Development of a Consensus Statement for the Definition, Diagnosis, and Treatment of Acute Exacerbations of Idiopathic Pulmonary Fibrosis Using the Delphi Technique.

© 2015, The Author(s).Introduction: There is a lack of agreed and established guidelines for the treatment of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). This reflects, in part, the limited evidence-base underpinning the management of AE-IPF. In the absence of high-quality evidence, the aim of this research was to develop a clinician-led consensus statement for the definition, diagnosis and treatment of AE-IPF. Methods: A literature review was conducted to obtain published material on the definition and treatment of AE-IPF. The results of this review were circulated to an online panel of clinicians for review. Statements were then shared with ten expert respiratory clinicians who regularly treat patients with IPF. A Delphi technique was then used to develop a consensus statement for the definition, diagnosis and treatment of AE-IPF. During the first round of review, clinicians rated the clarity of each statement, the extent to which the statement should be included and provided comments. In two subsequent rounds of review, clinicians were provided with the group median inclusion rating for each statement, and any revised wording of statements to aid clarity. Clinicians were asked to repeat the clarity and inclusion ratings for the revised statements. Results: The literature review, online panel discussion, and face-to-face meeting generated 65 statements covering the definition, diagnosis, and management of AE-IPF. Following three rounds of blind review, 90% of clinicians agreed 39 final statements. These final statements included a definition of AE-IPF, approach to diagnosis, and treatment options, specifically: supportive measures, use of anti-microbials, immunosuppressants, anti-coagulants, anti-fibrotic therapy, escalation, transplant management, and long-term management including discharge planning. Conclusion: This clinician-led consensus statement establishes the ‘best practice’ for the management and treatment of AE-IPF based on current knowledge, evidence, and available treatments. Funding: Boehringer Ingelheim Ltd., Bracknell, West Berkshire, UK

Quantum information can be negative

Given an unknown quantum state distributed over two systems, we determine how much quantum communication is needed to transfer the full state to one system. This communication measures the "partial information" one system needs conditioned on it's prior information. It turns out to be given by an extremely simple formula, the conditional entropy. In the classical case, partial information must always be positive, but we find that in the quantum world this physical quantity can be negative. If the partial information is positive, its sender needs to communicate this number of quantum bits to the receiver; if it is negative, the sender and receiver instead gain the corresponding potential for future quantum communication. We introduce a primitive "quantum state merging" which optimally transfers partial information. We show how it enables a systematic understanding of quantum network theory, and discuss several important applications including distributed compression, multiple access channels and multipartite assisted entanglement distillation (localizable entanglement). Negative channel capacities also receive a natural interpretation

Study protocol : the empirical investigation of methods to correct for measurement error in biobanks with dietary assessment

Peer reviewedPublisher PD

Detection of multipartite entanglement with two-body correlations

We show how to detect entanglement with criteria built from simple two-body correlation terms. Since many natural Hamiltonians are sums of such correlation terms, our ideas can be used to detect entanglement by energy measurement. Our criteria can straightforwardly be applied for detecting different forms of multipartite entanglement in familiar spin models in thermal equilibrium.Comment: 5 pages including 2 figures, LaTeX; for the proceedings of the DPG spring meeting, Berlin, March 200

Black Stork Down: Military Discourses in Bird Conservation in Malta

Tensions between Maltese hunters and bird conservation NGOs have intensified over the past decade. Conservation NGOs have become frustrated with the Maltese State for conceding to the hunter lobby and negotiating derogations from the European Union’s Bird Directive. Some NGOs have recently started to organize complex field-operations where volunteers are trained to patrol the landscape, operate drones and other surveillance technologies, detect illegalities, and lead police teams to arrest poachers. We describe the sophisticated military metaphors which conservation NGOs have developed to describe, guide and legitimize their efforts to the Maltese public and their fee-paying members. We also discuss why such groups might be inclined to adopt these metaphors. Finally, we suggest that anthropological studies of discourse could help understand delicate contexts such as this where conservation NGOs, hunting associations and the State have ended in political deadlock

The Uncertainty Principle in the Presence of Quantum Memory

The uncertainty principle, originally formulated by Heisenberg, dramatically illustrates the difference between classical and quantum mechanics. The principle bounds the uncertainties about the outcomes of two incompatible measurements, such as position and momentum, on a particle. It implies that one cannot predict the outcomes for both possible choices of measurement to arbitrary precision, even if information about the preparation of the particle is available in a classical memory. However, if the particle is prepared entangled with a quantum memory, a device which is likely to soon be available, it is possible to predict the outcomes for both measurement choices precisely. In this work we strengthen the uncertainty principle to incorporate this case, providing a lower bound on the uncertainties which depends on the amount of entanglement between the particle and the quantum memory. We detail the application of our result to witnessing entanglement and to quantum key distribution.Comment: 5 pages plus 12 of supplementary information. Updated to match the journal versio

