bluuebunny/crossref_metadata_2025 huggingface dataset:
Natural Law and Ethical Non-Naturalism
Authors: O’Connor John D.
Published: October 2020

There is a lack of clarity in the literature about what constitutes the natural law approach to ethics and what is incompatible with it. The standard, and largely historical, way of understanding the natural law approach risks overlooking theoretical differences of fundamental importance regarding what the natural law approach is usually taken to uphold. Against Craig Paterson, I argue that a necessary condition for an ethical account to uphold fully the natural law approach is that it does not contain any dependence upon the metaethical category of non-naturalism understood in non-supernaturalist (secular) terms. Using the ‘new natural law’ theory of John Finnis to illustrate my case, I also argue that an ethical theory can be largely in keeping with the natural law approach but nonetheless contain elements at odds with it: the issue is more complex than a simple binary. This is an under-explored possibility in natural law ethics.
Noise reduction of automobile cooling fan based on bio-inspired design
Authors: Wang Shuwen , Yu Xinke , Shen Lixia , Yang Ailing , Chen Eryun , Fieldhouse John , Barton David , Kosarieh Shahriar
Published: October 2020

This study aims to minimize the noise generated by automobile cooling fans. Fan blade structures with ridged surfaces based on bio-inspired principles are 3D printed and used to replace the conventional fan blades. The effect of the bio-inspired ridge structures on the noise reduction of the cooling fan is demonstrated by orthogonal experiments in a semi-anechoic chamber. Experimental results show that with an increase in the rotational speed, the effect of the surface textures on the acoustic performance of the cooling fan becomes more significant. For example, at a fan speed of 1750 r/min, all the bio-inspired blade designs reduce noise compared with the original fan and, in particular, the sound pressure level is reduced by 3.83 dB(A) for the design with a ridge width of 4 mm and a ridge pitch of 15 mm. Through variance analysis of the measured noise, the ridge pitch distance has the most significant impact on noise reduction under low speed conditions whilst, under high speed conditions, the ridge width has the most significant influence. In addition to the experimental studies, computational fluid dynamics (CFD) simulations of the cooling fan are carried out to explain the mechanism of noise reduction for the ridged fan blades. When the fan runs, the horseshoe vortexes generated by the ridge structures disturb the flow of the boundary layer, reduce the influence of the fluid flow on the boundary layer, and delay the transition of the fan blade laminar flow to turbulence. It is also seen that there is a reduction of the intensity of the fan blade trailing edge vortices and the scale of the secondary vortices, thereby achieving the overall aim of noise reduction. This research has significance in the noise reduction design of automobile cooling fans.
An intelligent approach to optimize the electrical discharge machining of titanium alloy by simple optimization algorithm
Authors: Sahu Anshuman Kumar , Thomas Joji , Mahapatra Siba Sankar
Published: October 2020

Electrical discharge machining (EDM) is a thermo-electrical process that can be conveniently utilized for generating complex shaped profiles on hard-to-machine conductive materials using metallic tool electrodes. In this work, composite tools made of copper-tungsten-boron carbide (Cu-W-B4C) manufactured by powder metallurgy (PM) route are used during machining of titanium alloy (Ti6Al4V). The effect of four input machining parameters viz. current, pulse-on-time, duty cycle and percentage of tungsten and boron carbide on material removal rate (MRR), tool wear rate (TWR) and surface roughness (Ra) is studied. A novel meta-heuristic approach such as simple optimization (SOPT) algorithm has been used for single and multi-objective optimization. The pareto-optimal solutions obtained by SOPT have been ranked by VIKOR method to find out the best suitable optimal solution. Analysis of experimental data suggests vital information for controlling the machining parameters to improve the machining performance.
The co-construction of humor in computer-mediated teacher-student communication
Authors: Moalla Asma , Amor Wafa Ben
Published: October 2020

This paper investigates the way online humorous exchanges are jointly constructed and recognized by a teacher and her students. It focuses on the role humor studies play in understanding issues related to Computer-mediated Communication (CMC). The data consist of synchronous discussions of 11 Tunisian learners of English and their teacher via instant messaging on Skype. The analysis uses the notion of script oppositions (SOs) in the General Theory of Verbal Humor (GTVH) and offers an account for the internal structure of exchanges; how the exchange begins with a serious mode, how it gradually develops into a humorous play frame, and how inferences are drawn. The study reveals that humor is created by activating binary SOs and shows that the teacher/student dynamics can make joking online more difficult to interpret than joking among peers. With reference to the analysis of the specific context of the CMC discussions, a serious set up of a humorous sequence created by a teacher can leave students uncertain toward the playfulness of the sequence. A playful set up, on the other hand, makes participants engage in a joint fantasy and build new layers of meaning as the conversation develops.
Preferences of Type 1 Diabetic Patients on Devices for Islet Transplantation
Authors: Mohammadi M. Rezaa , Dehkordi-Vakil Farideh , Ricks-Oddie Joni , Mansfield Robert , Kashmiri Himala , Daniels Mark , Zhao Weian , Lakey Jonathan RT
Published: October 2020

