bluuebunny/crossref_metadata_2025 huggingface dataset:
Human Exposure Assessment II: Quantifying and Reducing the Uncertainties
Authors: Whitmyre Gary K. , Driver Jeffrey H. , Ginevan Michael E. , Tardiff Robert G. , Baker Scott R.
Published: April 2018

Alternative methods of human exposure assessment that reduce and/or allow quantification of the uncertainties associated with exposure estimates are surveyed and illustrated. These alternative approaches include (1) use of more appropriate exposure parameter default values rather than values that result in extreme exposure estimates; (2) incorporation of time-activity data to better define appropriate exposure duration values; (3) the use of reasonable exposure scenarios rather than the traditional Maximally Exposed Individual (MEI) approach; (4) the use of stochastic approaches such as Monte Carlo-based and information analysis-based methods; (5) use of bivariate analysis to identify the extent to which interdependencies between different exposure parameters affect the distribution of exposure estimates; (6) use of less-than-lifetime exposure and risk assessment; and (7) incorporation of physiological considerations relevant to absorbed dose estimation, including route-specific impacts, use of improved absorption factors, and application of pharmacokinetic models. Other ways to improve the exposure assessment process, including assuring statistical equivalency in comparing different exposure estimates and incorporation of sensitive subpopulation considerations are also discussed, as are key research needs.
Subchronic Toxicity Study of Dicyclopentadiene Vapor in Rats
Authors: Bevan Christopher , Snellings William M. , Dodd Darol E. , Egan Gerard F.
Published: April 2018

Fischer 344 rats were exposed by inhalation to 0, 1, 5 or 50 ppm dicyclopentadiene (DCPD) vapor 6 hr/day, 5 days/week for 13 weeks, followed by a 13-week recovery period. Animals were euthanized following completion of exposure at 2, 6, or 13 weeks and at postexposure weeks 4 or 13. No mortality, overt signs, body weight changes, hematologic or clinical chemistry values were related to DCPD exposure. In the high-exposure male rats, relative liver weights were significantly increased but with no accompanying histopathologic changes. Exposure to DCPD produced adverse kidney effects in male, but not female, rats as evidenced by the excretion of epithelial cells in the urine. Histologic changes were localized to the proximal tubules of the kidney and included increased accumulation of protein droplets, regenerative epithelium, and the presence of intraluminal proteinaceous material. In addition, several alterations in renal function were observed. Urinary Na+ excretion rates were decreased and urinary K+ excretion rates were increased throughout the exposure period; however, glucose was not present in the urine, and creatinine clearance was normal. The ability of the kidney to concentrate urine was also impaired. After the recovery period, many of the treatment-related kidney effects were not observed, including the presence of hyaline droplets in the proximal tubules and epithelial cells in the urine. These findings indicate an overall low degree of systemic toxicity following sub-chronic inhalation exposure of dicyclopentadiene at exposure levels up to 50 ppm. The only effect that was observed was a male rat-specific nephropathy that is characteristic of the hyaline droplet nephropathy produced by a diverse group of compounds.
A Weight-of-Evidence Approach for Assessing Interactions in Chemical Mixtures
Authors: Mumtaz M. M. , Durkin P. R.
Published: April 2018

The risk assessment process must encompass all available toxicological data and scientific evidence on the plausible toxicities of a chemical or chemical mixture. As an extension to the approaches used to conduct risk assessments on chemical mixtures, a preliminary scheme, analogous to the IARC classification of carcinogens, is proposed to express the weight of evidence for the interactions in binary mixtures. This scheme is based on composite representation of all the toxicological evidence from animal bioassays and human data, pharmacokinetics studies, metabolism studies, and structure activity relationships. In addition, factors such as the relevance of route, duration and sequence of exposure, toxicological significance of interactions and the quality of in vivo and in vitro data are taken into consideration. The scheme yields an alphanumeric classification that can be used for qualitative risk assessment, and has the potential, as demonstrated in this paper, for quantitative application to site-specific risk assessments. Furthermore, the scheme can be used to estimate interactions or form hypotheses concerning binary interactions. It is flexible and allows all pertinent information to be incorporated in a methodical and consistent manner. Research is needed to identify interaction patterns for simultaneous and sequential exposure scenarios of chemical pollutants in order that this scheme may be developed further and its usefulness and limitations may be tested.
Contribution des MDD de terroir à la légitimité et aux images RSE et prix des distributeurs
Authors: Lacœuilhe Jérôme , Louis Didier , Lombart Cindy
Published: April 2018

