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Tang CSK, Siu TSU, Chow TS, Kwok HSH. The Role of Family Resilience and Pandemic Burnout on Mental Health: A Two-Wave Study in China. Int J Environ Res Public Health 2023; 20:3803. [PMID: 36900809 PMCID: PMC10001644 DOI: 10.3390/ijerph20053803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.
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Affiliation(s)
- Catherine So-kum Tang
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Tiffany Sok U Siu
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Tak Sang Chow
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Helen Sin-Hang Kwok
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
- Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
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Chow TS, Hui CM, Siu TSU. "It Is My Choice to Control Myself!": Testing the Mediating Roles of Expectancy and Value in the Association Between Perceived Choice and Self-Control Success. Front Psychol 2022; 13:851964. [PMID: 35450340 PMCID: PMC9018001 DOI: 10.3389/fpsyg.2022.851964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/14/2022] [Indexed: 12/03/2022] Open
Abstract
Past research suggested that when individuals feel that it is their free choice to perform a task, they are more likely to succeed. However, little has been known about the effect of perceived choice of self-control and the psychological processes underlying the benefits of this perception in everyday contexts. To fill this gap, a 7-day experience sampling study (115 college students and 1,725 reported episodes of self-control) was conducted to test whether confidence in sustaining the current self-control activity (expectancy) and perceived value of current self-control (value) could mediate the link between perceived choice and success in the current self-control activity. The results of multilevel analysis suggested that the perceived choice can boost self-control success by increasing expectancy and value of self-control. These findings add mechanistic understanding of the effect of perceived choice on self-control success.
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Affiliation(s)
- Tak Sang Chow
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China.,Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-Based Practice and Research, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
| | - Chin Ming Hui
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tiffany Sok U Siu
- Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-Based Practice and Research, Hong Kong Shue Yan University, Hong Kong, Hong Kong SAR, China
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Chow TS, Tang CSK, Siu TSU, Kwok HSH. Family Resilience Scale Short Form (FRS16): Validation in the US and Chinese Samples. Front Psychiatry 2022; 13:845803. [PMID: 35633805 PMCID: PMC9136042 DOI: 10.3389/fpsyt.2022.845803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/23/2022] [Indexed: 12/02/2022] Open
Abstract
Family resilience, which refers to the processes through which a family adapts to and thrives from adversities, has growing importance in recent years. In response to the need for further research on family resilience, the present research aims to abbreviate and validate Sixbey's Family Resilience Assessment Scale (FRAS) into a 16-item version Family Resilience Scale Short Form in the US (FRS16) and Chinese (FRS16_C) samples. The samples included 1,236 (Study 1) and 1,135 (Study 2) participants from the US and China, respectively. Results of confirmatory factor analysis (CFA) supported the proposed three-factor structure of FRS16: Family Communication and Connectedness, Positive Framing, and External Support across two samples. Overall, the reliability and validity of full and subscales of FRS16 and FRS16_C were satisfactory. Multi-group CFA revealed that both configural and metric invariance are supported, suggesting that participants in the US and Chinese samples assign comparable meaning to the latent factors of FRS16. Results suggested that FRS16 and FRS16_C are valid instruments for family resilience in the US and Chinese samples.
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Affiliation(s)
- Tak Sang Chow
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China.,Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Catherine So Kum Tang
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China.,Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Tiffany Sok U Siu
- Wan Chow Yuk Fan Centre for Interdisciplinary Evidence-based Practice and Research, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
| | - Helen Sin Hang Kwok
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong SAR, China
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Yeung NC, Chow TS. Coping with my own way: Mediating roles of emotional expression and social support seeking in the associations between individual differences and posttraumatic growth. Health Psychol Open 2019; 6:2055102919846596. [PMID: 31105967 PMCID: PMC6503603 DOI: 10.1177/2055102919846596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the associations between individual differences and posttraumatic growth, and coping strategies as mediators among 454 trauma-exposed American college students. Results showed that relational-interdependent self-construal, optimism, emotional expression, and social support seeking were associated with higher posttraumatic growth. Moreover, social support seeking and emotional expression partially mediated between relational-interdependent self-construal and posttraumatic growth, such that relational-interdependent self-construal was associated with posttraumatic growth through increased support seeking and emotional expression. However, the association between optimism and posttraumatic growth was partially mediated only by increased emotional expression, but not social support seeking. Findings imply that individual differences may facilitate posttraumatic growth through different coping mechanisms.
