bluuebunny/crossref_metadata_2025 huggingface dataset:
Following in parental footsteps? The influence of gender and learning experiences on entrepreneurial intentions
Authors: Bloemen-Bekx Mira , Voordeckers Wim , Remery Chantal , Schippers Joop
Published: April 2019

This study focusses on the influence of the family context on the development of entrepreneurial intention (EI) among young adults with entrepreneurial parents. It extends the EI literature by drawing on social cognitive career theory to study the interaction between entrepreneurial parents and their children. We introduce the learning experiences ‘vicarious learning’ and ‘social persuasion’ as antecedents of EI and found significant empirical support for the influence of social persuasion. In addition, we study the relationship between gender and EI. Our results not only confirm the direct effect of gender on EI but also reveal a significant mediating effect of parental preference – one of the social persuasion factors studied – on the gender–EI relationship.
Drug use beyond the licence in palliative care: A systematic review and narrative synthesis
Authors: Hagemann Vera , Bausewein Claudia , Remi Constanze
Published: April 2019

Background:

Drug use beyond the licence (off-label use, off-label drug use) is a common practice in palliative care and respective recommendations can often be identified in the literature. It is both risky and offers opportunities at the same time and, therefore, requires special attention in clinical practice.

Aim:

To determine the prevalence of off-label drug use in palliative care and to identify, evaluate and critically appraise studies describing the clinical practice, healthcare professionals’ awareness, knowledge and attitudes towards off-label-use and management strategies.

Design:

Systematic literature review following the guidance of the Centre for Reviews and Dissemination.

Data sources:

Medline, Embase, Web of Science and Current Contents Connect were searched in July 2018 as well as hand searches. The reference lists of pertinent studies were screened for further relevant publications, and citation tracking was performed.

Results:

Eight studies met the inclusion criteria. Due to the variety in study designs and settings, no meta-analysis or meaningful statistical analysis was possible and a narrative synthesis of the data was performed. Frequency of off-label drug use ranged from 14.5% to 35%. Up to 97% of palliative care units did not have any policy or guidance on handling off-label drug use. About 20% of prescribers never obtain consent in the context of off-label use.

Conclusion:

Off-label use is common in palliative care with up to one-third of prescriptions affected. Challenges are often related to obtaining informed consent. Little is known about the decision-making process. More information and guidance for the prescribers are needed to enable safe handling of drugs outside their licence in palliative care.
Learning to calibrate: Reinforcement learning for guided calibration of visual–inertial rigs
Authors: Nobre Fernando , Heckman Christoffer
Published: April 2019

We present a new approach to assisted intrinsic and extrinsic calibration with an observability-aware visual–inertial calibration system that guides the user through the calibration procedure by suggesting easy-to-perform motions that render the calibration parameters observable. This is done by identifying which subset of the parameter space is rendered observable with a rank-revealing decomposition of the Fisher information matrix, modeling calibration as a Markov decision process and using reinforcement learning to establish which discrete sequence of motions optimizes for the regression of the desired parameters. The goal is to address the assumption common to most calibration solutions: that sufficiently informative motions are provided by the operator. We do not make use of a process model and instead leverage an experience-based approach that is broadly applicable to any platform in the context of simultaneous localization and mapping. This is a step in the direction of long-term autonomy and “power-on-and-go” robotic systems, making repeatable and reliable calibration accessible to the non-expert operator.
Discrimination and Intimate Partner Violence Victimization and Perpetration Among a Convenience Sample of LGBT Individuals in Latin America
Authors: Swan Laura E. T. , Henry Richard S. , Smith Erin R. , Aguayo Arelis Adriana , Rabago Barajas Brenda Viridiana , Perrin Paul B.
Published: April 2019

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience intimate partner violence (IPV) at high rates, even bidirectionally, yet no studies to date have investigated IPV among LGBT individuals in Latin America. Thus, this study explored discrimination and IPV victimization and perpetration among LGBT individuals in Latin America. Participants ( N = 99) were recruited for this online, cross-sectional survey via convenience sampling and completed measures of LGBT discrimination and lifetime IPV victimization and perpetration. Results indicated that 60.61% of the sample reported at least one form of IPV victimization at some point in their life, and 56.57% reported at least one form of perpetration. Psychological aggression was the most common type of IPV victimization and perpetration. Physical assault victimization was positively correlated with work/school heterosexism. Perpetration and victimization of physical assault, psychological aggression, and sexual coercion were correlated with the “other” heterosexism subscale. Cluster analysis revealed a three-cluster solution: participants in Cluster 1 were high in IPV victimization and perpetration; Cluster 2 participants were low in IPV victimization and perpetration; and Cluster 3 participants were moderate on psychological aggression perpetration and victimization, but low on the other three forms of IPV. Cluster 1 participants had a higher score for the “other” heterosexism subscale than Cluster 2. This study highlights the need to address certain aspects of IPV, such as bidirectionality, in clinical encounters such as safety planning. Future research should examine the role of Latinx identity in LGBT individuals’ experiences of discrimination and IPV.
Climate Change in Common Core Policy Context: The Shifting Role of Attitudes and Beliefs
Authors: Liou Yi-Hwa , Bjorklund Peter , Daly Alan J.
Published: April 2019

