bluuebunny/crossref_metadata_2025 huggingface dataset:
Annexin A2 and its downstream IL-6 and HB-EGF as secretory biomarkers in the differential diagnosis of Her-2 negative breast cancer
Authors: Shetty Praveenkumar , Patil Vidya S , Mohan Rajashekar , D’souza Leonard Clinton , Bargale Anil , Patil Basavaraj R , Dinesh US , Haridas Vikram , Kulkarni Shrirang P
Published: August 2016

Background

AnnexinA2 (AnxA2) membrane deposition has a critical role in HB-EGF shedding as well as IL-6 secretion in breast cancer cells. This autocrine cycle has a major role in cancer cell proliferation, migration and metastasis. The objective of the study is to demonstrate annexinA2-mediated autocrine regulation via HB-EGF and IL-6 in Her-2 negative breast cancer progression.

Methods

Secretory annexinA2, HB-EGF and IL-6 were analysed in the peripheral blood sample of Her-2 negative ( n = 20) and positive breast cancer patients ( n = 16). Simultaneously, tissue expression was analysed by immunohistochemistry. The membrane deposition of these secretory ligands and their autocrine regulation was demonstrated using triple-negative breast cancer cell line model.

Results

Annexina2 and HB-EGF expression are inversely correlated with Her-2, whereas IL-6 expression is seen in both Her-2 negative and positive breast cancer cells. RNA interference studies and upregulation of annexinA2 proved that annexinA2 is the upstream of this autocrine pathway. Abundant soluble serum annexinA2 is secreted in Her-2 negative breast cancer (359.28 ± 63.73 ng/mL) compared with normal (286.10 ± 70.04 ng/mL, P < 0.01) and Her-2 positive cases (217.75 ± 60.59 ng/mL, P < 0.0001). In Her-2 negative cases, the HB-EGF concentrations (179.16 ± 118.81 pg/mL) were highly significant compared with normal (14.92 ± 17.33 pg/mL, P < 0.001). IL-6 concentrations were increased significantly in both the breast cancer phenotypes as compared with normal ( P < 0.001).

Conclusion

The specific expression pattern of annexinA2 and HB-EGF in triple-negative breast cancer tissues, increased secretion compared with normal cells, and their major role in the regulation of EGFR downstream signalling makes these molecules as a potential tissue and serum biomarker and an excellent therapeutic target in Her-2 negative breast cancer.
Using Go-Alongs for exploring immigrant entrepreneurs’ native customers
Authors: Parzer Michael , Rieder Irene , Wimmer Eva
Published: August 2016

The purpose of this article is to evaluate the methodological practice of Go-Alongs for exploring immigrant entrepreneurs’ native customers, a barely developed subfield within immigrant business research. Through accompanying individuals on outings in their familiar environments, Go-Alongs as a qualitative data collection method are used to gain access to practices, experiences and interpretations of individuals in their everyday routines. Drawing on current qualitative research on native customers in immigrant grocery shops in Vienna, the article demonstrates how Go-Alongs can be used for exploring consumption practices and patterns of interethnic interaction in this specific setting. What becomes apparent is that Go-Alongs provide an opportunity to gain access to reflexive aspects of lived experience in situ, in the present case expressed by spontaneous and emotional comments when the shop, ethnic products or interethnic interactions are commented on and evaluated. Moreover, Go-Alongs allow insights into modes of self-expression. However, Go-Alongs have limitations as they cannot capture consumption practices beyond the limited time and space of shopping. Furthermore, they do not fully provide access to narratives and discourses; therefore, Go-Alongs are most useful in combination with in-depth interviews.
The strength of collusion: A conceptual framework for interpreting hybrid social orders
Authors: Dewey Matías , Míguez Daniel Pedro , Saín Marcelo Fabián
Published: August 2016

By moving away from dualistic perspectives that see social order as the product of strong states but not weak states, this article develops a conceptual framework for interpreting hybrid social orders, i.e. those established by both legal and extra-legal actors. The initial premise is that hybrid forms of social domination resulting from the interaction between legal and extra-legal actors, and regulated by a combination of rational bureaucratic and neo-patrimonial rules, produce relevant economic and political outcomes such as job creation, the supply of basic services and the production of authority. Especially in contexts of continuous economic crisis, ethnic segregation, social marginalization and persistent inequality, these outcomes have ordering effects both in terms of reducing uncertainty and regulating social expectations. Furthermore, in such social contexts, socially tolerated illegal markets play a decisive role. Supported by recent and innovative research, this article concludes with hypotheses intended to promote further research.
Experiencing Unmet Medical Needs or Delayed Care Because of Cost
Authors: Choi Sunha
Published: August 2016