Transplantation of pancreatic islets within a biomaterial device is currently under investigation in clinical trials for the treatment of patients with type 1 diabetes (T1D). Patients’ preferences on such implants could guide the designs of next-generation implantable devices; however, such information is not currently available. We surveyed the preferences of 482 patients with T1D on the size, shape, visibility, and transplantation site of islet containing implants. More than 83% of participants were willing to receive autologous stem cells, and there was no significant association between implant fabricated by one’s own stem cell with gender ( χ 2 (1, n = 468) = 0.28; P = 0.6) or with age ( χ 2 (4, n = 468) = 2.92; P = 0.6). Preferred location for islet transplantation within devices was under the skin (52.7%). 48.3% preferred microscopic disks, and 32.3% preferred a thin device (like a credit card). Moreover, 58.4% preferred the implant to be as small as possible, 25.4% did not care about visibility, and 16.2% preferred their implants not to be visible. Among female participants, 81% cared about the implant visibility, whereas this number was 64% for male respondents ( χ 2 test (1, n = 468) = 16.34; P < 0.0001). 22% of those younger than 50 years of age and 30% of those older than 50 did not care about the visibility of implant ( χ 2 test (4, n = 468) = 23.69; P < 0.0001). These results suggest that subcutaneous sites and micron-sized devices are preferred choices among patients with T1D who participated in our survey.
The Development of Working Memory
Authors: Spencer John P.
Published: October 2020

Working memory is a central cognitive system that plays a key role in development, with working memory capacity and speed of processing increasing as children move from infancy through adolescence. Here, I focus on two questions: What neural processes underlie working memory, and how do these processes change over development? Answers to these questions lie in computer simulations of neural-network models that shed light on how development happens. These models open up new avenues for optimizing clinical interventions aimed at boosting the working memory abilities of at-risk infants.
Mechanical, thermal and dynamic-mechanical studies of functionalized halloysite nanotubes reinforced polypropylene composites
Authors: Krishnaiah Prakash , Manickam Sivakumar , Ratnam Chantara Thevy , Raghu MS , Parashuram L , Prasanna Kumar S , Jeon Byong-Hun
Published: October 2020

Mechanical, dynamic-mechanical and thermal performance of polypropylene (PP) composites which are composed of (3-Aminopropyl) triethoxysilane (APTES) functionalized Halloysite nanotubes (HNTs) were investigated. Functionalization of HNTs was confirmed by the presence of amine stretching peaks in the FTIR spectrum. A decrease in the agglomeration and high dispersion of APTES-HNTs across the PP matrix was confirmed by scanning electron micrographs (SEM). The mechanical properties of APTES-HNT-PP polymer composites were superior over their unmodified counterparts. Tensile properties such as maximum strength, Young’s modulus and impact strength were significantly enhanced by 28%, 45% and 60% respectively, with 6 wt% incorporation of surface-modified HNTs into PP matrix. A drastic improvement of stiffness and thermal stability of composites was noted with the incorporation of APTES modified HNTs into PP polymer. Differential scanning calorimetry (DSC) analysis showed a total increase of 22% in the crystallinity of clay polymer nanocomposite after filled with surface-modified HNTs. Overall, the outcome of this research confirms the modification of the surface of HNTs with a silane coupling agent, which enhances the mechanical and thermal performance of PP composites incorporated HNTs.
Effect of Low Intensity Magnetic Field Stimulation on Calcium-Mediated Cytotoxicity After Mild Spinal Cord Contusion Injury in Rats
Authors: Bhattacharyya Supti , Sahu Shivani , Kaur Sajeev , Jain Suman
Published: October 2020

Background:

Magnetic field (MF) stimulation has the potential to reduce secondary damage and promote functional recovery after neural tissue injury. The study aimed to observe the effect of very low intensity (17.96µT) MF on general body condition, secondary damage, pain status, and locomotion.

Methods:

We exposed rats to MF (2 h/day × 3 weeks) after 6.25 mm contusion spinal injury. Locomotor behavior was evaluated by BBB score, pain assessment was done by recording threshold for tail flick, expression of voltage-gated calcium channels and extent of secondary damage in the spinal cord was assessed by immunofluorescence and Cresyl violet staining, respectively.

Results:

A significant ( p ≤ .001) improvement in bladder function as well as BBB score was observed after MF exposure in comparison with sham and SCI over the observation period of 3 weeks. SCI group showed an increase in the threshold for vocalization after discharge, which decreased following MF exposure. Cresyl violet staining showed significantly higher tissue sparing (73%) at the epicenter after MF exposure when compared to SCI group. This was accompanied with a significant decrease in calcium channel expression in MF group as compared to SCI.