Meeting the global protein supply requirements of a growing and ageing population

\ua9 The Author(s) 2024.Human dietary patterns are a major cause of environmental transformation, with agriculture occupying ~ 50% of global land space, while food production itself is responsible for ~ 30% of all greenhouse gas emissions and 70% of freshwater use. Furthermore, the global population is also growing, such that by 2050, it is estimated to exceed ~ 9 billion. While most of this expansion in population is expected to occur in developing countries, in high-income countries there are also predicted changes in demographics, with major increases in the number of older people. There is a growing consensus that older people have a greater requirement for protein. With a larger and older population, global needs for protein are set to increase. This paper summarises the conclusions from a Rank Prize funded colloquium evaluating novel strategies to meet this increasing global protein need

Institutions and governance of communal rangelands in South Africa

The creation of local institutions with a mandate over land access and control is seen as a prerequisite for successful decentralisation of land tenure and effective local resource management in sub-Saharan Africa. However, with land tenure reform in South Africa currently at a state of legislative impasse, real uncertainty now exists over land rights and governance of rangeland in many communal areas. This paper draws on case study material from Eastern Cape province to illustrate how this ongoing uncertainty has resulted in the operation of a range of traditional authority and civil society institutions in different communal areas with varying degrees of legitimate authority over land administration and highly variable performance in managing rangeland resources. Collective management of rangeland resources seems most difficult in environments where land rights are contested because of the coexistence of traditional leaders and civil society institutions. On this basis an approach to tenure reform is advocated, which vests all powers over local land administration in democratically elected and accountable civil society institutions. Some successful examples of this already exist and might serve to guide policy formation, which must be flexible enough to accommodate collective management approaches that emphasise cooperation both within and between communities.Keywords: common property, land tenure, natural resource management, traditional leadersAfrican Journal of Range & Forage Science 2013, 30(1&2): 77–8

Experimental investigation of classical and quantum correlations under decoherence

It is well known that many operations in quantum information processing depend largely on a special kind of quantum correlation, that is, entanglement. However, there are also quantum tasks that display the quantum advantage without entanglement. Distinguishing classical and quantum correlations in quantum systems is therefore of both fundamental and practical importance. In consideration of the unavoidable interaction between correlated systems and the environment, understanding the dynamics of correlations would stimulate great interest. In this study, we investigate the dynamics of different kinds of bipartite correlations in an all-optical experimental setup. The sudden change in behaviour in the decay rates of correlations and their immunity against certain decoherences are shown. Moreover, quantum correlation is observed to be larger than classical correlation, which disproves the early conjecture that classical correlation is always greater than quantum correlation. Our observations may be important for quantum information processing.Comment: 7 pages, 4 figures, to appear in Nature Communication

Improving the management of pain from advanced cancer in the community: study protocol for a pragmatic multi-centre randomised controlled trial

Introduction: For patients with advanced cancer, research shows that pain is frequent, burdensome and undertreated. Evidence-based approaches to support cancer pain management have been developed but have not been implemented within the context of the UK National Health Service. This protocol is for a pragmatic multi-centre randomised controlled trial to assess feasibility, acceptability, effectiveness and cost effectiveness for a multi-component intervention for pain management in patients with advanced cancer. Methods and Analysis: This trial will assess the feasibility of implementation and uptake of evidence based interventions, developed and piloted as part of the IMPACCT Programme grant, into routine clinical practice and determine whether there are potential differences with respect to patient rated pain, patient pain knowledge and experience, healthcare use, quality of life, and cost effectiveness. 160 patients will receive either the intervention (usual care plus supported self-management) delivered within the oncology clinic and palliative care services by locally assigned community palliative care nurses, consisting of a self-management educational intervention and eHealth intervention for routine pain assessment and monitoring; or usual care. The primary outcomes are to assess implementation and uptake of the interventions, and differences in terms of pain severity. Secondary outcomes include pain interference, participant pain knowledge and experience, and cost effectiveness. Outcome assessment will be blinded and patient reported outcome measures collected via post at 6 and 12 weeks following randomisation. Ethics and Dissemination: This RCT has the potential to significantly influence NHS service delivery to community based patients with pain from advanced cancer. We aim to provide definitive evidence of whether two simple interventions delivered by community palliative care nurse in palliative care that support-self-management are clinically and cost effective additions to standard community palliative care