Hazardous particles during diesel engine cold-start and warm-up: Characterisation of particulate mass and number under the impact of biofuel and lubricating oil

The increasing share of using biofuels in vehicles (mandated by current regulations) leads to a reduction in particle size, resulting in increased particle toxicity. However, existing regulations disregarded small particles (sub-23 nm) that are more toxic. This impact is more significant during vehicle cold-start operation, which is an inevitable frequent daily driving norm where after-treatment systems prove ineffective. This study investigates the impact of biofuel and lubricating oil (as a source of nanoparticles) on the concentration, size distribution, median diameter of PN and PM, and their proportion at size ranges within accumulation and nucleation modes during four phases of cold-start and warm-up engine operation (diesel-trucks/busses application). The fuels used were 10% and 15% biofuel and with the addition of 5% lubricating oil to the fuel. Results show that as the engine warms up, PN for all the fuels increases and the size of particles decreases. PN concentration with a fully warmed-up engine was up to 132% higher than the cold-start. Sub-23 nm particles accounted for a significant proportion of PN (9%) but a smaller proportion of PM (0.1%). The fuel blend with 5% lubricating oil showed a significant increase in PN concentration and a decrease in particle size during cold-start.

Allocation of funding into blast injury-related research and blast traumatic brain injury between 2000 and 2019: analysis of global investments from public and philanthropic funders

INTRODUCTION

There is little systematic tracking or detailed analysis of investments in research and development for blast injury to support decision-making around research future funding.

METHODS

This study examined global investments into blast injury-related research from public and philanthropic funders across 2000-2019. Research databases were searched using keywords, and open data were extracted from funder websites. Data collected included study title, abstract, award amount, funder and year. Individual awards were categorised to compare amounts invested into different blast injuries, the scientific approaches taken and analysis of research investment into blast traumatic brain injury (TBI).

RESULTS

A total of 806 awards were identified into blast injury-related research globally, equating to US$902.1 million (m, £565.9m GBP). There was a general increase in year-on-year investment between 2003 and 2009 followed by a consistent decline in annual funding since 2010. Pre-clinical research received $671.3 m (74.4%) of investment. Brain-related injury research received $427.7 m (47.4%), orthopaedic injury $138.6 m (15.4%), eye injury $63.7 m (7.0%) and ear injury $60.5m (6.7%). Blast TBI research received a total investment of $384.3 m, representing 42.6% of all blast injury-related research. The U.S. Department of Defense funded $719.3 m (80%).

CONCLUSIONS

Investment data suggest that blast TBI research has received greater funding than other blast injury health areas. The funding pattern observed can be seen as reactive, driven by the response to the War on Terror, the rising profile of blast TBI and congressionally mandated research.

Hypnotic suggestibility in dissociative and related disorders: A meta-analysis

Elevated responsiveness to verbal suggestions is hypothesized to represent a predisposing factor for dissociative disorders (DDs) and related conditions. However, the magnitude of this effect has not been estimated in these populations nor has the potential moderating influence of methodological limitations on effect size variability across studies. This study assessed whether patients with DDs, trauma- and stressor-related disorders (TSDs), and functional neurological disorder (FND) display elevated hypnotic suggestibility. A systematic literature search identified 20 datasets. A random-effects meta-analysis revealed that patients displayed greater hypnotic suggestibility than controls, Hedges's g=0.92 [0.66, 1.18]. This effect was observed in all subgroups but was most pronounced in the DDs. Although there was some evidence for publication bias, a bias-corrected estimate of the group effect remained significant, g=0.57 [0.30, 0.85]. Moderation analyses did not yield evidence for a link between effect sizes and methodological limitations. These results demonstrate that DDs and related conditions are characterized by elevated hypnotic suggestibility and have implications for the mechanisms, risk factors, and treatment of dissociative psychopathology.

Melt stripping and agglutination of pyroclasts during the explosive eruption of low viscosity magmas

Volcanism on Earth and on other planets and satellites is dominated by the eruption of low viscosity magmas. During explosive eruption, high melt temperatures and the inherent low viscosity of the fluidal pyroclasts allow for substantial post-fragmentation modification during transport obscuring the record of primary, magmatic fragmentation processes. Here, we show these syn-eruption modifications, in the form of melt stripping and agglutination, to be advantageous for providing fundamental insights into lava fountain and jet dynamics, including eruption velocities, grain size distributions and melt physical properties. We show how enigmatic, complex pyroclasts termed pelletal lapilli form by a two-stage process operating above the magmatic fragmentation surface. Melt stripping from pyroclast surfaces creates a spray of fine melt droplets whilst sustained transport in the fountain allows for agglutination and droplet scavenging, thereby coarsening the grain size distribution. We conclude with a set of universal regime diagrams, applicable for all fluidal fountain products, that link fundamental physical processes to eruption conditions and melt physical properties.

The pyroclast properties and features can provide insights into the dynamics of explosive eruptions of low viscosity magma. Here, the authors show how lava droplets, or pyroclasts are subject to melt removal and melt addition during transport in a gas jet and present a method to reconstruct eruption conditions from the pyroclast textures.

