making. Results showed that shared decision making had significant indirect influence on overall quality of life via doctor–patient relationships ( b = 4.69, 95% confidence interval = [0.006, 9.555]). Shared decision making had a significant effect on doctor–patient relationships ( b = 7.63, t = 6.76, p < .001) but no significant direct effect on quality of life ( b = 2.72, t = 0.510, p = .61). Findings suggest that shared decision making results in improved doctor–patient relationships which probably lead to better quality of life among women living with breast cancer. These findings underscore the need for increased patient involvement in medical decisions to improve interpersonal relationships and consequently quality of life.
Championing the resilience of sub-Saharan adolescents: pointers for psychologists
Authors: Theron Linda
Published: October 2018

In this article, I argue that an ecological systems approach to resilience – specifically, one that is sensitive to how contextual determinants shape successful adaptation differentially – offers a meaningful way to enable sub-Saharan adolescents to adapt well to the apparently intractable risks to their health and well-being. Accordingly, I draw on studies of child and adolescent resilience from sub-Saharan Africa and the global North to show that the resilience field has largely moved beyond individual-focused theories of resilience that have the (long-term) potential to jeopardize adolescent health and well-being and advance neoliberal agendas. I emphasize that the recent attention to differentially impactful resilience-enablers casts suspicion on incautious application of universally recurring resilience-enablers. Allied to this, I problematize the delay in the identification of resources that impact the resilience of sub-Saharan adolescents differentially. Finally, I distil implications for resilience-directed praxis and research that have the potential to advance the championship of adolescent resilience in sub-Saharan Africa.
Ritualizing Jesus’ Grief at Gethsemane
Authors: Harkins Angela Kim
Published: October 2018

New light can be cast on Jesus’ grief-stricken prayer by contextualizing it within the growing scholarship on prayers and ritual mourning practices in the Second Temple period. The emotional prayer that Jesus prays in Gethsemane can be understood as a reenactment of a recognizable Second Temple ritual that joined emotional prayers of supplication and confession to mourning practices. This article proposes that a Second Temple ritual context is an overlooked but potentially fruitful way of understanding the ancient controversies that embroiled Jesus’ prayer at Gethsemane. The cultural specificity of the emotions associated with this prayer can help to account for why ancient Greek and Roman readers experienced such sharp and divergent responses to Jesus’ prayer.
An Evaluation of SPARC Protein as a Serum Biomarker of Chronic Rhinosinusitis
Authors: Asmar Marc‐Henri , Gaudreau Annie , Maniakas Anastasios , Mfuna Endam Leandra , Desrosiers Martin
Published: October 2018

Objective

Precision medicine initiatives for chronic rhinosinusitis (CRS) management suggest tailoring treatment to the patient's individual disease profile; however, serum biomarkers for evaluation of disease activity or predicting response to therapy are lacking in CRS. Epithelial‐to‐mesenchymal transition (EMT) has been described as a component of barrier dysfunction in CRS. SPARC (secreted protein acidic and rich in cysteine) is a marker of EMT that has previously been identified in sinus epithelium by gene expression profiling. We wished to determine if SPARC could represent a serum biomarker for CRS by verifying (1) if SPARC could be detected in serum, (2) whether levels were sensitive to disease burden reduction following surgery, and (3) if it could predict response to therapy.

Study Design

Prospective.

Setting

Tertiary care center.

Subjects

Patients with CRS undergoing endoscopic sinus surgery (ESS).

Methods

Twenty‐six patients undergoing ESS for CRS were prospectively recruited. Serum was collected at the time of surgery and 4 months following ESS and SPARC level measured using enzyme‐linked immunosorbent assay. Postoperative outcome was characterized as “remission” or “unfavorable” based on symptomatology and endoscopy.

Results

SPARC could be detected and measured in serum in all subjects. Following ESS, SPARC levels decreased by 33% (P =. 005) but did not predict evolution at 4 months postsurgery (P =. 94).

Conclusion

SPARC may be an interesting serum biomarker of disease activity in CRS, as it can be reliably measured and decreases following successful reduction of disease burden after surgery. However, it does not predict post‐ESS evolution, suggesting that the link between EMT and outcome is not linear.
Multimodal Transportation Network Modeling Based on the Generic Second Order Modeling Approach
Authors: Lebacque Jean-Patrick , Khoshyaran Megan M.
Published: October 2018

The generic second order modeling (GSOM) approach to vehicular traffic flow combines the traditional kinematic description of traffic with dynamic equations for vehicle attributes. The GSOM model provides a unifying framework for many models in the literature. This framework includes tools such as local supply and demand, discretization, variational formulation, and generic intersection models.The object of the paper is to extend this approach to multimodal modeling of transportation networks. In multimodal networks two connected but distinct flows co-exist: vehicular and passenger flow. The main idea of the paper is to express the passenger flow as the flow of a specific attribute: the passenger load of vehicles, the unit of which is expressed in passengers per vehicle. Supplementary attributes pertaining to passengers can be added: destinations, activity plans, information availability, passenger category, and so forth. Intermodal poles, stations (bus, taxi, train), and intersections are modeled as nodes. It is shown that the stock variables associated to vehicles and passengers satisfy a system of conservation equations (on links) coupled with a system of ordinary differential equations (in nodes). Boundary conditions and numerical methods are proposed for the resolution of the model. Some examples are given, notably a method for managing a major incident on an automatic train line. The method uses most elements of the model in order to define the control strategy: passenger and train dynamics, station models, and local traffic supply and demand analysis.
Estimating Vehicular Emission Impact of Nighttime Construction with VISSIM and Different MOVES Emission Estimation Approaches
Authors: Gu Chaoyi , Farzaneh Reza , Pesti Geza , Valdez Gabriel , Birt Andrew
Published: October 2018