Healthy People 2020 in the United States highlights timely access to necessary health care as a major factor that can reduce health-related disparities. This study examined the prevalence of delaying/missing necessary health care because of cost among foreign-born adults (26+ years old) in the United States by their region of origin, after controlling for geographic clustering at the county and state levels. Methods. Using the pooled 2007–2011 National Health Interview Survey and linked state/county-level data, this study analyzed data on 61,732 foreign-born adults from nine regions of birth. Three-level multilevel modeling (state > county > individual) was conducted. The age-adjusted percentages of foreign-born adults who delayed/missed necessary health care because of cost varied by region of birth, ranging from 7.0% (Southeast Asia) and 11.9% (Europe) to 15.5% (Mexico/Central America/Caribbean) and 16.7% (the Middle East). However, after controlling for geographic clustering and other individual-level covariates (e.g., insurance), adults from Mexico/Central America/Caribbean were less likely to delay or not receive necessary care compared to their counterparts from all other parts of the world except for those from Asian regions. This study implies that disparities can be reduced if some known risk factors (e.g., insurance) are improved among foreign-born adults.
Integrating across policy sectors: how the wider public impacts on the drafting process of EU trans-border healthcare
Authors: Hartlapp Miriam
Published: August 2016

Policy-making in the EU has been depicted as being starkly fragmented: initiatives are drafted in separate Directorates-General of the EU Commission, discussed in specific policy communities and decided upon in sectoral European Parliament Committees and Council formations. At the same time, we see growing numbers of complex policy problems that require cross-sectorally integrated solutions. This article argues that there are good grounds to expect policy-making in the EU Commission to favour fragmented solutions, while diffuse public interests will tend to push for integrated policies. However, it is only under specific constellations that the EU Commission will respond to these interests. The argument will be demonstrated using case study material on three policy instruments that address trans-border healthcare policy. While the Coordination of Social Security Systems Regulation and the Services in the Internal Market Directive favour largely fragmented solutions, the Patient Mobility Directive takes a more integrated approach.

Points for practitioners

Today, complex policy problems often demand integrated policy solutions that cut across organizational borders and areas of responsibility. At the same time, decision-making is often easier if policy solutions remain fragmented. Internal coordination is an important means for public administrations to reach integrated instead of fragmented policy solutions. Periods with high public attention are more likely to lead to more integrated policy solutions, since policy-makers will seize internal coordination to anticipate the interests of a wider public that is following the policy-making process. Evidence is provided from drafting processes inside the EU Commission on trans-border healthcare acts.
Competitive Performance Correlates of Mental Toughness in Tennis
Authors: Cowden Richard G.
Published: August 2016

This study investigated relationships between mental toughness and measures of competitive performance in tennis. Forty-three male ( N = 25) and female ( N = 18) players ( M age = 13.6 years, SD = 2.4) completed the mental toughness inventory, and the point-by-point outcomes recorded during a competitive tennis match (singles) were used to generate performance indices for each athlete. The results indicated that mental toughness was associated with several, but not all, macro, micro, and critical moment performance indices. The findings suggest mental toughness may contribute to successful performance during tennis competition, although the importance of the construct appears to depend on specific match situations. Future mental toughness research should consider a range of factors related to sport performance, including athletes’ and opponents’ physical, technical, and tactical abilities.
Kiosk Reporting Among Probationers in the United States
Authors: Ahlin Eileen M. , Hagen Carol A. , Harmon Michele A. , Crosse Scott
Published: August 2016

Kiosk reporting is one type of electronic reporting that reduces the need for a low-risk offender to meet face-to-face with a probation officer. Probationers are identified by the kiosk using biometric measures and are prompted to provide information they would typically discuss with a probation officer. Despite its use in a variety of contexts, little is known about kiosk reporting in practice. This research provides an overview of the use of kiosk reporting among probation agencies across the United States and examines the use of kiosk reporting from the perspective of probation officers.
Childhood Abuse and Drug Addiction Among Israeli Male Inmates
Authors: Chen Gila , Gueta Keren
Published: August 2016

The purpose of the study was to investigate types of childhood abuse in a sample of 60 inmates and to explore the relationships between childhood abuse, criminality, and drug addiction. Overall, the sample inmates came from risky families with a high prevalence of crime, drug addiction, and mental health problems. The results showed that a history of child abuse was common, and emotional neglect was more prevalent than physical, emotional, or sexual abuse. The odds for childhood abuse were higher among inmates whose fathers had been addicted to drugs and involved in crime, and whose siblings suffered from mental health problems.
Immobilization of titanium dioxide on PAN fiber as a recyclable photocatalyst via co-dispersion solvent dip coating
Authors: Zhao Jian , Wang Jinfeng , Fan Linpeng , Pakdel Esfandiar , Huang Shu , Wang Xungai
Published: August 2016