Analysis of cold-start NO2 and NOx emissions, and the NO2/NOx ratio in a diesel engine powered with different diesel-biodiesel blends

In the transportation sector, the share of biofuels such as biodiesel is increasing and it is known that such fuels significantly affect NOx emissions. In addition to NOx emission from diesel engines, which is a significant challenge to vehicle manufacturers in the most recent emissions regulation (Euro 6.2), this study investigates NO₂ which is a toxic emission that is currently unregulated but is a focus to be regulated in the next regulation (Euro 7). This manuscript studies how the increasing share of biofuels affects the NO₂, NOx, and NO₂/NOx ratio during cold-start (in which the after-treatment systems are not well-effective and mostly happens in urban areas). Using a turbocharged cummins diesel engine (with common-rail system) fueled with diesel and biofuel derived from coconut (10 and 20% blending ratio), this study divides the engine warm-up period into 7 stages and investigates official cold- and hot-operation periods in addition to some intermediate stages that are not defined as cold in the regulation and also cannot be considered as hot-operation. Engine coolant, lubricating oil and exhaust temperatures, injection timing, cylinder pressure, and rate of heat release data were used to explain the observed trends. Results showed that cold-operation NOx, NO₂, and NO₂/NOx ratio were 31-60%, 1.14-2.42 times, and 3-8% higher than the hot-operation, respectively. In most stages, NO₂ and the NO₂/NOx ratio with diesel had the lowest value and they increased with an increase of biofuel in the blend. An injection strategy change significantly shifted the in-cylinder pressure and heat release diagrams, aligned with the sudden NOx drop during the engine warm-up. The adverse effect of cold-operation on NOx emissions increased with increasing biofuel share.

What Does Neuroscience Tell Us About the Conversion Model of Functional Neurological Disorders?

A dualistic mind-body understanding of functional neurological disorders (FNDs), also known as conversion disorders, has led to the view that the cause of the symptom should be either psychological (psychogenic) or physical (neurogenic-"organic"). One of the most influential psychological approaches is the Freudian model of conversion, which suggests that FNDs arise from a defense process in which emotional stress is converted into physical symptoms. This conversion theory has been challenged in recent years, accompanied by a shift in emphasis toward neuropathophysiological models of FND and away from historical psychological concepts. In this review, the authors consider the contemporary relevance of the conversion model from the neuroscientific perspective to reconcile the role of both psychological and biological factors in FND. A narrative review of recent neuroscientific findings pertaining to the conversion model of FND, encompassing neuroimaging, cognitive psychology, biological markers, and epigenetic studies, was performed. Research on the role of psychological stressors is discussed. Neurobiological mechanisms of repression of traumatic memories and their translation into physical symptoms are then explored. Finally, the role of physical symptoms as a potential protective defense mechanism against social stressors is considered. The authors argue that the conversion concept is consistent with recent neuroscientific research findings, and the model allows psychological and neurobiological concepts to be reconciled within a single account of FND that begins to resolve the dualistic mind-body dichotomy.

Outcome Measures for Functional Neurological Disorder: A Review of the Theoretical Complexities

The development and selection of optimal outcome measures is increasingly recognized as a key component of evidence-based medicine, particularly the need for the development of a standardized set of measures for use in clinical trials. This process is particularly complex for functional neurological disorder (FND) for several reasons. FND can present with a wide range of symptoms that resemble the full spectrum of other neurological disorders. Additional physical (e.g., pain, fatigue) and psychological (e.g., depression, anxiety) symptoms are commonly associated with FND, which also can be highly disabling with implications for prognosis, and warrant concurrent assessment, despite an unclear etiological relationship with FND. Furthermore, several unique clinical aspects of FND make it likely that the usual prioritization of "objective" (or clinician-rated) over "subjective" (or patient-rated) measures might not be appropriate. Self-report measures may be more clinically meaningful in this patient population. Despite being a common and disabling disorder, there has been little research into outcome measures in FND, and to date trials have largely used measures designed for the assessment of other disorders. An international FND Core Outcome Measure group (FND-COM) has been established to develop a consensus battery of outcomes for FND: a "core outcome set." In this perspective article, the authors reviewed the process of outcome measure development and selection before considering the specific features of FND affecting the development of a core outcome set, as well as a research agenda to optimize outcome measurement in this complex neuropsychiatric disorder.

Material and debris transport patterns in Moreton Bay, Australia: The influence of Lagrangian coherent structures

Coastal tidal estuaries are vital to the exchange of energy and material between inland waters and the open ocean. Debris originating from the land and ocean enter this environment and are transported by currents (river outflow and tide), wind, waves and density gradients. Understanding and predicting the source and fate of such debris has considerable environmental, economic and visual importance. We show that this issue can be addressed using the Lagrangian coherent structures (LCS) technique which is highly robust to hydrodynamic model uncertainties. Here we present a comprehensive study showing the utility of this approach to describe the fate of floating material in a coastal tidal embayment. An example is given from Moreton Bay, a semi-enclosed subtropical embayment with high morphologic, ecological and economic significance to Southeast Queensland, Australia. Transport barriers visualised by the LCS create pathways and barriers for material transport in the embayment. It was found that the wind field modified both the rate attraction and location of the transport barriers. One of the key outcomes is the demonstration of the significant role of islands in partitioning the transport of material and mixing within the embayment. The distribution of the debris sources along the shoreline are explained by the relative location of the LCS to the shoreline. Therefore, extraction of LCS can help to predict sources and fate of anthropogenic marine debris and thus, serve as a useful way for effective management of vulnerable regions and marine protected areas.

Outcome measurement in functional neurological disorder: a systematic review and recommendations

OBJECTIVES

We aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes.

METHODS

A systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group.

RESULTS

Five FND-specific measures were identified-three clinician-rated and two patient-rated-but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost-utility (eg, healthcare resource use and quality-adjusted life years).

CONCLUSIONS

There are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.