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Affiliation(s)
- Nelson Cy Yeung
- The Chinese University of Hong Kong, Hong Kong.,University of Houston, USA
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Ng HKS, Hong YL, Chow TS, Leung ANM. Nature Does Not Always Give You a Helping Hand: Comparing the Prosocial Effects of Nature at Different Resource and Security Levels. Pers Soc Psychol Bull 2018; 45:616-633. [PMID: 30222043 DOI: 10.1177/0146167218794625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Humans become more prosocial after nature exposure. We proposed that the prosocial effect pertains to resource (e.g., food, water) and security (e.g., shelter, concealment) features in natural environments. Four studies tested the idea that prosociality changes with variations in environmental resource and security. Study 1 reported that urban greenspace, a resource feature to urban dwellers, predicted more volunteering in low-crime cities, but less so in high-crime cities. Studies 2 and 3 compared prosociality after exposure to natural sceneries in a Resource (high/low) × Security (high/low) design. Participants were more prosocial in the high-resource-high-security and low-resource-low-security conditions. Study 4 compared the four natural environments with two control conditions (urban, shape). It reported that not all natural environments led to higher prosociality, nor did any of them undermine prosociality. The findings supported heterogeneity in nature's prosocial effect. Implications are discussed in relation to urban greening and the evolutionary basis of nature's effect.
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Affiliation(s)
| | | | | | - Angel Nga Man Leung
- 3 Department of Psychology and Center for Psychosocial Health, The Education University of Hong Kong, Hong Kong
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Chow TS, Wan HY. Is there any ‘Facebook Depression’? Exploring the moderating roles of neuroticism, Facebook social comparison and envy. Personality and Individual Differences 2017. [DOI: 10.1016/j.paid.2017.07.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cahn P, Kaplan R, Sax PE, Squires K, Molina JM, Avihingsanon A, Ratanasuwan W, Rojas E, Rassool M, Bloch M, Vandekerckhove L, Ruane P, Yazdanpanah Y, Katlama C, Xu X, Rodgers A, East L, Wenning L, Rawlins S, Homony B, Sklar P, Nguyen BY, Leavitt R, Teppler H, Cahn PE, Cassetti I, Losso M, Bloch MT, Roth N, McMahon J, Moore RJ, Smith D, Clumeck N, Vanderkerckhove L, Vandercam B, Moutschen M, Baril J, Conway B, Smaill F, Smith GHR, Rachlis A, Walmsley SL, Perez C, Wolff M, Lasso MF, Chahin CE, Velez JD, Sussmann O, Reynes J, Katlama C, Yazdanpanah Y, Ferret S, Durant J, Duvivier C, Poizot-Martin I, Ajana F, Rockstroh JK, Faetkanheuer G, Esser S, Jaeger H, Degen O, Bickel M, Bogner J, Arasteh K, Hartl H, Stoehr A, Rojas EM, Arathoon E, Gonzalez LD, Mejia CR, Shahar E, Turner D, Levy I, Sthoeger Z, Elinav H, Gori A, Monforte AD, Di Perri G, Lazzarin A, Rizzardini G, Antinori A, Celesia BM, Maggiolo F, Chow TS, Lee CKC, Azwa RISR, Mustafa M, Oyanguren M, Castillo RA, Hercilla L, Echiverri C, Maltez F, da Cunha JGS, Neves I, Teofilo E, Serrao R, Nagimova F, Khaertynova I, Orlova-Morozova E, Voronin E, Sotnikov V, Yakovlev AA, Zakharova NG, Tsybakova OA, Botes ME, Mohapi L, Kaplan R, Rassool MS, Arribas JR, Gatell JM, Negredo E, Ortega E, Troya J, Berenguer J, Aguirrebengoa K, Antela A, Calmy A, Cavassini M, Rauch A, Stoeckle M, Sheng WH, Lin HH, Tsai HC, Changpradub D, Avihingsanon A, Kiertiburanakul S, Ratanasuwan W, Nelson MR, Clarke A, Ustianowski A, Winston A, Johnson MA, Asmuth DM, Cade J, Gallant JE, Ruane PJ, Kumar PN, Luque AE, Panther L, Tashima KT, Ward D, Berger DS, Dietz CA, Fichtenbaum C, Gupta S, Mullane KM, Novak RM, Sweet DE, Crofoot GE, Hagins DP, Lewis ST, McDonald CK, DeJesus E, Sloan L, Prelutsky DJ, Rondon JC, Henn S, Scarsella AJ, Morales JO, Ramirez, Santiago L, Zorrilla CD, Saag MS, Hsiao CB. Raltegravir 1200 mg once daily versus raltegravir 400 mg twice daily, with tenofovir disoproxil fumarate and emtricitabine, for previously untreated HIV-1 infection: a randomised, double-blind, parallel-group, phase 3, non-inferiority trial. The Lancet HIV 2017; 4:e486-e494. [DOI: 10.1016/s2352-3018(17)30128-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 06/22/2017] [Accepted: 06/23/2017] [Indexed: 12/20/2022]