Conclusion:

The results suggest facilitation of sensory-motor recovery after MF exposure, which could be due to attenuation of secondary damage and calcium-mediated excitotoxicity in a mild contusion rat model of SCI.
Adverse Childhood Experiences and Prevalence of Cigarette and E-Cigarette Use Among Adolescents in Bangkok, Thailand
Authors: Ofuchi Takuma , Zaw Aye Myat Myat , Thepthien Bang-on
Published: October 2020

Currently, e-cigarettes are the most popular tobacco product among adolescents. The purpose of this study was to explore the relationship between exposure to adverse childhood experiences (ACEs) and use of cigarettes, e-cigarettes, and dual use in a sample of adolescents in Bangkok, Thailand. The sample comprises 6167 students from 48 schools (grades 9, 11, and vocational year 2) who participated in the 2019 round of the Behavior Surveillance Survey. History of 11 ACEs was used to calculate a cumulative ACE score (range 0-11). Multinomial logistic regression was used to assess the relationship between history of ACEs and smoking. In the sample, 7.0% reported using e-cigarettes only and 9.5% used e-cigarettes and cigarettes (dual use). After controlling for sociodemographic characteristics, history of ACEs was associated with increased odds of dual use. The odds of cigarette, e-cigarette, and dual use was significantly greater if the adolescent had a history of ≥4 ACEs. Special attention is needed to prevent smoking of different types among those with a history of ACEs.
Using Game-Based Virtual Classroom Simulation in Teacher Training: User Experience Research
Authors: Kelleci Özge , Aksoy Nuri Can
Published: October 2020

Background.

Simulation-based training is an effective, and therefore increasingly widespread, tool used in the teaching and assessment of complex skills. In order to determine the effectiveness of the virtual classroom simulators used in teacher training, there is a need for studies into user experiences, within the scope of human-computer interaction, which provide an indicator of software usability.

Aim.

The aim of this study was to examine the experiences of teacher candidates and academics in the use of SimInClass, a game-based virtual classroom simulator.

Method.

16 senior teacher candidates and two academics, determined by the criterion sampling method, participated in the case study which involved a focus group interview, one-on-one interviews, and observation techniques. The case study centered around a 14-week teacher training program which used the SimInClass simulation. Data related to user experiences was analyzed independently by two researchers, and the fit index between the data encoders was calculated as being 0.94.

Results and Conclusion.

The participants who preferred to use the SimInClass simulation on a computer said they did so because of user input, usage control and screen size, while those who favored using a mobile device pointed to the easy access. All of the participants felt that the SimInClass simulation was effective in providing clear directions and giving feedback. One suggestion was that the simulation should give clues regarding the correct solution, while some users felt that it needed to be made more accessible for different disciplines. Despite some reservations and suggestions of this type, the overall impression of the test subjects was that the use of virtual classroom simulators in teacher training was effective.
Association Between Nonsyndromic Cleft Lip and Palate and 2 Polymorphic Loci: A Meta-Analysis
Authors: Wang Yusi , Jia Xueyuan , Qiao Yuandong , Xu Lidan , Zhang Xuelong , Li Qiuyan , Wang Ping , Sun Wenjing , Wu Jie
Published: October 2020

Objectives:

The relationship between Noggin ( NOG) and methylenetetrahydrofolate reductase and nonsyndromic cleft lip and palate (NSCLP) has been reported participate in craniofacial development but need further evidence. To indicate the susceptibility between the 2 genes and NSCLP, rs227731 and rs1801131 polymorphisms were included in the present research. This research may provide some genetic clues for disease detection and surveillance.

Design:

Seventeen studies including 4023 cases and 5691 controls were provided for meta-analysis, and odds ratio (OR) with 95% CI were obtained to estimate NSCLP risk.

Results:

Our analysis suggested potential association of rs227731C on increasing the risk of NSCLP in the Caucasian group and total group but not Asian group under all models: allele (OR = 1.45, 95% CI = 1.21-1.75, P < .0001), homozygote (OR = 2.03, 95% CI = 1.42-2.90, P < .0001), heterozygote (OR = 1.44, 95% CI = 1.19-1.73, P = .0001), dominant (OR = 1.61, 95% CI = 1.27-2.04, P < .0001), and recessive models (OR = 1.63, 95% CI = 1.25-2.12, P = .0003). Besides, increased risk is related to rs1801131 in Asian group under 3 models: allele (OR = 1.24, 95% CI = 1.06-1.44, P = .006), heterozygote (OR = 1.24, 95% CI = 1.02-1.52, P = .03), and dominant models (OR = 1.29, 95% CI = 1.06-1.56, P = .009).

Conclusions:

Our analysis indicates polymorphisms rs227731 and rs1801131 are associated with NSCLP, with predominance of different ethnic group and deepen understanding of NSCLP.
Mental Health Experiences Among Inmates Serving Life Sentences in Ghana Prisons
Authors: Baffour Frank Darkwa , Francis Abraham P. , Chong Mark David , Harris Nonie
Published: October 2020

In Ghana, a convicted person is not entitled to parole. The only hope for their return into the community is either completing the sentence or government amnesty. However, recidivists on life sentences are completely denied the chance of returning into the community. This coupled with the demand of adjusting to the country’s prison conditions affects the mental well-being of life-sentenced inmates. This study explored the mental health experiences of life-sentenced inmates. An interpretive phenomenological approach guided the analysis of qualitative data collected from 21 life-sentenced inmates who were serving terms in three selected prisons. We employed the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5) and International Classification of Diseases 11th Revision ( ICD-11) mental disorder symptomologies to situate the participants’ narration of their experiences. The participants reported feeling sad, hopelessness, and having sleepless days and nights due to thinking about their perceived spoiled plight. They also experienced stress and were fearful of uncertainties due to perceived prison officer apathy and harsh prison conditions. Additionally, the participants resorted to drug use as a means to cope with their mental health experiences. The participants’ descriptions of their experiences were consistent with some symptomologies of mental disorders as provided in the DSM-5 and ICD-11 and call for the creation of mental health treatment services in the country’s prisons to improve the mental health of inmates.
Parent-Focused Sexual Abuse Prevention: Results From a Cluster Randomized Trial
Authors: Guastaferro Kate , Felt John M. , Font Sarah A. , Connell Christian M. , Miyamoto Sheridan , Zadzora Kathleen M. , Noll Jennie G.
Published: October 2020

