Ultimate Aims Research Articles

Clinical impact of PET imaging in prostate cancer management.

Imaging of prostate cancer has been a rapidly evolving field in recent years with the introduction of multiple new PET tracer agents. Introduction of novel imaging techniques into clinical practice requires careful evaluation, with the ultimate aims of improved patient outcomes, better sequencing of treatments, and cost effectiveness. The increased sensitivity and specificity of these new PET agents present both challenges and opportunities. We know they frequently change management, but are these effective management changes, and is it always in the best interests of the patients? This review will focus on recent publications that provide high-level evidence for the use of PET in prostate cancer. It will discuss studies that have evaluated the clinical impact of PET imaging in prostate cancer and will review a number of trials that demonstrate the potential of PET to change current standard of care, from diagnosis, to prognostic capabilities in men with metastatic prostate cancer. Evidence for the use of PET in prostate cancer is building with studies evaluating diagnostic accuracy of PET at all stages of prostate cancer. We review the evidence available, focusing on prospective trials that are measuring the impact of new technology on patient outcomes.

Developing pathways for community-led research with big data: a content analysis of stakeholder interviews

BackgroundBig data (BD) informs nearly every aspect of our lives and, in health research, is the foundation for basic discovery and its tailored translation into healthcare. Yet, as new data resources and citizen/patient-led science movements offer sites of innovation, segments of the population with the lowest health status are least likely to engage in BD research either as intentional data contributors or as ‘citizen/community scientists’. Progress is being made to include a more diverse spectrum of research participants in datasets and to encourage inclusive and collaborative engagement in research through community-based participatory research approaches, citizen/patient-led research pilots and incremental research policy changes. However, additional evidence-based policies are needed at the organisational, community and national levels to strengthen capacity-building and widespread adoption of these approaches to ensure that the translation of research is effectively used to improve health and health equity. The aims of this study are to capture uses of BD (‘use cases’) from the perspectives of community leaders and to identify needs and barriers for enabling community-led BD science.MethodsWe conducted a qualitative content analysis of semi-structured key informant interviews with 16 community leaders.ResultsBased on our analysis findings, we developed a BD Engagement Model illustrating the pathways and various forces for and against community engagement in BD research.ConclusionsThe goal of our Model is to promote concrete, transparent dialogue between communities and researchers about barriers and facilitators of authentic community-engaged BD research. Findings from this study will inform the subsequent phases of a multi-phased project with the ultimate aims of organising fundable frameworks and identifying policy options to support BD projects within community settings.

Moral Education for Sustainable Development: Comparison of University Teachers’ Perceptions in China and Pakistan

Sustainable development is promoted when the system of education provides the learners with an opportunity to equip themselves with moral values, skills, and competences that assist them in effecting personal and community positive changes. For this purpose, teachers play an important role as moral agents, and students consider the teacher a role model. Therefore, the understanding and beliefs of teachers regarding moral education play a pivotal role in grooming the personality of the learners. This comparative study aimed to assess the practices and beliefs of university teachers regarding moral education in China and Pakistan. A mixed-method approach was used and data analysis was performed by using an interactive model and ANOVA. Responses of twelve tertiary teachers were collected from Pakistan and China for qualitative analysis. Seven themes were constructed that categorized teachers’ practice in the classroom and their beliefs regarding moral education. For quantitative analysis, 300 teachers’ responses were collected using a validated questionnaire. The results showed that the majority of Pakistani teachers hold a conservative mindset. According to the Pakistani teachers’ perspective, sovereignty of divine laws, loyalty to the constitution of the state, and a sense of serving society were the ultimate aims of moral education. Chinese teachers were promoting a political ideology that stressed collectivism in a socialist approach, with family and social values being most relevant. Not a single teacher reported using a theoretical or research-based approach while teaching in the class. In the light of the dearth of literature, this study has implications for future research in the field of English as a Foreign Language (EFL) and Islamic Studies in higher education, as it is a longitudinal study that provided insight into how teachers’ beliefs and attitudes are shaped over time and from moral educational experiences.

The Ethics of Delegating Monetary Policy

The global financial crisis of 2007 and 2008 transformed monetary policy, forcing central bankers to move far beyond their pre-crisis instruments, goals, and expertise. In this article, I investigate these developments from a perspective of normative democratic theory. Against authors who reject central bank independence entirely, I argue that it should in principle be permissible for governments to delegate political choices to unelected experts. From a democratic perspective, what matters is whether the act of delegation serves the government’s ultimate economic policy aims. Although central bank independence limits the government’s control over monetary policy, it can also improve monetary policy and thereby help the government pursue its larger economic policies. I outline a moral framework for balancing these competing considerations; focusing on the case of the European Central Bank, I then argue for democratic reform of existing institutions.