A systematic review of measures of therapist competence in psychodynamic, interpersonal, and/or relational models

PURPOSE

Assessment of psychotherapeutic competence is increasingly regarded as important in the delivery of psychological services and training programmes. This article reviews tools designed to assess clinical competence in psychodynamic, interpersonal, and relational models of therapy.

METHODS

PsycINFO, CINAHL, and Web of Science online databases were reviewed using terms relating to competence, psychotherapy, and measurement. Titles and abstracts of all articles were screened, and full texts of remaining articles were read. Reference lists of included articles were also screened. Papers that described a measure of psychotherapeutic competence in a psychodynamic, interpersonal, or relational model, and reported at least one assessment of the reliability and/or validity of the measure, were included. The quality of the studies was evaluated, and the quality of individual measures was summarized.

RESULTS

Fourteen studies met the inclusion criteria, examining 13 competence measures for 12 specific models of therapy. Competence measures were not found for several NICE-recommended models of therapy. Some measures demonstrated strengths in certain areas of reliability and validity; however, there were a number of quality issues in development and psychometric properties that suggest none of the measures are currently proven for widespread use.

CONCLUSIONS

Further research is required to refine currently existing measures and develop new measures for key NICE-recommended models of therapy.

PRACTITIONER POINTS

Assessment and improvement of therapist competence is key to provision of high-quality psychotherapeutic interventions. This review shows there are few measures of competence in relational therapy models and several NICE-recommended models do not have corresponding competence measures. Measures that do exist are mixed in terms of their validity and reliability and should therefore be used with caution.

Effect of cold start on engine performance and emissions from diesel engines using IMO-Compliant distillate fuels

Emissions from ships at berth are small compared to the total ship emissions; however, they are one of the main contributors to pollutants in the air of densely-populated areas, consequently heavily affecting public health. This is due to auxiliary marine engines being used to generate electric power and steam for heating and providing services. The present study has been conducted on an engine representative of a marine auxiliary, which was a heavy duty, six-cylinder, turbocharged and after-cooled engine with a high pressure common rail injection system. Engine performance and emission characterisations during cold start are the focus of this paper, since cold start is significantly influential. Three tested fuels were used, including the reference diesel and two IMO (International Maritime Organization) compliant spiked fuels. The research engine was operated at a constant speed and 25% load condition after 12 h cooled soak. Results show that during cold start, significant heat generated from combustion is used to heat the engine block, coolant and lubricant. During the first minute, compared to the second minute, emissions of particle number (PN), carbon monoxide (CO), particulate matter (PM), and nitrogen oxides (NO_x) were approximately 10, 4, 2 and 1.5 times higher, respectively. The engine control unit (ECU) plays a vital role in reducing engine emissions by changing the engine injection strategy based on the engine coolant temperature. IMO-compliant fuels, which were higher viscosity fuels associated with high sulphur content, resulted in an engine emission increase during cold start. It should be taken into account that auxiliary marine diesel engines, working at partial load conditions during cold start, contribute considerably to emissions in coastal areas. It demonstrates a need to implement practical measures, such as engine pre-heating, to obtain both environmental and public health advantages in coastal areas.

Factors Affecting Microalgae Production for Biofuels and the Potentials of Chemometric Methods in Assessing and Optimizing Productivity

Microalgae are swift replicating photosynthetic microorganisms with several applications for food, chemicals, medicine and fuel. Microalgae have been identified to be suitable for biofuels production, due to their high lipid contents. Microalgae-based biofuels have the potential to meet the increasing energy demands and reduce greenhouse gas (GHG) emissions. However, the present state of technology does not economically support sustainable large-scale production. The biofuel production process comprises the upstream and downstream processing phases, with several uncertainties involved. This review examines the various production and processing stages, and considers the use of chemometric methods in identifying and understanding relationships from measured study parameters via statistical methods, across microalgae production stages. This approach enables collection of relevant information for system performance assessment. The principal benefit of such analysis is the identification of the key contributing factors, useful for decision makers to improve system design, operation and process economics. Chemometrics proffers options for time saving in data analysis, as well as efficient process optimization, which could be relevant for the continuous growth of the microalgae industry.

Towards a Multi-Level Phenomenology of Delusional Disorder: The Dissociative Thought-Script

Delusional disorder (DD) is still considered a diagnosis of exclusion for a difficult-to-treat condition characterised by the presence of delusional beliefs in the absence of other psychiatric symptoms. Attempts to contextualise psychological processes recognised since the earliest observations of this disorder have had very limited impact on improving some fixed beliefs. In the Cambridge Early Intervention in Psychosis Service we have observed a particular phenomenon, often categorised as a delusional idea in the context of DD, which manifests through highly repetitive belief expression that fails to respond to pharmacological and psychological treatments. Key aspects of this phenomenon are similar to those observed in dissociative (functional neurological) presentations. Drawing on the Integrative Cognitive Model of functional neurological disorders, we developed a successful psychological intervention that places less emphasis on challenging delusional content and focuses more on dismantling dissociation and underlying affective factors associated with the activation of the fixed belief. Our initial findings reinforce the need to continue developing a multi-level phenomenological approach to define a variety of symptoms traditionally grouped under the concept of "delusion."

The context of litigation in evaluating physical and psychological outcomes from pain management programmes

Objectives

There has been extensive research in evaluating chronic pain in the context of litigation while considering the implications that it can have on healthcare outcomes and rehabilitation progress. The aim of this article is to present retrospective observational data about the levels of disability and distress reported by patients with ongoing litigation at the start and following a UK-based multi-disciplinary pain management programme (PMP) when compared with those without litigation.

