Network-based Metric for Measuring Combat Effectiveness

A conceptual definition of combat effectiveness is the overall capability of a force to produce a desiredoutcome from combat against an enemy force. An ability to measure combat effectiveness is critical to strategic andtactical decision making; however, it is a challenging task to develop an operational metric for combat effectivenessdue to the large complexity presented by the rich context of a combat environment. The present paper contendsthat, under a direct fire engagement, combat effectiveness can be reasonably assessed by the prevalence of attack opportunities a given force creates in a combat environment. The paper proposes a method to quantitatively measurecombat effectiveness of a military force in a direct fire engagement environment. The proposed metric is basedon a meta-network representation that captures various aspects of a combat environment. Using a meta-networkrepresentation, two types of basic unit structures of attack opportunity – isolated and networked – are identified,which are then used as a basic element for measuring combat effectiveness. Prevalence of network motifs in anetworked combat environment and availability of attack opportunities are computed as a measure of a militaryforce’s combat effectiveness.Defence Science Journal, 2014, 64(2), pp. 115-122. DOI: http://dx.doi.org/10.14429/dsj.64.553

Axiomatic Design: 30 Years After

In 1977, Nam P Suh proposed a different approach to design research. Suh’s approach was different in that it introduced the notions of domains and layers in a 2-D design thinking and stipulated a set of axioms that describes what is a good design. Following Suh’s 2-D reasoning structure in a zigzagging manner and applying these axioms through the design process should enable the designer to arrive at a good design. In this paper, we present our own experiences in applying Suh’s theories to software design, product design, organizational design, process design, and more in both academic and industrial settings. We also share our experience from teaching the Axiomatic Design theory to students at universities and engineers in industry, and draw conclusions on how best to teach and use this approach, and what results one can expect. The merits of the design axioms are discussed based on the practical experiences that the authors have had in their application. The process developed around the axioms to derive maximum value (solution neutral environment, design domains, what-how relationship, zig-zag process, decomposition, and design matrices) is also discussed and some updates are proposed

Effort and Self-Selection Effects of Compensation Scheme Changes under a Multi-output Setting

The analytical research from agency theory suggests that an outputbased compensation can have effort effects and self-selection effects. This study extended Banker et al.'s recent study to a multi-output setting and investigated those two effects in an insurance firm using individual monthly sales data for multiple products as well as employment history data. We have demonstrated that these two effects exist under a multi-output setting. The results showed that compensation scheme changes could induce sales mix changes by the effort reallocation process. In addition sales performance of remaining employees is better aligned with the new compensation scheme that that of employees who had quit supporting the self-selection hypothesis

Macrophage-Derived Thrombospondin 1 Promotes Obesity-Associated Non-Alcoholic Fatty Liver Disease

Background Thrombospondin 1 (TSP1) is a multifunctional matricellular protein. We previously showed that TSP1 has an important role in obesity-associated metabolic complications, including inflammation, insulin resistance, cardiovascular, and renal disease. However, its contribution to obesity-associated non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD or NASH) remains largely unknown; thus, we aimed to determine its role. Methods High-fat diet or AMLN (amylin liver NASH) diet-induced obese and insulin-resistant NAFLD/NASH mouse models were utilised, in addition to tissue-specific Tsp1-knockout mice, to determine the contribution of different cellular sources of obesity-induced TSP1 to NAFLD/NASH development. Results Liver TSP1 levels were increased in experimental obese and insulin-resistant NAFLD/NASH mouse models as well as in obese patients with NASH. Moreover, TSP1 deletion in adipocytes did not protect mice from diet-induced NAFLD/NASH. However, myeloid/macrophage-specific TSP1 deletion protected mice against obesity-associated liver injury, accompanied by reduced liver inflammation and fibrosis. Importantly, this protection was independent of the levels of obesity and hepatic steatosis. Mechanistically, through an autocrine effect, macrophage-derived TSP1 suppressed Smpdl3b expression in liver, which amplified liver proinflammatory signalling (Toll-like receptor 4 signal pathway) and promoted NAFLD progression. Conclusions Macrophage-derived TSP1 is a significant contributor to obesity-associated NAFLD/NASH development and progression and could serve as a therapeutic target for this disease. Lay summary Obesity-associated non-alcoholic fatty liver disease is a most common chronic liver disease in the Western world and can progress to liver cirrhosis and cancer. No treatment is currently available for this disease. The present study reveals an important factor (macrophage-derived TSP1) that drives macrophage activation and non-alcoholic fatty liver disease development and progression and that could serve as a therapeutic target for non-alcoholic fatty liver disease/steatohepatitis

Recurrent Thyroid Carcinoma in a Dog - Diagnosis by 18F-Fluorodeoxyglucose Positron Emission Tomography