The success of implementing Common Core State Standards (CCSS) depends not only on the extent to which educators deeply understand the new standards but also on the expectations, values, and resources that support their readiness for making necessary instructional change. Educators’ understanding of and beliefs about CCSS may largely drive their behaviors and action toward implementation. This study investigated a longitudinal dataset of teachers and principals in one large school district serving a diverse student population in California, examining the relationship between educators’ beliefs and trust and the organizational climate. Findings suggest that both teachers’ trust in the principal and an innovative climate play a consistent, critical role in educators’ beliefs about implementing CCSS.
Examining the interaction between university knowledge and firms’ innovation objectives
Authors: Nishikawa Kohei , Kanama Daisuke
Published: April 2019

To deal with uncertainties, firms have adopted a ‘parallel path’ strategy in which they apply research and development outcomes to a variety of objectives in innovation activities. Considering another factor of successful innovation, searching for ideas from wider technological domains can increase the probability of success. However, the number of possible combinations of a wider variety of knowledge sources and a greater number of objectives within innovation activity expands dramatically. This article focuses on the interaction between the utilization of university knowledge and objective diversification and analyses the relationship between that interaction and the technological outcome. The results show that the effect of interaction between the utilization of university-generated knowledge in innovation activities and the diversification of objectives has an inverse U-shaped relationship in product innovation, and the utilization of university knowledge leads to a better outcome when the firm has a moderate number of objectives, rather than few or many.
Characterization of mechanical behavior in repaired FC300 using directly deposited AISI-P21 and AISI-H13 metal powders
Authors: Yu Jae-Hyun , Lee Ki Yong , Shim Do-Sik , Park Sang-Hu
Published: April 2019

Remanufacturing is a promising technique for reducing manufacturing costs and material usage. This work presents a method for repairing casting parts using an additive metal-layer deposition process. To determine characteristics and mechanical properties of parts repaired using the proposed additive metal-layer-deposition-based method, tensile specimens were designed with grooves measuring 1 mm and 3 mm in depth. Two specific metal powders, AISI-P21 (SCM440) and AISI-H13 (SKD61), were melted using a highly focused laser, and molten droplets were subsequently built up layer-by-layer to fill-in the grooves. Mechanical and metallurgical characteristics of repaired parts were investigated via tensile and hardness tests and microstructural analyses. Experimental results demonstrate that the ultimate strength of specimens repaired using the proposed additive metal-layer deposition method measured approximately 9% lower compared with that of FC300. However, the mechanical strength of additive metal-layer deposition specimen was increased about 22% compared with that of welded specimen. Through this work, we can make a conclusion that the additive metal-layer deposition technique is well-suited for the repair and reproduction of castings.
Stochastic resonance as the averaged response to random broadband excitation and its possible applications
Authors: Blekhman I , Kremer E
Published: April 2019

Within the framework of vibrational mechanics, a stochastic analog of the Stephenson–Kapitza pendulum with random two-dimensional oscillations of the suspension point was considered and the dynamic properties of its averaged motion were studied. It is shown that, unlike the ordinary Stephenson–Kapitsa pendulum with deterministic vertical oscillations of the suspension point, both an increase and a decrease in the effective natural frequency are possible under the influence of high-frequency stochastic oscillations. A formula is derived for the amplitude of low-frequency oscillations as a function of the intensity of high-frequency stochastic oscillations and the possibility of a stochastic resonance in this system is shown. The dependence of the stochastic resonance on the mass and the damping coefficient is analyzed. It is shown that the points of the stochastic resonance lie in the plane of parameters “intensity of stochastic excitation” and “amplitude of low-frequency oscillation” on a universal curve that is independent of the mass of the pendulum. Peculiar self-oscillations in a system for which stochastic oscillations are produced by a technological load and, therefore, depend monotonically on the amplitude of low-frequency oscillations are discussed. A schematic diagram of these phenomena is proposed. The motion of the machine is described by the same equations as the stochastic analog of the Stephenson–Kapitza pendulum with random two-dimensional oscillations of the suspension point. A strategy of control for such a vibro-machine is proposed with the aim of maintaining it at resonance and providing an energetically efficient mode of operation.
Antibodies against Gangliosides in Patients with SLE and Neurological Manifestations
Authors: Martinez X. , Tintore M. , Montalban J. , Ordi J. , Vilardell M. , Codina A.
Published: April 2019