Shifting work zones from daytime to nighttime is a potential solution to air quality issues on roadway with high traffic volume and where it is undesirable to close lanes during peak hours. The expected benefit of such shifting is to reduce total fuel consumption and on-road vehicle emissions. However, the magnitude of emission reductions and air quality impacts has not been examined comprehensively at work zones. The study presented in this paper investigated the traffic-related emission impacts of work zones using an urban freeway case study. A VISSIM test bed combined with the Environmental Protection Agency’s MOVES emission model was used to estimate total emissions assuming daytime and nighttime lane-closure scenarios. Vehicle emissions were estimated using a link-based method and operating mode-based method. The results from both methods demonstrated that nighttime construction has a significant impact on both traffic speeds and vehicle emissions, primarily as a result of reductions in vehicle miles traveled. In addition, a horizontal comparison between the results from the two methods was made to assess the impact of different emission estimation approaches. The outcomes from the comparison highlight the potential importance of the operating mode-based approach for accurately estimate total traffic emission quantities when data or simulations are available.
Designing a Transit-Feeder System using Multiple Sustainable Modes: Peer-to-Peer (P2P) Ridesharing, Bike Sharing, and Walking
Authors: Nam Daisik , Yang Dingtong , An Sunghi , Yu Jiangbo Gabriel , Jayakrishnan R. , Masoud Neda
Published: October 2018

Peer-to-peer (P2P) ridesharing is a relatively new concept that aims to provide a sustainable method for transportation in urban areas. Previous studies have demonstrated that a system that incorporates both P2P ridesharing and transit would enhance mobility. We develop schemes to provide travel alternatives, routes and information across multiple modes, which includes P2P ridesharing, transit, city bike-sharing and walking, within the network. This study includes a case study of the operation of the multimodal system that includes P2P ridesharing participants (both drivers and riders), the Los Angeles Metro Red line subway rail, and the Los Angeles downtown bike-share system. The study conducts a simulation, enhanced by an optimization layer, of providing travel alternatives to passengers during morning peak hours. The results indicate that a multi-modal network expands the coverage of public transit, and that ride- and bike-sharing could be effective transit feeders when properly designed and integrated into the transit system.
Combining satellite and survey data to study Indian slums: evidence on the range of conditions and implications for urban policy
Authors: Rains Emily , Krishna Anirudh , Wibbels Erik
Published: October 2018

Projections suggest that most of the global growth in population in the next few decades will be in urban centres in Asia and Africa. Most of these additional urban residents will be concentrated in slums. However, government documentation of slums is incomplete and unreliable, and many slums remain undocumented. It is necessary to employ creative methods to locate and sample these understudied populations. We used satellite image analysis and fieldwork to build a sample of Indian slums. We show that living conditions vary along a wide-ranging continuum of wellbeing; different points correspond to different policy needs. We also show that most variation in conditions is due to differences across rather than within neighbourhoods. These findings have important implications for urban policy. First, satellite data can be a useful tool to locate undocumented settlements. Second, policy must be appropriately nuanced to respond to wide-ranging needs. Finally, variation patterns suggest that policies should be targeted at the neighbourhood rather than the individual level.
Sacred Sports: Moral Responses to Sports Media Content
Authors: Lewis Nicky , Hirt Edward R.
Published: October 2018

This study examines moral responses to sports media content. Using two conditions, participants ( N = 639) were randomly assigned to read a damaging sports article about their university’s basketball team, either written by an ingroup or outgroup member. Participants then reported their moral outrage to the article, moral cleansing responses, and team support intentions. Findings demonstrated that individuals demonstrated moral outrage, moral cleansing, and team support intentions when their favored team was derogated against, especially when the source of disparagement came from an outgroup member. Results are discussed in light of social identification and moral foundations theories.
The Expressions of Hope in the Face of Complex Surgery: Experiences of Patients and Their Loved Ones
Authors: Baur Karen M , Chamberlain Jill , Wendler M Cecilia , Harwood Paula , Colle Joni , Yeaman Deb
Published: October 2018

Background:

Lung volume reduction surgery (LVRS), a reduction in damaged lung tissue in end-stage chronic obstructive pulmonary disease, is a breakthrough surgical procedure requiring months of rigorous screening, testing, and conditioning. Engaging in this process is prolonged and challenging with no research found exploring patients and loved ones’ experiences through this demanding process.

Objective:

The purpose was to examine the experience of LVRS for patients and loved ones as they encounter the complex preparation required prior to, during, and throughout the extended convalescence following surgery.