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Chen LS, Wong PS, Leong KN, Chow TS. Filariasis in axillary lymph node. Trop Biomed 2017; 34:461-463. [PMID: 33593029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A case of adult filarial worms detected in an axillary lymph node of an asymptomatic patient. A 64 year-old Indian female underwent a mammogram and was incidentally found to have punctate microcalcifications in the upper outer quadrant of the left breast with left axillary lymphadenopathy. She has underlying hypertension and diabetes mellitus on oral medications. She has no family history of breast malignancy. Fine needle aspiration of the left axillary lymph node was suggestive of reactive lympha-denitis. Histopathological examination of excisional biopsy of left breast lump showed fibrocystic disease; no evidence of malignancy was detected whereas excisional biopsy of left axillary lymph node showed reactive lymphoid hyperplasia, featuring variably sized lymphoid follicles with intact mantle zone. No expansion of marginal zone was noted. Occasional pigment-laden macrophages were seen. One of the lymph node showed presence of calcified serpinginous tubular bodies, in keeping with non viable parasite organisms with intact outlines of the structures. There were no eosinophilic infiltrates. The possibility of filarial infestation was suspected. Histopathological sample was sent for further identification and confirmed the presence of adult filarial worm.
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Affiliation(s)
- L S Chen
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - P S Wong
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - K N Leong
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
| | - T S Chow
- Infectious Disease Unit, Department of Medicine, Penang General Hospital, Jalan Residensi, 10990 Georgetown, Pulau Pinang, Malaysia
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Ng HKS, Chow TS. The effects of environmental resource and security on aggressive behavior. Aggress Behav 2017; 43:304-314. [PMID: 27859336 DOI: 10.1002/ab.21690] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/06/2016] [Accepted: 10/13/2016] [Indexed: 11/10/2022]
Abstract
Exposure to different environments has been reported to change aggressive behavior, but previous research did not consider the underlying elements that caused such an effect. Based on previous work on environmental perception, we examined the role of environmental resource and security in altering aggression level. In three experiments, participants were exposed to environments that varied in resource (High vs. Low) and security (High vs. Low) levels, after which aggression was measured. The environments were presented through visual priming (Experiments 1-2) and a first-person gameplay (Experiment 3). We observed a consistent resource-security interaction effect on aggression, operationalized as the level of noise blast (Experiment 1) and number of unpleasant pictures (Experiments 2-3) delivered to strangers by the participants. High resource levels associated with higher aggression in insecure conditions, but lower aggression in secure conditions. The findings suggest that the adaptive value of aggression varies under different environmental constraints. Implications are discussed in terms of the effects of adverse environments on aggression, and the nature's effects on social behavior. Aggr. Behav. 43:304-314, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Tak Sang Chow
- Department of Counselling and Psychology; Hong Kong Shue Yan University; Hong Kong
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Abstract
In this paper, a new neural approach is introduced for the problem of blind equalization in digital communications. Necessary and sufficient conditions for blind equalization are proposed, which can be implemented by a two-layer linear neural network. In the hidden layer, the received signals are whitened, while the network outputs provide directly an estimation of the source symbols. We consider a stochastic approximate learning algorithm for each layer according to the property of the correlation matrices of the transmitted symbols. The proposed class of networks yield good results in simulation examples for the blind equalization of a three-ray multipath channel.
