bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Dancing for Frail Older People in Residential Aged Care: A Thematic Analysis of Barriers and Facilitators to Implementation
Authors: Gomaa Yasmine S. , Slade Susan C. , Tamplin Jeanette , Wittwer Joanne E. , Gray Richard , Blackberry Irene , Morris Meg E.
Published: June 2019

Background

Adults who live in residential aged care can have reduced participation in physical activities and sit for prolonged periods. Therapeutic dancing aims to optimize movement, creative expression, well-being, and social interaction.

Objectives

To investigate the benefits, challenges, and facilitators to implementing therapeutic dancing in residential aged care.

Methods

Thematic analysis of semistructured interviews of residential aged care staff and therapists. Interviews were digitally audio-recorded and thematically analyzed. Findings: Four main themes were identified: (a) despite frailty, dancing classes afforded motor and nonmotor benefits, (b) music and dance genre selections were key to success, (c) the skills of the dance instructor were associated with successful outcomes, and (d) there were modifiable and nonmodifiable facilitators and barriers to implementation.

Conclusion

Enablers included support from management, resident supervision, age-appropriate music with a strong rhythmical beat, and a dance instructor skilled in comprehensive care. Barriers included multimorbidity, frailty, severe cognitive impairment, and funding.
Fault-tolerant controller design with fault estimation capability for a class of nonlinear systems using generalized Takagi-Sugeno fuzzy model
Authors: Navarbaf Alireza , Khosrowjerdi Mohammad Javad
Published: June 2019

In this paper, a new design approach to construct a fault-tolerant controller (FTC) with fault estimation capability is proposed using a generalized Takagi-Sugeno (T-S) fuzzy model for a class of nonlinear systems in the presence of actuator faults and unknown disturbances. The generalized T-S fuzzy model consists of some local models with multiplicative nonlinear terms that satisfy Lipschitz condition. Besides covering a very wide range of nonlinear systems with a smaller number of local rules in comparison with the conventional T-S fuzzy model and hence having less computational burden, the existence of the multiplicative nonlinear term solves the uncontrollability issues that the other generalized T-S fuzzy models with additive nonlinear terms dealt with. A state/fault observer designed for the considered generalized T-S fuzzy model and then, a dynamic FTC law based on the estimated fault information is proposed and sufficient design conditions are given in terms of linear matrix inequalities (LMIs). It can be shown that the number of LMIs are less than that of previously proposed methods and then feasibility of our method is more likely. The effectiveness of the proposed FTC approach is verified using a nonlinear mass-spring-damper system.
Natural, But Not Supernatural, Literal Immortality Affirmation Attenuates Mortality Salience Effects on Worldview Defense in Atheists
Authors: Vail Kenneth E. , Soenke Melissa , Waggoner Brett , Mavropoulou Ilianna
Published: June 2019

The present research explored whether atheists managing death awareness would be effectively buffered by affirmations of supernatural and/or natural literal immortality. Prior data were reanalyzed, revealing ambiguous results, so further experiments were conducted. In Study 1 ( n = 382), atheists were randomly assigned to a supernatural afterlife-confirmed (vs. afterlife-disconfirmed) prime, an MS (vs. control topic) prime, and then given an opportunity to engage in secular worldview defense. In Study 2 ( n = 360), atheists were randomly assigned to supernatural (afterlife) versus natural (medical indefinite life extension; MILE) immortality prime, an MS (vs. control topic) prime, and then given an opportunity to engage in secular worldview defense. Atheists managing death awareness increased worldview defense in the supernatural/afterlife conditions but that effect was eliminated in the MILE condition. These findings are consistent with the terror management theory perspective on worldview defense. Implications for theory and research are discussed.
Introduction to the special section: Gender typicality and development
Authors: Bukowski William M. , Perry David G. , Castellanos Melisa
Published: June 2019

Introduction to Special Section: Gender Typicality and Development
OR to ICU handoff: theory of change model for sustainable change in behavior
Authors: Faiz Tahira , Saeed Bushra , Ali Sadaqat , Abbas Qalab , Malik Mahim
Published: June 2019

Background

Handoff in cardiac intensive care units has been associated with improved outcomes. We aimed to determine whether a standardized protocol for handover could be implemented using the “theory of change” model by education, introduction of a checklist, and developing feedback mechanisms, measured by better knowledge transfer and bedside care provider satisfaction.

Methods

A theory of change model was developed and implemented to introduce a teamwork-driven handover process. A standardized checklist was made available at every bedside. A preintervention assessment of patient handovers was obtained by direct observation using a standardized checklist. The same checklist was used for assessment after implementation. A survey was conducted to measure intensive care unit staff perception and satisfaction with the handover process.

Results

After implementation, the standardized handover process was employed in 53 of 60 patient transfers (88.3% compliance): 49 preintervention and 29 postintervention observations were performed. Postimplementation, critical knowledge omissions (total score of 25) decreased from a median of 10 (range 4–17) to 0 (range 0–4; p < 0.001). At 6 months, knowledge omission scores improved to a median of 0 (range 0–1; p < 0.001); and 96% (24/25) of staff reported improvement in the quality of information transfer, and 100% reported improvement in overall team work.