Methods:

A mixed-methods approach was used, combining health outcomes with interview data. Participants and loved ones were purposefully selected, invited, and consented during the perioperative phase of LVRS. Quantitative data were obtained via chart review, while qualitative data were gathered through a 2-stage interview process, preoperatively and postoperatively. Qualitative data were analyzed using naturalistic inquiry approaches.

Results:

Patients and loved ones described difficulties of living with illness during the preoperative phase, and expressed relief and joy for an improved quality of life afterward. The overarching theme uncovered was hope. Preoperatively, hope was coupled with anxiety about the upcoming surgery and potential outcomes, whereas the hope expressed after surgery focused on the future, in particular, a shared future. Statistically significant differences were found in the quality of life measures.

Conclusion:

For both patients and loved ones, LVRS is filled with hope for a more expansive future. Although that future is unclear prior to surgery, clarification and a new normal signals hope for a shared future following LVRS.
The Patient Teacher in General Practice Training: Perspectives of Residents
Authors: Aires Marie José , Gagnayre Rémi , Gross Olivia , Khau Cam-Anh , Haghighi Sophie , Mercier Alain , Ruelle Yannick , Marchand Claire
Published: October 2018

Background:

Patient teachers were involved in training general practice residents (GPRs) to strengthen the patient-centered approach. They teach a course on health democracy by themselves and teach in tandem with a physician teacher during reflective practice-based classes (named GEPRIs). We present the GPRs’ representations of patient teacher characteristics and capacities and their perception of how useful patient teachers are to their professional development.

Methods:

We administered a questionnaire based on a preliminary qualitative study to 124 GPRs. It explored (a) changes in the GPRs’ representations about patient teacher characteristics and capacities with regard to teaching over the first year of the experiment; (b) GPRs’ perception of patient teacher utility to their training and their contribution to developing patient perspective–related competencies.

Results:

The response rate was 89.5% (111/124). The majority of GPRs agreed with 17 (before) and 21 (after) of the 23 patient teacher characteristics and with 17 (before) and 19 (after) of the 20 capacities. The agreement rate increased, overall, after patient teacher participation. The GPRs found patient teacher useful to their training in 9 of 11 topics (agreement rate 65%-92%). They felt they had developed the 14 patient knowledge–related competencies (agreement rate 62%-93%), and 52% to 75% of the GPRs rated the patient teachers’ contribution to those competencies “high or very high,” depending on the competency.

Conclusion:

This study demonstrates the specific contribution of patient teachers to university-level medical training in France. The GPRs recognized that patient teachers helped them develop competencies by providing patient-specific content.
Voltage-gated calcium channels: Their discovery, function and importance as drug targets
Authors: Dolphin Annette C.
Published: October 2018

This review will first describe the importance of Ca2+ entry for function of excitable cells, and the subsequent discovery of voltage-activated calcium conductances in these cells. This finding was rapidly followed by the identification of multiple subtypes of calcium conductance in different tissues. These were initially termed low- and high-voltage activated currents, but were then further subdivided into L-, N-, PQ-, R- and T-type calcium currents on the basis of differing pharmacology, voltage-dependent and kinetic properties, and single channel conductance. Purification of skeletal muscle calcium channels allowed the molecular identification of the pore-forming and auxiliary α2δ, β and ϒ subunits present in these calcium channel complexes. These advances then led to the cloning of the different subunits, which permitted molecular characterisation, to match the cloned channels with physiological function. Studies with knockout and other mutant mice then allowed further investigation of physiological and pathophysiological roles of calcium channels. In terms of pharmacology, cardiovascular L-type channels are targets for the widely used antihypertensive 1,4-dihydropyridines and other calcium channel blockers, N-type channels are a drug target in pain, and α2δ-1 is the therapeutic target of the gabapentinoid drugs, used in neuropathic pain. Recent structural advances have allowed a deeper understanding of Ca2+ permeation through the channel pore and the structure of both the pore-forming and auxiliary subunits. Voltage-gated calcium channels are subject to multiple pathways of modulation by G-protein and second messenger regulation. Furthermore, their trafficking pathways, subcellular localisation and functional specificity are the subjects of active investigation.
New arsenate minerals from the Arsenatnaya fumarole, Tolbachik volcano, Kamchatka, Russia. X. Edtollite, K2NaCu5Fe3+O2(AsO4)4, and alumoedtollite, K2NaCu5AlO2(AsO4)4
Authors: Pekov Igor V. , Zubkova Natalia V. , Agakhanov Atali A. , Ksenofontov Dmitry A. , Pautov Leonid A. , Sidorov Evgeny G. , Britvin Sergey N. , Vigasina Marina F. , Pushcharovsky Dmitry Y.
Published: October 2018