Pathogenesis of neuropsychiatric manifestations of systemic lupus erythematosus (SLE) has not been clearly defined, and the search for pathogenic mechanisms has focused on the importance of several autoantibodies. There is increasing evidence that antibodies against gangliosides may have a pathogenic role in some neurological disorders. The aim of the present study was to examine the association between antibodies against gangliosides and neuropsychiatric SLE. We found anti-type II ganglioside antibodies in two out of 32 patients with multiple sclerosis (6.25%) and in 10 out of 60 patients with SLE (16.6%); five of 17 patients with neurological abnormalities also had high levels of these antibodies (29.4%). Five of the 10 patients with SLE and positive antiganglioside antibody assays had only IgM antibodies, three had IgG antibodies and two had both isotypes. By chi-square analysis, the incidence of anti-type II ganglioside antibodies was not significantly higher in patients with symptoms related to the nervous system than in SLE patients without neurological involvement (P > 0.2). No clear correlation was found between antibodies against gangliosides and cardiolipin.
Vitamin E and Discoid Lupus Erythematosus
Authors: Yell Jennifer Anne , Burge Susan , Wojnarowska Fenella
Published: April 2019

We treated seven patients with discoid lupus erythematosus (DLE) with Vitamin E in an oral dose of 400 mg three times per day for 12 weeks. All other systemic and topical treatments were discontinued 1 month before initiation of the trial. The drug was then stopped and follow-up continued for at least another 4 weeks. No patient showed clearing of lesions. The trial was conducted during summer, when DLE is likely to be most active. There was no deterioration in any patient. No side effects were noted.
Standardized Ultraviolet-A Exposure Provokes Skin Reaction in Systemic Lupus Erythematosus
Authors: Nived Ola , Johansen Per B. , Sturfelt Gunnar
Published: April 2019

The immediate, 1 day and 14 days skin reaction was determined in 23 female SLE patients and 23 age-matched controls after standardized exposure to ultraviolet light of the UV-A wavelengths (320-440 nm). Eighteen of the patients and 12 of the controls were photosensitive by history. Eight separate sites on the buttocks were exposed to UV-A light, four sites at doses between 42 and 252 kJ/m2 and four sites with longpass filters (320, 345, 360 and 375 nm). The reactions on test sites were graded by two independent observers unaware of given doses or filter location. All patients and controls reacted with immediate erythema irrespectively of the presence or absence of photosensitivity. After 1 day, 39% of controls and 78% of patients had erythema and the reactions were more pronounced to longwave UV-A light (>320 nm) in the patients (P < 0.001). After 14 days, six patients, but no control, had persistent erythema (P = 0.04). Interestingly, three of the four patients without anamnestic photosensitivity did not react on days 1 or 14, while the pattern seen in the controls on day 1 was totally unpredictable with regard to reported photosensitivity. These findings strongly suggest that a considerable proportion of SLE patients show pathological skin reactions to physiological doses of longwave UV-A and not only the far more studied shortwave UV-B (290-320 nm). The responsible chromatophore for the UV-A reaction is not known.
The use of antimalarials in combination with other disease modifying agents in RA – the British experience
Authors: Duncan MR , Capell HA
Published: April 2019

Antimalarial drugs are effective disease modifying agents in RA with a low incidence of serious toxic effects. Recently, combinations of second-line agents have been used in RA in attempts to treat patients with no response to a number of single agents, or suboptimal response to a single agent.

Combinations of drugs have been selected for maximum efficacy and minimum toxicity, but clinical trials are difficult to design and interpret. In particular, ensuring adequate power to detect small differences in response poses a major problem. Antimalarials are an attractive choice for combination therapy due to their efficacy, mechanisms of action and toxicity profile.

In this review, the evidence for the use of antimalarials in combination in RA is examined. No advantage has been shown in combining antimalarials with gold, penicillamine or sulphasalazine compared with monotherapeutic regimens. There is some evidence to suggest a beneficial combination of antimalarials with methotrexate, but this is as yet inconclusive. Open non-randomised uncontrolled studies have shown that antimalarials combined with cytotoxic agents are effective but highly toxic.

The authors conclude that there is little good evidence to support the introduction of combination second-line drug therapy for RA into widespread therapeutic use.
The use of chloroquine and hydroxychloroquine for non-infectious conditions other than rheumatoid arthritis or lupus: a critical review
Authors: Wallace DJ
Published: April 2019

Chloroquine and hydrocychloroquine have been evaluated in 30 noninfectious disorders and conditions other than rheumatoid arthritis or lupus erythematosus; 12 of these have been subjected to well-designed controlled trials. It is concluded that chloroquines are safe and effective first line therapies for selected patients with porphyria cutanea tarda, cutaneous sarcoidosis, cutaneous manifestations of dermatomyositis, hyperlipidemias and thromboembolic prophylaxis for patients with antiphospholipid antibodies. Published experience with these and other diseases or syndromes are critically reviewed.
Ophthalmologic considerations in using antimalarials in the United States
Authors: Rynes Richard I
Published: April 2019

