To feed or not to feed? Clinical aspects of withholding and withdrawing food and fluids at the end of life

The issue of withholding and withdrawing clinically assisted nutrition and hydration (CANH) for imminently dying patients is very contentious. There is no agreement between medical professionals and problem of forgoing CANH is subject of a fierce and sometimes emotional debate. This paper makes an attempt to examine briefly current clinical evidence on withdrawing and withholding CANH at the end of life. It tries to assess whether it is always beneficial for a patient to provide CANH or whether providing CANH may sometimes cause more harm than good. It also addresses a question whether forgoing CANH for some imminently dying patients is consistent with fundamentals of palliative care. For this reason withholding or withdrawing CANH will be analysed in a context of basic assumptions of palliative care which are presented in the World Health Organisation’s definition of this distinctive branch of medicine. Adv. Pall. Med. 2011; 10, 1: 3–10The issue of withholding and withdrawing clinically assisted nutrition and hydration (CANH) for imminently dying patients is very contentious. There is no agreement between medical professionals and problem of forgoing CANH is subject of a fierce and sometimes emotional debate. This paper makes an attempt to examine briefly current clinical evidence on withdrawing and withholding CANH at the end of life. It tries to assess whether it is always beneficial for a patient to provide CANH or whether providing CANH may sometimes cause more harm than good. It also addresses a question whether forgoing CANH for some imminently dying patients is consistent with fundamentals of palliative care. For this reason withholding or withdrawing CANH will be analysed in a context of basic assumptions of palliative care which are presented in the World Health Organisation’s definition of this distinctive branch of medicine. Adv. Pall. Med. 2011; 10, 1: 3–1

A cell-based smoothed finite element method for kinematic limit analysis

This paper presents a new numerical procedure for kinematic limit analysis problems, which incorporates the cell-based smoothed finite element method with second-order cone programming. The application of a strain smoothing technique to the standard displacement finite element both rules out volumetric locking and also results in an efficient method that can provide accurate solutions with minimal computational effort. The non-smooth optimization problem is formulated as a problem of minimizing a sum of Euclidean norms, ensuring that the resulting optimization problem can be solved by an efficient second-order cone programming algorithm. Plane stress and plane strain problems governed by the von Mises criterion are considered, but extensions to problems with other yield criteria having a similar conic quadratic form or 3D problems can be envisaged

A continuum-microscopic method based on IRBFs and control volume scheme for viscoelastic fluid flows

A numerical computation of continuum-microscopic model for visco-elastic flows based on the Integrated Radial Basis Function (IRBF) Control Volume and the Stochastic Simulation Techniques (SST) is reported in this paper. The macroscopic flow equations are closed by a stochastic equation for the extra stress at the microscopic level. The former are discretised by a 1D-IRBF-CV method while the latter is integrated with Euler explicit or Predictor-Corrector schemes. Modelling is very efficient as it is based on Cartesian grid, while the integrated RBF approach enhances both the stability of the procedure and the accuracy of the solution. The proposed method is demonstrated with the solution of the start-up Couette flow of the Hookean and FENE dumbbell model fluids

Peculiarities of electronic heat capacity of thulium cuprates in pseudogap state

Precise calorimetric measurements have been carried out in the 7 - 300 K temperature range on two ceramic samples of thulium 123 cuprates TmBa2Cu3O6.92 and TmBa2Cu3O6.70. The temperature dependence of the heat capacity was analyzed in the region where the pseudogap state (PGS) takes place. The lattice contribution was subtracted from the experimental data. The PGS component has been obtained by comparing electronic heat capacities of two investigated samples because the PGS contribution for the 6.92 sample is negligible. The anomalous behavior of the electronic heat capacity near the temperature boundary of PGS was found. It is supposed that this anomaly is due to peculiarities in N(E) function where N is the density of electronic states and E is the energy of carriers of charge.Comment: 12 pages, 3 Postscript figure