Cette recherche montre que l’attitude des consommateurs à l’égard des Marques De Distributeurs (MDD) de terroir a une influence positive et significative sur l’image prix du magasin et sur l’image RSE (Responsabilité Sociétale de l’Entreprise) de l’enseigne, quel que soit le format de magasin considéré (hypermarché, supermarché et proximité). Elle souligne ainsi que la MDD de terroir, par un rapport qualité-prix jugé satisfaisant par les consommateurs, participe au développement d’une image prix positive et d’une image RSE favorable. Cette recherche indique également que l’attitude des consommateurs à l’égard des MDD de terroir a une influence positive et significative directe, ou indirecte via son image RSE, sur les deux dimensions de sa légitimité territoriale (l’imprégnation territoriale et l’enracinement territorial). Elle révèle donc que la MDD de terroir est aussi un facteur de légitimation de l’enseigne.
Childhood Sexual Abuse: Sibling Perspectives
Authors: Crabtree Elaine , Wilson Charlotte , McElvaney Rosaleen
Published: April 2018

Despite a recent focus highlighting the systemic impact of childhood sexual abuse (CSA), the needs of nonabused siblings have been largely overlooked. This interpretative phenomenological analysis study explored the lived experience of nonabused adult siblings of survivors of CSA. Semistructured interviews were undertaken with five adult siblings who were, or had been attending a support service. Emergent themes demonstrated the personal and relational impact of CSA on siblings which were captured across five domains: trying to make sense of it all, struggling to provide support, managing the impact on the wider family, feeling silenced and finding a voice, and rescripting the future. Participants struggled to make sense of their sibling’s experience, questioning their own memories of happy childhoods, often in the face of limited information about what happened. The impact of the sexual abuse not only affected the sibling relationship but was compounded by the distress of other family members, particularly parents. Participants reported feeling a lack of reciprocity in terms of their own support needs and described ongoing issues arising from the sexual abuse that they believed would likely continue for the rest of their lives. How siblings can be supported through psychoeducation and family therapy is discussed, both for their own needs and those of the entire family.
The Sacred and the Myth: Havel’s Greengrocer, Twenty Years Later
Authors: Shore Marci
Published: April 2018

This essay juxtaposes two thinkers: the French literary critic and philosopher René Girard (1923–2015) and the Czech playwright, essayist, and dissident Václav Havel (1936–2011). In particular, the text examines Havel’s 1978 essay The Power of the Powerless through the lens of Girard’s structuralist model of mimetic desire, violent sacrifice, and a cultural order sustained by prohibition, ritual, and myth. Arguing against the French structural anthropologist Claude Lévi-Strauss (1908–2009), Girard insisted on a reality behind the text: myths disclosed real victims. Girard and Havel shared a merciless anti-populism: society was guilty. They shared something else as well: in an age of a loss of faith in Marxism and all grand narratives, and of skepticism about the possibility of any stable meaning, subjectivity, and truth, Havel and Girard insisted on the ontological reality of both truth and lies, and on the ontological reality of the distinction between them.
The Greengrocer and Compassion in Time of War
Authors: Pontuso James F.
Published: April 2018

This is a personal reflection on the effects of The Power of the Powerless on students living in post-tyrannical societies—the Czech Republic in 1993 and Iraq in 2010. Czech students read the essay as an indictment of Marxist ideology, one-party rule, bureaucratic stagnation, and their former educational system. Havel was a symbol of resistance, human rights, and courage. Iraqi students found a different lesson. The Power of the Powerless does not excuse tyranny, but it does explain the way people trying to live a normal life rationalize their compliance with repression. Havel’s essay made Iraqi students comprehend how complicated choices are under difficult circumstances. Perhaps, as its author intended, the essay proved upon reflection to be a source of compassion.
Truth in the Time of Infowars: Moral Politics and Conscience
Authors: Szulecki Kacper
Published: April 2018

Speaking truth to powers-that-be and overthrowing a “regime of lies” were both dissident trademarks during the Cold War era. But what if overreliance on such an idealized and static notion of Truth can be a problem in an age of post-factual politics and information warfare? In this essay, I first problematize the idea that “truth will set us free” and re-read Václav Havel’s The Power of the Powerless together with a contemporary work—the film Camouflage by Krzysztof Zanussi—to find other foundations for political strategies, beyond the “struggle for truth,” that might transcend the post-totalitarian situation and inform our normative choices and political agency today. In a reality over-flooded with information, where spreading doubt and forging counter-narratives has become a weapon, and where conspiracy theories seem to gain ground, relying on a self-evident distinction between Truth and Lies no longer has the power for political mobilization. It is individual conscience—nesting moral and political responsibility within the individual—rather than an externally existing Truth that might prove a more productive compass in a world of multiple vantage points and continuous re-interpretations.
Guilt-Tripping the Greengrocer
Authors: Lukes Steven Michael
Published: April 2018