This study tested whether a child sexual abuse (CSA) prevention program, Smart Parents–Safe and Healthy Kids (SPSHK), could be implemented as an additional module in evidence-based parent training and whether the added module might detract from the efficacy of the original program. In a cluster randomized trial, six community-based organizations were randomized to deliver Parents as Teachers (PAT) with SPSHK (PAT+SPSHK) or PAT as usual (PAT-AU). CSA-related awareness and protective behaviors, as well as general parenting behaviors taught by PAT were assessed at baseline, post-PAT, post-SPSHK, and 1-month follow-up. Multilevel analyses revealed significant group by time interactions for both awareness and behaviors ( ps < .0001), indicating the PAT+SPSHK group had significantly greater awareness of CSA and used protective behaviors more often (which were maintained at follow-up) compared to the PAT-AU group. No differences were observed in general parenting behaviors taught by PAT suggesting adding SPHSK did not interfere with PAT efficacy as originally designed. Results indicate adding SPHSK to existing parent training can significantly enhance parents’ awareness of and readiness to engage in protective behavioral strategies. Implementing SPHSK as a selective prevention strategy with at-risk parents receiving parent training through child welfare infrastructures is discussed.
Time Across the Lines: Collaborative Wonderings Under COVID-19
Authors: Bolander Brook , Smith Philippa
Published: October 2020

In this article, we “write-to” time from an autoethnographic perspective. Working intra-actively via a dialogic play script form, we collaboratively wonder about time during our experiences of COVID-19 as it relates to a compression of offline into online spaces. Presenting conversations we’ve had together over email, WhatsApp, and Google docs, with the reviewers of this Special Issue, and with scholarship, we foreground three main questions: What does time mean? How has our sense of time changed? And what is the link between these meanings and changes and the relationship between online and offline spaces?
Perception of Home Healthcare Nurses toward Persons with Dementia
Authors: Osakwe Zainab Toteh , Ikhapoh Izuagie , Arora Bhavleen Kaur , Fleur-Calixte Rose Saint
Published: October 2020

The objective of this study was to describe the perception of home healthcare (HHC) nurses toward persons with dementia (PWD). Using a cross-sectional survey design, data were collected from 225 registered nurses at 11 home care agencies across 7 states in the U.S. A web based modified Approaches to Dementia (ADQ) was used to assess nurses’ perception of person-centeredness. Most of the respondents were female (91.6%). Overall, greater years of experience as a registered nurse and age (<40 years) were associated with higher mean person-centeredness scores. Efforts to improve patient-centered dementia care in the HHC setting may need to be tailored to unique groups of HHC nurses.
The Mythical Taboo on Race and Intelligence
Authors: Jackson John P. , Winston Andrew S.
Published: October 2020

Recent discussions have revived old claims that hereditarian research on race differences in intelligence has been subject to a long and effective taboo. We argue that given the extensive publications, citations, and discussions of such work since 1969, claims of taboo and suppression are a myth. We critically examine claims that (self-described) hereditarians currently and exclusively experience major misrepresentation in the media, regular physical threats, denouncements, and academic job loss. We document substantial exaggeration and distortion in such claims. The repeated assertions that the negative reception of research asserting average Black inferiority is due to total ideological control over the academy by “environmentalists,” leftists, Marxists, or “thugs” are unwarranted character assassinations on those engaged in legitimate and valuable scholarly criticism.
The Self in the Periphery
Authors: Weger Ulrich , Herbig Klaus
Published: October 2020

The self is a multifaceted phenomenon that manifests in a complex configuration of character traits, roles, orientations, and other psychological components. The entity that is binding these subcomponents together has mostly eluded systematic enquiry. In an effort to approach this Gestalt-like whole in an empirical manner, we here introduce the concept of the “peripheral self”: the moments of growth and expansion where the current self grows beyond the horizon of already successful mastery. Over the course of 1 year, we have pursued an empirical first-person approach to explore this continuously shifting horizon of self-development. Our main result is a collection of signature qualities—“experiential echoes”—that demarcate the peripheral self as it advances from potentiality to conscious insight. We provide a roadmap for other researchers to follow up on this approach and relate our findings to the still sparse literature on what constitutes the overarching character of the self.
A comparison of homemade vascular access ultrasound phantom models for peripheral intravenous catheter insertion
Authors: Selame Lauren Ann , Risler Zachary , Zakaria Saami J , Hughes Liam P , Lewiss Resa E , Kehm Kelly , Goodsell Kelly , Kalwani Rishi , Mirsch Daniel , Kluger Samuel Blake , Au Arthur
Published: October 2020

Background:

Ultrasound (U/S) guided peripheral IV catheter (PIV) placement is often needed after unsuccessful traditional IV attempts. Commercial U/S PIV training phantoms are expensive and difficult to alter. Non-commercial phantoms have been described; however, there has been no comparison of these models. The primary objectives of this study were to compare the echogenic and haptic properties of various non-commercial phantoms. Secondary objectives were to characterize the cost and ease of making the phantoms.