Method

Between June 2014 and September 2017, 859 patients attended and completed a 16-day PMP at a tertiary-level National Health Service (UK) pain clinic. Patients were split into two groups: (1) litigation (n = 110) and (2) non-litigation (n = 749). As a part of the assessment procedure, the patients were given a battery of psychological and physical measures to complete over two time points.

Results

Patients with litigation are statistically significantly more distressed at assessment but make comparable clinically meaningful change in PMP intervention when compared with a non-litigation sample. A very small proportion of the variance in depression scores post-treatment is accounted for by the context of litigation (0.5%), which may be accounted for by employment status. There was no effect of litigation on physical outcome post-intervention.

Discussion

This article concludes that it is not appropriate to merely assume that the context of litigation results in limited positive psychological and physical outcomes post-PMP. There are some limitations to the clinical sample presented in respect to the conclusions.

Effect of sulphur and vanadium spiked fuels on particle characteristics and engine performance of auxiliary diesel engines

Particle emission characteristics and engine performance were investigated from an auxiliary, heavy duty, six-cylinder, turbocharged and after-cooled diesel engine with a common rail injection system using spiked fuels with different combinations of sulphur (S) and vanadium (V) spiking. The effect of fuel S content on both particle number (PN) and mass (PM) was clearly observed in this study. Higher PN and PM were observed for fuels with higher S contents at all engine load conditions. This study also found a correlation between fuel S content and nucleation mode particle number concentration which have more harmful impact on human health than larger particles. The highest PN and PM were observed at partial load conditions. In addition, S in fuel resulted in higher viscosity of spiked fuels, which led to lower engine blow-by. Fuel V content was observed in this study, evidencing that it had no clear effect on engine performance and emissions. Increased engine load also resulted in higher engine blow-by. The lower peak of in-cylinder pressure observed at both pre-mixed and diffusion combustion phases with the spiked fuels may be associated with the lower energy content in the fuel blends compared to diesel fuel.

Attending away from the body predicts increased physical symptom reports at six months in primary care patients

OBJECTIVE

High symptom reporting (HSR) and medically unexplained symptoms (MUS) are associated with considerable distress, disability, healthcare utilization and costs, but are poorly understood, and current treatments are of limited benefit. Most models of HSR and MUS implicate cognitive-perceptual factors, such as increased body-focused attention, reduced perceptual thresholds and a tendency to experience somatic misperception, but little is known about the causal role of these variables. We investigated this issue by studying whether there is a longitudinal relationship between perceptual-attentional variables and later clinical outcomes in primary care patients.

METHOD

Primary care patients (N = 102) completed clinical (physical symptom reporting, health anxiety and healthcare utilization) and perceptual-attentional (body-focused attention, perceptual threshold, somatic misperception) measures at baseline and then again six months later (N = 72). Hierarchical regression was used to examine cross-lagged relationships between baseline and follow-up scores.

RESULTS

Contrary to expectation, attending away from the body at baseline predicted increased not decreased symptom reporting six months later. Neither perceptual threshold nor somatic misperception predicted clinical outcomes at six months.

CONCLUSIONS

These findings suggest that body avoidance, rather than increased body focus, contribute to the development of HSR. Future studies should consider the potential clinical benefits of reducing bodily avoidance, via techniques that promote adaptive engagement with bodily sensations.

Neural representations of aversive value encoding in pain catastrophizers

Chronic pain is exacerbated by maladaptive cognition such as pain catastrophizing (PC). Biomarkers of PC mechanisms may aid precision medicine for chronic pain. Here, we investigate EEG biomarkers using mass univariate and multivariate (machine learning) approaches. We test theoretical notions that PC results from a combination of augmented aversive-value encoding ("magnification") and persistent expectations of pain ("rumination"). Healthy individuals with high or low levels of PC underwent an experimental pain model involving nociceptive laser stimuli preceded by cues predicting forthcoming pain intensity. Analysis of EEG acquired during the cue and laser stimulation provided event-related potentials (ERPs) identifying spatially and temporally-extended neural representations associated with pain catastrophizing. Specifically, differential neural responses to cues predicting high vs. low intensity pain (i.e. aversive value encoding) were larger in the high PC group, largely originating from mid-cingulate and superior parietal cortex. Multivariate spatiotemporal EEG patterns evoked from cues with high aversive value selectively and significantly differentiated the high PC from low PC group (64.6% classification accuracy). Regression analyses revealed that neural patterns classifying groups could be partially predicted (R² = 28%) from those neural patterns classifying the aversive value of cues. In contrast, behavioural and EEG analyses did not provide evidence that PC modifies more persistent effects of prior expectation on pain perception and nociceptive responses. These findings support the hypothesis of magnification of aversive value encoding but not persistent expression of expectation in pain catastrophizers. Multivariate patterns of aversive value encoding provide promising biomarkers of maladaptive cognitive responses to chronic pain that have future potential for psychological treatment development and clinical stratification.

On-board measurements of particle and gaseous emissions from a large cargo vessel at different operating conditions

This study investigated particle and gaseous emission factors from a large cargo vessel for her whole voyage including at berth, manoeuvring and cruising. Quantification of these factors assists in minimising the uncertainty in the current methods of exhaust gas emission factor estimation. Engine performance and emissions from the main marine engine were measured on-board while the ship was manoeuvring and cruising at sea. Emissions of an auxiliary engine working at 55% of maximum continuous rating (MCR) were measured when the ship was at actual harbour stopovers. Gaseous and particle emission factors in this study are presented in g kWh^-1 or # kWh^-1, and compared with previous studies. Results showed that the SO₂ emission factor is higher than that of previous studies due to the high sulphur content of the fuel used. The particle number size distributions showed only one mode for different operating conditions of the ship, with a peak at around 40-50 nm, which was dominated by ultrafine particles. Emission factors of CO, HC, PM and PN observed during ship manoeuvring were much higher than that of those recorded at cruising condition. These findings highlight the importance of quantification and monitoring ship emissions in close proximity to port areas, as they can have the highest impact on population exposure.