Two new isostructural minerals edtollite K2NaCu5Fe3+O2(AsO4)4and alumoedtollite K2NaCu5AlO2(AsO4)4have been found in the Arsenatnaya fumarole, Second scoria cone of the Northern Breakthrough of the Great Tolbachik Fissure Eruption, Tolbachik volcano, Kamchatka, Russia. They are associated with sylvite, tenorite, dmisokolovite, shchurovskyite, johillerite, bradaczekite, and orthoclase. Edtollite forms prismatic crystals up to 0.02 mm × 0.1 mm; alumoedtollite forms long-prismatic crystals up to 0.01 mm × 0.1 mm. Both minerals have a semi-metallic lustre. Edtollite is brown–black to black and alumoedtollite is bronze coloured.Dcalc.= 4.26 (edtollite) and 4.28 (alumoedtollite) g cm–3. In reflected light, both minerals are grey, with distinct anisotropy. Reflectance values [edtollite/alumoedtollite:R1–R2, % (λ, nm)] are: 8.3–8.2/8.7–7.7 (470); 7.7–7.4/8.3–7.4 (546); 7.1–6.9/8.3–7.4 (589); and 6.3–6.3/7.6–7.2 (650). Chemical data are: (edtollite/alumoedtollite, wt.%, electron-microprobe): Na2O 3.13/2.58, K2O 8.12/9.09, Rb2O 0.00/0.11, CaO 0.00/0.52, CuO 36.55/38.35, ZnO 0.46/0.00, Al2O30.00/3.48, Fe2O37.34/1.79, TiO20.27/0.00, As2O543.57/43.66, total 99.44/99.58. The empirical formulae, based on 18 O apfu, for edtollite is: K1.83Na1.07Cu4.88Zn0.06Fe3+0.98Ti0.04As4.03O18; and for alumoedtollite is: K2.02Rb0.01Na0.87Ca0.10Cu5.06Al0.72Fe3+0.24As3.99O18. Both minerals are triclinic,P$\bar{1}$; unit-cell parameters (edtollite/alumoedtollite) are:a= 5.1168(6)/5.0904(11),b= 9.1241(12)/9.0778(14),c= 9.6979(14)/9.6658(2) Å, α = 110.117(13)/110.334(17), β = 102.454(12)/102.461(19), γ = 92.852(11)/92.788(15)°,V= 411.32(9)/404.88(14) Å3andZ= 1/1. The strongest reflections in the powder X-ray diffraction pattern [d,Å(I)(hkl)] are for edtollite: 8.79(92)(001), 7.63(41)(0$\bar{1}$1), 5.22(44)(011), 3.427(100)(012), 3.148(64)(0$\bar{1}$3), 2.851(65)($\bar{1}$03) and 2.551(40)($\bar{2}$01); and for alumoedtollite: 8.78(81)(001), 7.62(67)(0$\bar{1}$1), 3.418(100)(012), 3.147(52)(0$\bar{1}$3), 2.558(58)($\bar{1}$22), 2.544(65)($\bar{2}$01) and 2.528(52)($\bar{1}\bar{3}$2). The crystal structures [single-crystal X-ray diffraction,R= 0.0773 (edtollite) and 0.0826 (alumoedtollite); 1504 and 1046 unique reflections, respectively] represent a novel structure type. It is based upon a heteropolyhedral pseudo-framework with the column formed by Cu2+-centred octahedra and square pyramids, octahedraMO6(M= Fe3+, Al3+or Cu2+) and AsO4tetrahedra as the main building unit. K+and Na+are located in wide and narrow channels, respectively. Edtollite is named after the Russian geologist and Arctic explorer Eduard Vasilievich Toll (1858–1902), alumoedtollite is its analogue with Al prevailing among trivalent cations.
Brain and Spinal Epidural Abscess
Authors: Chow Felicia
Published: October 2018

PURPOSE OF REVIEW

Brain abscesses and spinal epidural abscesses are serious, potentially life-threatening infections of the central nervous system. This article outlines the clinical presentation, evaluation, and management of brain abscesses and spinal epidural abscesses, with a specific focus on bacterial infections.

RECENT FINDINGS

The overall incidence of brain abscesses has declined, in part because of fewer brain abscesses associated with otogenic infections. However, emerging patient populations at high risk for brain abscess include those with a history of penetrating head trauma, neurosurgery, or immunodeficiency. Improved mortality rates for brain abscess are attributable to modern diagnostic imaging, stereotactic-guided aspiration, and newer antimicrobials that readily penetrate into the central nervous system and abscesses. Brain MRI is more sensitive than CT for brain abscess, particularly in the early stages, but CT remains more widely available and can adequately identify potential abscesses and confirm response to treatment. With the advent of minimally invasive neurosurgical techniques, surgical excision is often employed only for posterior fossa, multiloculated, or superficial well-circumscribed abscesses. In select clinical scenarios, conservative medical management may be a safe alternative to a combined surgical and medical approach. Unlike brain abscess, the incidence of spinal epidural abscess is on the rise and has been attributed to higher prevalence of predisposing factors, including spinal procedures and instrumentation.

Successful diagnosis and management of brain abscess and spinal epidural abscess requires a collaborative approach among neurologists, neurosurgeons, radiologists, and infectious disease physicians. The foundation of management of brain abscess includes surgical intervention for diagnostic purposes if a pathogen has not been identified or for decompression of larger abscesses or those with mass effect and significant surrounding edema; appropriate dosing and adequate duration of an antimicrobial regimen tailored to the presumptive source of infection and available culture data, and eradication of the primary source of infection. For spinal epidural abscesses, neurologic status at the time of presentation is directly related to outcomes, underscoring the importance of prompt recognition and intervention.
Tetanus, Botulism, and Diphtheria
Authors: Berkowitz Aaron L.
Published: October 2018

PURPOSE OF REVIEW

This article reviews the pathophysiology, epidemiology, clinical manifestations, diagnosis, and treatment of tetanus, botulism, and diphtheric neuropathy.