Two ways of reading Havel’s classic essay are proposed. According to the first, the focus is on the peculiarities of the post-totalitarian system, inhabited by the famous greengrocer, where slogans, ritual communication, pervasive manipulation, and arbitrariness prevail and power operates as if automatic and anonymous. The lines of conflict run though each person: everyone is both victim and supporter. Comparison is made with Michel Foucault’s (early) view of power, which similarly rejected seeing power as exercised by some over others, stressing power’s anonymity and pervasiveness. For Foucault, at that stage of his thinking, however, power constitutes “regimes of truth,” whereas for Havel the “power of truth” is a force that has the potential successfully to resist and subvert domination. The power of truth is that of the greengrocer and others “living within the lie” to expose and shatter the world of appearances. Havel calls on them to end their complicity. This might seem moralistic, but Havel’s view was that under post-totalitarian conditions, morality would prove the best strategy. The second reading suggests that the post-totalitarian system is the “extreme version of technological civilization and the industrial-consumer society.” But this account of power is at odds with the first, since in this view the powerless would have no prospects of resisting and overcoming domination. Havel’s account is thus political and relevant to other political contexts, raising several empirical questions concerning the dynamics of power and the conditions for the success of morally fueled protest and normative questions concerning power and responsibility.
Boredom, Apocalypse, and Beyond: Reading Havel through Patočka
Authors: Krapfl James
Published: April 2018

What is the power of the powerless today? By drawing on the philosophy of history that informed Havel’s landmark essay, this piece presents notes for a possible sequel. It assesses the contemporary state of what Havel’s mentor, Jan Patočka, called “technological civilization,” particularly with respect to the growing linkage Patočka perceived between boredom (a product of this civilization) and orgiastic violence. Reflecting on the Havelian panoramas of our time and the ideologies associated with them, the piece situates our present in the multimillennial Patočkan history of human beings’ relation to meaning, violence, and responsibility. Following the logic behind Patočka’s and Havel’s Cassandra-like warnings from the 1970s, the piece concludes by confronting the increasing probability of global catastrophe, but it takes inspiration from their work to outline a program of responsible hope.
Prospective Observational Evaluation of Sedation and Pain Management Guideline Adherence Across New Jersey Intensive Care Units
Authors: Brophy Alison , Cardinale Maria , Andrews Liza B. , Kaplan Justin B. , Adams Christopher , Opsha Yekaterina , Brandt Kimberly A. , Dixit Deepali , Nerenberg Steven F. , Saleh Julie A.
Published: April 2018

Background:

The practice guidelines for the management of pain, agitation, and delirium (PAD) from the Society of Critical Care Medicine shifted from primarily focusing on the treatment of anxiety in 2002 to the treatment of pain in 2013.

Objective:

This prospective, observational, multicenter study aimed to assess the degree of practice adherence to the PAD guidelines for ventilated patients in New Jersey intensive care units (ICUs).

Methods:

Pharmacist investigators at 8 centers designated 4 days at least 10 days apart to evaluate all patients on mechanical ventilation. The primary outcomes included adherence to 4 guideline recommendations: treatment of pain before sedation, use of nonnarcotic analgesic medications, use of nonbenzodiazepine sedative medications, and use of goal-directed sedation.

Results:

Of 138 patients evaluated, 50% had a primary medical diagnosis (as opposed to surgical, cardiac, or neurological diagnosis), and the median Sequential Organ Failure Assessment (SOFA) score was 7. Pain was treated prior to administration of sedatives in 55.4% of subjects, with fentanyl being the primary analgesic used. In addition, 19% received no analgesia, and 11.5% received nonopioid analgesia. Sedative agents were administered to 87 subjects (48 nonbenzodiazepine and 39 benzodiazepine). Of those receiving benzodiazepines, 22 received intermittent bolus regimens and 16 received continuous infusions, of which 5 were for another indication besides sedation. Validated scales measuring the degree of sedation were completed at least once in 56 (81.6%) patients receiving sedatives.

Conclusions:

Current sedation practices suggest that integration of evidence-based PAD guidelines across New Jersey adult ICUs is inconsistent despite pharmacist involvement.
Researching disabled children and young people’s views on decision-making: Working reflexively to rethink vulnerability
Authors: Skyrme Sarah Louise , Woods Simon
Published: April 2018

Issues relating to qualitative research with disabled children and young people will be discussed. Semi-structured interviews with boys who have Duchenne muscular dystrophy were conducted to explore their thoughts on how they might make a decision to take part in medical research. Assumptions about disabled children’s vulnerability can impact how researchers conduct qualitative research, and how they are involved in significant decision-making. Working reflexively and in partnership with children illustrates their competence, supporting reconsideration of their vulnerability.
Huntington’s disease: Managing neuropsychiatric symptoms in Huntington’s disease
Authors: Loi Samantha M , Walterfang Mark , Velakoulis Dennis , Looi Jeffrey CL
Published: April 2018

Objectives:

This clinical update review focuses on the management of the neuropsychiatric manifestations of Huntington’s disease (HD). The review highlights current issues regarding pharmacological and non-pharmacological treatment, putative therapeutics and recent relevant research findings in this area.