Polyacrylonitrile (PAN) fiber coated with photocatalyst titanium dioxide (P25) was successfully fabricated by a dip coating process using dimethyl sulfoxide (DMSO)/ethanol (EtOH) as co-dispersion solvent. Photocatalytic performance of P25-coated PAN fibers was evaluated by degrading a model dye rhodamine B (RhB) in aqueous solution under ultraviolet (UV) light irradiation. The preparation parameters of P25-coated PAN fibers were optimized by an orthogonal design, and were found to be a P25 concentration of 0.05 g/L, a ratio of 85/15 (v/v) DMSO/EtOH, and a take-up speed of 0.5 m/min. A possible mechanism of co-dispersion solvent dip coating was proposed based on Hansen solubility parameters’ theory. The P25-coated PAN fibers prepared at the optimum conditions had high dye removal efficiency. They also showed an excellent cycling performance for dye removal of up to 99% recovery over several cycles. The coating process has little impact on both the fiber strength and the breaking strength. The breaking strength of P25-coated PAN fibers was maintained even after several cycles. This study provides an easy-to-scale-up method for preparing P25-coated PAN fibers. The obtained P25-coated PAN fibers show great potential as a low-cost, easy handling, and recyclable photocatalyst for dye effluent treatment.
Ultraviolet protection performance of cotton fabric modified by ionic liquid iron coordination complex
Authors: Cheng Dehong , Yu Zhi-Cai , Lu Sheng , Gong Shengchen , Li Jia , Wang Boxiang , Lu Yanhua
Published: August 2016

In order to endow cotton fabric with the full wave band (290–410 nm) ultraviolet (UV) protection property, ionic liquid iron coordination complex (ILICC) was applied to modify cotton fabric. ILICC was prepared by in situ reaction on the surface of the cotton fiber directly. The Fourier transform infrared spectra, thermogravimetric and differential scanning calorimetry curves indicated that the strong interaction between ILICC and cellulose macromolecules of cotton fiber occurred through the O-Fe bond. Scanning electron microscopy images and particle size analysis indicated that the surface of the modified cotton fiber was covered by the agminate ILICC particles with diameters of 700–1600 nm. Investigation on the UV protection performances indicated that the UV transmittances ( T%) of the modified cotton fabric were less than 1.3% for the full wave band (UVA and UVB) UV. The washing durability results showed that the UV protection factor values were more than 95 when the modified cotton fabric was washed with 30 st washing cycles. The reason for the excellent UV protection performance of the modified cotton fabric was absorption and shielding of ILICC particles to UV light.
A novel approach for precise determination of in-plane shear behavior of woven fabrics
Authors: Uren Nazli , Oner Eren , Okur Ayse
Published: August 2016

The ability of a textile product to change shape under motion-based diagonal forces defines the shear behavior of a fabric and its suitability for a wearable garment design. The principal aim of this study is to introduce a new shear frame and investigate the effects of raw material and setting on in-plane shear behavior of woven fabrics. For this purpose, the mechanical properties of systematic and commercially available non-systematic fabrics were measured. A novel approach to determine the in-plane shear behavior of woven fabrics via two complementary shear frame measurements was presented. The results were also compared with a conventional method known as the bias extension method. It was established that the proposed method provides more accurate and precise results. In order to investigate the correlation between in-plane shear behavior and other mechanical properties, bending rigidity and extension ability of fabrics were measured as well. The analyses regarding the relations between selected fabric parameters showed that there are considerably high correlation coefficients. The effect of raw material and setting was likewise found out to be statistically significant.
Effects of parameters of the shell formation process on the performance of microencapsulated phase change materials based on melamine-formaldehyde
Authors: Wang Xianfeng , Zhao Tao
Published: August 2016

Shell formation process is a very vital step in the fabrication of melamine-formaldehyde microencapsulated phase change materials (microPCMs). In this research, the effects of parameters in this process, including system pH value, initial temperature and dropping rate of the prepolymer, were studied systematically to prepare microPCMs with potential application in thermo-regulated textiles. The various properties of obtained microcapsules were investigated by scanning electron microscopy, differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). Revised encapsulation efficiency ( RE) was calculated with a new method based on the results of DSC and TGA, and was used to characterize the encapsulation efficiency of the microPCMs. The experimental results indicated moderate pH, such as 4.6, benefited the formation of regular spherical capsules with high encapsulation efficiency. The products prepared at low pH were almost irregular aggregates, while the microcapsules formed at high pH were easily damaged. It was found that the microcapsules synthesized at a lower initial temperature, such as 40℃, presented poor appearance and low encapsulation efficiency. The suitable initial temperature for shell formation was about 75℃. With the decrease of the dropping rate, the surface morphology of microPCMs showed obvious improvement, while the increment speed of RE was slow. The medium dropping speed could be selected to ensure the encapsulation efficiency as well as the productivity in this experiment. It was also found that RE could reflect the effects of these parameters more accurately in comparison with the conventional apparent encapsulation efficiency ( AE).
Exploring the Influence of Neighborhood-Level Factors on Adolescent Birth Rates in California: A Social-Ecological Approach
Authors: Decker Martha J. , Gutmann-Gonzalez Abigail , Lara Diana , Brindis Claire D.
Published: August 2016