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Affiliation(s)
- Y Fang
- Department of Electronic Engineering, City University of Hong Kong, Kowloon, Hong Kong
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Abstract
In this paper, we present a neural-based reflectance model of which the physical parameters of the reflectivity under different lighting conditions are interpreted by the network weights. The idea of our method is to optimize a proper reflectance model by an effective learning algorithm and to recover the object surface by a simple shape from shading recursive algorithm with this resulting model. Experimental results, including synthetic and real images, were performed to demonstrate the performance of the proposed method for practical applications.
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Cho SY, Chow TS. Learning parametric specular reflectance model by radial basis function network. IEEE Trans Neural Netw 2008; 11:1498-503. [PMID: 18249875 DOI: 10.1109/72.883483] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
For the shape from shading problem, it is known that most real images usually contain specular components and are affected by unknown reflectivity. In this paper, these limitations are addressed and a new neural-based specular reflectance model is proposed. The idea of this method is to optimize a proper specular model by learning the parameters of a radial basis function network and to recover the object shape by the variational approach with this resulting model. The obtained results are very encouraging and the performance is demonstrated by using the synthetic and real images in the case of different specular effects and noisy environments.
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Chan CM, Wong KH, Chung WK, Chow TS, Wong PK. Photocatalytic degradation of di(2-ethylhexyl)phthalate adsorbed by chitin A. Water Sci Technol 2007; 56:125-134. [PMID: 17951876 DOI: 10.2166/wst.2007.685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Di(2-ethylhexyl)phthalate (DEHP) is a ubiquitous environmental contaminant due to its extensive use as a plasticiser and its persistence. Currently, there is no cost-effective treatment method for its removal from industrial wastewater. In a previous study, DEHP was effectively adsorbed from aqueous solution by biosorption onto chitinous materials. Biosorption can pre-concentrate DEHP from the aqueous phase for further treatment. As biosorption cannot degrade DEHP, in this study the degradation (and detoxification) of DEHP adsorbed onto chitinous material by photocatalytic oxidation (PCO) is attempted. PCO relies on hydroxyl radical (.OH), which is a strong oxidising agent, for the oxidative degradation of pollutants. It is a non-selective process which can degrade DEHP adsorbed onto chitinous material. The first part of this study is the optimisation of the degradation of adsorbed DEHP by PCO. Adsorption was carried out in the physicochemical conditions optimised in the previous study, with 500 mg/L chitin A and 40 mg/L DEHP at initial pH 2, 22+/-2 degrees C and 150 rpm agitation for 5 min. After optimisation of PCO, a 61% removal efficiency of 10 mg/L of DEHP was achieved within 45 min under 0.65 mW/cm2 of UV-A with 100 mg/L TiO2, and 10 mM of H2O2 at initial pH 12. The optimisation study showed that UV-A and TiO(2) are essential for the degradation of DEHP by PCO. The degradation intermediates/products were identified by GC-MS analysis. GC-MS results showed that the di(2-ethylhexyl) side chain was first degraded, producing phthalates with shorter side chains. Further reaction produced phathalic anhydride and aliphatic compounds such as alkanol and ester. The toxicities of parental and degradation intermediates in the solution phase and on chitinous materials were followed by the Microtox test. Results indicated that toxicity can be removed after 4 h treatment by PCO. Thus the decontamination of DEHP by integrating biosorption and PCO is feasible.
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Affiliation(s)
- C M Chan
- Department of Biology, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.
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Abstract
A model is developed to describe the adhesion between deformable fractal surfaces over the mesoscopic realm that covers the familiar range of interest in nanotechnology from atomic dimensions to microns. This model helps us gain a quantitative understanding of the variation of adhesion with surface energy, with microstructure of rough surfaces, and with bulk deformability. The present analysis goes beyond the Gaussian distribution of asperity heights by investigating the influence of the microstructure of self-affine fractal surfaces. Our calculation reveals that orders of magnitude increase in adhesion are possible as the roughness exponent decreases.