Ophthalmologic considerations continue to be important in the use of antimalarials. In the United States, hydroxychloroquine is prescribed much more frequently than chloroquine. Despite the favorable safety record, potential retinal problems cause patients to often be afraid to take antimalarial medicine. Ophthalmologic visits are recommended every three months by the drug manufacturer, but most often are scheduled every six months by physicians. Ophthalmologic examination includes questioning about visual symptoms, visual acuity tests, careful fundoscopic evaluation and a visual field assessment. Amsler grid self evaluation is not yet wide-spread.
Effects of dry needling in the sternocleidomastoid muscle on cervical motor control in patients with neck pain: a randomised clinical trial
Authors: Martín-Rodríguez Aida , Sáez-Olmo Esther , Pecos-Martín Daniel , Calvo-Lobo César
Published: April 2019

Objective:

To determine the changes produced by trigger point dry needling (TrP-DN) of sternocleidomastoid in patients with neck pain, and to observe how it might modify cervical motor control (CMC).

Design:

Single-centre, randomised, double-blinded clinical trial.

Setting:

Participants were recruited through advertising. The duration of the study was 6 months.

Subjects:

Thirty-four subjects with non-specific neck pain, aged over 18 years with an active myofascial trigger point in sternocleidomastoid, participated in the study. They were randomly assigned to treatment or control groups.

Methods:

TrP-DN inside or (1.5 cm) outside of the active myofascial trigger point of sternocleidomastoid.

Main outcome measures:

CMC, visual analogue scale and cervical range of motion were assessed before treatment, immediately post treatment, and 24 h, 1 week and 1 month after the intervention; the neck disability index was evaluated before treatment and 1 month later.

Results:

With a confidence interval of 99%, TrP-DN of sternocleidomastoid was associated with a decrease in pain after 1 week and CMC improved 1 month after the intervention (p < 0.001), when compared with baseline measurements, within the experimental group; there were no statistically significant differences between experimental and control groups.

Conclusion:

The effects of TrP-DN inside and outside of active myofascial trigger points did not differ in this study. Both interventions were associated with a similar temporal effect, specifically a reduction in neck pain at 1 week and an increase CMC at 1 month. However, these findings should be interpreted with caution due to the lack of a contemporaneous untreated control group.
Vibration control with the converse flexoelectric effect on the laminated beams
Authors: Fan Mu , Tzou Hornsen
Published: April 2019

Flexoelectric material under inhomogeneous electric field can be used as control and actuation systems in engineering applications based on the converse flexoelectric effect. The electric field gradient can be generated by using the atomic force microscope probe placed on the top of flexoelectric layer and coupled with a bottom electrode surface. The induced membrane force and the corresponding control moment in turn influence the dynamic response of the beam. The response of a laminated cantilever beam with initial vibration caused by an external loading is studied. The beam was modelled as a laminated beam to explore the influence of flexoelectric layer stiffness on the dynamic response of the structure. When the flexoelectric layer has higher Young’s modulus and mass density than the elastic layer, with increasing the thickness of the flexoelectric layer, the tip displacement of the laminated beam decreased rapidly. Through case studies, the optimal control positions for each mode of vibration were found to be dependent on the flexoelectric layer properties as well. A displacement-based feedback control was introduced to avoid overactuation caused by open-loop control.
Psychologists’ Perspectives on the implementation of Psychological Therapy for Psychosis in the Acute Psychiatric Inpatient Setting
Authors: Wood Lisa , Williams Claire , Billings Jo , Johnson Sonia
Published: April 2019

Psychological therapies should be delivered in psychiatric inpatient settings to people experiencing psychosis. However, inpatient populations present with complex needs and usually are admitted only briefly. This makes the delivery of psychological therapies for people experiencing psychosis particularly challenging. Our aim was to explore the adaptations required to deliver psychological therapies to this population from the perspective of inpatient psychological practitioners. Twelve participants were recruited, and a qualitative semistructured interview schedule was administered examining their perspectives on important factors required to deliver psychological interventions in this context. Data were analyzed using thematic analysis. Three superordinate themes were identified: “crisis-focused psychological approaches,” “working with and supporting the wider system,” and “environmental adaptations.” Traditional psychological therapies are a challenge to deliver in inpatient environments due to complex needs, essentiality of team working, and brief admission. Several adaptations are required to ensure psychological therapy is effective in this setting.
Understanding Cultural Differences in Consumers’ Reactions to Foreign-Market Brand Extensions: The Role of Thinking Styles
Authors: Allman Helena F. , Hewett Kelly , Kaur Mandeep
Published: April 2019

One popular strategy for brands to grow outside of their home markets is to use line extensions. Although extensive research has examined how factors such as culture influence product acceptance across markets, far less is known regarding how such factors influence parent brand perceptions in response to an extension. This article investigates the role of one aspect of culture, consumers’ thinking styles, in terms of postextension parent brand spillover effects, and considers potential implications for firms’ global brand strategies, including the extension’s direction (upward or downward) and parent brand concept (functional or prestige). Through two studies, one using consumer panels in the United States and India and the other set in the United States, the authors examine consumer-level differences by measuring thinking styles. Results based on both studies indicate that vertical line extension type affects analytic thinkers’ reactions more than those of holistic thinkers, and parent brand image benefits (suffers) when a vertical line extension is for a functional (prestige) brand, regardless of consumers’ thinking style. The authors find interesting differences in the role of thinking styles based on the particular dimension examined.
Feasibility, Implementation and Outcomes of Tablet-Based Two-Step Screening for Adult ADHD in Primary Care Practice
Authors: Loskutova Natalia Y. , Callen Elisabeth , Pinckney Richard G. , Staton Elizabeth W. , Pace Wilson D.
Published: April 2019