Background: Thyroid tumor is a common endocrine tumor that accounts for up to 3.8% of all tumors in dogs. Most of them are malignant and usually nonfunctional in dogs. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is an imaging modality that detects intracellular accumulation of radioactive deoxyglucose administered in the body and is used in combination with computed tomography to provide functional information with exact anatomical localization. It is used in human medicine to detect residual or recurrent head and neck neoplasm after treatments, such as surgical resection. This report describes the first case of diagnosing recurrent thyroid carcinoma (TC) through FDG-PET in a dog. Case: A 9-year-old castrated male Maltese dog presented with a palpable mobile mass in the right ventral cervical region. Radiography and ultrasonography (US) showed a radiopaque mass adjacent to the trachea, and the right thyroid gland was enlarged on computed tomography. The surgically excised mass was encapsulated and measured to be 2.3 × 1.0 × 3.4 cm (width x length x height) in size. Histopathologically, the mass was diagnosed as differentiated follicular TC, and gross and vascular invasions were observed. To prevent recurrence, postoperative carboplatin chemotherapy was performed for 5 months. Two months after completion of chemotherapy, a nodule of approximately 7 mm in diameter was detected in the thyroidectomy bed by US. FDG-PET scanning was performed as an effective means of evaluating the malignancy, local recurrence, and metastasis of differentiated follicular TC. The nodule had the dimensions of 2.8 × 5.9 × 8.6 mm, a maximum standardized uptake value (SUV) of 8.49, and a mean SUV of 5.6. The results of FDG-PET suggested the recurrence of TC; therefore, the second chemotherapy protocol using toceranib was applied for 16 months. After initiation of the second chemotherapy, follow-up examinations were conducted approximately every 4 months. On the 134th day, although the nodule was not palpated, its size was observed to have increased to 5.0 × 3.8 × 13.6 mm on cervical US on the 232nd day, showing heterogeneous and hypoechoic parenchyma. On the 405th day, the tumor was enlarged to a size of 13.4 × 12.9 × 22 mm and identified as a lobular, amorphous shape, and its heterogeneity was increased. Moreover, two pulmonary nodules with well-defined margins were found on radiography in the left caudal lung lobe (9 × 10 mm and 12 × 12 mm [width × length]); thus, lung metastasis was suspected. On the 536th day, anorexia and lethargy occurred, and the dog was lost to follow-up. Discussion: In the present case, local recurrence of TC was suspected based on cervical US. Although US was useful as a screening tool, additional examinations were necessary for evaluating local invasiveness, malignancy, and nodal/distant metastasis. FDG-PET can detect recurrence at an early stage because it can sense increased tumor metabolism through physiologic absorption of FDG, even before the beginning of anatomic change in the lesion. Therefore, FDG-PET can assist in treatment planning and provide better prognosis. In humans, focal FDG uptake and a high maximum SUV in the thyroid gland on FDG-PET were associated with a higher risk of cancer. Because there was no evidence of neoplasia except the thyroid lesion during the FDG-PET examination, the tumor showed an increasingly malignant pattern of the thyroid gland on US during the follow-up period, and the metastatic pulmonary nodules were identified on the 650th day after the thyroidectomy. Therefore, the present case was diagnosed as recurrent TC. This report describes the use of FDG-PET for diagnosing local recurrence of TC, pointing to FDG-PET as a potential strategy to evaluate loco-regional recurrence and distant metastasis of TC. Keywords: canine, FDG-PET, follicular thyroid carcinoma, metastasis, tumor, cancer

Cystitis in a Bitch with Chronic Kidney Disease Caused by Multidrug-Resistant Escherichia coli