Contemporary factors influencing genetic diversity in the Alaska humpback whitefish Coregonus clupeaformis complex

Thirteen microsatellite loci were used to address three hypotheses regarding genetic diversity in the humpback whitefish Coregonus clupeaformis complex in Alaska. The test results provided further insight into the factors influencing C. clupeaformis complex population structure and level of genetic variation. First, the microsatellite data did not provide evidence of two spatially distinct Beringian and Eurasian refugial groups as revealed in previous phylogeographic analyses of mitochondrial DNA variation. Rather, the population structure inferred from the microsatellite variation appears to reveal the influence of factors on a more recent time scale, including gene flow among the refugial groups and isolation of some anadromous and freshwater resident populations. Second, anadromous C. clupeaformis complex collections exhibited higher intra-population genetic diversity than freshwater resident collections. This outcome is consistent with previous meta analyses suggesting that freshwater resident populations probably have smaller historical effective population sizes and less conspecific gene flow because the habitat tends to be smaller and supports fewer and smaller populations. Finally, the analysis of contemporary immigration rates was consistent with, but did not provide statistical support for, the hypothesis that gene flow among anadromous C. clupeaformis complex populations along coastal Alaska is influenced by the Alaska Coastal Current. Further studies are needed to evaluate gene flow among coastal Alaska C. clupeaformis complex populations.

Negative expectations interfere with the analgesic effect of safety cues on pain perception by priming the cortical representation of pain in the midcingulate cortex

It is well known that the efficacy of treatment effects, including those of placebos, is heavily dependent on positive expectations regarding treatment outcomes. For example, positive expectations about pain treatments are essential for pain reduction. Such positive expectations not only depend on the properties of the treatment itself, but also on the context in which the treatment is presented. However, it is not clear how the preceding threat of pain will bias positive expectancy effects. One hypothesis is that threatening contexts trigger fearful and catastrophic thinking, reducing the pain-relieving effects of positive expectancy. In this study, we investigated the disruptive influence of threatening contexts on positive expectancy effects while 41 healthy volunteers experienced laser-induced heat pain. A threatening context was induced using pain-threatening cues that preceded the induction of positive expectancies via subsequent pain-safety cues. We also utilised electroencephalography (EEG) to investigate potential neural mechanisms underlying these effects. Lastly, we used the Fear of Pain Questionnaire to address whether the disruptive effect of negative contexts on cued pain relief was related to the degree of fear of pain. As predicted, participants responded less to pain-safety cues (i.e., experienced more pain) when these were preceded by pain-threatening cues. In this threatening context, an enhancement of the N2 component of the laser-evoked potential was detected, which was more pronounced in fearful individuals. This effect was localised to the midcingulate cortex, an area thought to integrate negative affect with pain experience to enable adaptive behaviour in aversive situations. These results suggest that threatening contexts disrupt the effect of pain relief cues via an aversive priming mechanism that enhances neural responses in the early stages of sensory processing.

From headache to tumour: An examination of health anxiety, health-related Internet use and ‘query escalation’

The current study aimed to explore the phenomenon of disease-related ‘query escalation’ in high/low health anxious Internet users ( N = 40). During a 15-minute health-related Internet search, participants rated their anxiety and the perceived seriousness of information on each page. Post-search interviews determined the reasons for, and effects of, escalating queries to consider serious diseases. Both groups were found to be significantly more anxious after escalating queries. The high group was significantly more likely to escalate queries. Evaluating personal relevance of material was the main reason for escalations and moderated anxiety post-escalation. We conclude that searching for online disease information can increase anxiety, particularly for people worried about their health.

Psychological and psychiatric aspects of psychogenic non-epileptic seizures (PNES): A systematic review

Psychogenic non-epileptic seizures (PNES) are common in neurological settings and often associated with considerable distress and disability. The psychological mechanisms underlying PNES are poorly understood and there is a lack of well-established, evidence-based treatments. This paper advances our understanding of PNES by providing a comprehensive systematic review of the evidence pertaining to the main theoretical models of this phenomenon. Methodological quality appraisal and effect size calculation were conducted on one hundred forty empirical studies on the following aspects of PNES: life adversity, dissociation, anxiety, suggestibility, attentional dysfunction, family/relationship problems, insecure attachment, defence mechanisms, somatization/conversion, coping, emotion regulation, alexithymia, emotional processing, symptom modelling, learning and expectancy. Although most of the studies were only of low to moderate quality, some findings are sufficiently consistent to warrant tentative conclusions: (i) physical symptom reporting is elevated in patients with PNES; (ii) trait dissociation and exposure to traumatic events are common but not inevitable correlates of PNES; (iii) there is a mismatch between subjective reports of anxiety and physical arousal during PNES; and (iv) inconsistent findings in this area are likely to be attributable to the heterogeneity of patients with PNES. Empirical, theoretical and clinical implications are discussed.