Methods:

This prospective observational study trialed six unique phantom models: Amini Ballistics; Morrow Ballistics; University of California San Diego (UCSD) gelatin; Rippey Chicken; Nolting Spam; and Johnson Tofu. Total cost and creation time were noted. Emergency Ultrasound Fellowship trained physicians performed U/S guided PIV placement on each model to evaluate their resemblance to human tissue haptic and echogenicity properties, utility for training, and comparability to commercial phantoms (Likert scale 1–5; higher performance = 5).

Results:

The Rippey model scored highest for each primary objective with an aggregate score of 4.8/5. UCSD ranked second and Nolting last for all primary objectives, with aggregate scores 3.7/5 and 1.3/5 respectively. Cost of production ranged from $4.39 (Johnson) to $29.76 (UCSD). Creation times ranged from 10 min (Johnson) to 120 min (UCSD).

Conclusion:

In our study the Rippey model performed best and offered a mid-level cost and creation time. Non-commercial U/S phantoms may represent cost-effective and useful PIV practice tools. Future studies should investigate the utility of these phantoms in teaching U/S guided PIV to novices and compare non-commercial to commercial phantoms.
The beginning of the sociological study of BDSM: A personal reflection
Authors: S Weinberg Thomas
Published: October 2020

This paper discusses the beginnings of sociological research in BDSM and the author’s role in the development of the field.
He looks so cute: The discourse of heterosexual relationship initiation by female youth in Nigeria
Authors: Mensah Eyo O
Published: October 2020

In many cultural traditions in Africa and beyond, it is taboo for women to initiate sexual offers to men. However, with the new wave of gender fluidity, exposure to media, and affiliation with modernity, some young women in Nigeria initiate heterosexual relationships with their choice of partners. This article explores the nuanced narratives, motivations and experiences of young women in such relationships from a qualitative ethnographic approach using participant observations, focus group and semi-structured interviews. The study is rooted in gender performativity, a postmodern feminist approach to gender and sexuality which allows an individual to express his or her sexual identity and roles based on preference, freedom and responsibility. The results, based on linguistic evidence, show that through initiating sexual relationships, young women find a source of empowerment and agency that challenges their stereotyped passive roles, breaks down gender barriers in normative heterosexual relationships, and thus expand the boundary of their femininity.
Fatigue strength prediction of hybrid composites via IR-thermography and energy loss methods
Authors: Sharba Mohaiman J
Published: October 2020

Materials Fatigue life assessment is known to be a time consuming test with high cost and large sample size. To overcome these issues, non-destructive methods provide the possibility for fast determination of material fatigue limit. In the current study the high cyclic fatigue limits of jute/glass reinforced hybrid composites is determined using IR-thermography method by adopting Risitano’s thermographic approach which has not tested yet on natural fiber composites. Also, the effect of jute fiber ratio on fatigue strength of hybrid composites is investigated through three sets of hybrid. In order to validate the determined fatigue limits, the obtained results of thermography were compared with previous conventional fatigue results, also compared with the results of energy loss measurements which effectively predicted the fatigue limit of hybrid composites. Based on the achieved observation and comparisons, the accuracy of measured fatigue limits using thermography method was ranging from 92 - 98% for all composites when compared with corresponded conventional results. In addition, energy loss method has effectively predicted the fatigue limit of hybrid composites that almost matches thermography method results. Lastly, found that there is no significant influence of jute fiber content on fatigue limit detection, as all hybrid composites were almost have similar fatigue strength. According to the results obtained in this work, the reliability of thermographic technique is confirmed to measure fatigue limits of natural fiber composites.
Firefighter With Co-Morbid Psychogenic Non-Epileptic Seizures and Post-Traumatic Stress Disorder Treated With Prolonged Exposure Therapy: Long-Term Follow-Up
Authors: Myers Lorna , Trobliger Robert , Goszulak Shanneen
Published: October 2020

Psychogenic non-epileptic seizures (PNES), are events that resemble epileptic seizures but lack electrophysiological or clinical evidence for epilepsy. Instead, they are psychogenic in origin. These episodes tend to occur with alterations in consciousness and bodily functions and are the result of mechanisms of conversion. Psychological trauma and post-traumatic stress disorder (PTSD) are prevalent among patients with PNES. This is a case report of a 32-year-old male who began treatment 1-year after developing PTSD followed some months later by PNES. His seizures were characterized by contorted movements of the head and neck, guttural sounds, and left sided movements or whole-body arching and were accompanied by frequent falls and injuries. They were usually brief but occurred daily. Psychotherapy had been discontinued because violent seizures often interrupted the sessions. He was treated with prolonged exposure (PE) at a PNES program and by the last session, had achieved an improvement in his seizure frequency (one every 4–6 days rather than daily episodes). This allowed him to begin therapy with a local therapist. Two years after completing treatment, the patient returned for a follow up visit. At that point, his seizure frequency, was one per month which shows he sustained and improved on this symptom. Former head drops, and grunting sounds disappeared, and he was no longer using a cane to ambulate. From an emotional standpoint (PTSD, suicidality, anxiety, quality of life), the patient had achieved and maintained a much healthier level of functioning (though no change on alexithymia, anger, depression, and trait anxiety).
Acceptance and Commitment Therapy Delivered via Telehealth for the Treatment of Co-Occurring Depression, PTSD, and Nicotine Use in a Male Veteran
Authors: Smith Brandon P. , Coe Elizabeth , Meyer Eric C.
Published: October 2020