This article examines neighborhood-level factors to help explain why adolescent birth rate trajectories differ in certain communities in California, with rates in some areas remaining elevated or increasing while rates in other areas with similar demographic characteristics declined. Researchers conducted in-depth interviews with 94 community stakeholders and 22 focus groups with 186 adolescents from five “promising” communities (with declining adolescent birth rates) and five “struggling” communities (persistently elevated or increasing rates). Promising communities had more employment prospects, better neighbor interactions, and greater educational opportunities for youth. Parent–child communication around sex and youth knowledge of clinics were also more common. In contrast, struggling communities tended to have higher perceived levels of crime and poverty and more negative attitudes toward youth. These findings illustrate the complexity of factors that influence adolescents’ lives and decision-making. Synergistic community-based approaches to adolescent health and development are critical to promote positive health outcomes.
Failure Matters: Conflicting Practices in a High-Tech Case
Authors: Pflugfelder Ehren Helmut
Published: August 2016

Technical communication researchers have studied failure through a number of different case studies, though none more often than the space shuttle Challenger explosion. While scholars have offered several explanations in the intervening three decades, this work often treats the disaster as a failure of organizational communication, a failure of the material O-ring, or a failure of two discourse communities, engineers and managers, to engage in mutually comprehensible forms of meaningful deliberation. This essay hypothesizes that the real cause of failure was neither positivist nor social constructionist in nature, but discursive-material. I offer discussion of the Challenger case in order to frame a different study of project failure and show that complex technical projects fail for a number discursive-material reasons. Employing assumptions from actor–network theory and Barad’s theory of agential realism, this essay establishes a basis for how to read the Challenger disaster as one of competing and unresolved “conceptual structures of practice.” I then take this framework and apply it to a case study of a transportation project at a large, Midwestern research university. This project, the electric personal transportation vehicle, failed because competing structures of practice generated powerful actants that mattered in different ways. Insufficient project management activities also contributed to failure; the conclusion identifies concepts technical communicators can employ in establishing more effective project management strategies that work to resolve competing actants.
Patient perceptions of weight loss
Authors: Nelson David A , Ruffalo Leslie A , Dyer Alexandra J , Nelson Karen H
Published: August 2016

Objectives

The prevalence of overweight and obese individuals in the United States is growing, and primary health care represents a setting in which providers may address weight with their patients. However, many providers and medical trainees feel ill-prepared to address the full scope of complexities associated with weight loss. This study sought to investigate patients’ perceptions of the barriers and facilitators they encountered in their weight loss journeys. The results of the mixed-methods study will be used to inform a better understanding among providers and medical students of how to address weight loss with their patients. This study was approved by the institutional review board of Medical College of Wisconsin.

Methods

Participants were selected from patient panels at a Family Medicine Residency Program. Participants who enrolled in the study completed a survey that collected attitudes and behaviors about weight loss and demographics. The patients also participated in a 60- to 90-min guided interview. Interviews were transcribed verbatim and analyzed using open-coding techniques and principles of grounded theory.

Results

To date, five participants completed the study. All were female with a mean age of 52 years. Two primary themes emerged from a grounded theory model. The first theme centered on individual’s knowledge, attitudes, and behaviors to lost weight. The second theme emphasized that societal relationships serve as both a barrier and a facilitator to weight loss.

Conclusion

The overarching conclusion of this study is that individuals often have the knowledge to make positive health behaviors changes, but multiple factors may prohibit this from occurring. When a supportive environment exists, healthy behavior changes are more attainable. Physicians, mid-level providers, and medical trainees and even medical systems can provide appropriate support to join the patient on their weight loss journey.
Comprehensive care of pain
Authors: Rickert Julie , Devlin Kwanza , Krohn Kimberly
Published: August 2016

Chronic non-cancer pain is a common condition associated with tremendous risk for morbidity and mortality. In many settings, the management of chronic non-cancer pain by primary care providers, although customary, can be difficult due to inadequate training and conflicts between patient expectations and best practices. Resident physicians, faculty, and staff of this family medicine residency program developed a comprehensive chronic pain management program to address these issues while improving patient outcomes. The program was aligned with evidence-based chronic non-cancer pain management strategies yet tailored to the needs of the providers and patients and the strengths of the clinic. In the end, the societal demand for improved chronic non-cancer pain management resulted in a massive curricular and clinical practice overhaul for this residency program.
The elephant in the room
Authors: White-Davis Tanya , Stein Emma , Karasz Alison
Published: August 2016

Objectives

For centuries, the concept of race, a uniquely pervasive social construct, has often complicated dialogue and interactions between groups of people. This study assessed perceptions and attitudes of faculty and trainees with varied racial backgrounds within graduate medical and psychology programs. Self-reported responses addressed potential barriers and facilitating factors required for meaningful conversations about race.

