The Reasonableness of Argumentation from Expert Opinion in Medical Discussions: Institutional Safeguards for the Quality of Shared Decision Making

The ideal of shared decision making starts from the assumption that physicians and patients are able to take a joint decision as to what is the best treatment. However, since medical consultations are to be viewed as discussions between an expert and a layman, in practice it will often be the case that the patient has to rely on the physician’s expertise. In this article we examine the extent to which the Dutch laws, guidelines and professional conventions within the medical domain positively influence the quality of the process of shared decision making, even in cases where the physician makes use of an argument from expert opinion. To this end, we will chart some of the most important institutional safeguards for the quality of medical decisions and analyze how these safeguards relate to the critical questions associated with the argument scheme of argumentation from expert opinion

Dialectical Profiles and Indicators of Argumentative Moves

In this paper the authors give a brief overview of the theoretical background of their research project “Linguistic indicators of argumentative moves.” Starting from the pragma-dialectical ideal model of a critical discussion, they design dialectical profiles for capturing the moves that may or must be made at a particular stage or sub-stage of such a discussion. They explain how these dialectical profiles can be methodically exploited for systematically identifying the verbal expressions that can be indicative of any of these moves in argumentative practice

Fibre engineered cementitious materials (FECM) optimization by the use of hybrid polypropylene fibres and supplementary powder addition

Development of Fibre Engineered Cementitious Materials with Self-Healing Capacity (SH-FECM) was an important goal of the recent research programmes conducted in NIRD URBAN-INCERC Cluj-Napoca Branch. Several theoretical and experimental studies were performed in order to improve the composites, considering both, fresh and hardened state properties and also the performance as filling material of the narrow spaces at the beam to column interface within the Hybrid spatial joint model [1]. Present studies are focused in optimising the already developed mixtures regarding several aspects: the self-compacting behaviour of the fresh composites, considering the increased risk of balling effect when using 2% (of volume) of polymeric fibres as disperse reinforcement of the cementitious matrix, bleeding control during and after the mixes sequences by using supplementary powder addition, evaluation of the mixes when using a combination of two distinct types of polypropylene fibres, and development of controlled multiple cracks under loading, etc. The present paper offers the first results regarding the performance of the cement based composites, namely the fresh state self-compacting effect and also the flexural and compressive strengths at 7 and 28 days of age. Initial conclusions when replacing the traditional silica sand as aggregate of initial mixes with regular sand (0/1 mm fraction) are also considered. The Self-Healing potential of the mixes will be evaluated further on, ensuring the complete range of characteristics related to durability improving, repair and maintenance cost reduction and superior structural performance, in the context of the expected features of the sustainable development

Dynamic loading performance of fibre engineered cementitious materials with self-healing capacity (SH-FECM)

Structural performance under dynamic actions, apart from geometric characteristics, supports loading conditions, design methods, etc., is mainly related to the intrinsic material properties of the structural elements. Earthquake events, as typical examples of accidental dynamic loading, involve strong stress waves, induced in the structure in very short time intervals. Increased loading rates, difficult to withstand, are generated. Therefore, superior complementary characteristics, namely strength and ductility, are required in order to avoid sudden failure and, as direct consequence, casualties and economic losses. Engineered Cementitious Composite (ECC), a unique type of mortar framed in the category of high-performance fibre-reinforced cementitious composites (HPFRCC), is defined by metal-like behaviour due to the multiple cracking patterns developed under applied loads. ECC proves an increased deformability potential and, as consequence ductility, which indicate a superior performance when subjected to dynamic actions. The multiple microcracking property of the composite, together with some specific matrix attributes and environmental conditions, also ensures an already proved self-healing potential [1], [2]. All these intrinsic material characteristics induce increased durability, considerable material and manpower reduction, improved structural performance and reduced repair and maintenance costs. Consequently, ECC is a valuable building material alternative and it is obvious that will bring a major to future sustainable development. This paper presents the incipient evaluation of the dynamic performance of Fibre Engineered Cementitious Materials with Self-Healing potential (SH-FECM), developed using the ECC theoretical and applied design principles, in the terms of the strain rate sensitivity, which proves to be an essential and difficult to control parameter

Experimental application of sum rules for electron energy loss magnetic chiral dichroism