Background: Primary care clinicians need to recognize and diagnose Adult ADHD (AADHD). We tested the feasibility and outcomes of a two-step screening process for AADHD in primary care. Methods: Seven practices screened patients using computerized surveys. Patients screening positive completed the AADHD Quality of Life (AAQoL). We explored the impact of screening on workflow and the acceptability to patients, and identified key barriers/opportunities to continuing screening. Results: Of the 711 participating adults, 188 (26.4%) screened positive, of which 32 (17.0%) had scores at least one standard deviation below means on two or more domains on the AAQoL (average 23.6 ± 7.3). These 32 individuals represented 4.5% of all participants. Clinicians were willing to screen, diagnose, and treat AADHD, but need additional resources. The screening process and technology was acceptable to patients and staff. Conclusions: A two-step screening method shows promise for routine screening for AADHD.
“Placing” Space: Exploring the Sociospatial Impacts of Cosmopolitan Place-Marketing Approaches on British Migrants in Spain
Authors: Dixon Laura
Published: April 2019

This article explores the sociospatial underpinnings of cosmopolitan place-marketing narratives and their impacts on British migrants living in Sitges, an affluent tourist town in Spain. Sitges’ place-marketing suggests that moving there automatically fosters a cosmopolitan identity. For British migrants in Sitges, this was understood to be exemplified through integration into the local community. Yet the vast majority found such integration impossible, not least because this conceptualization of cosmopolitanism overlooked the subjectivity of locals themselves, by whom they were most often rejected. It is argued that this mismatch between British migrants’ experiences and Sitges’ cosmopolitan place-marketing occurs because it relies on an understanding of subjective identity as generated locationally, enacted via movement to a specific “type” of place that incorporates particular understandings of space, place, and culture in relation to that identity. This overrides the necessity of relationality, undermining the ideal of reflexive identity-making on which cosmopolitan place-marketing narratives rely.
Artistic memory and Roma women’s history through an intersectional lens: The Giuvlipen Theater
Authors: Asavei Maria Alina
Published: April 2019

This article addresses cultural (artistic) memory’s ability to address past and present injustices by focusing on the artistic-political practices displayed by the professional actresses of Roma descent from the independent theater the Giuvlipen in Bucharest (Romania). The founders of this Romani women-centered theater also have ‘invented’ the word ‘Giuvlipen’ – ‘feminism’ in the Romani language – because there had previously been no word to connote both the forms of oppression and the consciousness raising politics performed by Romani women. By applying the lens of intersectional feminism, the argument this article aims to put forth is that Giuvlipen’s artistic performances can foster the awareness raising of the Romani women’s ‘double jeopardy’ (as women and as members of a discriminated ethnic minority). At the same time, the artistic performances displayed by the Giuvlipen Theater challenge the habits of historical remembering and its politics of oblivion, which can in turn promote experiential forms of knowledge and new structures and archives of feelings.
Postfeminism, popular feminism and neoliberal feminism? Sarah Banet-Weiser, Rosalind Gill and Catherine Rottenberg in conversation
Authors: Banet-Weiser Sarah , Gill Rosalind , Rottenberg Catherine
Published: April 2019

In this unconventional article, Sarah Banet-Weiser, Rosalind Gill and Catherine Rottenberg conduct a three-way ‘conversation’ in which they all take turns outlining how they understand the relationship among postfeminism, popular feminism and neoliberal feminism. It begins with a short introduction, and then Ros, Sarah and Catherine each define the term they have become associated with. This is followed by another round in which they discuss the overlaps, similarities and disjunctures among the terms, and the article ends with how each one understands the current mediated feminist landscape.
The process of tip wetting at the spray injection end
Authors: Hélie Jérôme , Lamarque Nicolas , Fremaux Jean-Luc , Serrecchia Philippe , Khosravi Maziar , Berkemeier Oliver
Published: April 2019

Gasoline direct injection engines mainly use multi-hole high-pressure injectors. To respect the current pollutant regulation (particle number and particle mass) and continue to decrease pollutant emissions in the future, it is of outmost importance to identify the various sources of carbon particles. In gasoline direct injection, tip wetting can generate a progressive tip sooting that can be a source of large number of particles especially in hot engine conditions. The different topics related to the tip wetting are investigated here without counterbore after the metering hole in order to have a direct access to the optical visualization. In this article, the different phases of the tip wetting are identified experimentally and phenomenological models are proposed.
Attending to the Alliance in the Application of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders: A Case Study
Authors: Donahue Joseph M. , Hormes Julia M. , Gordis Elana B. , Anderson Drew A.
Published: April 2019