RECENT FINDINGS

Tetanus is most common in lower-income settings, but rare cases are seen in higher-income settings because of the inadequate maintenance of vaccination status. Foodborne botulism remains rare, but botulism can also be caused by IV drug use (wound botulism) and medical use of botulinum toxin (iatrogenic botulism); botulinum toxin has also been considered a potential agent of bioterrorism. Diphtheric neuropathy is rare but has been seen in recent epidemics in the former Soviet Union, and vaccination status is inadequate in a significant proportion of older individuals, creating the potential for subsequent epidemics.

Tetanus, botulism, and diphtheric neuropathy are rare in higher-resource settings where most neurologists practice; however, familiarity with the unique clinical manifestations of and laboratory evaluation for these disorders is essential for the rapid diagnosis and treatment of patients with these conditions.
Zika Virus and Other Emerging Arboviral Central Nervous System Infections
Authors: Sejvar James J.
Published: October 2018

PURPOSE OF REVIEW

In recent years, we have observed the emergence and reemergence of a number of arthropod-borne viruses (arboviruses). Zika virus is the most recent addition to this group, first causing sporadic cases of uncomplicated febrile illness followed by sizeable outbreaks in the Pacific. However, the epidemiology and clinical features of Zika virus infection have changed rapidly and dramatically; it is now recognized as causing Guillain-Barré syndrome (GBS) in children and adults and congenital abnormalities in infected fetuses. This article reviews the epidemiology, clinical features, and diagnosis of Zika virus–associated neurologic illness and briefly reviews features of West Nile virus and Japanese encephalitis virus.

RECENT FINDINGS

Zika virus has emerged as a significant human pathogen in recent years. In 2015, it began to cause large outbreaks of febrile rash illness in South America and the Caribbean. During these large Zika virus outbreaks, a significant increase in the incidence of GBS was also observed in multiple countries/territories. Zika virus–associated GBS has several unique features, including a relatively short interval between febrile illness and GBS onset, an unusually high incidence among older people, and prominent cranial nerve abnormalities. Congenital Zika syndrome includes a myriad of abnormalities, including microcephaly, lissencephaly, hydrocephalus, arthrogryposis, and parenchymal calcifications. Currently, no treatment has been identified for Zika virus, although work on vaccines is under way.

Arboviruses continue to surprise us with unexpected emergence in various locations, the nature of clinical illness, and outcomes. Zika virus presents a classic example of this type of emergence. Ongoing surveillance will be needed to evaluate the long-term pattern of Zika virus and related arboviruses.
Central Nervous System Infections Complicating Immunosuppression and Transplantation
Authors: Pruitt Amy A.
Published: October 2018

PURPOSE OF REVIEW

This article reviews infections associated with cancer treatments and immunosuppressive/immunomodulatory therapies used in both neoplastic and non-neoplastic conditions, including hematopoietic cell transplantation and solid organ transplantation. It provides a clinical approach to the most commonly affected patient groups based on clinicoanatomic presentation and disease-specific risks resulting from immune deficits and drugs received.

RECENT FINDINGS

The clinical presentations, associated neuroimaging findings, and CSF abnormalities of patients with central nervous system infections who are immunocompromised may differ from those of patients with central nervous system infections who are immunocompetent and may be confused with noninfectious processes. Triggering of brain autoimmunity with emergence of neurotropic antibodies has emerged as a recognized parainfectious complication. New unbiased metagenomic assays to identify obscure pathogens help clinicians navigate the increasing range of conditions affecting the growing population of patients with altered immunity.

Despite evidence-based prophylactic regimens and organism-specific antimicrobials, central nervous system infections continue to cause significant morbidity and mortality in an increasing range of patients who are immunocompromised by their conditions and therapies. Multiple new drugs put patients at risk for progressive multifocal leukoencephalopathy, which has numerous imaging and clinical manifestations; patients at risk include those with multiple sclerosis, for whom infection risk is becoming one of the most important factors in therapeutic decision making. Efficient, early diagnosis is essential to improve outcomes in these often-devastating diseases.
Effects of Sprint-Interval and Endurance Respiratory Muscle Training Regimens
Authors: SCHAER CORINA E. , WÜTHRICH THOMAS U. , BELTRAMI FERNANDO G. , SPENGLER CHRISTINA M.
Published: October 2018

Introduction

Recently a novel, time-saving respiratory muscle sprint-interval training (RMSIT) was developed. To test the extent to which RMSIT improves respiratory muscle performance compared with a conventional respiratory muscle endurance training (RMET), a novel incremental respiratory muscle test (IncRMT), loading inspiratory and expiratory muscles, was designed to assess performance changes associated with respiratory muscle training (RMT).