Conclusions:

Neuropsychiatric symptoms may precede the classic motor clinical symptoms of HD (prodromal HD) by decades and cause significant functional impairment. Early recognition and comprehensive non-pharmacological, usually in combination with pharmacological, treatment is essential.
Magnetorheological finishing of silicon for nanometric surface generation: An experimental and simulation study
Authors: Khatri Neha , Tewary Suman , Manoj Xavier J , Garg Harry , Karar Vinod
Published: April 2018

Silicon mirrors are essential for guiding the X-ray beam and focusing it to a specific location. These mirrors using total internal reflection require super smooth surface finish due to small wavelength of X-ray. Magnetorheological finishing is a computer-controlled technique used in the production of high-quality optical lenses. This process utilizes polishing slurries based on magnetorheological fluids, whose viscosity changes with the change in magnetic field. In this work, polishing potential of silicon mirrors by magnetorheological finishing process is examined to achieve nanometric surface finish for X-ray applications. The individual effect of parameters such as magnetizing current, working gap, rotational speed on surface roughness is investigated, and optimized parameters are identified. To investigate the physical essence underlying magnetorheological finishing process, the molecular dynamics simulations are used. Molecular dynamics simulation is used to study the atomic-scale removal mechanism of single-crystalline silicon in magnetorheological finishing process and attention is paid to study the effect of gap between the tool and the workpiece on surface quality. The outcome is promising and the final surface roughness achieved is as low as 6.4 nm. The surface quality is analyzed in terms of arithmetic roughness, power spectral density, and image analysis of scanning electron microscopy for uniform evaluation.
Informational Need, Institutional Capacity, and Court Receptivity: Interest Groups and Amicus Curiae in State High Courts
Authors: Becker Kane Jenna
Published: April 2018

Interest group participation in state courts of last resort has increased substantially over the past four decades, and the scope of this litigation activity has expanded to include a wider range of group participation. Despite the fact that organized interests increasingly recognize state high courts as legitimate policy venues, little is known about how interest groups choose the specific cases in which they participate. Beginning with the assumption that interest groups seek policy influence, this paper tests the hypothesis that groups strategically target cases that will best serve the policy and institutional interests of the group, while focusing group resources on cases and courts where they are most likely to be successful. Using an original dataset assembled from content analysis of more than 2,300 state supreme court decisions handed down between 1995 and 2010 and spanning three distinct areas of law—products liability, environmental law, and free speech and expression—this paper investigates the case-level and court-level factors that attract interest group participation as amicus curiae in state high courts.
Extensions of Auxiliary Variable Approaches for the Investigation of Mediation, Moderation, and Conditional Effects in Mixture Models
Authors: McLarnon Matthew J. W. , O’Neill Thomas A.
Published: April 2018

Person-centered analyses and mixture models, such as latent profile analyses (LPA), are becoming increasingly common in the organizational literature. However, common usage of LPA rarely extends to the estimation of moderation, conditional effects, and mediation within a single model. This can affect the accuracy of parameter estimates, and it interferes with development and investigation of complex theories. The current study provides an overview of systematic approaches that allows researchers to investigate models involving moderation, conditional effects on outcomes, and mediation. Using M plus, we offer an accessible method of testing complex statistical models that are auxiliary to the focal mixture model. We provide syntax for typical moderation, conditional effects, and mediation hypotheses, and we provide a detailed explanation of the procedures. We demonstrate these procedures with applications involving the five-factor model (FFM) of personality and several additional variables that comprise complex auxiliary statistical models. The pedagogical approach offered by this research will facilitate future theoretical developments and empirical advancements in the use of person-centered analyses.
Factors influencing the caregiving performance of mothers of hospitalized toddlers with acute respiratory diseases: A path analysis
Authors: Hye-Yul Han , Shin-Jeong Kim , Wayne Ellis Kevin , Kyung-Ah Kang
Published: April 2018

Studies on the management of respiratory diseases in children have focused on family members’ participation and caregivers’ needs. However, evidence-based data on the effectiveness of mothers’ management of acute respiratory diseases (ARDs) in toddlers are lacking. This study aimed to examine the factors influencing the caregiving performance of mothers of toddlers hospitalized for an ARD and to test a hypothetical causal model based on the Caregiving Effectiveness Model (CEM). A cross-sectional design was used, and participants included 291 mothers of toddlers aged 12–36 months who were hospitalized for an ARD. Based on the CEM, data were analyzed to identify the path of relationships between the factors influencing mothers’ care of their hospitalized children and the mothers’ caregiving performance. The modified path model had a good fit with the data, with optimal values for all fit indices. The mothers’ caregiving performance was influenced by the children’s number of hospitalizations, the mother–child relationship, and the mothers’ anxiety level. These three factors explained 51.4% of the variance in the mothers’ caregiving performance. Educational interventions targeting controllable factors such as mother–child relationships and mothers’ anxiety levels may be considered to improve mothers’ caregiving performance.
When contact goes wrong: Negative intergroup contact promotes generalized outgroup avoidance
Authors: Meleady Rose , Forder Laura
Published: April 2018