As conceptualizations of mood and anxiety disorders shift toward a dimensional approach, transdiagnostic treatments have gained recognition and support. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is an evidence-based cognitive behavioral therapy that targets the core processes that underlie common and comorbid mental disorders. It is designed to help clients learn how to confront, experience, and respond to their emotions in adaptive ways through the modification of their emotion regulation strategies. The current case study describes the flexible application of the UP with a treatment-naïve 25-year-old female who presented to outpatient therapy with symptoms of anxiety and depression. Additions to the UP were made to address issues related to the therapeutic alliance and information discovered over the course of treatment. Outcome measures administered to the client reflect significant symptom improvement and add to a growing body of literature that supports the usefulness of transdiagnostic approaches to treating a range of disorders. Moreover, quantitative and qualitative data point to the necessity for clinicians to attend to the therapeutic alliance and consider cultural factors when delivering manualized treatment approaches to individuals from diverse backgrounds.
Inside the Scrambler Therapy, a Noninvasive Treatment of Chronic Neuropathic and Cancer Pain: From the Gate Control Theory to the Active Principle of Information
Authors: Marineo Giuseppe
Published: April 2019

Scrambler therapy (ST) is an electro-analgesia therapy for the noninvasive treatment of chronic neuropathic and cancer pain based on a new generation of medical device that uses 5 artificial neurons and is based on a novel theoretical model the differs from gate control theory. The active principle with Scrambler Therapy is such that synthetic “non-pain” information is transmitted by C fiber surface receptors. This is a different theoretical mechanism than the traditional electric stimulation of A-Beta fibers to produce paresthesia and/or block the conduction of nerve fibers to produce an analgesic effect, that is, via TENS (transcutaneous electrical nerve stimulation) machines. Scrambler therapy was developed to treat chronic neuropathic pain and cancer pain resistant to opioids and other types of treatments. The goal of Scrambler Therapy is to eliminate pain during treatment and allow for long-lasting analgesia after a series of 10 to 12 consecutive treatments performed over a 2-week period. The aim of this review is to clarify the underlying theory of Scrambler Therapy and describe the appropriate usage method that maximizes its effectiveness while reducing bias and deepen the explanation of the artificial neuron technology associated with Scrambler Therapy.
Silas Weir Mitchell, MD, LLD, FRC: Neurological Evaluation and Rehabilitation of the Injured Upper Extremity
Authors: Klifto Kevin M. , Dellon A. Lee
Published: April 2019

Appreciating the history of Hand Surgery is part of what most of us enjoy about our profession. Most of us know that Silas Weir Mitchell, MD, coined the terms “Causalgia” and “Phantom Limb,” yet few of us know that our present-day evaluation of the sensory and motor function of the hand and some of our rehabilitation methods for motor palsy were introduced by Mitchell as he worked, scholarly, in Turner’s Lane Hospital, the first hospital devoted to nerve injuries, to understand Civil War gunshot wounds related to musket ball. Mitchell’s contributions to neurosensory and motor evaluation were reviewed by reading his historical publications. Mitchell’s described cervical sympathetic injury Horner’s Syndrome), sensory recovery preceding motor recovery after proximal nerve injury, that more sensory information can be perceived by applying greater pressure, importance of passive joint movement to prevent contracture, value of electrical stimulation after motor palsy, value of rest to facilitate healing, ability of 1- and 2-point sensory testing to evaluate sensibility, value of testing temperature to understand neuropathology, importance of experimental peripheral nerve surgery to clinical care, recorded muscle strength by manual evaluation, staged degree of nerve injury, described Saturday night and crutch palsy, and first described Hoffmann-Tinel sign. Mitchell made signifiant and seminal observations, that have largely gone unrecognized and that we use today in care of the injured upper extremity.
The Complex Interplay Between Weight, Chronic Pain, and Mood: How Team-Based Care and Personalized Approaches Can Improve Function and Quality of Life
Authors: Geyer Cindy
Published: April 2019

Patients presenting with a desire to lose weight often have underlying factors that complicate recommendations regarding diet and exercise. In this woman’s story, a significant physical injury resulted in chronic pain and a loss in her ability to participate in activities she had previously enjoyed and which played a role in her self-identity. While her previous history of a mood disorder may have increased her risk of developing chronic pain, the impact her injury had on her sense of self was also a likely factor. A multidisciplinary approach that addressed her sense of loss; incorporated innovative adaptations that enabled her to exercise outdoors and led to a renewed sense of hope; helped her find creative outlets and increase her sense of self efficacy; and improve the quality of sleep was instrumental in supporting her ability to incorporate dietary change, lose weight, and improve her mood and well-being. The biopsychosocial model of pain provides a framework of understanding for the complex interplay between mood, pain, and social support, which in turn can impact weight and ability to incorporate lifestyle change. Addressing these underlying factors is a critical part of whole person health.
Study on mechanical properties and strength relation between cube and cylinder specimens of steel fiber reinforced concrete
Authors: Zhu Haitang , Li Chuanchuan , Gao Danying , Yang Lin , Cheng Shengzhao
Published: April 2019