Hyperspectral remote sensing for assessment of chlorophyll sufficiency levels in mature oil palm (Elaeis guineensis) based on frond numbers: Analysis of decision tree and random forest

A common practice of chlorophyll (chl) determination has been using the chemical analysis that is destructive and time-consuming. A current prospective alternative method such hyperspectral remote sensing offers a non-destructive measurement of chl which provides a result in the rapid and real-time manner. Therefore, the ultimate aims of this study were to propose the chls (chl a, chl b, total chl content (TCC) and relative chl content (RCC)) sufficiency levels via Jenks Natural Breaks (JNB) classification and recommend the best subset of chl-sensitive wavelengths, frond number and classifier for classifying the chls according to the designated sufficiency levels via hyperspectral remote sensing platform. In order to achieve the objectives, an experiment was conducted on mature Tenera palm stands (12 and 15 years old) with N treatments varied from 0 to 2 kg. The Jenks Natural Breaks (JNB) classification was proposed to determine the chl sufficiency levels. Feature selection was carried out to select the chl-sensitive wavelengths while Decision Tree (DT) and Random Forest (RF) classifiers were used to classify the chl sufficiency levels using the selected wavelengths. Results from this study showed that the chl-sensitive wavelengths mostly belong to the red-edge region and importantly, they were frond age-dependent. Generally, the classification accuracy tended to decrease as frond gets older. The RF performed the best in discriminating the chl sufficiency levels with accuracy ranging from 92.79 to 98.77% compared to 56.30–90.48% achieved by DT. In the nutshell, the execution of frond 9 was more ideal than frond 17 for monitoring chl content of mature oil palm via remote sensing and RF portrayed promising insight in assessing chls content of mature oil palm.

Integrated framework to improve health policy implementation in the way of Iran 2025 vision: Bridging policy to practice gap in developing countries.

INTRODUCTION:Health policymaking seems simple; in practice, but, it is very complex. However, this study aimed to provide a framework to bridge the gap between policy and action in order to present an interconnected model for developing countries.MATERIALS AND METHODS:This was a qualitative study. Using desk search, different models were searched from various scientific databases for formulation of an integrated policy-making framework. In next stage, the identified National upstream documents were analyzed to achieve existing policymaking evidence. Then to determine the validity of the initial model and to gather the views of key experts, two Delphi rounds were used. The tool used in Delphi method was a 9-point Likert questionnaire that was sent to the experts via E-mail.RESULTS:This model, by employing integrated chain of visions and strategic targeting of ultimate aims on the one hand and expected key functions and support functions for generating output (operational goal) on the other, provides an extensive operable insight being influenced by human-Islamic principles and values, social, technological, economic, environmental, and political for strategic as well as operational managers./Policy makersCONCLUSION:This framework consisted of general, strategic, and executive levels. It creates the needed institutional and structural capacity to achieve a comprehensive health approach for all laws and policies to control social factors affecting health, improve health situation, and promote the health of citizens.

Synthesis of reduced graphene oxide/zinc ferrite/nickel nanohybrids: as a lightweight and high-performance microwave absorber in the low frequency

The study of materials with lightweight and high-performance microwave absorption in low frequency range is of great significance for many critical fields. Nevertheless, the prominent issues of traditional absorbing materials such as high dielectric constant and thick thickness seriously restrict their practical applications. Consequently, ultimate aims for the development of high-performance multicomponent microwave absorbing materials with lightweight and high reflection loss are urgently required in the low frequency range. A spherical-like nanohybrids of reduced graphene oxide/ZnFe2O4/Ni (RGO/ZnFe2O4/Ni) in paraffin with an outstanding microwave absorption property was synthesized by hydrothermal method. When increased content of RGO/ZnFe2O4/Ni nanohybrids to 40 wt%, the best reflection loss (RL) of − 22.57 dB occurred at 4.21 GHz with a thickness of only 2.5 mm and the absorption bandwidth (RL ≤ − 10 dB) covered from 3.6 to 10.22 GHz with thin thickness of 1.5–4.0 mm. A possible absorption mechanism of RGO/ZnFe2O4/Ni in Paraffin wax was discussed. This work demonstrates that RGO/ZnFe2O4/Ni nanohybrids as a powerful candidate microwave absorber in low frequency could provide a new strategy for designing carbon-based microwave absorbing materials with lightweight.

Database of Families with Twins and Higher Order Multiples in Japanese Twins Mothers Clubs.