Conclusion

Implementation of a standardized patient handover process improved the quality of knowledge transfer and overall staff satisfaction. The theory of change model is a unique and highly effective tool to implement and sustain behavior change.
Mindfulness-Based Stress Reduction in Prison: Experiences of Inmates, Instructors, and Prison Staff
Authors: Bouw N. , Huijbregts S. C. J. , Scholte E. , Swaab H.
Published: June 2019

Mindfulness intervention aims to reduce stress and to improve physical and mental health. The present study investigated feasibility and effectiveness of mindfulness intervention in a prison context, in both a qualitative and quantitative fashion. Specifically, the mindfulness-based stress reduction (MBSR) intervention was investigated, in a retrospective pre–post design, in five Dutch prisons. Twenty-two inmates (out of 25 approached, mean age: 40.1 years ( SD = 11.1), convicted of murder, manslaughter, sexual offenses, drug offenses, robbery with violence, and/or illegal restraint/kidnap, and sentenced to incarceration between 15 and 209 months ( M = 5.5 years; SD = 3.8) took part in a semistructured interview after completion of the MBSR intervention. The interviews addressed level of satisfaction and challenges regarding the MBSR intervention as well as potential effects on stress responsivity, coping style, impulse control, aggression, and self-esteem. Ten staff members and four MBSR instructors were interviewed about their own practical issues experienced while providing or facilitating the MBSR intervention, and about the effects or changes they observed in the inmates who underwent the intervention. Both participants and instructors/prison staff reported improvements in all of the addressed domains and expressed satisfaction with the intervention. Challenges were mainly identified in practical issues regarding the organization of the intervention sessions. Future studies should investigate mindfulness in longitudinal randomly controlled designs, should strive for a multi-method approach, and distinguish inmates according to personality characteristics.
“I Forgive My Sons for Any Disgust They Might Have Caused Me”: Alvise I Mocenigo and the Decline of Paternal Authority in Nineteenth-century Venice
Authors: Delmedico Sara
Published: June 2019

To a nineteenth-century noble family, cohesion was synonymous with status and played a major role in the construction of its identity as part of a powerful social class. Within this society—so reliant on inequality and strongly centered around obedience and hierarchy—the story of Alvise I Mocenigo and his sons shows how the paterfamilias problematized his relatives’ insubordination and how, despite the several challenges to his authority, his decisions regarding the devolution of his wealth were driven to ensure the continuing of the family name and status. In doing so, Alvise bequeathed his goods to his grandsons (i.e., sons of his unsubordinated son, who at that time was already dead) and penalized his own sons. When one of his disinherited sons, Alvise IV Pietro Giulio, went before a court to claim his rightful share of the paternal patrimony, he was not just challenging his father’s will but his own world, where personal ambitions and expectations had to be sacrificed in the name of obedience and family honor. Through the consultation of a number of firsthand materials such as letters, wills, and judicial records held at Venetian archives, this article contributes to the understanding of the Venetian upper-class families and uncovers the changing family dynamics in place in nineteenth-century society.
Chondrogenic Progenitor Cells Exhibit Superiority Over Mesenchymal Stem Cells and Chondrocytes in Platelet-Rich Plasma Scaffold-Based Cartilage Regeneration
Authors: Wang Ketao , Li Ji , Li Zhongli , Wang Bin , Qin Yuanyuan , Zhang Ning , Zhang Hao , Su Xiangzheng , Wang Yuxing , Zhu Heng
Published: June 2019

Background:

Platelet-rich plasma (PRP) has been considered a promising tool for cartilage regeneration. However, increasing evidence has demonstrated the controversial effects of PRP on tissue regeneration, partially due to the unsatisfactory cell source. Chondrogenic progenitor cells (CPCs) have gained increasing attention as a potential cell source due to their self-renewal and multipotency, especially toward the chondrogenic lineage, and, thus, may be an appropriate alternative for cartilage engineering.

Purpose:

To compare the effects of PRP on CPC, mesenchymal stem cell (MSC), and chondrocyte proliferation, chondrogenesis, and cartilage regeneration.

Study Design:

Controlled laboratory study.

Methods:

Whole blood samples were obtained from 5 human donors to create PRPs (0, 1000 × 109, and 2000 × 109platelets per liter). The proliferation and chondrogenesis of CPCs, bone marrow–derived MSCs (BMSCs), and chondrocytes were evaluated via growth kinetic and CCK-8 assays. Immunofluorescence, cytochemical staining, and gene expression analyses were performed to assess chondrogenic differentiation and cartilaginous matrix formation. The in vivo effects of CPCs, BMSCs, and chondrocytes on cartilage regeneration after PRP treatment were measured by use of histopathological, biochemical, and biomechanical techniques in a cartilage defect model involving mature male New Zealand White rabbits (critical size, 5 mm).

