A New Method for Estimating the Moisture Content and Flexibility of Polymerised Bentonite Clay Mat

This paper presents a scientific development to address the current absence of a convenient technique to identify the ductile to brittle transition of bentonite clay mats. The instrumented indentation and 3-point bending tests were performed on different liquid polymer hydrated bentonite clay mats at varying moisture content. Properties measured include modified Brinell Hardness Number (BHN) and elastic structural stiffness (EI). The dependence of flexural stiffness on moisture content is demonstrated to conform to a best power function variation. The ductile to brittle transition of clay mat is affected primarily by the change in the moisture content and for the clay mat to remain flexible, critical moisture content of 1.7 times of its plastic limit is required. Results also indicate that a strong correlation between indentation hardness and the structural stiffness. The subsequent outcome in the development of a portable quality control device to monitor the acceptable moisture content level to ensure flexibility of the clay mats was also described in this paper.

'Day number': a promoter routine of flexibility and conceptual understanding

This paper is part of the Project “Adaptive thinking and flexible computation: Critical issues”. In this paper we discuss different perspectives of flexibility and adaptive thinking in literature. We also discuss the idea of proceptual thinking and how this idea is important in our perspective of adaptive thinking. The paper analyses a situation developed with a first grade classroom and its teacher named the day number. It is a daily activity at the beginning of the school day. It consists on to look for the date number and to think about different ways of writing it using the four arithmetic operations. The analyzed activity was developed on March 19, so the challenge was to write 19 in several ways. The data show the pupils’ enthusiasm and their efforts to find different ways of writing the number. Some used large numbers and division, which they were just starting to learn. The pupils presented symbolic expressions of 19, decomposing and recomposing it in a flexible manner.

Prevalence of thoracic spine pain in a surveillance network

International audience

Validation of the Flexibility of Responses to Self-Critical Thoughts Scale (FoReST) in a clinical population

Background: The Flexibility of Responses to Self-Critical Thoughts Scale (FoReST) is a questionnaire that was developed to assess whether people can be psychologically flexible when experiencing critical thoughts about themselves. This measure could have important application for evaluating third wave therapies such as Acceptance and Commitment Therapy (ACT) and Compassion Focused therapy (CFT). This study investigated the validity (concurrent, predictive and incremental), internal consistency and factor structure of the FoReST in a sample of people experiencing mental health difficulties. Method: A total of 132 individuals attending Primary Care and Community Mental Health Teams within NHS Greater Glasgow and Clyde (NHS GGC) and Psychological Therapy Teams within NHS Lanarkshire participated in this study. Participants completed a battery of assessments that included the FoReST and related measures of similar constructs (psychological flexibility, self-compassion and self-criticism) and measures of mental health and well-being. A cross-sectional correlational design was used. Results: An Exploratory factor analysis described an interpretable 2-factor structure within the items of the FoReST: unworkable action and experiential avoidance. The FoReST demonstrated good internal consistency ( = .89). Concurrent validity was supported through moderate to strong correlations with similar measures and moderate correlations with other mental health and well-being outcomes. Conclusions: The FoReST appears to be a valid assessment measure for using with individuals experiencing mental health difficulties. This new measure will be of use for practitioners using ACT, CFT and those integrating both, to help monitor the process of change in flexibility and self-critical thinking across therapy. Further longitudinal studies are required to assess the test-retest reliability of the FoReST.

Influences of change strategies to achieve organizational flexibility: a system dynamics approach.

257 p.

High protein flexibility and reduced hydration water dynamics are key pressure adaptive strategies in prokaryotes

Water and protein dynamics on a nanometer scale were measured by quasi-elastic neutron scattering in the piezophile archaeon Thermococcus barophilus and the closely related pressure-sensitive Thermococcus kodakarensis, at 0.1 and 40 MPa. We show that cells of the pressure sensitive organism exhibit higher intrinsic stability. Both the hydration water dynamics and the fast protein and lipid dynamics are reduced under pressure. In contrast, the proteome of T. barophilus is more pressure sensitive than that of T. kodakarensis. The diffusion coefficient of hydration water is reduced, while the fast protein and lipid dynamics are slightly enhanced with increasing pressure. These findings show that the coupling between hydration water and cellular constituents might not be simply a master-slave relationship. We propose that the high flexibility of the T. barophilus proteome associated with reduced hydration water may be the keys to the molecular adaptation of the cells to high hydrostatic pressure.