Methods

Healthy, moderately trained males and females (age: 26 ± 5 yr, V˙O2peak: 47 ± 12 mL·min−1·kg−1) were randomized and balanced to three groups (RMSIT 5m/5f; RMET 6m/6f; PLAT 5m/6f). Lung function, respiratory muscle strength, and IncRMT performance were tested before and after 1 month of RMT. During the IncRMT, muscle activity and muscle deoxygenation were assessed via surface EMG and near-infrared spectroscopy of sternocleidomastoid (STERNO), intercostal (INTER), and abdominal (ABDO) muscles.

Results

Two-way ANOVA revealed a main effect of training for increased maximal voluntary ventilation (P = 0.001) and maximal inspiratory pressure (P = 0.017). Both RMT groups increased work of breathing during training sessions to the same extent (RMSIT: +17.4 ± 8.9 kJ; RMET: +26.2 ± 16.1 kJ; P = 0.143) with a larger increase in average mouth pressure in RMSIT (RMSIT: +20.0 ± 15.0 cm H2O; RMET: +3.3 ± 1.5 cm H2O; P = 0.001). After training, IncRMT duration increased in both RMT groups compared with PLAT (RMSIT: +5.6 ± 2.1 min, P = 0.0006 vs PLAT; RMET: +3.8 ± 4.2 min, P = 0.020 vs PLAT). At similar work, only INTER activity during inspiration increased after RMET. Higher performance after RMSIT was associated with higher activity in STERNO and ABDO, but after RMET, STERNO, INTER, and ABDO showed higher activity.

Conclusion

One month of RMSIT and RMET shows similar improvements in respiratory muscle performance despite different duration of training sessions. Also, muscular adaptations might differ.
Baseline Concussion Clinical Measures Are Related to Sensory Organization and Balance
Authors: VANDER VEGT CHRISTINA B. , REGISTER-MIHALIK JOHNA K. , FORD CASSIE B. , RODRIGO COREY J. , GUSKIEWICZ KEVIN M. , MIHALIK JASON P.
Published: October 2018

Purpose

This study aimed to examine relationships among baseline demographics, symptom severity, computerized neurocognitive outcomes, and balance performance in collegiate athletes.

Methods

Collegiate varsity athletes (N= 207, age = 19.3 ± 1.0 yr) participating in an ongoing clinical research program who completed concussion baseline assessments including a demographic questionnaire, a graded symptom checklist, a neurocognitive assessment, and the Sensory Organization Test (SOT) were included in this study. The SOT composite equilibrium score (COMP) and three sensory ratio scores—vestibular (VEST), visual (VIS), and somatosensory (SOM)—were used to describe athletes’ overall sensory organization and ability to use input from each sensory system to maintain balance. Separate stepwise multiple linear regression models were performed for each SOT outcome. Total symptom severity level and CNS Vital Signs domain scores served as predictor variables.

Results

Stepwise regression models for COMP (R2= 0.18,F4,201= 11.29,P< 0.001), VEST (R2= 0.14,F4,201= 8.16,P< 0.001), and VIS (R2= 0.10,F4,201= 5.52,P< 0.001) were all significant. Faster reaction times and higher executive function scores were associated with higher COMP and VEST scores in separate models. Those with faster reaction times also had significantly higher VIS scores.

Conclusion

Reaction time and executive function demonstrated significant relationships with SOT balance performance. These cognitive processes may influence athletes’ ability to organize and process higher-order information and generate appropriate responses to changes in their environment, with respect to balance and injury risk. Future investigations should consider these relationships after injury, and clinicians should be mindful of this relationship when considering concussion management strategies.
The Effect of Dietary Protein on Protein Metabolism and Performance in Endurance-trained Males
Authors: WILLIAMSON ERIC , KATO HIROYUKI , VOLTERMAN KIMBERLY A. , SUZUKI KATSUYA , MOORE DANIEL R.
Published: October 2018

Recommendations for dietary protein are primarily based on intakes that maintain nitrogen (i.e., protein) balance rather than optimize metabolism and/or performance.

Purpose

This study aimed to determine how varying protein intakes, including a new tracer-derived safe intake, alter whole body protein metabolism and exercise performance during training.

Methods

Using a double-blind randomized crossover design, 10 male endurance-trained runners (age, 32 ± 8 yr; V˙O2peak, 65.9 ± 7.9 mL O2·kg−1·min−1) performed three trials consisting of 4 d of controlled training (20, 5, 10, and 20 km·d−1, respectively) while consuming diets providing 0.94 (LOW), 1.20 (MOD), and 1.83 (HIGH) g protein·kg−1·d−1. Whole body protein synthesis, breakdown, and net balance were determined by oral [15N]glycine on the first and last day of the 4-d controlled training period, whereas exercise performance was determined from maximum voluntary isometric contraction, 5-km time trial, and countermovement jump impulse (IMP) and peak force before and immediately after the 4-d intervention.

Results

Synthesis and breakdown were not affected by protein intake, whereas net balance showed a dose–response (HIGH > MOD > LOW, P < 0.05) with only HIGH being in positive balance (P < 0.05). There was a trend (P = 0.06) toward an interaction in 5-km Time Trial with HIGH having a moderate effect over LOW (effect size = 0.57) and small effect over MOD (effect size = 0.26). IMP decreased with time (P < 0.01) with no effect of protein (P = 0.56). There was no effect of protein intake (P ≥ 0.06) on maximum voluntary isometric contraction, IMP, or peak force performance.