Results:

The CPCs possessed migration abilities and proliferative capacities superior to those of the chondrocytes, while exhibiting a chondrogenic predisposition stronger than that of the BMSCs. The growth kinetic, CCK-8, cytochemical staining, and biochemical analyses revealed that the CPCs simultaneously displayed a higher cell density than the chondrocytes and stronger chondrogenesis than the BMSCs after PRP stimulation. In addition, the in vivo study demonstrated that the PRP+CPC construct yielded better histological (International Cartilage Repair Society [ICRS] score, mean ± SEM, 1197.2 ± 163.2) and biomechanical (tensile modulus, 1.523 ± 0.194) results than the PRP+BMSC (701.1 ± 104.9, P < .05; 0.791 ± 0.151, P < .05) and PRP+chondrocyte (541.6 ± 98.3, P < .01; 0.587 ± 0.142, P < .01) constructs at 12 weeks after implantation.

Conclusion:

CPCs exhibit superiority over MSCs and chondrocytes in PRP scaffold-based cartilage regeneration, and PRP+CPC treatment may be a favorable strategy for cartilage repair.

Clinical Relevance:

These findings provide evidence highlighting the preferable role of CPCs as a cell source in PRP-mediated cartilage regeneration and may help researchers address the problem of unsatisfactory cell sources in cartilage engineering.
Accountability or Efficiency? Body-Worn Cameras as Replicative Technology
Authors: Koslicki Wendy M.
Published: June 2019

Body-worn cameras (BWCs) have been implemented and studied at an unprecedented rate since their emergence in the mid-2000s, largely due to their touted benefits of increasing police accountability. As current empirical research is largely inconclusive regarding BWC effects on police organizational change, the present study approaches the question of whether BWCs will fundamentally change occupational and organizational police culture by applying the theories of Manning’s and Chan’s interpretation of Bourdieu regarding police culture and technology. The findings of the theoretical application conclude that BWCs will likely become replicative technology, meaning that their primary effects will be to increase the efficiency of current police tactics rather than change the fundamental practices and values of policing. BWCs may also become symbolic in that their use may represent increased accountability and legitimacy while the core of police culture remains largely unchanged. Due to the limits of technology in achieving greater police accountability, police practitioners and scholars are encouraged to refocus on the fundamental processes of recruiting, selection, hiring, and training, and ways to improve these practices to encourage a culture of greater accountability.
Perspectives and Experiences of Persons With Dementia With Advance Care Planning: An Integrative Literature Review
Authors: Geshell Lisa , Kwak Jung , Radhakrishnan Kavita
Published: June 2019

Objective:

An integrative review of the literature on advance care planning (ACP) preferences and practices from the perspective of persons with dementia (PWDs) was conducted, both to learn how health-care providers might engage and empower PWDs in ACP during the early stages of dementia and to identify where researchers should focus future work to improve ACP in this population.

Methods:

In November 2017, CINAHL, Legal Collection, PsycINFO, PubMed, and SocIndex were searched for empirical studies with PWDs as participants and ACP as a topic of interest.

Results:

Eighteen articles, which sampled 1304 PWDs, were found, focusing on 4 domains: engagement in and correlates of ACP participation; ability and attitudes toward ACP participation; ACP interventions; and values and preferences for end of life (EOL). Demographics were reported for correlates of participation. Many PWDs held a neutral to negative view toward ACP, although values exploration exercises in interventions were well received. No intervention study reported significant findings for ACP participation. Most PWDs emphasized the importance of family at EOL.

Conclusion:

Research is needed with methodologically rigorous designs and theoretical frameworks that examine cognitive, psychosocial, and environmental factors influencing ACP attitudes, preferences, and behaviors among PWDs in order to improve engagement among this population.
Vibration source identification of a heavy commercial vehicle cab based on operational transfer path analysis
Authors: Zhang Zhiyong , Pan Da , Wu Wenguang , Huang Caixia
Published: June 2019

Operational transfer path analysis is applied in this study to identify the vibration source and its critical transfer path. A simple analytical five-degrees-of-freedom mechanical isolation system is first taken as an example to illustrate the analysis flow and to validate the accuracy of operational transfer path analysis. The acceleration amplitude spectrum of the receiver is used to prove the accuracy, and the path contribution of each path is used to identify the critical path. Operational transfer path analysis is then applied to the cab mount system of a heavy commercial vehicle to identify the vibration source and its critical transfer path. The vibration energy propagation capabilities from the four cab mounts to the driver’s seat are analyzed by operational transfer path analysis with the path contribution analysis, and the maximum vibration source is identified by the path operation contribution analysis. The analysis and evaluation method of the operational transfer path analysis introduced in this study can provide a research foundation and reference for vibration or noise source identification in mechanical systems.
Relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress in a textile industry
Authors: Abbasi Milad , Yazdanirad Saeid , Habibi Peymaneh , Arabi Saeid , Fallah Madvari Rohollah , Mehri Ahmad , Poursadeghiyan Mohsen , Ebrahimi Mohammad Hossein , Ghaljahi Maryam
Published: June 2019