Symptoms of depression, posttraumatic stress, and substance use disorders commonly co-occur and are a tremendous health burden among the U.S. military veteran population. Acceptance and Commitment Therapy (ACT) is an evidence-based, transdiagnostic, integrated approach that has been used to treat these problems. Delivering psychotherapy via telehealth helps to break down barriers to care. This case study describes the application of ACT via telehealth with a male veteran with co-occurring symptoms of depression, PTSD and nicotine addiction. His depressive symptoms, PTSD symptoms, and nicotine use decreased substantially over the course of therapy. He demonstrated increased willingness to experience negatively evaluated internal experiences such as emotions and urges to use nicotine, defusion from self-critical and other unhelpful thoughts, more consistent engagement in values-consistent behaviors, and increased behavioral engagement in his social life. Treatment implications and unique aspects of the telehealth modality are discussed. Recommendations are made for training clinicians who may be considering providing services via telehealth or using ACT.
Cybersecurity threats and experimental testbed for a generator system
Authors: Werth Aaron W , Griffith SueAnne N , Hairston Jesse R , Morris Thomas H
Published: October 2020

In this work, a high-fidelity virtual testbed modeling a networked diesel generator, similar to those used commercially and by the military, is described. This testbed consists of a physical system model of a generator, a digital control system, a remote monitoring system, and physical and networked connections. The virtual testbed allows researchers to emulate a cyber-physical system and perform cyber attacks against the system without the monetary and safety risks associated with a testbed created from physical components. The testbed was used to feasibly simulate network, hardware Trojan, and software Trojan attacks against the diesel generator, and to observe the cyber and physical outcomes.
Robust fixed time controller with motor dynamics and composite disturbances for a quadrotor unmanned aerial vehicle
Authors: Shang Wei , Hu Shichao , Li Xiao , Tu Xikai
Published: October 2020

A fixed time robust control method is presented for trajectory tracking control of quadrotor systems with motor dynamics in the presence of unmodeled disturbances and external disturbances. The recommended control method avoids the negative effect to the quadrotor system caused by motor dynamic which is considered as first-order dynamic with dynamic disturbance. And fixed time extended state observer is adopted to estimate the composite disturbances and obtain the first and second derivative of desired trajectory and virtual control. Together with fixed time convergence control method, the stability and convergence characteristics of quadrotor system can be guaranteed. Finally, several simulations prove the effectiveness of the novel method with different time constants of motor dynamics.
Role of biomarkers in evaluation, treatment and clinical studies of pulmonary arterial hypertension
Authors: Hemnes Anna , Rothman Alexander M.K. , Swift Andrew J. , Zisman Lawrence S.
Published: October 2020

Pulmonary arterial hypertension is a complex disease resulting from the interplay of myriad biological and environmental processes that lead to remodeling of the pulmonary vasculature with consequent pulmonary hypertension. Despite currently available therapies, there remains significant morbidity and mortality in this disease. There is great interest in identifying and applying biomarkers to help diagnose patients with pulmonary arterial hypertension, inform prognosis, guide therapy, and serve as surrogate endpoints. An extensive literature on potential biomarker candidates is available, but barriers to the implementation of biomarkers for clinical use in pulmonary arterial hypertension are substantial. Various omic strategies have been undertaken to identify key pathways regulated in pulmonary arterial hypertension that could serve as biomarkers including genomic, transcriptomic, proteomic, and metabolomic approaches. Other biologically relevant components such as circulating cells, microRNAs, exosomes, and cell‐free DNA have recently been gaining attention. Because of the size of the datasets generated by these omic approaches and their complexity, artificial intelligence methods are being increasingly applied to decipher their meaning. There is growing interest in imaging the lung with various modalities to understand and visualize processes in the lung that lead to pulmonary vascular remodeling including high resolution computed tomography, Xenon magnetic resonance imaging, and positron emission tomography. Such imaging modalities have the potential to demonstrate disease modification resulting from therapeutic interventions. Because right ventricular function is a major determinant of prognosis, imaging of the right ventricle with echocardiography or cardiac magnetic resonance imaging plays an important role in the evaluation of patients and may also be useful in clinical studies of pulmonary arterial hypertension.
Constellations of pain: a qualitative study of the complexity of women’s endometriosis-related pain
Authors: Drabble Sarah J , Long Jaqui , Alele Blessing , O’Cathain Alicia
Published: October 2020

Introduction:

Prior research into endometriosis-related pain has focused on specific aspects of the pain experience such as cyclical pain, emotional aspects of pain and certain types of pain such as dysmenorrhea and dyspareunia. However, research has paid less attention to the diversity and complexity of women’s pain experiences, which can lead to failure to recognise some symptoms as part of endometriosis and poor symptom management.