This paper broadens our understanding of the consequences of negative intergroup contact. Study 1 reports cross-sectional evidence that negative contact with European immigrants in Britain is not only associated with increased prejudice, but also the avoidance of future contact with this group. Studies 2A and 2B provided an experimental replication in a different intergroup context. A negative encounter with an outgroup member, but not an ingroup member, was found to reduce intentions to engage in contact with the outgroup in the future. Study 3 went on to demonstrate that the effect of negative contact on outgroup avoidance is not limited to the contacted outgroup, but is indirectly associated with reduced intentions to engage with other, secondary outgroups—an effect we refer to as avoidance generalization effect. Negative contact was also associated with lower general contact self-efficacy. Together, findings suggest that negative contact is damaging not just because it increases prejudice but also because it compromises future engagement with diversity.
Thermodynamics of indirect water injection in internal combustion engines: Analysis of the fresh mixture cooling effect
Authors: Vaudrey Alexandre
Published: April 2018

Water injection is a well-known efficient way to improve the performance of internal combustion engines. Amazingly, most of previous studies have yet only assess this process in an experimental manner, depriving us of an understanding of its specific influence on different operating phases of the engine – density of the aspirated fresh mixture, work required by the compression stroke, and so on – but also of the possibility to predict its effects if set up on an existing engine. Thanks to a theoretical framework specifically developed, and similar to the one commonly used for the analysis of air conditioning systems, we start in this article to untangle in a theoretical manner the different consequences of water injection on internal combustion engines. This first study is specifically focused on the fresh mixture density increase, due to the vaporisation of liquid water in the intake manifold. Results show that in the best scenarios, we cannot expect to increase the amount of fuel finally aspirated into the cylinders by more than 10%. The methodology presented here can be of a precious help for the optimisation of such process if applied to existing or future engines.
Innovative assessment scheme of navigation risk based on improved multi-source information fusion techniques
Authors: Li Bo , Pang Fuwen
Published: April 2018

To deal with highly time complexity and unstable assessments for conflicting evidences from various navigation factors, we put forward an innovative assessment scheme of navigation risk based on the improved multi-source information fusion techniques. Different from the existing studies, we first deduce the nonlinear support vector machine classification model for the general scenario. The slack variable is adaptively computed based on the Euclidean distance ratio. Considering the unsatisfactory characteristics of the standard Dempster–Shafer evidence theory, the optimal combination rule is derived step by step. What"s more, the lowly dimensional Kalman filter is applied to forecast the navigation risk. Simultaneously, the time complexity of each technique is analyzed. With respect to the vessel navigation risk, the assessment results are provided to indicate the reliability and efficiency of the proposed scheme.
Tumor Cell–Accelerated Senescence Is Associated With DNA-PKcs Status and Telomere Dysfunction Induced by Radiation
Authors: Zhang Miaomiao , Guo Xiaopeng , Gao Yue , Lu Dong , Li Wenjian
Published: April 2018

Whether telomere structure integrity is related to radiosensitivity is not well investigated thus far. In this study, we investigated the relation between telomere instability and radiation-induced accelerated senescence. Partial knockdown of DNA-dependent catalytic subunit of protein kinase (DNA-PKcs) in human breast cancer cell line MCF-7 was established by small interfering RNA. Radiosensitivity of control and DNA-PKcs knockdown MCF-7 cells was analyzed by clonogenetic assay. Cell growth was measured by real-time cell electronic sensing. Senescence and apoptosis were evaluated by β-galactosidase histochemical staining and fluorescence-activated cell sorting, respectively. DNA damage was determined by long polymerase chain reaction (PCR). Telomere length and integrity were analyzed by real-time PCR and cytogenetic assay, respectively. DNA-PKcs knockdown MCF-7 cells were more sensitive to X-irradiation than control cells. Further investigation revealed that accelerated senescence is more pronounced than apoptosis in cells after radiation, particularly in DNA-PKcs knockdown cells. The cytogenetic assay and kinetics of DNA damage repair revealed that the role of telomere end-capping in DNA-PKcs, rather than DNA damage repair, was more relevant to radiosensitivity. To our knowledge, this is the first study to show that DNA-PKcs plays an important role in radiation-induced accelerated senescence via maintenance of telomere integrity in MCF-7 cells. These results could be useful for future understanding of the radiation-induced genome instability and its consequences.
Formulation of noise isolation index for evaluating the interior acoustics level in vehicle cabin
Authors: AlDhahebi Adel Mohammed , Junoh Ahmad Kadri , Desa Afifi MD , Zakaria Mohd Hafiz , Ahmed Amran
Published: April 2018

This article proposes noise isolation index to assess the acoustical comfort level in the interior vehicle cabin. The noise isolation index is developed, validated, and compared for three local compact cars, namely, Axia, Myvi, and Viva which are most widely used vehicles in Malaysia and have not been yet studied. Toward this end, the interior and exterior sound signals are recorded on both stationary and non-stationary (highway, pavement, and urban) conditions and the trends of sound quality loudness (sone) and sharpness (acum) with respect to sound pressure level (Pa) are observed. The findings of this study indicate that the noise isolation index results are literally influenced by factors including type of road surface, engine transmissions, and vehicle design characteristics. The proposed index can be successfully extended by automotive researchers to assess the interior vehicle noise and can be significant factor in vehicle manufacturing process.
Position tracking control in torque mode for a robotic running foot for footwear testing
Authors: Thanh Luan NGUYEN , ALLEN Samuel James , Soo Jay Louis PHEE
Published: April 2018