Effects of Load History on Ovine Spinal Range of Motion

Loading of spinal motion segment units alters biomechanical properties by modifying flexibility and range of motion. This study utilizes angular displacement due to an applied bending moment to assess biomechanical function during high-magnitude and prolonged compressive loading of ovine lumbar motion segments. High compressive loads, representative of physiological lifestyle and occupational behaviors, appear to limit fluid recovery of the intervertebral disc, thereby modifying spinal flexibility and increasing spinal instability. Intermittent extensions, or backwards bending movements, may provide a protective effect against the load-induced spinal instability. This study contributes a greater understanding of the effects of load history on the function and health of the lumbar spine. Findings may inform future efforts investigating adjustments in spinal posture to preserve or promote the recovery of lumbar spinal biomechanics.

Restricting the flexibility in DEA models

DEA models have been applied as the benchmarking tool in operations management to empirically account operational and productive efficiency. The wide flexibility in assigning the weights in DEA approach can result on indicators of efficiency who do not take account the relative importance of some inputs. In order to overcome this limitation, in this research we apply the DEA model under restricted weight specification. This model is applied to Spanish hotel companies in order to measure operational efficiency. The restricted weight specification enables us to decrease the influence of assigning unrealistic weights in some units and improve the efficiency estimation and to increase the discriminating potential of the conventional DEA model.

Variety, flexibility, and use of abstract concepts. A multiple grounded perspective.

The nature of concepts is a matter of intense debate in cognitive sciences. While traditional views claim that conceptual knowledge is represented in a unitary symbolic system, recent Embodied and Grounded Cognition theories (EGC) submit the idea that conceptual system is couched in our body and influenced by the environment (Barsalou, 2008). One of the major challenges for EGC is constituted by abstract concepts (ACs), like fantasy. Recently, some EGC proposals addressed this criticism, arguing that the ACs comprise multifaced exemplars that rely on different grounding sources beyond sensorimotor one, including interoception, emotions, language, and sociality (Borghi et al., 2018). However, little is known about how ACs representation varies as a function of life experiences and their use in communication. The theoretical arguments and empirical studies comprised in this dissertation aim to provide evidence on multiple grounding of ACs taking into account their varieties and flexibility. Study I analyzed multiple ratings on a large sample of ACs and identified four distinct subclusters. Study II validated this classification with an interference paradigm involving motor/manual, interoceptive, and linguistic systems during a difficulty rating task. Results confirm that different grounding sources are activated depending on ACs kind. Study III-IV investigate the variability of institutional concepts, showing that the higher the law expertise level, the stronger the concrete/emotional determinants in their representation. Study V introduced a novel interactive task in which abstract and concrete sentences serve as cues to simulate conversation. Analysis of language production revealed that the uncertainty and interactive exchanges increase with abstractness, leading to generating more questions/requests for clarifications with abstract than concrete sentences. Overall, results confirm that ACs are multidimensional, heterogeneous, and flexible constructs and that social and linguistic interactions are crucial to shaping their meanings. Investigating ACs in real-time dialogues may be a promising direction for future research.