An experimental study was performed on the splitting tensile strength of steel fiber reinforced concrete using cube and cylinder specimens. Effects of volume fraction, aspect ratio, geometry, and tensile strength of steel fiber on the splitting tensile strength of steel fiber reinforced concrete with different water-to-binder ratio were investigated systematically. The test results showed that the splitting tensile strength of steel fiber reinforced concrete increases with volume fraction and aspect ratio of steel fiber. And it can be improved more obviously by hooked-end steel fiber compared with wave-shaped and corrugated steel fibers. Steel fibers with higher tensile strength (>600 MPa) are recommended for steel fiber reinforced concrete with compressive strength larger than 70 MPa. A factor used to convert cubic strength to cylindrical strength for steel fiber reinforced concrete was obtained, which is 0.738 for compressive strength and 0.96 for splitting tensile strength. In addition, a calculation method for predicting the splitting tensile strength of hooked-end steel fiber reinforced concrete including impact coefficient of steel fiber was developed based on the test results, which shows reasonable predictions for all test data.
A novel single-gimbal control moment gyroscope driven by an ultrasonic motor
Authors: Pan Song , Xu Zhangfan , Zhao Chunsheng
Published: April 2019

This article presents a structure-compacted single-gimbal control moment gyroscope, which is directly driven by an ultrasonic motor. The momentum wheel and the ultrasonic motor are designed and optimized based on software simulation. Considering the gyroscope’s dynamic disturbance and the nonlinearities of the ultrasonic motor, an expert control algorithm combining a two-degree-of-freedom pole placement controller with a pattern reasoning controller is designed for the gimbal servo system. The presented controller realizes a wide-range closed-loop speed control of the gimbal from 0.2 mrad/s to 1.6 rad/s, which is the base of the high stability and high precision of the control moment gyroscope. The presented control moment gyroscope and its controller board are manufactured and assembled for experiments. The experimental results show that the momentum wheel has almost no impact on the gimbal servo system at high speeds, but with the decrease in the gimbal speed the impact increases gradually.
Brake Response Time Recovery After Achilles Tendon Repair
Authors: Reb Christopher W. , McDonald Elizabeth , Shakked Rachel J. , Winters Brian S. , Pedowitz David I. , Raikin Steven M. , Daniel Joseph N.
Published: April 2019

Background. This study evaluated when patients’ brake response time (BRT) recovers after right Achilles repair. Methods. Institutional review board–approved prospective study of 60 patients. Assessments included visual analogue scale pain (VAS) score, Achilles Tendon Total Rupture Score (ATRS), and a driver readiness survey. Emergent brake pedal operation was simulated at 6 weeks postoperatively and repeated until patients achieved a passing BRT. Results. Fifty-seven patients completed the study. At 6 weeks, 54 of 59 (91.5%) patients had a passing BRT with a mean of 0.60 seconds (SD 0.08 seconds). Five (8.5%) patients had a failing BRT with a significantly higher mean of 0.95 seconds (SD 0.13 seconds, P = .01). At first testing, all patients were ambulating in a walking boot with removable heel wedges. Those who passed were using significantly fewer wedges (mean 1.9 vs 2.6 wedges, P = .04). Mean VAS pain scores (Passed: 1.1, SD 1.57, vs Failed: 2.8, SD 3.35, P = .32) were not significantly different. The mean ATRS was significantly lower among those who passed (63.7, SD 16.7, vs 85.4, SD 11.1, P = .01. Three patients repeated testing at a mean 7.3 weeks (range 6.7-8). All achieved passing times (mean 0.68 seconds, range 0.55 to 0.77 seconds). The driving readiness survey was 100% sensitive but 31.3% specific for passing BRT. Its positive predictive value was 80%, and its negative predictive value was 100%. Conclusion. BRT normalizes around 6 to 7 weeks after open right Achilles tendon repair. The ATRS and driver readiness questionnaire corresponded to achieving a passing BRT.