It is desirable for twin researchers to be aware of the needs and concerns of families of multiples and provide participants with appropriate and useful feedback and advice based on scientific evidence. Our most recent database on families with twins throughout Japan is based on a questionnaire survey conducted in 2016. Mailed questionnaires, consisting of over 500 items, were used to collect the basic data. The response rate was 38% (566/1478). This is part of a nationwide study designed to assess the long-term effect of perinatal conditions on mothers of multiples. Its aim was to study the growth and development of multiples in childhood, and for the creation of a multifetal mother and child health handbook, and to conduct a genetic epidemiologic study to test the developmental origin of health and disease hypothesis. One of the ultimate aims of this research was to provide evidence-based information on parenting of multiples for families with multiples.

Room temperature hidden state in a manganite observed by time-resolved X-ray diffraction

Realizing active quantum control of materials near room temperature is one of the ultimate aims for their practical applications. Recent technological breakthroughs demonstrated that optical stimulation may lead to thermally inaccessible hidden states with unique properties. However, most of the reported hidden states were induced around or below liquid nitrogen temperature. Here, we optically manipulated a manganite near its Curie temperature of 300 K, where typically complex phase competitions locate as well as opportunities for new functionality. A room temperature hidden state was formed with threshold behavior evidenced by a femtosecond paramagnetic to ferromagnetic order switching and a structural change distinct from thermal induced lattice expansion in tens of picoseconds accompanying with phonon softening. We propose that such a hidden state originates from the charge transfer between antiferromagnetic chains after strongly correlated spin-charge quantum excitation, which subsequently initiates an orbital polarization rearrangement described as {mathrm{Mn}}_{3x^2 - {r}^2/3y^2 - {r}^2}^{3 + }{mathrm{Mn}}^{4 + } to {mathrm{Mn}}^{4 + }{mathrm{Mn}}_{3z^2 - {r}^2}^{3 + } and associated non-thermal lattice change. This study started from room temperature yet near a phase transition point, which suggests a new route to create or manipulate novel phases for practical purpose.

A Mixed Method Approach on Greek Civil Society Organizations Supporting Migrants During the Refugee Crisis

Between 2015 and the beginning of 2016, Greece became one of the epicenters of the European migrant crisis as it was one of the major entry points by the sea of thousands of refugees entering its territory en route to wealthier countries. The unpreparedness of the Greek state and the European Union leaders to deal with the massive migrant flows significantly contributed to the pivotal role that informal and formal actors, including civil society migrant organizations, played to respond to migrants’ needs. The article using data from the EU-funded TransSOL project and applying a mixed method approach with the rationale of complementarity explores attributes (such as organizational structure, main activities, ultimate aims and means to achieve them, collaborative networks, etc.) as well as unveils the meaning of solidarity initiatives of specific formal and informal migrant organizations operating in the country. The indicative findings provide some preliminary evidence on the distinct features of informal and formal migrant organizations uncovering their diverse roles and tasks in meeting migrants’ needs and rights in Greece. It is recommended that further research on migrant organizations examining their main features and potential challenges in supporting migrants is essential not only for migrants themselves but for the whole society, specifically in times marked by a refugee crisis.

Understanding and Evaluating Research and Scholarly Publishing in the Social Sciences and Humanities (SSH)

Internationalization is important for research quality and for specialization on new themes in the social sciences and humanities (SSH). Interaction with society, however, is just as important in these areas of research for realizing the ultimate aims of knowledge creation. This article demonstrates how the heterogenous publishing patterns of the SSH may reflect and fulfill both purposes. The limited coverage of the SSH in Scopus and Web of Science is discussed along with ideas about how to achieve a more complete representation of all the languages and publication types that are actually used in the SSH. A dynamic and empirical concept of balanced multilingualism is introduced to support combined strategies for internationalization and societal interaction. The argument is that all the communication purposes in all different areas of research, and all the languages and publication types needed to fulfill these purposes, should be considered in a holistic manner without exclusions or priorities whenever research in the SSH is evaluated.

The Case of Islamic State as a Renovative Totalist Movement

ABSTRACT This paper uses the concept of totalism to analyze the main features of Islamic State and thus the implications of containing and confronting it and its potential future offshoots. The first part of the paper deals with the origins and concept of totalism, depicting its main features and types. This part begins by briefly showing the main features of totalism, why it must be ultimately differentiated from totalitarianism. The second part of the paper explores the extent to which Islamic State conforms to the model of a renovative totalist movement and why terms such as political religion are unsuited for explaining Islamist and Salafi-Jihadist movements, including Islamic State. Due to the overall direction of its ultimate ideological aims and the way in which it pursues the total reconstruction of public and private life, Islamic State is then found to contain the main features of a militant, renovative totalist movement. Lastly, the paper argues that it is primarily this totalist nature of the movement which, together with total commitment to emulating what it sees as the essential early Islamic traditions and examples, contributes to its long-term resilience even in the face of overwhelming odds and military reversals.