Methods

A brief 18-question survey was developed and administered electronically to three professional and academic Listservs within a large metropolitan city in northeast United States. Quantitative and qualitative analysis were conducted using SPSS Statistical Software and Text analyzer.

Results

Results revealed that among participants ( N = 57) a majority experienced cross-racial supervision, and more than half indicated engaging in conversations about race within supervision. Respondents endorsed lack of comfort and lack of opportunity/time as significant barriers to discussing race within supervision. When race-related dialogues occurred, a majority of supervisees and supervisors found it beneficial. Most Supervisors of Colora actively initiated these conversations in supervision, while White supervisees endorsed the least benefit from these conversations. Contrary to our expectations, few respondents endorsed limited training as a barrier.

Discussion

The current study revealed cross-racial dialogues about race may be occurring frequently in supervisory relationships. Supervisees of Color reported benefiting from these dialogues, in contrast to their White counterparts, who endorsed the least benefit. Lack of comfort in supervisory relationships appears to be a significant barrier to having these conversations. Therefore, it is important for supervisors to create supervisory relationships emphasizing safety and comfort. Directions for future research are discussed.
Innovative patient-centered skills training addressing challenging issues in cancer communications
Authors: Bishop Thomas W , Gorniewicz James , Floyd Michael , Tudiver Fred , Odom Amy , Zoppi Kathy
Published: August 2016

This workshop demonstrated the utility of a patient-centered web-based/digital Breaking Bad News communication training module designed to educate learners of various levels and disciplines. This training module is designed for independent, self-directed learning as well as group instruction. These interactive educational interventions are based upon video-recorded patient stories. Curriculum development was the result of an interdisciplinary, collaborative effort involving faculty from the East Tennessee State University (ETSU) Graduate Storytelling Program and the departments of Family and Internal Medicine at the James H. Quillen College of Medicine. The specific goals of the BBN training module are to assist learners in: (1) understanding a five-step patient-centered model that is based upon needs, preferences, and expectations of patients with cancer and (2) individualizing communication that is consistent with patient preferences in discussing emotions, informational detail, prognosis and timeline, and whether or not to discuss end-of-life issues. The pedagogical approach to the training module is to cycle through Emotional Engagement, Data, Modeled Practices, Adaptation Opportunities, and Feedback. The communication skills addressed are rooted in concepts found within the Reaching Common Ground communication training. A randomized control study investigating the effectiveness of the Breaking Bad News module found that medical students as well as resident physicians improved their communication skills as measured by an Objective Structured Clinical Examination. Four other similarly designed modules were also created: Living Through Treatment, Transitions: From Curable to Treatable/From Treatable to End-of-Life, Spirituality, and Family.
Integrating motivational interviewing and narrative therapy to teach behavior change to family medicine resident physicians
Authors: Oshman Lauren D , Combs Gene N
Published: August 2016

Introduction

Motivational interviewing is a useful skill to address the common problem of patient ambivalence regarding behavior change by uncovering and strengthening a person’s own motivation and commitment to change. The Family Medicine Milestones underline the need for clear teaching and monitoring of skills in communication and behavior change in Family Medicine postgraduate training settings.

Methods

This article reports the integration of a motivational interviewing curriculum into an existing longitudinal narrative therapy-based curriculum on patient-centered communication.

Outcomes

Observed structured clinical examination for six participants indicate that intern physicians are able to demonstrate moderate motivational interviewing skill after a brief 2-h workshop. Participant self-evaluations for 16 participants suggest a brief 2-h curriculum was helpful at increasing importance of learning motivational interviewing by participants, and that participants desire further training opportunities.