Planning and assessment techniques for spine surgeries

The rate of diagnosis and treatment of degenerative spine disorders is increasing, increasing the need for surgical intervention. Posterior spine fusion is one surgical intervention used to treat various spine degeneration pathologies To minimize the risk of complications and provide patients with positive outcomes, preoperative planning and postsurgical assessment are necessary. This PhD aimed to investigate techniques for the surgical planning and assessment of spine surgeries. Three main techniques were assessed: stereophotogrammetric motion analysis, 3D printing of complex spine deformities and finite element analysis of the thoracolumbar spine. Upon reviewing the literature on currently available spine kinematics protocol, a comprehensive motion analysis protocol to measure the multi-segmental spine motion was developed. Using this protocol, the patterns of spine motion in patients before and after posterior spine fixation was mapped. The second part investigated the use of virtual and 3D printed spine models for the surgical planning of complex spine deformity correction. Compared to usual radiographic images, the printed model allowed optimal surgical intervention, reduced surgical time and provided better surgeon-patient communication. The third part assessed the use of polyetheretherketone rods auxiliary to titanium rods to reduce the stiffness of posterior spine fusion constructs. Using a finite element model of the thoracolumbar spine, the rods system showed a decrease in the overall stress of the uppermost instrumented vertebra when compared to regular fixation approaches. Finally, a retrospective biomechanical assessment of a lumbopelvic reconstruction technique was investigated to assess the patients' gait following the surgery, the implant deformation over the years and the extent of bony fusion between spine and implant. In conclusion, this thesis highlighted the need to provide surgeons with new planning and assessment techniques to better understand postsurgical complications. The methodologies investigated in this project can be used in the future to establish a patient-specific planning protocol.

The Effect Of Pelvic Floor Muscle Training Alone Or In Combination With Electrostimulation In The Treatment Of Sexual Dysfunction In Women With Multiple Sclerosis.

Sexual dysfunction (SD) affects up to 80% of multiple sclerosis (MS) patients and pelvic floor muscles (PFMs) play an important role in the sexual function of these patients. The objective of this paper is to evaluate the impact of a rehabilitation program to treat lower urinary tract symptoms on SD of women with MS. Thirty MS women were randomly allocated to one of three groups: pelvic floor muscle training (PFMT) with electromyographic (EMG) biofeedback and sham neuromuscular electrostimulation (NMES) (Group I), PFMT with EMG biofeedback and intravaginal NMES (Group II), and PFMT with EMG biofeedback and transcutaneous tibial nerve stimulation (TTNS) (Group III). Assessments, before and after the treatment, included: PFM function, PFM tone, flexibility of the vaginal opening and ability to relax the PFMs, and the Female Sexual Function Index (FSFI) questionnaire. After treatment, all groups showed improvements in all domains of the PERFECT scheme. PFM tone and flexibility of the vaginal opening was lower after the intervention only for Group II. All groups improved in arousal, lubrication, satisfaction and total score domains of the FSFI questionnaire. This study indicates that PFMT alone or in combination with intravaginal NMES or TTNS contributes to the improvement of SD.

Cervical Injuries Scored According To The Subaxial Injury Classification System: An Analysis Of The Literature.

The Subaxial Injury Classification (SLIC) system and severity score has been developed to help surgeons in the decision-making process of treatment of subaxial cervical spine injuries. A detailed description of all potential scored injures of the SLIC is lacking. We performed a systematic review in the PubMed database from 2007 to 2014 to describe the relationship between the scored injuries in the SLIC and their eventual treatment according to the system score. Patients with an SLIC of 1-3 points (conservative treatment) are neurologically intact with the spinous process, laminar or small facet fractures. Patients with compression and burst fractures who are neurologically intact are also treated nonsurgically. Patients with an SLIC of 4 points may have an incomplete spinal cord injury such as a central cord syndrome, compression injuries with incomplete neurologic deficits and burst fractures with complete neurologic deficits. SLIC of 5-10 points includes distraction and rotational injuries, traumatic disc herniation in the setting of a neurological deficit and burst fractures with an incomplete neurologic deficit. The SLIC injury severity score can help surgeons guide fracture treatment. Knowledge of the potential scored injures and their relationships with the SLIC are of paramount importance for spine surgeons who treated subaxial cervical spine injuries.

Basilar Invagination: Surgical Results.