Collective Progress in the Light of Equity Under the Global Stocktake

The Global Stocktake compels states periodically to focus on the Paris Agreement’s ultimate aims. Without it, each state’s attention would have been fixated on its own Nationally Determined Contribution and little else. The Paris Rulebook clarifies how the stocktaking mechanism is to function—in all but one respect: although the rules keep the emphasis squarely on “collective progress” as the proper object of the stocktake’s assessment, the text is ambiguous on whether its implied opposite—individual state progress—is to be excluded from the assessment. The ambiguity rides mainly on the notion of “equity”—a term as dutifully inserted into key passages of the Rulebook as its explanation is studiously avoided. Whatever the negotiators may have intended in this respect, an objective construction of the Rulebook shows that an assessment of the individual progress of states is permitted to occupy a substantial part of the stocktaking process, except when it comes to formal reporting on the stocktake’s outputs. The non-exclusion of individual assessment from the dialogue that powers the stocktake means that, while the ideology of “national self-determination” may have succeeded in turning out an Article 15 Committee of unprecedented blandness, it has neglected to defend its flanks in the Global Stocktake, making for an unpredictable, yet potentially useful process.

Life Quality Index Assessment in Breast Cancer Patients.

Breast cancer (BC) is the most common cancer in Indian females whether they are from urban or rural area. Quality of life after treatment in BC patients is a very vital issue as its assessment will guide the clinicians, hospital authorities, and administrators to take appropriate steps to improve the delivery of treatment and address the concern. Improvement in QOL should be one of the ultimate aims of treatment in BC. The aim of this review is to collect and examine literature available on QOL in breast cancer patients and define what type of issues or domains should be studied. Four factors including chemotherapy treatment received by the patient, associated comorbidities, social support to patients from family, friends, support groups, and income of family have been found to have a strong association with QOL in BC patients/survivors. QOL assessment should include an instrument which assesses physical health, social health, psychological health, and spiritual health. There are less studies having all above domains so more studies are required for better understanding of QOL issue in BC patients/survivors.

3440 Emergency Dispatch Research Workshop: Engaging a Forgotten Professional Population in Research

OBJECTIVES/SPECIFIC AIMS: Emergency (911) dispatchers are the first link in the chain of care for the estimated 240 million emergency calls made each year. Yet even as emergency medicine, public safety, and public health have seen increasing study, emergency dispatch has very seldom been included in that research. Part of the reason is that, while emergency medicine is connected with hospital physicians and public health with university departments, emergency dispatch is largely invisible, not represented in university programs, and staffed by professionals without research training–and often without higher education or academic degrees. The purpose of our Dispatch Research Workshop is to engage these professionals in guided research projects of their own design, with the ultimate aims of both engaging more emergency dispatchers in research and increasing the field’s overall capacity to generate evidence-based practice. METHODS/STUDY POPULATION: The workshop is help in tandem with a national Emergency Dispatch conference. Participants are recruited through advertisements in professional journals and relevant social media sites. The workshop is co-led by members of a partnership between the nonprofit organizations the International Academies of Emergency Dispatch and the UCLA Prehospital Care Research Forum, along with the dispatch data aggregation company FirstWatch. The Workshop occurs over two eight-hour days, and participants generally have no research experience or background. By the end of the second day, groups have developed research questions and methods, begun to write IRB proposals, and created data collection and analysis plans. Throughout the remainder of the year, research mentors support the completion of the project, and completed projects are presented at the following year’s conference and submitted (if desired) for publication. RESULTS/ANTICIPATED RESULTS: During the first two years of the workshop, 36 attendees participated (17 the first year and 19 the second). Three successful attendees of the first workshop helped lead the second as research mentors. Three research projects were completed from the first year; all three were presented as posters and are now being prepared for publication as manuscripts. Four projects have emerged from the second year’s workshop. Assessments and one-on-one interviews with participants at the end of each workshop have led to continuous change and improvement in the delivery of the material, as well as the outline of a year’s worth of support materials, which is currently in development. DISCUSSION/SIGNIFICANCE OF IMPACT: Developing a true evidence base for practice in emergency dispatch will serve all of our communities, and feedback from our participants (as well as significant existing research in practitioner-engaged research) indicates that those who participate in research have a better understanding of the value of evidence-based practice, are more likely to adopt it, and are more likely to raise questions and test theories in their own professional life. Also, providing these practitioners the opportunity to conduct and publish research raises their stature and the stature of their profession, helping it achieve its rightful place alongside other professions in public safety and health.