Conclusion

A brief motivational interviewing curriculum can be integrated into existing communication training in a Family Medicine residency training program.
Relationship between processing and electrical properties in SEBS/CNT nanocomposites
Authors: Latko Paulina , Bielecki Mateusz , Kozera Rafał , Boczkowska Anna
Published: August 2016

This article describes nanocomposites of triblock copolymer styrene–ethylene/butylene–styrene doping with 5 wt% of multiwalled carbon nanotubes (CNTs) prepared by melt mixing process. The selection of processing temperature was made according to the state of macrodispersion of CNTs within polymer matrix. Afterwards, the relationship between rotational speed, mixing time and electrical conductivity has been noted. It was confirmed that the temperature of 300°C and rotational speed of 100 r/min lead to significant decreasing of CNT agglomerations resulting in high electrical conductivity equal to 8.0 S/m.
Resign in Protest? A Cure Worse Than Most Diseases
Authors: Feaver Peter D.
Published: August 2016

Advocates of cultivating a resignation-in-protest ethic understate the costs and exaggerate the benefits. Military officers who believe that the policymaking process is heading in a bad direction already have ample recourse in the form of advising within the chain of command. If their advice is not heeded, it is exceedingly unlikely that the country would be better served by senior officers provoking a civil–military crisis to advertise their policy differences with civilian leaders.
On Resignation
Authors: Kohn Richard H.
Published: August 2016

Arguments in favor of the topmost senior officers exercising “principled resignation” in opposition to policies, decisions, or orders that they find immoral, unethical, or disastrous for the country weaken the military profession and endanger American national security. A member of the Joint Chiefs, a combatant commander, or a topmost war commander who “resigns” would be injecting themselves improperly into a policy role, opposing civilian authority, and undermining civilian control of the military. The act would be politicizing for the military and likely fail to change what the officer opposes. Most importantly, their act of personal conscience would poison civil–military relations long into the future; civilian trust in military subordinates not to undermine support for policies and decisions with the public and other political leaders would decline. Even more than today, they would choose their senior military leaders for compatibility and agreement above other traits.
Introduction to Symposium
Authors: M. Shields Patricia
Published: August 2016

This Armed Forces & Society symposium on the ethics of senior officer resignation in the United States includes a collection of four papers, each looking at principled resignation in different ways. Two authors, Dubik and Snider, believe principled resignation of senior military officers is sometimes justified, especially in wartime, where their inherent morals clash with their professional demands; these senior officer’s ability to resign in protest distinguishes their service to this nation between stewards and servants. Conversely, Feaver and Kohn believe principled resignation is almost never justified as this action weakens the military profession and ultimately threatens national security. Further, the disastrous effects increase the ever present friction and mistrust in the civil-military process. Each author answers the question in the context of current American civil military relations and it is their hope that this symposium will lead to further discussions, research, and policies regarding the ethics surrounding the issue.
Salt production, standardization, and specialization
Authors: Eubanks Paul N
Published: August 2016

Recent archaeological data from the Upper and Little salt licks at the Drake’s Salt Works Site Complex in northwestern Louisiana suggest that this saline was visited on an opportunistic or short-term basis. These sites, particularly the Little Lick, have standardized salt production vessels when compared to other salines, but both lack evidence of extended occupation, which was viewed as a likely prerequisite for full-time or prolonged seasonal specialization. This study also addresses several potential conditions that may have affected the development of salt production specialization in northwestern Louisiana. While the demand for salt may have been relatively high following European contact, the numerous and flood-prone salt deposits in this region made it difficult for producer specialization to develop.
Energy and development in the periphery: A regional perspective on small hydropower projects
Authors: Bere Jemma , Jones Calvin , Jones Stuart , Munday Max
Published: August 2016

Investments in renewable energy have been identified as one mechanism for encouraging development in lagging regions, with community owned or operated facilities potentially having a relatively greater impact. The development of small hydropower installations in Wales is examined to establish the economic and community benefits of such schemes. The sector displays a number of locally beneficial economic characteristics that are absent from larger scale renewable investments. However, this is shown to be a fragile sector dependent on a small number of key individuals and institutions, and with an investment model relying on depreciating UK government subsidies. Following an introduction, the paper first examines why renewables, and small-scale, community renewables in particular, have attracted attention as a part response to declining economic, social and environmental conditions in rural communities. It then describes the Welsh energy and policy context before describing the data and the method employed in the research. The paper then examines the economic value of small hydropower developments, the nature and scale of impacts on local social capital and on communities, and then the extent to which small hydropower might be considered distinct from other local energy sectors in terms of business behaviours and inter-organisation relationships. The discussion then focuses on factors affecting prospects for the small hydropower sector, and which will limit how far development of the sector can lead to transformative outcomes for communities close to the natural resource.
Maxwell and Rankine reciprocal diagrams via Minkowski sums for two-dimensional and three-dimensional trusses under load
Authors: McRobie Allan
Published: August 2016