Background: In dogs with bacterial cystitis that is resistant to multiple antibiotics, resulting from repeated infections and antimicrobial administration, especially if the dog has impaired renal function and the induction of systemic side effects by intravenous or oral administration is a concern, intravesical instillation of antibiotics might represent an alternative treatment option. In human and veterinary medicine, a number of studies showed intravesical instillation of antibiotics is effective for the therapy multidrug-resistant bacterial urinary tract infection (UTI). This report firstly illustrates successful intravesical meropenem treatment of a UTI caused by multidrug-resistant Escherichia coli with no systemic side effects in dog with chronic kidney disease (CKD).Case: A 15-year-old spayed female Maltese was presented with recurrent bacterial cystitis. The risk factors for the recurrent UTI were spinal cord injury and CKD which had been managed for 1 year. Ultrasound-guided cystocentesis was performed to obtain a urine sample for urinalysis, bacteriologic culture, and antibiotic susceptibility testing. Bacterial cystitis caused by multidrug-resistant Escherichia coli was diagnosed on the basis of bacterial culture, and antimicrobial susceptibility testing. Because the dog had CKD, reducing the clearance of meropenem, intravesical instillation of antibiotics was initiated. The intravesical instillation process consisted of the emptying of the urinary bladder, infusion of a diluted meropenem solution (8.5 mg/kg diluted in 20 mL of saline solution) into the bladder through a urethral catheter, and retention of the meropenem solution in the bladder for 1 h, and its removal. The procedure was repeated every 8 h. On day 8 of the intravesical instillation therapy, Bactereologic culture yielded a growth of E. coli (50,000 CFUs/mL), which was less than previously obtained. the concentration of the meropenem solution being administered was increased to 17 mg/kg diluted in 20 mL of saline solution, to improve the effectiveness of the therapy. After 21 days of the intravesical meropenem instillation, the bacterial cystitis was resolved. One year after completion of the treatment, the dog is still alive without any recurrence of bacterial cystitis. Discussion: Because resistant uropathogens can cause zoonotic infections, effective therapy is important with increasing incidence not only for patients, but also for public health. Intravesical instillation of antibiotics can be an effective treatment method for dogs with urinary tract infection in which oral antibiotics are likely to be ineffective and injectable antibiotics cannot be a treatment option. The antibiotics can be administered directly to the affected location, and systemic side effects can be minimized by the impermeabtility of the bladder wall via intravesical instillation procedure. Meropenem is likely to accumulate in dogs with impaired renal function, leading to systemic side effects and the aggravation of CKD in old dogs. This report describes the successful treatment of multidrug-resistant E. coli infection by intravesical instillation of meropenem without any side effects in dogs with CKD. Therefore, clinician should consider the use of intravesical instillation of antibiotics which predominately excreted in the urine for the control of urinary tract infection caused by multidrug-resistant bacteria in dogs showing reduced renal function. Keywords: canine, intravesical instillation, meropenem, multidrug-resistant organism, urinary tract infection

Treatment of Discoid Lupus Erythematosus in a Dog with Human Intravenous Immunoglobulin

Background: Discoid lupus erythematosus (DLE) is a common canine autoimmune skin disease, in which systemic manifestations are absent. Skin Lesions are usually present on the nasal planum, and characterised by erythema, depigmentation, erosion, ulceration, and crusting. The diagnosis is based on histopathological results, which should demonstrate lymphoplasmacytic lichenoid-interface dermatitis. Human intravenous immunoglobulin (hIVIg) has been used in veterinary medicine to treat cutaneous diseases including erythema multiforme, PF, and severe adverse cutaneous drug reactions. In human medicine, it has been effective to treat DLE. This report firstly describes the clinical response to hIVIg in a dog with DLE resistant to common immunosuppressive drugs.Case: A 5-year-old, intact female Shih Tzu presented with a 1-month history of slowly progressive black crusting on the nasal planum, chin, and claw. Based on the results of a dermatologic examination, superficial pyoderma was diagnosed. The skin lesions did not improve during and after anti-infective treatment. After removing the crusts, a skin biopsy was obtained from the muzzle. Histopathology of lesional skin biopsy specimens revealed lymphoplasmacytic interface dermatitis at the dermoepidermal junction. Microscopic examination also revealed vacuolar changes and pigmentary incontinence of the basal layer as a lichenoid tissue reaction. No mites or fungi were detected on the skin section. The absence of acantholytic cells excluded pemphigus foliaceus, which is also characterised by the lesions of the nasal planum. Based on the distribution of the lesions, histopathology and exclusion of other dermatoses, the dog was diagnosed with DLE. The skin lesions temporarily improved after treatment with prednisolone (2 mg/kg PO q12h). However, after tapering the dose of prednisolone, new black crusts developed on the nasal planum and claw. Although the dog was successively treated with other immunosuppressive drugs, including azathioprine, cyclosporin with dexamethasone, and mycophenolate mofetil, black crusts still remained. Due to the low efficacy of these immunosuppressive drugs, hIVIg was administered at 0.5 g/kg once daily for 4 days, for a total dose of 2 g/kg. During hIVIg administration, the crusted lesions gradually improved. After the hIVIg administration, the dog was treated with prednisolone (1 mg/kg PO q12h). The lesions were almost in complete remission at 21 days after an additional application of prednisolone. The skin lesions did not recur, and the treatment was eventually discontinued after 6 weeks of additional prednisolone application.Discussion: The standard treatment of canine DLE includes glucocorticoids, and second-line immunosuppressive drugs, such as azathioprine and cyclosporine, are usually added in cases resistant to steroids. This case suggests that hIVIg may be beneficial as an adjunctive treatment option for canine DLE, especially when the application of standard immunosuppressive drugs is limited due to adverse effects or low efficacy. There is evidence from several studies that the steroid-sparing effect of hIVIg is significant in human patients. In the current case, the effective dose of prednisolone was reduced to 2 mg/kg/day after hIVIg administration, and prednisolone therapy was finally discontinued completely. The hIVIg appears to lower the daily steroid dose requirement in this dog. Keywords: autoimmune skin disease, discoid lupus erythematosus, canine dermatology, immunosuppressive drug, human intravenous immunoglobulin