We present a derivation of the orbital and spin sum rules for magnetic circular dichroic spectra measured by electron energy loss spectroscopy in a transmission electron microscope. These sum rules are obtained from the differential cross section calculated for symmetric positions in the diffraction pattern. Orbital and spin magnetic moments are expressed explicitly in terms of experimental spectra and dynamical diffraction coefficients. We estimate the ratio of spin to orbital magnetic moments and discuss first experimental results for the Fe L_{2,3} edge.Comment: 11 pages, 2 figure

The Development of Models for Carbon Dioxide Reduction Technologies for Spacecraft Air Revitalization

Through the respiration process, humans consume oxygen (O2) while producing carbon dioxide (CO2) and water (H2O) as byproducts. For long term space exploration, CO2 concentration in the atmosphere must be managed to prevent hypercapnia. Moreover, CO2 can be used as a source of oxygen through chemical reduction serving to minimize the amount of oxygen required at launch. Reduction can be achieved through a number of techniques. NASA is currently exploring the Sabatier reaction, the Bosch reaction, and co- electrolysis of CO2 and H2O for this process. Proof-of-concept experiments and prototype units for all three processes have proven capable of returning useful commodities for space exploration. All three techniques have demonstrated the capacity to reduce CO2 in the laboratory, yet there is interest in understanding how all three techniques would perform at a system level within a spacecraft. Consequently, there is an impetus to develop predictive models for these processes that can be readily rescaled and integrated into larger system models. Such analysis tools provide the ability to evaluate each technique on a comparable basis with respect to processing rates. This manuscript describes the current models for the carbon dioxide reduction processes under parallel developmental efforts. Comparison to experimental data is provided were available for verification purposes

Size effect on magnetism of Fe thin films in Fe/Ir superlattices

In ferromagnetic thin films, the Curie temperature variation with the thickness is always considered as continuous when the thickness is varied from $n$ to $n+1$ atomic planes. We show that it is not the case for Fe in Fe/Ir superlattices. For an integer number of atomic planes, a unique magnetic transition is observed by susceptibility measurements, whereas two magnetic transitions are observed for fractional numbers of planes. This behavior is attributed to successive transitions of areas with $n$ and $n+1$ atomic planes, for which the $T_c$'s are not the same. Indeed, the magnetic correlation length is presumably shorter than the average size of the terraces. Monte carlo simulations are performed to support this explanation.Comment: LaTeX file with Revtex, 5 pages, 5 eps figures, to appear in Phys. Rev. Let

De consultatie-liaisonpsychiatrie in de Belgische ziekenhuizen van de eenentwintigste eeuw : quo vadis?

In een tijd waarin de geneeskunde zich uitsplitst in een groeiend aantal specialismen, subspecialismen en superspecialismen is er in de algemene en de universitaire ziekenhuizen een toenemende nood aan multidisciplinaire samenwerking. Deze vorm van samenwerking is nodig om hoogstaande holistische zorg te blijven verlenen aan de patiënt als centrale figuur in het zorgproces. De technologische mogelijkheden in de geneeskundige zorg nemen toe, maar er is een belangrijke comorbiditeit tussen de medische aandoeningen. De consultatie-liaisonpsychiatrie (CLP) is een van de disciplines die hierop inspeelt. Deze discipline focust vanuit een multidisciplinaire en integrale zorgvisie op de psychiatrische diagnostiek en behandeling van patiënten met psychiatrische en somatische comorbiditeit die hiervoor behandeld en opgevolgd worden in een algemeen ziekenhuis. Dit artikel wil een overzicht geven van de functies van de CLP zowel binnen als buiten het ziekenhuis en licht het historische en huidige Belgische beleid en de wetgeving ter zake toe. Er worden ook aanbevelingen geformuleerd voor de toekomst en men pleit voor de implementatie van de CLP als een volwaardige en structurele klinische activiteit en opdracht in de algemene ziekenhuizen

Recommendations of RILEM TC 260-RSC for using superabsorbent polymers (SAP) for improving freeze–thaw resistance of cement-based materials

This recommendation is focused on application of superabsorbent polymers (SAP) for the improvement of the resistance of cement-based materials to freeze—thaw attack with or without deicing salts. A simple approach to the determination of the amount and properties of SAP as well as methods to verify SAP effectiveness for frost resistance protection are presented