A method is presented for computing and displaying the Maxwell (two-dimensional) or Rankine (three-dimensional) diagram reciprocal to a truss under load. Reciprocals are constructed via the two-dimensional Airy stress function or its three-dimensional analogue. A linear combination of the coordinates of each original node and the coordinates of its reciprocal object leads to the finished diagram. This is related to an underlying Minkowski sum of the polyhedral stress functions of the original and reciprocal diagrams. Some regions of the resulting combined diagram have units of length [Formula: see text] and other regions use units of force [Formula: see text]These regions are connected in a consistent manner, in two dimensions by rectangular areas and in three dimensions by prismatic volumes, each having work units of dimension [Formula: see text] and which give a visual representation of the [Formula: see text] terms in Maxwell’s load path theorem. A linear combination weighted in favour of the original leads to a diagram where original bars are augmented by a thickness (in two-dimensional) or a polygonal cross-sectional area (in three-dimensional). The diagrams thus give an appealing visual representation of the material required for a constant stress design. Although the method gives a complete description of loaded trusses in two dimensions, in three dimensions, it is currently only applicable to those trusses which possess a Rankine reciprocal.
Admissible geometrical domains and graphic statics to evaluate constitutive elements of structural robustness
Authors: Zastavni Denis , Deschuyteneer Aurélie , Fivet Corentin
Published: August 2016

Structural robustness is related to the insensitivity of a structure to local failure, which is linked to the ability of force redistribution. Current approaches—probabilistic, risk-based, deterministic, and energetic—are poorly suited to inform the design of a structure at conceptual stage. Yet robustness issues must be addressed early in the design process, when interaction with the structural model is still feasible. This article explores how geometrical solution domains provide indicators that summarize the ability of a structure to redistribute load paths. Since geometric methods only build on abstract load path networks, directly connected to form and force diagrams, they suit well for early design explorations. This article presents two case studies, shows how geometrical domains provide qualitative and relevant constitutive indicators of structural robustness, and finally compares the results with indices of deterministic and energetic criteria currently proposed in the literature.
Experiences of patients and caregivers with early palliative care: A qualitative study
Authors: Hannon Breffni , Swami Nadia , Rodin Gary , Pope Ashley , Zimmermann Camilla
Published: August 2016

Background:

Early palliative care improves quality of life and satisfaction with care and is increasingly endorsed for patients with advanced cancer. However, little is known about the experience of receiving early palliative care from a patient and caregiver perspective.

Aim:

The aim of this qualitative study was to determine, from a participant perspective, the experience of receiving early palliative care and elements of that care.

Design:

Qualitative grounded theory study using individual interviews.

Setting/participants:

The study took place at a comprehensive cancer centre. Patients ( n = 26) and caregivers ( n = 14) from the intervention arm of a cluster-randomised controlled trial of early palliative care versus standard oncology care participated in qualitative interviews. Participants were asked to comment on their quality of life, the quality of care provided over the intervention period and their experiences with the palliative care team.

Results:

Participants described feeling supported and guided in their illness experience and in their navigation of the healthcare system. Specific elements of early palliative care included prompt, personalised symptom management; holistic support for patients and caregivers; guidance in decision-making; and preparation for the future. Patients with symptoms particularly valued prompt attention to their physical concerns, while those without symptoms valued other elements of care. Although three patients were ambivalent about their current need for palliative care, no distress was reported as a consequence of the intervention.

Conclusion:

The elements of care described by participants may be used to develop, support and refine models of early palliative care for patients with cancer.
Understanding patterns and factors associated with place of death in patients with end-stage kidney disease: A retrospective cohort study
Authors: Lovell Natasha , Jones Chris , Baynes Dawn , Dinning Sarah , Vinen Katie , Murtagh Fliss EM
Published: August 2016

Background:

Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death.

Aim:

To understand patterns of place of death in patients with end-stage kidney disease known in one UK renal unit.

Design:

A retrospective cohort study of all patients with chronic kidney disease stage 4–5, age ⩾75 and known to one UK renal unit, who died between 2006 and 2012. Patients were categorised into three management pathways: haemodialysis, conservative and pre-dialysis.

Results:

A total of 321 patients (mean age, 82.7; standard deviation, 5.21) died (61.7% male). In all, 62.9% died in hospital (95% confidence interval, 57.5%–68.1%), 21.8% died in their usual place of residence (95% confidence interval, 17.5%–26.6%) and 15.3% died in an inpatient palliative care unit (95% confidence interval, 11.6%–19.5%). Management pathway and living circumstances were most strongly associated with place of death. Patients on the conservative pathway had four times the odds of dying out of hospital (odds ratio, 4.0; 95% confidence interval, 2.1–7.5; p < 0.01). Patients living alone were less likely to die out of hospital (odds ratio, 0.3; 95% confidence interval, 0.1–0.6; p < 0.01). There were also changes in place of death over time, with more patients dying out of hospital in 2012 compared to 2006 (odds ratio, 3.1; 95% confidence interval, 1.0–9.7; p < 0.05).