Influence of oxygen content of the certain types of biodiesels on particulate oxidative potential

Oxidative potential (OP) is related to the organic phase, specifically to its oxygenated organic fraction (OOA). Furthermore, the oxygen content of fuel molecules has significant influence on particulate OP. Thus, this study aimed to explore the actual dependency of the OOA and ROS to the oxygen content of the fuel. In order to reach the goal, different biodiesels blends, with various ranges of oxygen content; have been employed. The compact time of flight aerosol mass spectrometer (c-ToF AMS) enabled better identification of OOA. ROS monitored by using two assays: DTT and BPEA-nit. Despite emitting lower mass, both assays agreed that oxygen content of a biodiesel is directly correlated with its OOA, and highly related to its OP. Hence, the more oxygen included in the considered biodiesels, the higher the OP of PM emissions. This highlights the importance of taking oxygen content into account while assessing emissions from new fuel types, which is relevant from a health effects standpoint.

Discovery of Narrow Spectrum Kinase Inhibitors: New Therapeutic Agents for the Treatment of COPD and Steroid-Resistant Asthma

The discovery of a novel series of therapeutic agents that has been designed and optimized for treating chronic obstructive pulmonary disease is reported. The pharmacological strategy was based on the identification of compounds that inhibit a defined subset of kinase enzymes modulating inflammatory processes that would be effective against steroid refractory disease and exhibit a sustained duration of action after inhaled delivery.

Dissociation and functional neurologic disorders

Dissociation has been cited as a possible psychologic mechanism underpinning functional neurologic disorders (FND) since the 19th century. Since that time, changes in psychiatric classification have created confusion about what the term dissociation actually means. The available evidence suggests that it now refers to at least two qualitatively distinct types of phenomena: detachment (an altered state of consciousness characterized by a sense of separation from the self or world) and compartmentalization (a reversible loss of voluntary control over apparently intact processes and functions), as well as their underlying mechanisms. This chapter considers some of the problems with conflating these phenomena under a single heading as well as the relationship between detachment, compartmentalization, and FND. It is argued that FNDs are fundamentally compartmentalization disorders, but that detachment is often part of the clinical picture and may contribute to the development and maintenance of functional symptoms in many cases. By this view, understanding compartmentalization requires an appreciation of the mechanisms involved in controlling and accessing mental processes and contents. Two possible mechanisms in this regard are described and the evidence for these is considered, followed by a discussion of clinical and empiric implications.

Particle emissions from microalgae biodiesel combustion and their relative oxidative potential

Microalgae are considered to be one of the most viable biodiesel feedstocks for the future due to their potential for providing economical, sustainable and cleaner alternatives to petroleum diesel. This study investigated the particle emissions from a commercially cultured microalgae and higher plant biodiesels at different blending ratios. With a high amount of long carbon chain lengths fatty acid methyl esters (C20 to C22), the microalgal biodiesel used had a vastly different average carbon chain length and level of unsaturation to conventional biodiesel, which significantly influenced particle emissions. Smaller blend percentages showed a larger reduction in particle emission than blend percentages of over 20%. This was due to the formation of a significant nucleation mode for the higher blends. In addition measurements of reactive oxygen species (ROS), showed that the oxidative potential of particles emitted from the microalgal biodiesel combustion were lower than that of regular diesel. Biodiesel oxygen content was less effective in suppressing particle emissions for biodiesels containing a high amount of polyunsaturated C20-C22 fatty acid methyl esters and generated significantly increased nucleation mode particle emissions. The observed increase in nucleation mode particle emission is postulated to be caused by very low volatility, high boiling point and high density, viscosity and surface tension of the microalgal biodiesel tested here. Therefore, in order to achieve similar PM (particulate matter) emission benefits for microalgal biodiesel likewise to conventional biodiesel, fatty acid methyl esters (FAMEs) with high amounts of polyunsaturated long-chain fatty acids (≥C20) may not be desirable in microalgal biodiesel composition.

Influence of fuel molecular structure on the volatility and oxidative potential of biodiesel particulate matter

We have studied the effect of chemical composition of biodiesel fuel on the physical (volatility) and chemical (reactive oxygenated species concentration) properties of nano particles emitted from a modern common-rail diesel engine. Particle emissions from the combustion of four biodiesels with controlled chemical compositions and different varying unsaturation degrees and carbon-chain lengths, together with a commercial diesel, were tested and compared in terms of volatility of particles and the amount of reactive oxygenated species carried by particles. Different blends of biodiesel and petro diesel were tested at several engine loads and speeds. We have observed that more saturated fuels with shorter carbon chain lengths result in lower particle mass but produce particles that are more volatile and also have higher levels of Reactive Oxygen Species. This highlights the importance of taking into account metrics that are relevant from the health effects point of view when assessing emissions from new fuel types.

A particle based model to simulate microscale morphological changes of plant tissues during drying

Fundamental understanding on microscopic physical changes of plant materials is vital to optimize product quality and processing techniques, particularly in food engineering. Although grid-based numerical modelling can assist in this regard, it becomes quite challenging to overcome the inherited complexities of these biological materials especially when such materials undergo critical processing conditions such as drying, where the cellular structure undergoes extreme deformations. In this context, a meshfree particle based model was developed which is fundamentally capable of handling extreme deformations of plant tissues during drying. The model is built by coupling a particle based meshfree technique: Smoothed Particle Hydrodynamics (SPH) and a Discrete Element Method (DEM). Plant cells were initiated as hexagons and aggregated to form a tissue which also accounts for the characteristics of the middle lamella. In each cell, SPH was used to model cell protoplasm and DEM was used to model the cell wall. Drying was incorporated by varying the moisture content, the turgor pressure, and cell wall contraction effects. Compared to the state of the art grid-based microscale plant tissue drying models, the proposed model can be used to simulate tissues under excessive moisture content reductions incorporating cell wall wrinkling. Also, compared to the state of the art SPH-DEM tissue models, the proposed model better replicates real tissues and the cell-cell interactions used ensure efficient computations. Model predictions showed good agreement both qualitatively and quantitatively with experimental findings on dried plant tissues. The proposed modelling approach is fundamentally flexible to study different cellular structures for their microscale morphological changes at dehydration.