Planning and Conducting Clinical Research: The Whole Process.

The goal of this review was to present the essential steps in the entire process of clinical research. Research should begin with an educated idea arising from a clinical practice issue. A research topic rooted in a clinical problem provides the motivation for the completion of the research and relevancy for affecting medical practice changes and improvements. The research idea is further informed through a systematic literature review, clarified into a conceptual framework, and defined into an answerable research question. Engagement with clinical experts, experienced researchers, relevant stakeholders of the research topic, and even patients can enhance the research question’s relevance, feasibility, and efficiency. Clinical research can be completed in two major steps: study designing and study reporting. Three study designs should be planned in sequence and iterated until properly refined: theoretical design, data collection design, and statistical analysis design. The design of data collection could be further categorized into three facets: experimental or non-experimental, sampling or census, and time features of the variables to be studied. The ultimate aims of research reporting are to present findings succinctly and timely. Concise, explicit, and complete reporting are the guiding principles in clinical studies reporting.

Environmental and Animal Defense

The controversy between the ultimate aims of environmental defense, on one hand, and animal defense, on the other, is a much unexplored topic. This special issue aims to fill this gap by gathering ...

Developing definitions for invasive fungal diseases in critically ill adult patients in intensive care units. Protocol of the FUNgal infections Definitions in ICU patients (FUNDICU) project

The reliability of diagnostic criteria for invasive fungal diseases (IFD) developed for severely immunocompromised patients is questionable in critically ill adult patients in intensive care units (ICU). To develop a standard set of definitions for IFD in critically ill adult patients in ICU. Based on a systematic literature review, a list of potential definitions to be applied to ICU patients will be developed by the ESCMID Study Group for Infections in Critically Ill Patients (ESGCIP) and the ESCMID Fungal Infection Study Group (EFISG) chairpersons. The proposed definitions will be evaluated by a panel of 30 experts using the RAND/UCLA appropriateness methods. The panel will rank each of the proposed definitions on a 1-9 scale trough a dedicated questionnaire, in two rounds: one remote and one face-to-face. Based on their median rank and the level of agreement across panel members, selected definitions will be organised in a main consensus document and in an executive summary. The executive summary will be made available online for public comments. The present consensus project will seek to provide standard definitions for IFD in critically ill adult patients in ICU, with the ultimate aims of improving their clinical outcome and facilitating the comparison and generalizability of research findings.

Can social innovation make a difference to forest-dependent communities?

Attention to social innovation and its role in sustainable development have been rising. However, the knowledge of social innovation pertaining to rural areas, including the forestry sector is lacking. Therefore, in this Special Issue of Forest Policy and Economics we exchange understandings and advance scientific knowledge of the role and place of social innovation in the development of forest-dependent communities and of forest social-ecological systems, underpinning this development. Papers included in this Issue blend diverse theoretical positions into a coherent explanation of spatial variability, case and context specificity of social innovation, encompassing its empirical diversity, complexities and multiple dimensions. The suggested articles improve existing knowledge of determinants of success seeking to answer the question of how to support enhanced governance and social innovations, addressing multiplicity and priorities of social needs, and new social relationships and collaborations. We also provide innovative solutions and sustainable forestry considerations, ideas potentially useful for policy makers and practice communities of different levels, having ultimate aims of increasing the well-being of forest-dependent communities and building the resilience to changes taking place in remote rural areas of Europe and beyond.

A meta-model for software protections and reverse engineering attacks

Software protection techniques are used to protect valuable software assets against man-at-the-end attacks. Those attacks include reverse engineering to steal confidential assets, and tampering to break the software’s integrity in unauthorized ways. While their ultimate aims are the original assets, attackers also target the protections along their attack path. To allow both humans and tools to reason about the strength of available protections (and combinations thereof) against potential attacks on concrete applications and their assets, i.e., to assess the true strength of layered protections, all relevant and available knowledge on the relations between the relevant aspects of protections, attacks, applications, and assets need to be collected, structured, and formalized. This paper presents a software protection meta-model that can be instantiated to construct a formal knowledge base that holds precisely that information. The presented meta-model is validated against existing models and taxonomies in the domain of software protection, and by means of prototype tools that we developed to help non-modelling-expert software defenders with populating a knowledge base and with extracting and inferring practically useful information from it. All discussed tools are available as open source, and we evaluate their use as part of a software protection work flow on an open source application and industrial use cases.