Conclusion:

Most patients with end-stage kidney disease die in hospital, but patients managed without dialysis are significantly more likely to die outside of hospital. Planning ahead is key to be able to meet preference for place of death.
Carbogen-induced increases in tumor oxygenation depend on the vascular status of the tumor: A multiparametric MRI study in two rat glioblastoma models
Authors: Chakhoyan Ararat , Corroyer-Dulmont Aurélien , Leblond Marine M , Gérault Aurélie , Toutain Jérôme , Chazaviel Laurent , Divoux Didier , Petit Edwige , MacKenzie Eric T , Kauffmann François , Delcroix Nicolas , Bernaudin Myriam , Touzani Omar , Valable Samuel
Published: August 2016

The alleviation of hypoxia in glioblastoma with carbogen to improve treatment has met with limited success. Our hypothesis is that the eventual benefits of carbogen depend on the capacity for vasodilation. We examined, with MRI, changes in fractional cerebral blood volume, blood oxygen saturation, and blood oxygenation level dependent signals in response to carbogen. The analyses were performed in two xenograft models of glioma (U87 and U251) recognized to have different vascular patterns. Carbogen increased fractional cerebral blood volume, blood oxygen saturation, and blood oxygenation level dependent signals in contralateral tissues. In the tumor core and peritumoral regions, changes were dependent on the capacity to vasodilate rather than on resting fractional cerebral blood volume. In the highly vascularised U87 tumor, carbogen induced a greater increase in fractional cerebral blood volume and blood oxygen saturation in comparison to the less vascularized U251 tumor. The blood oxygenation level dependent signal revealed a delayed response in U251 tumors relative to the contralateral tissue. Additionally, we highlight the considerable heterogeneity of fractional cerebral blood volume, blood oxygen saturation, and blood oxygenation level dependent within U251 tumor in which multiple compartments co-exist (tumor core, rim and peritumoral regions). Finally, our study underlines the complexity of the flow/metabolism interactions in different models of glioblastoma. These irregularities should be taken into account in order to palliate intratumoral hypoxia in clinical trials.
The Spatial Representation of Angles
Authors: Fumarola Antonia , Prpic Valter , Fornasier Deanna , Sartoretto Flavio , Agostini Tiziano , Umiltà Carlo
Published: August 2016

We investigated whether angle magnitude, similarly to numerical quantities (i.e., the spatial-numerical association of response codes effect), is associated to the side of response execution. In addition, we investigated whether this association has the properties of a spatially oriented mental line, since angles are taught in a right-to-left progression. We tested two groups of participants: civil engineering students (high familiarity with angles) and psychology students (low familiarity with angles). In Experiment 1, participants were asked to judge the continuity of the angles’ arms (continuous vs. dashed). Magnitude of the angles was task-irrelevant. In Experiment 2, they were asked to judge whether the presented angles were smaller or larger than a right angle (90°). Therefore, the angle magnitude was relevant for performing the task. Overall, engineering students responded faster with their left hand to large angles and with their right hand to small angles. Conversely, psychology students did not show any reliable differences between left- and right-hand responses. In the case of engineering students, the spatial association has a right-to-left (counter clockwise) direction, suggesting the influence of education and practice on the mental representation of angle magnitude.
Degradation of frigid swampy meadows on the Qinghai–Tibet Plateau
Authors: Gao Jay , Li Xilai
Published: August 2016

The frigid swampy meadows of the Qinghai–Tibet Plateau in western China have suffered widespread degradation. The severe degradation of such meadows can lead to the formation of a landscape commonly known as heitutan. Much research has been undertaken to study its triggers, formation mechanism, grading of severity, and rehabilitation. These studies are comprehensively reviewed in this paper. In particular, it attempts to reconcile two divergent theories on heitutan formation by proposing a new model to elucidate the role of a given factor at each stage of degradation. In this model, climate desiccation is the most important in transforming healthy meadow to dry grassland, while rodent attack is the most important in worsening dry grassland to degraded meadow. Overgrazing is the most important factor during the early stages of degradation. Wind and water erosion is important during the final stage, when a large quantity of loose materials has been accumulated by rodent burrowing. Also covered in this paper is how to rehabilitate heitutan to productive use, including the effectiveness of various measures. Finally, this paper identifies the gap in our understanding of swampy meadow degradation and spells out a future research agenda. It is concluded that future research on heitutan will undergo a transformation from descriptive to quantitative. The expected research outcome will inform herders of the appropriate strategies that can be adopted to prevent heitutan formation. This proactive approach will minimize economic loss from swampy meadow degradation and reduce its adverse impact on the environment.