Levels of Evidence: Prognostic Level II: Prospective Cohort Study
Young people’s sense of fairness and social action: A survey analysis of Taiwan, Hong Kong, and Macao
Authors: Zheng Victor , Hsiao Hsin-Huang Michael , Wan Po-san , Wong Kevin
Published: April 2019

Based on a comparative survey conducted in 2016, this article explores the social actions of young people in Taiwan, Hong Kong, and Macao from the perspective of social injustice and social frustration as advanced by Gurr (2011). Applying a two-dimensional model of perceptions of social and individual fairness, it is found that young people in Taiwan and Hong Kong have higher levels of frustration and show greater tolerance and acceptance towards radical confrontational approaches than those in Macao. Furthermore, in Hong Kong, young people with a higher level of both social and individual unfairness display more interest in local politics, are more likely to take part in social movements, and are more inclined to agree to a radical confrontational approach.
A Very Rare Case of Coronary Artery Bypass Grafting in a Progeria Child
Authors: Cerejo Rui Pedro Soares , Rodrigues Rui A. N. , Martins José D. , Torres Carolina G. E. C. , Sousa Lídia M. , Pinto Fátima F. , Fragata José I. G.
Published: April 2019

Hutchinson-Gilford progeria syndrome is a rare genetic disorder, characterized by progressive premature aging and early death in the first or second decade of life, usually secondary to cardiovascular events (myocardial infarction and stroke). We report a case of a 14-year-old boy with progeria syndrome and cardiac arrest due to myocardial infarction, who was submitted to an immediate coronary angiography which revealed left main stem and three-vessel coronary artery disease. A prompt double bypass coronary artery grafting surgery was performed, and, despite successful coronary reperfusion, the patient remained in coma and brain death was declared on fourth day after surgery.
Application of Manual Therapy for Dysphagia in Head and Neck Cancer Patients: A Preliminary National Survey of Treatment Trends and Adverse Events
Authors: Krisciunas Gintas P , Vakharia Aneri , Lazarus Cathy , Taborda Stephanie Gomez , Martino Rosemary , Hutcheson Katherine , McCulloch Timothy , Langmore Susan E
Published: April 2019

Background

Radiation-associated dysphagia is a common and debilitating consequence of treatment for head and neck cancer (HNC). Since commonly employed dysphagia therapy programs for HNC patients still lack authoritative efficacy, some speech-language pathologists (SLPs) have started employing manual therapy (MT) techniques in an attempt to prevent or rehabilitate dysphagia in this patient population. However, exceptionally little is known about the use of MT in this patient population.

Objectives

The purpose of this study was to describe practice patterns as well as the rate, type, and severity of adverse events associated with SLP provision of MT to HNC patients.

Methods

An Internet-based questionnaire geared toward SLPs who practice MT was developed and sent to SLPs practicing in the United States, 3 times, through 3 national listservs (American Speech Language Hearing Association [ASHA] Special Interest Division 13, ASHA Special Interest Division 3, and University of Iowa Voiceserv), over the course of 4 weeks.

Results

Of the 255 respondents, 116 (45.5%) performed MT on HNC patients. Of these 116 SLPs, 27.6% provided proactive MT during radiation, 62.1% provided 1 to 2 sessions per week, and 94.8% prescribed a MT home program. The rate, type, and severity of reported adverse events were similar between HNC and non-HNC patients.

Conclusion

This preliminary survey demonstrated that SLPs provide MT to HNC patients during and after cancer treatment, and that reported adverse events paralleled those experienced by noncancer patients. However, these results should be taken with caution, and a well-designed prospective study is needed to formally establish the safety and the preliminary efficacy of this novel clinical intervention.
Blunted Reward Sensitivity and Trait Disinhibition Interact to Predict Substance Use Problems
Authors: Joyner Keanan J. , Bowyer Colin B. , Yancey James R. , Venables Noah C. , Foell Jens , Worthy Darrell A. , Hajcak Greg , Bartholow Bruce D. , Patrick Christopher J.
Published: April 2019

Reward-deficit models of addiction posit weaknesses in reward sensitivity to be promotive of substance dependence, whereas the externalizing spectrum model views substance problems as arising in large part from a general disinhibitory liability. In the current study we sought to integrate these perspectives by testing for separate and interactive associations of disinhibition and reward dysfunction with interview-assessed substance use disorders (SUDs). Community and college adults ( N = 199) completed a scale measure of trait disinhibition and performed a gambling-feedback task yielding a neural index of reward sensitivity, the “Reward Positivity” (RewP). Disinhibition and blunted RewP independently predicted SUDs and also operated synergistically, such that participants—in particular, men—with high levels of disinhibition together with blunted RewP exhibited especially severe substance problems. Though limited by its cross-sectional design, this work provides new information about the interplay of disinhibition, reward processing, and gender in SUDs and suggests important directions for future research.
Relationship Between the Spiritual and the Secular: Vivekananda, Gandhi and Radhakrishnan
Authors: Singh Vijendra
Published: April 2019

This article explores the repeated invocation of the spiritual by Vivekananda, Gandhi and Radhakrishnan. It attempts to understand the nature of the relationship they established between the spiritual and the secular domains while invoking the spiritual. The article argues that what was distinctive about frequent usage of the spiritual was its usage to articulate both the secular and the otherworldly goals in different ways. Moreover, none of them are strictly secular, if it means differentiation of the social and political domain from religion on the one hand and rise of ‘exclusive humanism’ on the other. For them, the domain of secular is the domain of realizing the spiritual. They are not two separate domains but constituted an integral whole where the activities of secular were defined and redefined in the light of the quest for the spiritual and vice versa.