Conclusion

Our data suggest that athletes who consume dietary protein toward the upper end of the current recommendations by the American College of Sports Medicine (1.2–2 g·kg−1) would better maintain protein metabolism and potentially exercise performance during training.
Dynamic Cerebral Autoregulation Is Maintained during High-Intensity Interval Exercise
Authors: TSUKAMOTO HAYATO , HASHIMOTO TAKESHI , OLESEN NIELS D. , PETERSEN LONNIE G. , SØRENSEN HENRIK , NIELSEN HENNING B. , SECHER NIELS H. , OGOH SHIGEHIKO
Published: October 2018

Introduction

High-intensity interval exercise (HIIE) is more effective at increasing metabolic and cardiovascular health compared with moderate-intensity continuous exercise for patients with cardiovascular disease, but exhaustive high-intensity continuous exercise attenuates dynamic cerebral autoregulation (CA). This study assessed the effect of HIIE on dynamic CA.

Methods

Nine healthy men (age, 24 ± 3 yr; mean ± SD) warmed up at 50%–60% maximal workload (W
max) for 5 min before HIIE including four 4-min bouts of exercise at 80%–90% W
max interspaced by four 3-min bouts at 50% to 60% W
max. Transcranial Doppler determined middle cerebral artery mean blood velocity (MCA V
mean), and brachial artery catheterization determined mean arterial pressure (MAP). Dynamic CA was evaluated by transfer function analysis of changes in MAP and MCA V
mean.

Results

The HIIE increased MAP (from 92 ± 9 to 104 ± 10 mm Hg; P < 0.0125), whereas MCA V
mean did not change. Transfer function phase increased and coherence decreased during HIIE (P < 0.0125 vs rest, respectively), whereas gain was unchanged.

Conclusions

The results suggest that dynamic CA is unaffected during HIIE, indicating that the brain is protected from fluctuations in MAP. Thus, we propose that HIIE may be beneficial for brain-related health as maintenance of cerebral perfusion in contrast to high-intensity continuous exercise.
Cardiorespiratory Fitness, Adiposity, and Heart Rate Variability: The Coronary Artery Risk Development in Young Adults Study
Authors: CHEN LIN Y. , ZMORA RACHEL , DUVAL SUE , CHOW LISA S. , LLOYD-JONES DONALD M. , SCHREINER PAMELA J.
Published: October 2018

Purpose

The importance of cardiorespiratory fitness versus adiposity in determining heart rate variability (HRV) is unclear.

Methods

From the Coronary Artery Risk Development in Young Adults study, an observational cohort study, we included 2316 participants (mean age = 45.2 ± 3.6 yr at year 20, 57% female, 43% Black) with HRV measured in 2005–2006 (year 20) and graded exercise test duration (GXTd) and adiposity measures (body mass index and waist circumference) obtained in 1985–1986 (baseline) and 2005–2006. HRV measures (SD of all normal RR intervals [SDNN] and square root of the mean value of the squares of differences between all successive RR intervals [RMSSD]) were obtained from resting 30-s 12-lead ECG. Cross-sectional associations between GXTd, adiposity, and HRV were assessed at year 20. Longitudinal changes in GXTd and adiposity measures were categorized as ≥10% increase, <10% change (no change), or ≥10% decrease. We used multivariable logistic regression to assess associations of GXTd and adiposity measures with unfavorable versus more favorable HRV (lower 25th percentile vs upper 75th percentile).

Results

A 1-SD increment in GXTd was associated with 22% and 32% lower odds of unfavorable SDNN and RMSSD, respectively; associations remained significant after adjustment for adiposity. A 1-SD increment in adiposity measures was associated with 16%–28% higher odds of unfavorable RMSSD; associations were not significant after adjustment for GXTd. Compared with no change/increase in GXTd, longitudinal decrease in GXTd was significantly associated with 55% and 94% higher odds of unfavorable SDNN and RMSSD, respectively, at year 20. These associations remained significant after adjusting for adiposity.

Conclusion

Cardiorespiratory fitness may be a stronger determinant of HRV than adiposity. Intervention studies are needed to better determine the differential effects of improved cardiorespiratory fitness versus weight loss on HRV.
Construction machinery
Authors: Доценко Анатолий , Dotsenko Anatoliy
Published: October 2018

The textbook describes the main types of construction machines used in industrial, civil and municipal construction. The purpose, design and description of the working processes of machines, their application, technical, economic and operational characteristics, as well as the basics of their operation. The main elements of the hydraulic drive and automatic control systems of construction machines are given. Recommended for students of construction specialties of universities; it can be useful for College students, students of courses and faculties of advanced training, as well as professionals working in construction
Therapist interventions and patient outcome: addressing the common versus specific factor debate
Authors: Antunes-Alves Sara , Vukovic Boris , Milyavskaya Marina , Kramer Ueli , Dobson Keith , Drapeau Martin
Published: October 2018