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Affiliation(s)
- T S Chow
- Xerox Research and Technology, 800 Phillips Road, 0114-39D, Webster, New York 14580, USA
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Chow TS. Fluctuations in dispersion rheology. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 2000; 62:2475-9. [PMID: 11088727 DOI: 10.1103/physreve.62.2475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2000] [Indexed: 04/15/2023]
Abstract
On the basis of the mesoscopic fluctuations of excess density, an experimentally verified model is developed to describe the effective shear viscosity and modulus of complex dispersions as a function of concentration, frequency, and temperature. A stochastic differential equation is used in the derivation of the zero-shear viscosity that shows large viscosity enhancement over a broad range of concentrations. The scaling behavior of shear thinning is determined from an anomalous diffusion equation. We obtain the shear-thinning exponent 1>beta>1 / 2, which depends on the tenuous fractal structure of the complex systems. The divergence of the shear viscosity in the vicinity of a critical temperature is derived as a dynamic critical phenomenon due to thermal fluctuations, and the critical exponent relates directly to the shear-thinning exponent.
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Affiliation(s)
- TS Chow
- Xerox Research and Technology, 800 Phillips Road, 0114-39D, Webster, New York 14580, USA
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Abstract
OBJECTIVE AND IMPORTANCE An unusual foreign body traversing the spinal canal at the foramen magnum level is described. Interesting radiological findings and a review of nonmissile penetrating injuries are presented. This case demonstrates the importance of a thorough physical examination and the use of neurodiagnostic imaging in an inebriated, uncooperative patient with neurological dysfunction. CLINICAL PRESENTATION The patient presented with quadriparesis confounded by cocaine intoxication. A physical examination revealed only a small punctate lesion in the posterior occipital region. INTERVENTION After detection of the foreign body, the patient underwent immediate surgical exploration and removal of the object. The dura was repaired primarily, and the patient was maintained on intravenous antibiotics for 7 days. CONCLUSION With physical therapy, the patient was walking with assistance at 2 weeks postsurgery. Upper extremity strength, especially intrinsic hand movement, was most severely affected. At 10 months' follow-up, the patient's only deficits were mild intrinsic hand weakness and incoordination with fine finger movements. Immediate surgical exploration is indicated for patients with retained fragments and progressive neurological dysfunction.
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Affiliation(s)
- C R Tomaras
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
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Abstract
The authors retrospectively reviewed the surgical outcomes in 10 cases of symptomatic intradural extramedullary spinal metastases of nonneurogenic origin because the collective experience in treating this rare manifestation of systemic cancer is limited. Pain and weakness were the presenting complaints in 70% of the patients and sensory changes were found in all cases. Cytological tests on one specimen of cerebrospinal fluid (CSF) from each of seven patients showed malignant cells in two cases. Gadolinium contrast-enhanced biplanar magnetic resonance (MR) imaging was effective in localizing the lesion and showed evidence of leptomeningeal carcinomatosis in two cases; myelography showed leptomeningeal carcinomatosis in one case and erroneously identified the lesion as intramedullary in the other. Eight of 10 cases had antecedent intracranial metastatic foci with the interval from presentation of the intracranial lesion to appearance of the spinal disease ranging from 3 to 51 months. The majority of the spinal lesions occurred in the thoracolumbar area. The most frequent histological type was adenocarcinoma and the most frequent source was the lung. In all cases laminectomies, intradural exploration, and biopsy or subtotal excision aided by microscopy and ultrasonography were performed. Results of surgical decompression were poor with only 30% of the patients showing improvement, at a 20% risk of perioperative mortality and a 60% risk of morbidity. Plans for surgical intervention in patients with intradural extramedullary metastases from a distant noneurogenic source should be weighed against the high association with intracranial lesions, overall poor prognosis, and modest symptomatic results of decompression. Comprehensive evaluation including multiple specimens of CSF for cytology and contrast-enhanced MR imaging should be undertaken to exclude patients with diffuse leptomeningeal involvement, who should be treated by means other than surgery.
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Affiliation(s)
- T S Chow
- Department of Neurosurgery, University of Texas M.D. Anderson Cancer Center, Houston, USA
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Chow TS. Viscoelasticity of concentrated dispersions. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1994; 50:1274-1279. [PMID: 9962089 DOI: 10.1103/physreve.50.1274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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