Health-related internet habits and health anxiety in university students

Health-related Internet use has grown rapidly, yet little research has considered how health anxious individuals use the Internet for this purpose. Our aim was to examine the relationships between health anxiety and the extent of, reasons for, and consequences of health-related Internet usage in university students (n = 255). Responses on a purpose-made Internet use questionnaire were correlated with health anxiety scores; multiple regression analyses controlling for depression and anxiety were also conducted. Health anxiety positively correlated with (all ps < .01): frequency of health-related searching (r(s) = .163), proportion of health-related information sought (r(s) = .200), time spent online for health purposes (r(s) = .166), and number of searches for both illness (r(s) = .453) and wellness (r(s) = .208) information. Health anxiety further positively correlated with advantages perceived in health-related Internet use (r(s) = .183), heightened tension (r(s) = .364) and relief (r(s) = .174) post-search, and perceived doctor disadvantages (r(s) = .306), yet a greater likelihood to visit a doctor post-search (r(s) = .217). Health anxiety also correlated with six measures of possible addiction to using the Internet for health purposes (r(s) range = .171 to .366, all ps < .01). Some (including several potentially dysfunctional) aspects of health-related Internet use correlate with health anxiety. Research evaluating the possible role of Internet use in the development and maintenance of health anxiety is warranted.

The majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells

AIMS/HYPOTHESIS

Classically, type 1 diabetes is thought to proceed to absolute insulin deficiency. Recently developed ultrasensitive assays capable of detecting C-peptide under 5 pmol/l now allow very low levels of C-peptide to be detected in patients with long-standing type 1 diabetes. It is not known whether this low-level endogenous insulin secretion responds to physiological stimuli. We aimed to assess how commonly low-level detectable C-peptide occurs in long-duration type 1 diabetes and whether it responds to a meal stimulus.

METHODS

We performed a mixed-meal tolerance test in 74 volunteers with long-duration (>5 years) type 1 diabetes, i.e. with age at diagnosis 16 (9-23) years (median [interquartile range]) and diabetes duration of 30 (19-41) years. We assessed fasting and stimulated serum C-peptide levels using an electrochemiluminescence assay (detection limit 3.3 pmol/l), and also the urinary C-peptide:creatinine ratio (UCPCR).

RESULTS

Post-stimulation serum C-peptide was detectable at very low levels (>3.3 pmol/l) in 54 of 74 (73%) patients. In all patients with detectable serum C-peptide, C-peptide either increased (n = 43, 80%) or stayed the same (n = 11) in response to a meal, with no indication of levels falling (p < 0.0001). With increasing disease duration, absolute C-peptide levels fell although the numbers with detectable C-peptide remained high (68%, i.e. 25 of 37 patients with >30 years duration). Similar results were obtained for UCPCR.

CONCLUSIONS/INTERPRETATION

Most patients with long-duration type 1 diabetes continue to secrete very low levels of endogenous insulin, which increase after meals. This is consistent with the presence of a small number of still functional beta cells and implies that beta cells are either escaping immune attack or undergoing regeneration.

Emotional dysregulation, alexithymia, and attachment in psychogenic nonepileptic seizures

OBJECTIVES

Psychogenic nonepileptic seizures (PNESs) are poorly understood and difficult to treat. Research and theory suggest that problems with recognizing, acknowledging, and regulating emotional states (i.e., emotional dysregulation) may contribute to the development and maintenance of PNESs. However, there is a lack of well-controlled studies using dedicated measures of emotional regulation with patients with PNESs. The current study sought to address this gap.

METHODS

Forty-three patients with PNESs and 24 with epilepsy completed a postal survey comprising measures of emotional dysregulation (Difficulties in Emotion Regulation Scale), alexithymia (Toronto Alexithymia Scale), attachment (Relationship Scales Questionnaire), and psychopathology (Generalized Anxiety Disorder-7; Patient Health Questionnaire-9; Somatoform Dissociation Questionnaire-20). Cluster analysis was used to identify possible subgroups of patients with PNESs characterized by distinct patterns of emotional dysregulation.

RESULTS

Two clusters of patients with PNESs were identified. The first (n=11) was characterized by higher levels of psychopathology, somatization, alexithymia, and difficulties with most aspects of emotional regulation (including identifying, accepting, and describing feelings, accessing adaptive regulatory strategies, performing goal-directed behaviors, and controlling feelings and actions) compared with the group with epilepsy. The second (n=32) was characterized by relatively high somatization and depression scores but comparatively normal levels of alexithymia and emotional regulation.

CONCLUSIONS

The findings suggest that patients with PNESs can be divided into at least two meaningful subgroups characterized by distinct psychological profiles, only one of which is characterized by significant problems with emotional dysregulation. Further research is needed to determine whether the relatively normal emotional dysregulation and high somatization scores of some patients with PNESs are due to emotional avoidance or more basic problems with perceptual and behavioral control.