Available automatic footwear testing systems still lack flexibility and bio-fidelity to represent the human foot and reproduce the wear conditions accurately. The first part of this article introduces a new design of the robotic running foot for footwear testing using cable conduit mechanisms. This robotic running foot is integrated with an upper leg mechanism to form a complete integrated footwear testing system. The cable conduit mechanisms help remove the bulky actuators and transmissions out of the fast-moving robotic foot. Thus, this robotic running foot design not only allows high-power actuators to be installed, but also avoids a significant dynamic mass and inertia effects on the upper leg mechanism. This means that the integrated footwear testing system can have multiple powered degrees of freedom in the robotic running foot and simulate much higher human running speeds than other available systems. However, cable conduit mechanisms cause significant challenges in control approaches, especially in high-speed systems, due to their nonlinear transmission characteristics. Furthermore, the robotic running foot actuators must operate in a torque/force control mode to reproduce the foot–shoe interaction during gaits while it is critical to control the foot joints’ position in the swing phase of gaits. The latter part of this article presents a study on position tracking control in torque mode for the robotic running foot joints using adaptive and proportional–integral–derivative control designs to evaluate the system’s ability to mimic the human foot kinematics in running. Both controllers proved their effectiveness, implying that the proposed control approach can be implemented on the integrated footwear testing system to control the foot joints’ position in the swing phase of running gaits.
Exploring a compassion-focused intervention for persistent pain in a group setting
Authors: Penlington Chris
Published: April 2018

Introduction:

It is widely known that the mind and the body, although described medically almost as separate entities, are in fact highly interrelated. This is not, however, always reflected within medical settings where physical interventions are often favoured over more holistic management, even in the case of long-term symptoms and/or pain where there is a strong evidence to favour the use of the latter. Mindfulness is an established and evidence-based intervention which can help people living with pain and physical symptoms. Interventions based on Compassion and Loving-kindness have also shown early promise but have not been fully explored. This study proposes a compassion-focused conceptualisation of persistent pain and reports on an intervention based upon this formulation.

Methods:

The study took place within a routine clinical setting. Standardised outcome measures were collected pre- and post-intervention and effect sizes calculated for mean differences on each measure. Written qualitative comments that participants attributed to the group were also collected post-intervention and analysed with a thematic analysis. This was an uncontrolled, unpowered study conducted within a clinical setting which aimed to examine the intervention for any initial evidence of promise and to explore how it would be received by patients.

Results:

The results of the study indicated that engagement of patients in the intervention was reasonable. Improvements were recorded in pain distress (effect size (ES), 0.47) and intensity (ES, 0.23), anxiety (ES, 0.72), depression (ES, 0.46) and self-efficacy (ES, 0.36). Following the intervention, patients described changes that were grouped into the categories of feeling different, doing things differently and changed attitude.

Conclusion:

This exploratory study has demonstrated that a group-based intervention based on a model of compassion and including mindfulness and loving-kindness exercise has potential as an intervention to be used within routine pain management settings.
Angiogenic Molecules in Hodgkin's Disease: Results from Sequential Serum Analysis
Authors: Passam F.H. , Alexandrakis M.G. , Moschandrea J. , Sfiridaki A. , Roussou P.A. , Siafakas N.M.
Published: April 2018

Increased angiogenic activity has been demonstrated in lymphoproliferative diseases including Hodgkin's disease. In the current study, the levels of circulating angiogenic molecules in 60 Hodgkin's patients were determined prior to and after treatment and correlated to disease stage and prognostic score. Hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were increased in Hodgkin's patients in comparison to healthy controls (p<0.001). Angiogenin and angiopoietin-2 levels did not differ from controls. HGF, VEGF, TNF-α and angiogenin decreased significantly in Hodgkin's patients after standard treatment (p<0.001 for HGF, p<0.05 for VEGF, TNF-α and angiogenin). Furthermore, HGF and TNF-α increased with advancing stage of disease (p<0.05). HGF and VEGF correlated significantly with IL-6 (r=0.56, p<0.0005 and r=0.57, p<0.001 respectively). In conclusion, Hodgkin's disease displays an angiogenic activity as depicted by the increased serum levels of a number of angiogenic cytokines. HGF seems to be the prominent molecule in Hodgkin's disease, which may be used to monitor the disease status and the response to treatment.
Serological Markers of Pulmonary Tuberculosis and of Response to Anti-Tuberculosis Treatment in a Patient Population in Guinea
Authors: Azzurri A. , Kanaujia G.V. , Sow O.Y. , Bah B. , Diallo A. , Prete G. Del , Gennaro M.L.
Published: April 2018