Methods:

We conducted qualitative semi-structured face-to-face interviews with 20 women in the United Kingdom recruited from an endometriosis self-help group with a diagnosis of endometriosis via laparoscopy. A topic guide framed questions around experiences of pain. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using inductive thematic analysis.

Results:

Women experienced multiple types of pain that they felt were caused by endometriosis and affected many different parts of the body including bowel, bladder, lungs, kidneys, nerves, upper body, lower limbs and head. These pains consisted of different conceptual categories: type, pattern and intensity. These categories came together to create a complex, interrelated experience for each individual that we termed ‘constellations of pain’ because each woman had a complex set of pain categories and no two individuals appeared to have the same pain experience.

Conclusion:

The complexity and diversity of endometriosis-related pain found in this study has implications for improving diagnosis, medical and non-medical pain management and improving the clinical encounter between women and healthcare professionals.
Paralytic ileus in the United States: A cross-sectional study from the national inpatient sample
Authors: Solanki Shantanu , Chakinala Raja Chandra , Haq Khwaja Fahad , Singh Jagmeet , Khan Muhammad Ali , Solanki Dhanshree , Vyas Manasee J , Kichloo Asim , Mansuri Uvesh , Shah Harshil , Patel Achint , Haq Khwaja Saad , Iqbal Umair , Nabors Christopher , Khan Hafiz Muzaffar Akbar , Aronow Wilbert S
Published: October 2020

Introduction:

Paralytic ileus is a common clinical condition leading to significant morbidity and mortality. Most studies to date have focused on postoperative ileus, a common but not exclusive cause of the condition. There are limited epidemiological data regarding the incidence and impact of paralytic ileus and its relationship to other clinical conditions. In this cross-sectional study, we analyzed national inpatient hospitalization trends, demographic variation, cost of care, length of stay, and mortality for paralytic ileus hospitalizations as a whole.

Methods:

The National Inpatient Sample database was used to identify all hospitalizations with the diagnosis of paralytic ileus (International Classification of Diseases, 9th Revision code 560.1) as primary or secondary diagnosis during the period from 2001 to 2011. Statistical analysis was performed using Cochran–Armitage trend test, Wilcoxon rank sum test, and Poisson regression.

Results:

In 2001, there were 362,561 hospitalizations with the diagnosis of paralytic ileus as compared to 470,110 in 2011 (p < 0.0001). The age group 65–79 years was most commonly affected by paralytic ileus throughout the study period. In-hospital all-cause mortality decreased from 6.03% in 2001 to 5.10% in 2011 (p < 0.0001). However, the average cost of care per hospitalization increased from US$19,739 in 2001 to US$26,198 in 2011 (adjusted for inflation, p < 0.0001).

Conclusion:

There was a significant rise in the number of hospitalizations of paralytic ileus with increased cost of care and reduced all-cause mortality.
Unusual and rare cause of PUJ obstruction with a brief review of the literature
Authors: Sahu Priya , Singh Shashikant , Ahuja Arvind , Sharma Umesh , Mattoo Sahil , Bhardwaj Minakshi
Published: October 2020

Paragangliomas or extra adrenal pheochromocytoma of the genitourinary tract are infrequent and arise from chromaffin cells of the autonomic nervous system. They have been described in the kidney, bladder, prostate, urethra and spermatic cord. However, the occurrence of paragangliomas in the ureter is very unusual. We present one such case in a patient who presented with signs and symptoms of pelvi-ureteric junction obstruction, wherein the initial clinical and imaging findings were deceptive. The patient underwent right-sided open end-to-end uretero-ureterostomy with excision of the strictured segment. Histopathological examination of excised tissue revealed a tumour with clear cell morphology, and in conjunction with immunohistochemistry a final diagnosis of paraganglioma of the ureter was rendered. The case is discussed here with differential diagnosis in the context of its location.
A giant simple cortical cyst with a surprisingly odd presentation
Authors: Jamaluddin M , Batool Syeda Sarah , Sharif Khurram
Published: October 2020

Simple cortical cysts or simple renal cysts are one the most common benign lesions of the kidney. These are fairly prevalent in the elderly population. Simple renal cysts remain asymptomatic and are usually <2 cm, but huge renal cysts can produce symptoms and are rarely reported. We report the unique case of a 80-year-old woman with a huge renal cyst with atypical symptoms. The patient underwent open surgery through which cyst decompression with excision was done successfully. The patient’s recovery period was uneventful. We conclude that huge renal cysts may present with very unique clinical features. To the best of our knowledge, this is the most atypical presentation of a large renal cyst in the medical literature.
From ‘the mind isolated with the body’ to ‘the mind being embodied’: Contemporary approaches to the philosophy of the body
Authors: Fei Duoyi
Published: October 2020