Basilar invagination (BI) is a congenital craniocervical junction (CCJ) anomaly represented by a prolapsed spine into the skull-base that can result in severe neurological impairment. In this paper, we retrospective evaluate the surgical treatment of 26 patients surgically treated for symptomatic BI. BI was classified according to instability and neural abnormalities findings. Clinical outcome was evaluated using the Nürick grade system. A total of 26 patients were included in this paper. Their age ranged from 15 to 67 years old (mean 38). Of which, 10 patients were male (38%) and 16 (62%) were female. All patients had some degree of tonsillar herniation, with 25 patients treated with foramen magnum decompression. Nine patients required a craniocervical fixation. Six patients had undergone prior surgery and required a new surgical procedure for progression of neurological symptoms associated with new compression or instability. Most of patients with neurological symptoms secondary to brainstem compression had some improvement during the follow-up. There was mortality in this series, 1 month after surgery, associated with a late removal of the tracheal cannula. Management of BI requires can provide improvements in neurological outcomes, but requires analysis of the neural and bony anatomy of the CCJ, as well as occult instability. The complexity and heterogeneous presentation requires attention to occult instability on examination and attention to airway problems secondary to concomitant facial malformations.

Cephalometric And Anthropometric Data Of Obstructive Apnea In Different Age Groups.

Patients with obstructive sleep apnea syndrome usually present with changes in upper airway morphology and/or body fat distribution, which may occur throughout life and increase the severity of obstructive sleep apnea syndrome with age. To correlate cephalometric and anthropometric measures with obstructive sleep apnea syndrome severity in different age groups. A retrospective study of cephalometric and anthropometric measures of 102 patients with obstructive sleep apnea syndrome was analyzed. Patients were divided into three age groups (≥20 and <40 years, ≥40 and <60 years, and ≥60 years). Pearson's correlation was performed for these measures with the apnea-hypopnea index in the full sample, and subsequently by age group. The cephalometric measures MP-H (distance between the mandibular plane and the hyoid bone) and PNS-P (distance between the posterior nasal spine and the tip of the soft palate) and the neck and waist circumferences showed a statistically significant correlation with apnea-hypopnea index in both the full sample and in the ≥40 and <60 years age group. These variables did not show any significant correlation with the other two age groups (<40 and ≥60 years). Cephalometric measurements MP-H and PNS-P and cervical and waist circumferences correlated with obstructive sleep apnea syndrome severity in patients in the ≥40 and <60 age group.

Long-term Efficacy And Safety Of Tenofovir Disoproxil Fumarate In Hiv-1-infected Adolescents Failing Antiretroviral Therapy: The Final Results Of Study Gs-us-104-0321.

Reports of long-term tenofovir disoproxil fumarate (TDF) treatment in HIV-infected adolescents are limited. We present final results from the open-label (OL) TDF extension following the randomized, placebo (PBO)-controlled, double-blind phase of GS-US-104-0321 (Study 321). HIV-infected 12- to 17-year-olds treated with TDF 300 mg or PBO with an optimized background regimen (OBR) for 24-48 weeks subsequently received OL TDF plus OBR in a single arm study extension. HIV-1 RNA and safety, including bone mineral density (BMD), was assessed in all TDF recipients. Eighty-one subjects received TDF (median duration 96 weeks). No subject died or discontinued OL TDF for safety/tolerability. At week 144, proportions with HIV-1 RNA <50 copies/mL were 30.4% (7 of 23 subjects with baseline HIV-1 RNA >1000 c/mL initially randomized to TDF), 41.7% (5 of 12 subjects with HIV-1 RNA <1000 c/mL who switched PBO to TDF) and 0% (0 of 2 subjects failed randomized PBO plus OBR with HIV-1 RNA >1000 c/mL and switched PBO to TDF). Viral resistance to TDF occurred in 1 subject. At week 144, median decrease in estimated glomerular filtration rate was 38.1 mL/min/1.73 m (n = 25). Increases in median spine (+12.70%, n = 26) and total body less head BMD (+4.32%, n = 26) and height-age adjusted Z-scores (n = 21; +0.457 for spine, +0.152 for total body less head) were observed at week 144. Five of 81 subjects (6%) had persistent >4% BMD decreases from baseline. Some subjects had virologic responses to TDF plus OBR, and TDF resistance was rare. TDF was well tolerated and can be considered for treatment of HIV-infected adolescents.