The purpose of this study was to investigate the relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress among the workers of a textile industry. In this study, Weinstein’s Noise Sensitivity Scale, Noise Annoyance Questionnaire (recommended based on ISO 15666-2003), Health and Safety Executive (HSE) Job Stress Questionnaire, and Job Satisfaction Scale were used to determine the degree of noise sensitivity, noise annoyance, occupational stress, and job satisfaction, respectively. The results showed that there was a significant difference in the mean of job satisfaction, job stress, noise sensitivity, and noise annoyance between case and control groups. The results of multivariate analysis of covariance showed that noise exposure, noise sensitivity, and noise annoyance can justify 0.09, 0.19, and 0.06 of the variance of job stress, respectively. These variables also could justify 0.09, 0.12, and 0.05 of the variance of job satisfaction, respectively. Noise sensitivity had the greatest effect on increasing the occupational stress and job satisfaction.
Organizational Characteristics and Small Firms’ Performance Revisited
Authors: Cragg Paul B. , King Malcolm
Published: June 2019

Numerous studies have attempted to gain a greater understanding of small firm performance with the intent of isolating factors which are important for success. The studies, some with serious limitations, suggest that many different variables are Important to success. A further study of 179 small, metal goods manufacturers enabled some of the specific relationships to be re-examined, but with mixed support for previous findings. Various suggestions are made for future research studies. A causal model of small firm financial performance is proposed.
Deconstructing Information Elaboration: The Critical Role of Framing and Initial Dialogue
Authors: Sanner Bret , Evans Karoline
Published: June 2019

Information elaboration is crucial for successfully responding to change, and teams inevitably frame changes to ground them. Yet, there is sparse knowledge around how framing affects information elaboration. In investigating the relationship that framing has with information elaboration, we show that framing starts a domino effect throughout the phases of information elaboration. Our experiment shows that opportunity framing motivates teams to engage with the change by asking questions about it, which increases the sharing and integrating of unique information, thereby improving decision performance. In contrast, threat framing is followed by avoiding the change through making status quo-directed statements and then discussing shared information, ultimately lowering decision performance. Our findings contribute to the information elaboration literature by helping explain differences in information elaboration’s effectiveness through uncovering interdependent behaviors. Next, we move information elaboration’s antecedents beyond static characteristics to include dynamic tactics.
Scandcleft Project, Trial 1: Comparison of Speech Outcome in Relation to Timing of Hard Palate Closure in 5-Year-Olds With UCLP
Authors: Willadsen Elisabeth , Lohmander Anette , Persson Christina , Boers Maria , Kisling-Møller Mia , Havstam Christina , Elander Anna , Andersen Mikael
Published: June 2019

Objective:

To compare in-depth speech results in Scandcleft Trial 1 as well as reference data from peers without cleft palate (CP).

Design:

A prospective randomized clinical trial.

Setting:

A Danish and a Swedish CP center.

Participants:

143 of 148 randomized 5-year-olds with unilateral cleft lip and palate. All received lip and velum closure at 4 months, and hard palate closure at 12 months (arm A) or 36 months (arm B).

Main Outcome Measures:

A composite measure based on velopharyngeal competence (VPC) or velopharyngeal incompetence (VPI), an overall assessment of VPC from connected speech (VPC-Rate), Percentage of Consonants Correct (PCC-score), and consonant errors. Speech therapy visits, average hearing thresholds, and secondary pharyngeal surgeries documented burden of treatment.

Results:

Across the trial, 61.5% demonstrated VPC and 38.5% VPI. Twenty-two percent of participants achieved age appropriate PCC-scores. There were no statistically significant differences between arms or centers for these measures. In the Danish center, arm B: achieved lower PCC-scores ( P = .01); obtained PCC-scores without s-errors below 79% ( P = .002); produced ≥3 active oral cleft speech characteristics ( P = .004) than arm A. In both centers, arm B attended more speech visits.

Conclusions:

At age 5, differences between centers and treatment arms were not statistically significant for VPC/VPI, but consonant proficiency differed between treatment arms in the Danish center. Poor speech outcomes were seen for both treatment arms. Variations between centers were observed. As the Swedish center had few participants, intercenter comparisons should be interpreted with caution.
Envisioning Two-Way Immersion Language Learning in China: An Initial Kindergarten Curriculum Plan
Authors: Zhang Kaili C.
Published: June 2019

This article describes the practical application of an innovative bilingual preschool program that involves two-way immersion of both English and Chinese in classrooms. This has not been written about extensively, especially in the context of early childhood classrooms in Asian countries. The primary goal of the two-way immersion kindergarten is to offer children aged 3 to 5 the opportunity to achieve their maximum potential in all aspects of personal growth by using an enriched bilingual education model and an integrated learning curriculum. This initial curriculum plan has been developed for a two-way immersion kindergarten in Beijing, China. This framework articulates the goals of the program, program planning, implementation and design, as well as the expectations for these children. Samples of preschool and kindergarten schedules, Kindergarten Year 1 (K-1) curriculum projects, and Kindergarten Year 2 (K-2) curriculum maps are included in Supplementary A, B, and C. A detailed description of different type of activity centers is given in Supplementary D.
Giant Primary Neuroendocrine Neoplasms of the Liver: Report of 2 Cases With Molecular Characterization
Authors: Pastrián Laura G. , Ruz-Caracuel Ignacio , Gonzalez Raul S.
Published: June 2019

