Almost four decades of study of Desmoinesian strata of Middle Pennsylvanian age in south-central Iowa and north-central Missouri have provided the stratigraphic control required to test the variation of clay mineralogy vertically and laterally within various paralic clay and shale facies. Local and regional variations in clay mineralogy within Desmoinesian strata are generally predictable and are in agreement with current knowledge of deltaic deposition. A principal environmental variation within a deltaic system is the change from normal marine salinities in deltaic marine environments to brackish- and fresh-water conditions in the marshy delta plains, in upper interdistributary bays, and within flanking interdeltaic embayments. Changes from marine to nonmarine facies coincide with a decrease in illite, and an increase in kaolin, mixed-layer clays, and in the percentage of expansible layers in the mixed-layer clay. The principal clay detritus entering the area was illite, which underwent various degrees of alteration in different aqueous and subaerial environments within deltaic and interdeltaic areas. Clay-mineral composition alone does not provide unique environmental answers. The distribution of clay-mineral suites within these systems, however, both supports the deltaic-interdeltaic depositional model and can be understood within the context of this framework.

Malnutrition and sarcopenia are prevalent in patients with head and neck squamous cell carcinoma (HNSCC). Pre-treatment sarcopenia and adverse oncological outcomes in this population are well described. The impact of myosteatosis and post-treatment sarcopenia is less well known. Patients with HNSCC (n = 125) undergoing chemoradiotherapy, radiotherapy alone and/or surgery were assessed for sarcopenia and myosteatosis, using cross-sectional computed tomography (CT) imaging at the third lumbar (L3) vertebra, at baseline and 3 months post-treatment. Outcomes were overall survival (OS) at 12 months and 5 years post-treatment. One hundred and one participants had a CT scan evaluable at one or two time points, of which sixty-seven (66 %) participants were sarcopenic on at least one time point. Reduced muscle attenuation affected 93 % (n = 92) pre-treatment compared with 97 % (n = 90) post-treatment. Five-year OS favoured those without post-treatment sarcopenia (hazard ratio, HR 0·37, 95 % CI 0·16, 0·88, P = 0·06) and those without both post-treatment myosteatosis and sarcopenia (HR 0·33, 95 % CI 0·13, 0·83, P = 0·06). Overall, rates of myosteatosis were high at both pre- and post-treatment time points. Post-treatment sarcopenia was associated with worse 5-year OS, as was post-treatment sarcopenia in those who had myosteatosis. Post-treatment sarcopenia should be evaluated as an independent risk factor for decreased long-term survival post-treatment containing radiotherapy (RT) for HNSCC.

In the family therapy literature there is increasing interest in the dialogical approach, particularly as it becomes well-grounded in psychotherapy research. One embodiment is ‘open dialogues’, which has developed over a 30-year period in Western Lapland, Finland. This paper outlines my experience of visiting Keropudas Hospital in Tornio, Finland, the birthplace of open dialogues. It explores the seven theoretical principles of open dialogues, associated elements of clinical practice, and the therapist use of self. The author utilises these aspects to reflect on dialogical moments through words and images based on three conceptual themes, which illustrate the relevance of open dialogues for family therapy practitioners and their contexts.

Continual low-level exposure of sheep to the helminth Teladorsagia circumcincta elicits a temporary protective immunity, where factors in the immune abomasal mucosa prevent penetration of infective larvae, but which is essentially lost within 6 weeks of cessation of parasite challenge. Here, a proteomic approach was used to identify proteins that are differentially regulated in immune compared to naïve sheep, as potential key mediators of immunity. Six naïve sheep and 12 sheep trickle-infected with T. circumcincta were treated with anthelmintic, and the naïve (control) and 6 immune sheep were killed 7 days later. The remaining 6 sheep (immune waning) were killed 42 days after anthelmintic treatment. Abomasal tissue samples were subjected to 2D-gel electrophoresis and densitometric analysis. Selected spots (n=73) were identified by peptide mass fingerprinting and confirmatory Western blotting was carried out for 10 proteins. Spots selectively up-regulated in immune versus control, but not immune waning versus control sheep, included galectin-15 and thioredoxin, which were confirmed by Western blotting. In immune sheep, serum albumin was significantly down-regulated and albumin proteolytic cleavage fragments were increased compared to controls. Unexpectedly, albumin mRNA was relatively highly expressed in control mucosa, down-regulated in immune, and was immunolocalized to mucus-producing epithelial cells. Thus we have identified differential expression of a number of proteins following T. circumcincta trickle infection that may play a role in host protection and inhibition of parasite establishment.

The primary aim of the three Milan principles of hypothesising, circularity and neutrality was to proffer an effective methodology for interviewing families, with a secondary aim of casting off the stereotypical personal therapist qualities such as intuition, charisma and concern. The progression of the principles from the original Milan model through to contemporary approaches is intriguing. The following article consists of two sections. First it tracks the progression of the three principles through the Milan, post-Milan and postmodern approaches to family therapy. Given their recursive nature, they are revealed as responsive to developments in theory and practice, as well as the influence of the wider societal context. The second section of the article explores hypothesising, circularity and neutrality in the contemporary approach of dialogical family therapy. The relevance of the three principles to the therapeutic process, the therapeutic role and the therapeutic relationship is considered. Such an exploration does not seek definitive answers or ‘truths’, but seeks to conceptualise a vague ‘knowing’ that there is continual learning and growth in grappling with the tensions in this field, in remaining ever curious, in asking the questions …