The aim of the study was to evaluate serological correlates of active tuberculosis and of response to antituberculosis treatment in a cohort of HIV-negative patients with pulmonary tuberculosis studied at diagnosis and during treatment at the Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea. Two similar cohorts of HIV-negative healthy households of patients and healthy community controls were included in the study. Plasma samples were obtained from 168 untreated tuberculosis patients, 167 healthy household controls, and 168 healthy community controls. Serial plasma samples were also obtained from the tuberculosis patients at 2 and 8 months after initiation of chemotherapy. IgG antibody levels were measured by an enzyme-linked immunosorbent assay (ELISA) using ten purified M. tuberculosis antigens. ELISA results were analysed by comparing geometric means of data. Of the ten antigens tested, five (14kDa Ag, 19kDa Ag, AlaDH, MS, and MPT83) elicited similar antibody responses in untreated TB patients and controls. In contrast, levels of three antibodies (ESAT-6, LAM, and 38kDa Ag) were higher in untreated TB patients than in household or community controls (p < 0.0001). Levels were higher in untreated patients than in community controls also for the anti-Rv2626c antibody (p = 0.0001) and, at a lower significance level, for the anti-FdxA antibody (p < 0.025). Antibody levels against ESAT-6 and Rv2626c decreased during therapy, while antibody levels to the 38 kDa antigen and LAM increased during therapy; FdxA antibody levels did not vary with treatment. Neither severity of presentation nor chest X-ray patterns affected levels of these antibodies before treatment. In contrast, after the 8-month therapeutic course, patients who presented with moderate/severe disease had higher levels of anti-ESAT-6, anti-FdxA, and anti-38kDa antibodies than those of patients with mild disease onset. Patients with bilateral lung lesions had significantly higher anti-38kDa and anti-LAM levels, both at diagnosis and after 8-month treatment, than patients with lesions involving only one lung. Antibodies to alanine dehydrogenase and malate synthetase measured at initiation of treatment were higher in tuberculosis patients who subsequently failed therapy than in those who were cured. The main conclusions of the study are: a) plasma levels of antibodies to a number of M. tuberculosis represent serological correlates of active disease; b) these correlates are affected in an antigen-specific fashion by anti-tuberculosis treatment; c) particular serological markers may be predictive of treatment outcome.
Diet and endometriosis-revisiting the linkages to inflammation
Authors: Saguyod Sofia Jade U , Kelley Angela S , Velarde Michael C , Simmen Rosalia CM
Published: April 2018

Endometriosis is a chronic inflammatory condition that may cause pelvic pain, dysmenorrhea, and/or infertility in women of reproductive age. While treatments may include medical or surgical management, the majority of therapeutic options are non-curative, and women may experience longstanding pain and/or disability. In general, chronic diseases are believed to result from modifiable risk factors, including diet. In this review, we discuss recent data on evidence-based associations between diet and endometriosis and the mechanistic points of action of constituent dietary factors with emphasis on inflammatory events that may contribute to the promotion or inhibition of the disease. Understanding the convergence of diet and endometriosis may lead to the development of clinical strategies to improve the quality of life for symptomatic women.
Gender-Affirming Surgery for Transgender Individuals: Perceived Satisfaction and Barriers to Care
Authors: El-Hadi Hadal , Stone Jill , Temple-Oberle Claire , Harrop Alan Robertson
Published: April 2018

Purpose:

The purpose of this study was to examine the perceived satisfaction and barriers to care for transgender patients after they decide to undergo gender-affirming surgery (GAS).

Method:

A survey consisting of 21 multiple-choice and short-answer questions was distributed to transgender organizations and online forums across Canada and the United States. The data were then analyzed using descriptive statistics.

Results:

There were 32 participants, 12 who identified as female to male and 20 as male to female. The mean age was 36 years, with a range of 18 to 81 years. The mean age of their first GAS was 33 years, and the range of wait time was 6 months to 7 years. Most of the participants received information about GAS from transgender websites and transgender surgery clinics (91% and 50%, respectively). Most participants (74%) felt like they had access to appropriate care and 89% felt like their surgeons provided enough information about GAS. There were 38% of participants who would change their experience with GAS. Participants stated several barriers toward receiving GAS: financial (73%), finding a physician (65%), and access to information (63%). Surgical transition was important to the quality of life for 91% of participants and 100% were happy with their decision to undergo GAS.

Conclusions:

Transgender participants demonstrated that GAS is important to their quality of life and this study showed significant barriers to GAS.
The Effect of Simulated Total Distal Interphalangeal Joint Stiffness on Grip Strength
Authors: Wu Kitty , Ahluwalia Romeet , Chinchalkar Shrikant J. , Vincent Joshua I. , Richards Robert S. , Suh Nina
Published: April 2018

Purpose:

Production of a functional grip pattern requires the concerted action of numerous structures within the hand. This study quantifies the effect of total distal interphalangeal joint (DIPJ) stiffness to grip strength.

Methods:

Fifty (25 men, 25 women, 100 hands) individuals with a mean age of 38 years (range: 17-69 years) were recruited. Exclusion criteria included history of previous upper limb injury, neuropathies, or systemic disease. Custom thermoplastic orthoses were used to splint participants’ DIPJ in full extension simulating stiffness. Grip strength before and after splinting was measured using a calibrated Jamar dynamometer. Data were analyzed using paired and independent sample t tests and 2 × 2 repeated-measures analysis of variance with hand dominance and configuration (splinted or unsplinted) as within-subject factors.