Primary neuroendocrine neoplasms of the liver have occasionally been reported in the liver, though many reports do not convincingly exclude metastases. In this article, we report 2 “giant” hepatic neuroendocrine lesions without evidence of a primary elsewhere after clinical workup. One occurred in a 21-year-old male; the lesion was a large cell neuroendocrine carcinoma measuring 24 cm. The patient died of disease in 10 months. The other occurred in a 25-year-old patient, was 18 cm wide, and was diagnosed as a well-differentiated neuroendocrine tumor, World Health Organization grade 3. The patient died of disease after 30 months. Molecular testing demonstrated only the presence of TP53 mutations in common. These cases expand our knowledge of seemingly primary neuroendocrine neoplasms of the liver, in particular, giant cases measuring more than 8 cm. Guidelines for clinical workup and therapy for these lesions remain unclear, but future thorough workup of such cases is necessary for specific characterization.
Clinical Outcomes of Retrograde Intrarenal Surgery as a Primary Treatment for Staghorn Calculi: A Single-Center Experience
Authors: Niwa Naoya , Matsumoto Kazuhiro , Ohigashi Takashi , Komatsuda Akari , Katsui Masahiro , Bessyo Hideharu , Arakawa Takashi
Published: June 2019

Objective:

We investigated the efficacy and safety of retrograde intrarenal surgery (RIRS) as a primary treatment for staghorn calculi.

Methods:

From 2012 to 2016, we identified 39 patients with staghorn calculi who received RIRS as a primary treatment. During the study period, no staghorn calculi were treated primarily with percutaneous nephrolithotomy or any other modality. A stone-free status after RIRS was defined as no detectable stone fragments on X-rays or computed tomography scans.

Results:

Of 39 patients who received 134 procedures (median 3 procedures per patient; range: 1-11; mean stone length: 60.5 ± 23.0 mm), 18 (46%) and 21 (54%) had staghorn calculi <60 and >60 mm in maximum length, respectively. The stone-free rates after the first and final procedures were 21% (8 of 39) and 62% (24 of 39), respectively; overall, 39% (7 of 18) and 78% (14 of 18), respectively, for the 18 patients with <60 mm staghorn calculi; and 5% (1 of 21) and 48% (10 of 21), respectively, for the 21 patients with >60 mm calculi. Multivariate analysis revealed a maximum stone length >60 mm to be the only independent predictor of a stone-free status after the first and final procedures. During the treatment series, perioperative complications occurred in 16 (41%) patients. Only one patient presented with a Clavien-Dindo grade III complication (malposition of a ureteral stent).

Conclusions:

RIRS is a safe and effective treatment option for staghorn calculi.
Tourism, insularity, and remoteness: A gravity-based approach
Authors: Dropsy Vincent , Montet Christian , Poirine Bernard
Published: June 2019

This study investigates the sensitivity of bilateral tourism flows to distance, relative prices, and cultural and political proximity variables, with a special focus on small island destinations, using a gravity model. We find that these flows are negatively affected by larger distances between origin and destination countries and by lower gross domestic product (GDP) in both countries. There are significant differences between our subset of islands and other nations. On the one hand, small islands have higher elasticities of demand with regard to distance and destination GDP and are at a disadvantage compared to other destinations since they are small and remote. Furthermore, they have a much higher price elasticity of demand. On the other hand, sharing a common language and a common colonial past with the origin country has a greater positive impact on tourism flows to small islands than to other countries.
Gateways for consumption: A rhythmanalysis
Authors: Massey Joanne
Published: June 2019

This article uses participant observation data to explore teenagers’ presence in two urban public spaces in Manchester, England. The urban spaces under investigation are public, but surrounded by retail outlets and act as gateways for consumption. The aim is to answer the question ‘how do the rhythms of teenage life differ when ordinary and extraordinary activities occur in urban public spaces of consumption?’ Lefebvre’s Rhythmanalysis is employed to analyse the data and identify instances of eurhythmia (harmonious rhythms), arrhythmia (discordant rhythms) and polyrhythmia (multiple simultaneous rhythms) during periods of typical and extraordinary use. Ordinarily the teenagers used the spaces of consumption to mostly meet and socialise with friends with a small number of them using the space to skateboard. This occurred harmoniously alongside others who pass through these gateways to consumption indicating multiple rhythms. The findings indicate that the teenagers were displaced from urban space during the staging of official events which involved increased control from authorities such as the local council and police. They were replaced by a different crowd of people consisting of mostly families and adults. Paradoxically, the ‘festival’ atmosphere created by extraordinary events in the gateways of consumption resulted more interaction among those present despite increased control from the authorities. Rhythmanalysis proved useful in understanding of spaces when researching spaces of consumption, as it exposes the temporal and fluid nature of urban space. Ultimately, there was no room for the presence of regular users (teenagers) during the staging of extraordinary events indicating a lack of multiple rhythms.
Aberrant Extracranial Branch Prevents Internal Carotid Artery Occlusion
Authors: Ettaher Abraham , Scissons Robert , Afridi Sophia
Published: June 2019