The functional neuroimaging correlates of psychogenic versus organic dystonia

The neurobiological basis of psychogenic movement disorders remains poorly understood and the management of these conditions difficult. Functional neuroimaging studies have provided some insight into the pathophysiology of disorders implicating particularly the prefrontal cortex, but there are no studies on psychogenic dystonia, and comparisons with findings in organic counterparts are rare. To understand the pathophysiology of these disorders better, we compared the similarities and differences in functional neuroimaging of patients with psychogenic dystonia and genetically determined dystonia, and tested hypotheses on the role of the prefrontal cortex in functional neurological disorders. Patients with psychogenic (n = 6) or organic (n = 5, DYT1 gene mutation positive) dystonia of the right leg, and matched healthy control subjects (n = 6) underwent positron emission tomography of regional cerebral blood flow. Participants were studied during rest, during fixed posturing of the right leg and during paced ankle movements. Continuous surface electromyography and footplate manometry monitored task performance. Averaging regional cerebral blood flow across all tasks, the organic dystonia group showed abnormal increases in the primary motor cortex and thalamus compared with controls, with decreases in the cerebellum. In contrast, the psychogenic dystonia group showed the opposite pattern, with abnormally increased blood flow in the cerebellum and basal ganglia, with decreases in the primary motor cortex. Comparing organic dystonia with psychogenic dystonia revealed significantly greater regional blood flow in the primary motor cortex, whereas psychogenic dystonia was associated with significantly greater blood flow in the cerebellum and basal ganglia (all P < 0.05, family-wise whole-brain corrected). Group × task interactions were also examined. During movement, compared with rest, there was abnormal activation in the right dorsolateral prefrontal cortex that was common to both organic and psychogenic dystonia groups (compared with control subjects, P < 0.05, family-wise small-volume correction). These data show a cortical–subcortical differentiation between organic and psychogenic dystonia in terms of regional blood flow, both at rest and during active motor tasks. The pathological prefrontal cortical activation was confirmed in, but was not specific to, psychogenic dystonia. This suggests that psychogenic and organic dystonia have different cortical and subcortical pathophysiology, while a derangement in mechanisms of motor attention may be a feature of both conditions.

Mixing and dispersion of pollutants emitted from an outboard motor

This paper quantifies the mixing and dispersion from an outboard motor by field experiments in a small subtropical waterway. Organic dye was used as a surrogate for exhaust emissions and was mixed with uncontaminated creek water before being dispersed into the creek. Dye concentrations were measured with an array of concentration probes stationed in the creek. The data were then processed and fitted with a power law function. The corresponding dispersion constants agreed well with the literature. However, the amplitude was lower than the IMO equation but higher than the correlation from laboratory tests. Results for dye concentration intermittency (presence of dye) are presented for the first time from such field measurements and show significant mixing in-homogeneity.

A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need

Background

Non-motor symptoms are present in Parkinson's disease (PD) and a key determinant of quality of life. The Non-motor Symptoms Scale (NMSS) is a validated scale that allows quantifying frequency and severity (burden) of NMS. We report a proposal for using NMSS scores to determine levels of NMS burden (NMSB) and to complete PD patient classification.

Methods

This was an observational, cross-sectional international study of 935 consecutive patients. Using a distribution of NMSS scores by quartiles, a classification based on levels from 0 (no NMSB at all) to 4 (very severe NMSB) was obtained and its relation with Hoehn and Yahr (HY) staging, motor and health-related quality of life scales was analyzed. Concordance between NMSB levels and grouping based on clinician's global impression of severity, using categorical regression, was determined. Disability and HRQoL predictors were identified by multiple regression models.

Results

The distribution of motor and QoL scales scores by HY and NMSB levels was significantly discriminative. The difference in the classification of cases for both methods, HY and NMSB, was significant (gamma = 0.45; ASE = 0.032). Concordance between NMSB and global severity-based levels from categorical regression was 91.8%, (kappa_w = 0.97). NMS score was predictor of disability and QoL.

Conclusions

Current clinical practice does not address a need for inclusion of non-motor scores in routine assessment of PD in spite of the overwhelming influence of NMS on disability and quality of life. Our data overcome the problems of “pure motor assessment” and we propose a combined approach with addition of NMSB levels to standard motor assessments.

Application of multicriteria decision making methods to compression ignition engine efficiency and gaseous, particulate, and greenhouse gas emissions

Compression ignition (CI) engine design is subject to many constraints, which present a multicriteria optimization problem that the engine researcher must solve. In particular, the modern CI engine must not only be efficient but must also deliver low gaseous, particulate, and life cycle greenhouse gas emissions so that its impact on urban air quality, human health, and global warming is minimized. Consequently, this study undertakes a multicriteria analysis, which seeks to identify alternative fuels, injection technologies, and combustion strategies that could potentially satisfy these CI engine design constraints. Three data sets are analyzed with the Preference Ranking Organization Method for Enrichment Evaluations and Geometrical Analysis for Interactive Aid (PROMETHEE-GAIA) algorithm to explore the impact of (1) an ethanol fumigation system, (2) alternative fuels (20% biodiesel and synthetic diesel) and alternative injection technologies (mechanical direct injection and common rail injection), and (3) various biodiesel fuels made from 3 feedstocks (i.e., soy, tallow, and canola) tested at several blend percentages (20-100%) on the resulting emissions and efficiency profile of the various test engines. The results show that moderate ethanol substitutions (~20% by energy) at moderate load, high percentage soy blends (60-100%), and alternative fuels (biodiesel and synthetic diesel) provide an efficiency and emissions profile that yields the most "preferred" solutions to this multicriteria engine design problem. Further research is, however, required to reduce reactive oxygen species (ROS) emissions with alternative fuels and to deliver technologies that do not significantly reduce the median diameter of particle emissions.