In the interpretation of the body in the 20th century, philosophy placed less emphasis than before on its natural composition and sought to integrate value judgements from different perspectives. The philosophy of the body addresses the deepest essential problems of human society and culture, it generates a uniquely detailed analysis of human nature and its various roles and performances in social operations, and it reveals contemporary society’s operating mechanisms and deep internal contradictions. Accordingly, philosophy no longer gives the mind any priority or superiority in terms of cognition, and the focus of research has moved away from pure consciousness and towards the body. Contemporary philosophical exploration of the body covers both the concept of belongingness and the feasibility of bodily freedom. It not only foregrounds the impossibility of viewing the body and the mind as separate entities but also leads us to examine the connections between humans and the world, taking meaning, reason and the body as their basis. This paper explores the connections between body and thought in modern philosophy, traces the development of philosophy’s increasing concern with the body, elucidates the main contributions of representative figures in the field of philosophy of the body, and analyses the methodological significance and influence of the philosophy of the body as a contemporary philosophical trend.
Does Money Matter More in the Country? Education Funding Reductions and Achievement in Kansas, 2010–2018
Authors: Rauscher Emily
Published: October 2020

The U.S. Department of Education made recent technical changes reducing eligibility for the Rural and Low-Income School Program. Given smaller budgets and lower economies of scale, rural districts may be less able to absorb short-term funding cuts and experience stronger negative achievement effects. Kansas implemented a state-level finance change (block grant funding) after 2015, which froze district revenue regardless of enrollment and reduced funding in districts where enrollment increased. Difference-in-differences models compare achievement before and after block grant implementation to estimate effects of funding cuts separately in rural and nonrural districts. Between-state and within-state comparisons offer complementary identification strategies in which the strengths of one approach help address limitations of the other. Revenue/spending reductions are similar by geography but represent a larger fraction of rural district budgets. Results indicate that revenue reductions have larger implications for achievement in rural areas, where they represent a larger proportion of the total budget.
Is there still a role for cyclophosphamide in the treatment of systemic sclerosis?
Authors: Vonk Madelon C
Published: October 2020

Cyclophosphamide has been the cornerstone of treatment of systemic sclerosis for a long time and is the first-choice therapy for treating systemic sclerosis–associated interstitial lung disease according to the European League Against Rheumatism recommendations on treatment of systemic sclerosis. However, new therapeutic options are emerging, and treatment with cyclophosphamide is hampered by its toxicity and restricted possible treatment duration. This review has a focus on the evidence of efficacy of cyclophosphamide in different aspects of systemic sclerosis and its organ involvements, reviews its toxicity, and will answer the question whether there is still a role for cyclophosphamide in the treatment of systemic sclerosis, taking the evidence and current therapeutic options into account.
Prediabetes and working memory in older adults
Authors: Ennis Gilda E. , Saelzler Ursula , Umpierrez Guillermo E. , Moffat Scott D.
Published: October 2020

Insulin sensitivity, pancreatic β-cell function, fasting glucose, and 2-h post-load glucose were related to cognition in cognitively healthy nondiabetic older adults. Thirty-five adults (⩾65 years) underwent a 2-h oral glucose tolerance test and cognitive testing. Seventeen had normal glucose tolerance and 18 had intermediate hyperglycaemia or prediabetes (World Health Organization criteria). Fasting glucose and 2-h post-load glucose and oral glucose tolerance test–derived measures of β-cell function (oral disposition index) and insulin sensitivity were analysed as predictors of four cognitive domains: verbal episodic memory, verbal fluency, executive function, and working memory. The prediabetes group had significantly worse working memory performance than the normal glucose tolerance group. Controlling for age and education, decreased oral disposition index, and increased 2-h post-load glucose were significantly related to worse working memory performance. Prediabetes may worsen working memory in healthy older adults. Reduced pancreatic β-cell function should be investigated as a contributor to age-related cognitive decline.
Thiamine Dosing for the Treatment of Alcohol-Induced Wernicke’s Encephalopathy: A Review of the Literature
Authors: Smith Haleigh , McCoy Morgan , Varughese Kevin , Reinert Justin P.
Published: October 2020

Objective: To determine the most appropriate thiamine replacement regimen by evaluating safety and efficacy of the drug specific to alcohol-induced Wernicke’s encephalopathy (WE). Data Sources: A comprehensive literature search was conducted using PubMed, MEDLINE, Scopus, and ProQuest between January and August 2020 using the following keyword and Boolean search terminology: “thiamine” AND “alcohol” AND (encephalopathy OR korsakoff). Study Selection and Data Extraction: Randomized control trials; prospective, observational, and retrospective cohort analyses; and case reports and series were included in this evaluation. A confirmed diagnosis of alcohol-induced WE and treatment with parenteral or intramuscular (IM) thiamine were required for inclusion. Data Synthesis: Six publications composed of 138 patients were evaluated in this review, in which a wide variety of thiamine supplementation strategies were employed. Clinical diagnostic criteria varied significantly between publications. Doses ranged from 100 to 1500 mg intravenous thiamine and up to 300 mg IM thiamine, with no apparent difference in patient outcomes. All patients who received thiamine experienced symptom improvement, and adverse drug events were minimal. Conclusions: Despite the clinical controversy regarding the appropriate thiamine supplementation regimen, the heterogeneity of published works combined with symptom resolution across the gamut of dosing strategies makes a definitive consensus elusive. Clinicians should continue to provide parenteral or IM thiamine in doses of ≥100 mg to patients with confirmed alcohol-induced WE.