The internal carotid artery (ICA) is a terminal vessel that does not give rise to branches in the extracranial segment. The ICA occlusion typically extends to the first intracranial branch, the ophthalmic artery. We present a rare case of isolated ICA occlusion with distal patency due to an aberrant extracranial branch. A 52-year-old man with longstanding tobacco use, hypertension, hyperlipidemia, diabetes, and extensive coronary artery disease was referred to the vascular laboratory for evaluation of carotid disease. The patient had no history of transient ischemic attack (TIA), amaurosis fugax, or cerebrovascular accident. Carotid duplex results prompted further evaluation by computed tomography angiography (CTA). Duplex imaging demonstrated right common carotid artery (CCA) plaque with significantly elevated velocities and turbulent flow extending into the ICA. Mild heterogeneous plaque was noted proximally in the left ICA followed by less than 2-cm occlusion and reconstitution of flow in the distal extracranial segment. The CTA testing revealed a moderate right CCA stenosis, mild proximal left ICA plaque and an isolated occlusion of the mid-ICA and distal reconstitution via an aberrant collateral branch. The left intracranial ICA segment remained patent throughout its course but was of smaller caliber. Aberrant branches of the extracranial ICA are unusual and rarely identified by carotid duplex analysis. Awareness of this anomaly underscores the importance of determining patency of distal ICA flow in the presence of an occluded proximal segment; aberrant collaterals can make surgical exploration and endarterectomy in these patients feasible.
Brain Activations During Optokinetic Stimulation in Acute Right-Hemisphere Stroke Patients and Hemispatial Neglect: An fMRI Study
Authors: von der Gablentz Janina , Könemund Inga , Sprenger Andreas , Heide Wolfgang , Heldmann Marcus , Helmchen Christoph , Machner Björn
Published: June 2019

Objective. Leftward optokinetic stimulation (OKS) is a promising therapeutic approach for right-hemisphere stroke patients with left hemispatial neglect. We questioned whether the putative neural basis is an activation of frontoparietal brain regions involved in the control of eye movements and spatial attention. Methods. We used functional magnetic resonance imaging to investigate brain activations during OKS in acute right-hemisphere stroke patients (RHS, n = 19) compared with healthy control subjects (HC, n = 9). Based on neuropsychological testing we determined the ipsilesional attention bias in all RHS patients, 11 showed manifest hemispatial neglect. Results. In HC subjects, OKS in either direction led to bilateral activation of the visual cortex (V1-V4), frontal (FEF) and supplementary (SEF) eye fields, intraparietal sulcus (IPS), basal ganglia, and thalamus. RHS patients’ activations were generally reduced compared with HC. Nevertheless, leftward OKS bilaterally activated the visual cortex (V1-V4), FEF, SEF, IPS, and thalamus. The neural response to OKS was negatively correlated with patients’ behavioral impairment: The greater the individual attention bias/neglect the weaker the brain activations. Conclusion. In RHS patients, leftward OKS activates frontoparietal regions (FEF, IPS) that are spared from structural brain damage and functionally involved in both oculomotor control and spatial attention. This may provide a neural basis for the known therapeutic effects of OKS on hemispatial neglect. In acute stroke stages, reduced activation levels correlating with neglect severity indicate functional downregulation of the underlying dorsal attention network. Therefore, chronic RHS patients with less severe neglect after recovery of network disturbances may be more suitable candidates for OKS rehabilitation.
Hamstring Muscle Activity After Primary Anterior Cruciate Ligament Reconstruction—A Protective Mechanism in Those Who Do Not Sustain a Secondary Injury? A Preliminary Study
Authors: Palmieri-Smith Riann M. , Strickland Meagan , Lepley Lindsey K.
Published: June 2019

Background:

Individuals who experience a subsequent ipsilateral anterior cruciate ligament (ACL) reinjury may use hazardous muscle activation strategies after primary ACL reconstruction (ACLR). The purpose of this study was to compare electromyograms (EMGs) of the quadriceps, hamstrings, and gastrocnemius muscles during a dynamic hopping task among individuals with a single ACL injury (ACLx1), individuals who went on to have secondary ipsilateral ACL injury (ACLx2), and individuals who have never sustained an ACL injury (ACLx0).

Hypothesis:

We expected that individuals who went on to experience a secondary ACL injury would use less quadriceps muscle activity as compared with individuals who experienced a single ACL injury.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

Fourteen individuals that were returned to play post-ACLR and 7 non-ACL-injured individuals participated. Individuals who had undergone an ACLR were placed into groups depending on whether they had experienced a secondary ipsilateral ACL reinjury postprimary ACLR. EMG data of the vastus lateralis, biceps femoris, and lateral gastrocnemius were measured during 2 phases of a single-leg dynamic hopping task: preactivity (100 ms prior to ground contact) and reactivity (250 ms post–ground contact). Processed EMG data were compared across groups using 1-way analyses of variance, with post hoc independent t tests where appropriate ( P ≤ 0.05).