Results:

Restriction of DIPJ flexion led to a 20% decrease in grip strength ( P < .001). There was no significant difference in this decrease between dominant and non-dominant hands. Univariate analysis did not demonstrate any interaction between hand dominance and testing configuration. Post hoc analysis revealed no statistical difference in baseline grip strength between the dominant and non-dominant hands. Furthermore, men had significantly stronger grip strength than women in all configurations ( P < .001).

Conclusions:

Flexion at the DIPJ contributes significantly to grip strength, and stiffness at this joint greatly limits functional capabilities of the hand. This necessitates the need for targeted rehabilitation in DIPJ injuries to minimize adverse effects on grip strength.
Facilitators and Barriers Affecting Adherence Among People Living With HIV/AIDS: A Qualitative Perspective
Authors: Ahmed Syed Imran , Farooqui Maryam , Syed Sulaiman Syed Azhar , Hassali Mohamed Azmi , Lee Christopher K C
Published: April 2018

Background:

It is widely accepted that for HIV-positive persons on highly active antiretroviral treatment, high levels of adherence to treatment regimens are essential for promoting viral suppression and preventing drug resistance.

Objectives:

This qualitative study examines factors affecting the adherence to HIV/AIDS treatment among patients with HIV/AIDS at a local hospital in Malaysia.

Methods:

The data from purposefully selected patients were collected by in-depth interviews using a pretested interview guide. Saturation was reached at the 13th interview. All interviews were audio-taped and transcribed verbatim for analysis using thematic content analysis.

Results:

Fear and stigma of perceived negative image of HIV diagnosis, lack of disease understating, poor support from the community, and perceived severity or the treatment side effects were among the reasons of nonadherence. Appropriate education and motivation from the doctors and reduction in pill burden were suggested to improve adherence.

Conclusion:

Educational interventions, self-management, and peer and community supports were among the factors suggested to improve adherence. This necessitates uncovering efficient ways to boost doctor–patient communication and recognizing the role of support group for the social and psychological well-being of the patients.
How to Conceptualize and Implement a PhD Program in Health Sciences—The Basel Approach
Authors: Keller Franziska , Dhaini Suzanne , Briel Matthias , Henrichs Sina , Höchsmann Christoph , Kalbermatten Daniel , Künzli Nino , Mollet Annette , Puelacher Christian , Schmidt-Trucksäss Arno , von Niederhäusern Belinda , De Geest Sabina
Published: April 2018

Objectives:

Over the past decade, several excellent guidelines have been published on how to enhance the quality of PhD education in Europe. Aimed primarily at preparing students for innovative roles in their fields, they include variously structured approaches to curricular offerings, as well as other program components applicable across specialties (eg: supervisor support, scientific conduct, transferable skills). Since 2012, the interdisciplinary PhD Program in Health Sciences (PPHS) at the Faculty of Medicine of the University of Basel in Switzerland has focused on translating these guidelines into a 21st-century health sciences PhD program.

Results:

The PPHS started in 2012 based on the European Union (EU) guidelines for PhD education. This article describes the resulting interdisciplinary PhD program’s conceptual underpinnings, rationale, structures, and 10 building blocks, like student portfolios, thematic training, interdisciplinary research seminars, student-initiated interdisciplinary activities, financial support of course participation, top-up and extension stipends, PhD supervision, research integrity, alumni follow-up network, and promotional tools including a dedicated website. Students enter from Clinical Research, Medicine Development, Nursing Science, Epidemiology and Public Health including Insurance Medicine, Sport Science (all from the Faculty of Medicine), and Epidemiology (Faculty of Science).

Discussion and Conclusion:

The Basel PPHS exemplifies state-of-the-art PhD education in Health Sciences based on European guidelines and offers guidance to other groups from conceptualization to rollout of an interdisciplinary health sciences PhD program.
What makes learning Chinese characters difficult? The voice of students from English secondary schools
Authors: Yang Juan
Published: April 2018

This study initially investigated the beliefs of beginner learners of Chinese as a foreign language (CFL) about the difficulties of learning Chinese and how they can overcome the difficulties they encounter. Pupils (179) from two state secondary schools in England responded to a Likert scale questionnaire and shared their views in interviews. Surprisingly, pupils think that character recognition is more difficult than their production. They also showed their concern about homophones in Chinese and the lack of links between the sound and logography of characters. In order to make good progress in learning Chinese, students overwhelmingly agreed that they should put effort into it. Some of these findings relate to particular aspects of learning Chinese, such as characters and homophones. Other findings, however, are unrelated to the language demands of Chinese and suggest that the practices of learning Chinese have a particular impact on the views of learners about who can learn Chinese and what it takes to be successful. We suggest that these beliefs may be empowering for language learners in an English context.