While innumerable studies have demonstrated the efficacy of CBT with patients with depression, the mechanisms responsible for depression reduction are not well understood. Aim. This study explored the relationship between therapists’ individual techniques and patients’ symptoms of depression, cognitive errors, and coping. Of particular interest was the relative importance of techniques specific to CBT and those common to all therapies. Method. CBT therapy sessions of 43 patients with major depressive disorder (MDD) were analyzed using observer-rated measures: the Comprehensive Psychotherapeutic Interventions Rating Scale (CPIRS; Trijsburg et al., 2002) for therapist interventions, and the Cognitive Errors Rating Scale (CERS; Drapeau, Perry, & Dunkley, 2008), and Coping Patterns Rating Scale (CPRS; Perry, Drapeau, & Dunkley, 2005) for patients’ cognitive errors and coping strategies. The Beck Depression Inventory (BDI; Beck, Rush, Shaw, & Emery, 1979) was used to assess symptoms of depression. Results. Results of hierarchical multiple regressions, controlling for pre-treatment depression scores and early cognitive errors and coping scores, showed the common factor intervention ‘rapport’ as the only intervention that significantly predicted improvement. Among CBT interventions, only the structuring intervention ‘scheduling and structuring activities’ emerged as a positive predictor of symptoms of depression. Discussion. These results provide further support for the importance of the therapeutic alliance in predicting depression outcome. While the lack of positive results on therapist CBT technique seem to cast doubt on their relative importance, it may also highlight the importance of measuring technique more contextually.
Therapeutic difficulties in management of the patient with anorexia nervosa and comorbid borderline personality disorder – case study
Authors: Kordyńska Katarzyna , Kostecka Barbara , Sala Paweł , Kucharska Katarzyna
Published: October 2018

Aim: This case report addresses some clinical challenges occurring throughout the therapeutic process of specialized management treatment of Anorexia Nervosa with comorbid Borderline Personality Disorder. Materials and method: Clinical examinations and measures – Structured Clinical Interview for DSM-IV (SCID-II), Eating Attitudes Test (EAT-26), Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS), Beck Depression Inventory-II (BDI-II), Toronto Alexithymia Scale (TAS-20), and State-Trait Anxiety Inventory (STAI) have been employed to identify the nature and severity of patient’s psychopathology and its potential change throughout the therapeutic process. Results: Despite some improvement in the symptoms of the eating disorder following the treatment, some other measures of psychopathology (e.g., depression) remained at similar level. Conclusions: Only partial improvement in the profile of F.C.’s psychopathology was observed. Discussion: Management of AN with comorbid BPD requires a comprehensive care package including integrative psychotherapy, nutritional interventions and pharmacotherapy at an inpatient setting as well as follow-up care thereafter.
THE INFLUENCE OF CO2+ CONCENTRATION ON THE PROPERTIES OF THE ELECTRODEPOSITED ZINC–COBALT ALLOY COATINGS
Authors: Diafi Malika , Louiza Tahraoui , Digheche Kelthoum , Khamouli Farida
Published: October 2018

The effects the concentration of cobalt on zinc-cobalt alloys obtained from sulphate baths under continuous current deposition are described. The deposit morphology was analyzed using Scanning Electron Microscopy (SEM) and an X-Ray Diffraction (XRD) was used to determine the preferred crystallographic orientations of the deposits. Protection against corrosion properties studied in a solution of 3 % wt NaCl in the potentiodynamic polarization measurements (Tafel), electrochemical impedance spectroscopy (EIS) to the potential of corrosion free. The parameters that characterize the corrosion behavior can be determined from the plots and Nyquist plots. It has been observed that the Zn–Co alloy is characterized by enhanced the resistance of corrosion compared to the Zn alloys and the addition of Co in the Zn-Co increases the micro-hardness, XRD and SEM results an identify any coatings Zn-Co alloy composition reveals that. zinc - rich ( η- phase) , cubic Co5Zn21 .
MORPHOLOGICAL, STRUCTURAL, MICROHARDNESS AND ELECTROCHEMICAL CHARACTERIZATIONS OF ELECTRODEPOSITED Cr AND Ni–W COATINGS
Authors: Aidaoui Elkhanssa , Temam Hachemi Ben , Belahssen Okba , Temam El Hachmi Guettaf
Published: October 2018

Currently, Ni-Cr coatings are widely used in a number of important applications due to their excellent properties. In this study, Ni-Cr alloys were electrodeposited from citrate bath onto Cu substrates by using different values of applied current densities. The effects of plating deposition current density on morphological and structural characterization of Ni-Cr electrodeposited coatings were investigated by means of scanning electron microscopy (SEM) and X-ray diffraction (XRD). Microhardness of the coatings is also evaluated using Vickers’s microhardness. Potentio-dynamic polarization and electrochemical impedance spectroscopy (EIS) tests in 3.5 wt % NaCl solution were used to evaluate corrosion résistance of Ni-Cr coatings. The results showed that the surface morphology of the all coatings contained micro cracks and pores. XRD patterns indicate the formation of Ni-Cr and Cr3Ni2 phases. Microhardness measurements show that all Ni-Cr samples are harder than copper substrate. Electrochemical tests show that 3 A.dm-² is an optimal value of applied current density in the sense of the least value of Ecorr = -12.3 mV and the best charge transfer resistance Rp = 303.03 Ω.cm².