Results:

At preactivity, ACLx1 (0.48% ± 0.2%max) was found to use significantly more hamstring activity than ACLx2 (0.20% ± 0.1%max, P = 0.018), but not than ACLx0 (0.38% ± 0.1%max, P > 0.05). At reactivity, both ACL groups were found to use less quadriceps activity than ACLx0 (ACLx1: 0.38% ± 0.1%max, P = 0.016; ACLx2: 0.40% ± 0.1%max, P = 0.033; ACLx0: 0.58% ± 0.1%max), but not than each other ( P > 0.05).

Conclusion:

Quadriceps muscle activity during landing was diminished in all ACL participants as compared with participants who had never sustained an ACL injury. Individuals who did not experience a secondary ipsilateral ACL reinjury (ACLx1) used greater levels of hamstring activity prior to landing.

Clinical Relevance:

The higher hamstring activity in patients who did not experience a secondary injury may be interpreted as a protective mechanism that is used to dynamically stabilize the reconstructed limb.
A computationally efficient numerical model for progressive collapse analysis of reinforced concrete structures
Authors: Li Zhong-Xian , Zhong Bo , Shi Yanchao , Ding Yang , Hao Yifei
Published: June 2019

Although marked advancements have been achieved to improve the computer power, progressive collapse analysis of large-scale reinforced concrete structures is still time-consuming or even impractical. In this study, a numerical model is proposed for efficient progressive collapse analysis of reinforced concrete structures. Recent advancements that can accurately and efficiently model the mechanical behavior of structural components are incorporated in the numerical model of reinforced concrete structure. The beams/columns, joint regions, and slabs are modeled by enhanced fiber beam element, macrojoint model, and layered shell element, respectively. In this way, the shear failure of beams/columns, failure of joints, and resistance contribution from floor slab can be taken into account for progressive collapse analysis of reinforced concrete structures. A six-story reinforced concrete frame structure is modeled using the approach proposed in this study. The progressive collapse of the structure is analyzed under column removal and direct blast loading scenarios. For comparison purpose, other popularly used finite element models are also adopted to carry out numerical simulations. The proposed model is proven to yield accurate simulation results with the least cost of time among all models. Based on the proposed model, parametric simulations are performed to investigate effective measures to improve the structural resistance to progressive collapse. It is found that increasing longitudinal reinforcement ratio in beams and columns can increase the catenary action capacity, but hardly increases the compressive arch action capacity. Moreover, the steel mesh reinforcement at top layer of slabs plays a significant role in resisting progressive collapse of reinforced concrete structures, which should be considered in design to resist progressive collapse.
Adrenal crisis: prevention and management in adult patients
Authors: Dineen Rosemary , Thompson Christopher J , Sherlock Mark
Published: June 2019

Adrenal crisis is an acute life-threatening emergency contributing to the excess mortality that is reported in patients with adrenal insufficiency. The incidence of adrenal crisis is estimated to be 8 per 100 patient years in patients with adrenal insufficiency. Patients with adrenal crisis present systemically unwell with nonspecific signs and symptoms often leading to misdiagnosis and delayed treatment. An adrenal crisis may be the first presentation of adrenal insufficiency or can occur in patients who have been established on glucocorticoid replacement therapy. Infections are the major precipitating factor, but other causes include physical stress such as a surgical procedure or trauma, forgetting or discontinuing glucocorticoid therapy, pronounced physical activity, and psychological stress. The emergency treatment involves prompt recognition and administration of parenteral hydrocortisone, rehydration and management of electrolyte abnormalities. Prevention is centred around patient education. All patients should be educated on stress dosing and parenteral glucocorticoid administration. They should carry a steroid dependency alert card and wear a medical alert bracelet or similar identification. Despite many improvements in the management of patients with adrenal insufficiency, adrenal crisis continues to occur and represents a major source of morbidity, mortality and distress for patients. Improved patient and clinician education and measures to facilitate parenteral hydrocortisone self-administration in impending crisis are central to the management of this life-threatening event.
Pharmacological effects and safety monitoring of anabolic androgenic steroid use: differing perceptions between users and healthcare professionals
Authors: Hill Stephanie A. , Waring W. Stephen
Published: June 2019

Background:

Androgenic anabolic steroids (AASs) have a number of licensed clinical indications but are also subject to abuse within the body building community. They have a number of potentially important adverse pharmacological effects, and users require health monitoring, including selected laboratory investigations. The extent to which AAS users are able to seek medical supervision and the ability of healthcare providers to respond to the needs of users is uncertain. The present study sought to ascertain how AAS abusers interact with healthcare providers, and self-reported knowledge among doctors regarding the healthcare effects and need for monitoring of AAS users.

Methods:

Questionnaires were administered, and there were 216 respondents among AAS users and 134 doctors.

Results:

A high proportion of AAS users cited various barriers to accessing healthcare, including 136 of 189 (72%) that reported a fear of reproach, and 107 of 194 (55%) that had avoided seeking medical advice; 137 of 193 respondents (71%) did not disclose AAS use to healthcare professionals. Doctors across a broad range of seniority stated a lack of knowledge of AASs; 130 (97%) had received no formal training, and 109 (82%) did not know which blood tests could be used for safety monitoring.

Conclusions:

The present study has highlighted some perceptions among the body-building community that create obstacles to them accessing appropriate safety monitoring while using AASs. Doctors may not have adequate knowledge of AASs, which may prevent them giving accurate and complete information. Further work is needed to address the barriers of communication between users and health professionals in order to facilitate better healthcare monitoring and drug safety.
A test of the initiation–termination model of worry
Authors: Berenbaum Howard , Chow Philip I. , Flores Luis E. , Schoenleber Michelle , Thompson Renee J. , Most Steven B.
Published: June 2019

An initial test of the initiation–termination model of worry was conducted in a sample of 51 individuals (half of whom had at least one anxiety disorder). On multiple occasions each day, participants were prompted to answer a variety of questions regarding their worrying. Worrying about new topics was presumed to reflect ease of worry initiation, whereas continuing to worry about the same topics and the duration of worrying were presumed to reflect difficulty with worry termination. Results aggregated across the sampling period revealed that worry initiation and termination incrementally predicted global worry and anxiety severity and were differentially associated with depression severity and emotion-induced blindness. Multilevel modeling indicated that, within participants, worry initiation and termination were differentially associated with the perceived costs of undesirable outcomes and with worry beliefs.
Attentional control associated with core cognitive maintenance factors of social anxiety
Authors: Sluis Rachel A. , Boschen Mark J. , Neumann David L. , Murphy Karen
Published: June 2019

Models of social anxiety emphasize anticipatory processing (AP) and post-event processing (PEP) as repetitive negative thinking (RNT) processes that occur before and after social-evaluative events, respectively. Both AP and PEP have been implicated as maladaptive processes which maintain social anxiety. Accordingly, a common vulnerability, such as poor attentional control, may serve to maintain both. The present research included two separate samples to investigate the relationship between attentional control and AP (Sample 1) and PEP (Sample 2). Participants ( n = 49 for Sample 1; n = 35 for Sample 2) completed self-report measures of social anxiety, AP or PEP, attentional control, and trait anxiety. Poorer total attentional control was associated with social anxiety in both samples. In addition, attentional control total and attentional shifting were negatively associated with PEP (Sample 2) but not with AP (Sample 1). Mediation modeling suggested that trait anxiety mediated the relationship between total attentional control and PEP. The findings suggest that attentional control plays a role in the regulation of emotion, such as anxiety, and RNT processes, such as PEP, but not AP.
Isolating therapeutic procedures to investigate mechanisms of change in cognitive behavioral therapy for depression
Authors: Bruijniks Sanne J. E. , Sijbrandij Marit , Schlinkert Caroline , Huibers Marcus J. H.
Published: June 2019

Background:

Isolating a therapeutic procedure might be a powerful way to enhance our understanding of how cognitive behavior therapy (CBT) works. The present study explored new methods to isolate cognitive procedures and to study their direct impact on hypothesized underlying processes and CBT outcome.

Method:

The effects of a cognitive therapy skill acquisition procedure ( n = 36) were compared to no procedure ( n = 36) on cognitive therapy skills, dysfunctional thinking, distress, and mood in response to induced distress following a social stress test in healthy participants.

Results:

Participants reported more cognitive therapy skills after the procedure that focused on the acquisition of cognitive therapy skills compared to no procedure, but there were no differences in dysfunctional thinking, distress, and mood between the groups.

Conclusions:

By demonstrating an experimental approach to investigate mechanisms of change, including the pitfalls that come along with it, the present experiment provides a blueprint for other researchers interested in the underlying mechanisms of change in CBT for depression.
Blinded by our emotions: The impact of borderline personality disorder and affect on emotion recognition sensitivity
Authors: McMahon Kibby , Kim Kwanguk , Fang Caitlin M. , Neacsiu Andrada D. , Rosenthal M. Zachary
Published: June 2019

Previous studies have demonstrated abnormalities in emotion recognition within individuals diagnosed with borderline personality disorder (BPD). However, it is yet unknown how much these abnormalities can be attributed to emotional states or affect. Therefore, the current study aimed to investigate the independent effects of BPD, positive affect, and negative affect on emotion recognition sensitivity. We recruited a mixed, transdiagnostic community sample of 118 adults diagnosed with either a personality disorder, only an affective disorder, or without psychopathology. Participants completed self-report assessments of positive and negative affect and two behavioral assessments of emotion recognition sensitivity. We found that both positive and negative affect predict lower overall emotion recognition sensitivity in both tasks, beyond the effect of BPD. We did not find a significant, independent effect of the diagnosis of BPD. Additionally, we found that the diagnosis of BPD moderated the relationship between negative affect and emotion recognition sensitivity within one task. Findings from the present study suggest that sensitivity to other people’s emotional expressions may be influenced by affect beyond the effect of the BPD diagnosis. The implications for future research efforts on emotion recognition and BPD are discussed.