Teaching Legal Ethics: Exploring the Continuum

Spaeth et al assert that the only reason to teach legal ethics, or professional responsibility, is to try to make the legal profession more worthy of its stated ideals. The University of Pennsylvania Law School Center on Professionalism\u27s efforts to achieve this are discussed

The Nonpenetrating Telescopic Sham Needle May Blind Patients with Different Characteristics and Experiences When Treated by Several Therapists

Background. Little is known which factors influence the blinding in acupuncture studies. Aim. To investigate if blinding varied between patients with different characteristics receiving verum or sham acupuncture. Methods. We randomised cancer patients to verum (n = 109) or sham acupuncture (n = 106) with a nonpenetrating telescopic sham needle for nausea. Level of blinding was compared between different sub-groups of patients using Bang's blinding index (BI) ranged −1 to 1 (−1 = all state the opposite treatment, 1 = all identify treatment). Results. Most patients in the verum (74 of 95; 78%, BI 0.72) and the sham (68 of 95; 72%, BI −0.60). acupuncture group believed they had received verum acupuncture. The probability for a patient to believe he/she received verum acupuncture was related to the received needling type (P = .003) and to the patient's belief in received treatment effects (P = .008). Hospital (P = .425), therapist (P = .434), previous acupuncture experience (P = .578), occurrence of nausea (P = .157), gender (P = .760), and age (P = .357) did not affect blinding. Conclusions. Blinding was successfully achieved irrespective of age, gender, acupuncture experience, treatment effect, or in which hospital or by which therapist the patient received treatment. Patients with higher belief in the effect of the treatment were more likely to believe they had received verum acupuncture

The Fetal Brain Sparing Response to Hypoxia: Physiological Mechanisms

How the fetus withstands an environment of reduced oxygenation during life in the womb has been a vibrant area of research since this field was introduced by Joseph Barcroft, a century ago. Studies spanning five decades have since used the chronically instrumented fetal sheep preparation to investigate the fetal compensatory responses to hypoxia. This defence is contingent on the fetal cardiovascular system, which in late gestation adopts strategies to decrease oxygen consumption and redistribute the cardiac output away from peripheral vascular beds and towards essential circulations, such as those perfusing the brain. The introduction of simultaneous measurement of blood flow in the fetal carotid and femoral circulations by ultrasonic transducers has permitted investigation of the dynamics of the fetal brain sparing response for the first time. Now we know that major components of fetal brain sparing during acute hypoxia are triggered exclusively by a carotid chemoreflex and that they are modified by endocrine agents and the recently discovered vascular oxidant tone. The latter is determined by the interaction between nitric oxide and reactive oxygen species. The fetal brain sparing response matures as the fetus approaches term, in association with the prepartum increase in fetal plasma cortisol and treatment of the preterm fetus with clinically-relevant doses of synthetic steroids mimics this maturation. Despite intense interest into how the fetal brain sparing response may be affected by adverse intrauterine conditions, this area of research has been comparatively scant but it is likely to take centre stage in the near future.Dino Giussani is supported by the British Heart Foundation, The Biotechnology and Biological Sciences Research Council, The Royal Society, The Wellcome Trust, Action Medical Research and the Isaac Newton Trust. I am grateful to past and present members of my group and Professor Abigail Fowden and Dr Caroline Shaw for insightful discussion.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1113/JP27109

Acupuncture as Treatment of Hot Flashes and the Possible Role of Calcitonin Gene-Related Peptide

The mechanisms behind hot flashes in menopausal women are not fully understood. The flashes in women are probably preceded by and actually initiated by a sudden downward shift in the set point for the core body temperature in the thermoregulatory center that is affected by sex steroids, β-endorphins, and other central neurotransmitters. Treatments that influence these factors may be expected to reduce hot flashes. Since therapy with sex steroids for hot flashes has appeared to cause a number of side effects and risks and women with hot flashes and breast cancer as well as men with prostate cancer and hot flashes are prevented from sex steroid therapy there is a great need for alternative therapies. Acupuncture affecting the opioid system has been suggested as an alternative treatment option for hot flashes in menopausal women and castrated men. The heat loss during hot flashes may be mediated by the potent vasodilator and sweat gland activator calcitonin gene-related peptide (CGRP) the concentration of which increases in plasma during flashes in menopausal women and, according to one study, in castrated men with flushes. There is also evidence for connections between the opioid system and the release of CGRP. In this paper we discuss acupuncture as a treatment alternative for hot flashes and the role of CGRP in this context

Guidelines and Best Practices for Large and Mass Tort MDLs (First Edition)

Mass-tort MDLs dominate the federal civil docket, yet they present enormous challenges to transferee judges assigned to manage them. There is little official guidance and no rules specific to the management of mass-tort MDLs, often requiring the transferee judge to develop procedures out of whole cloth. Beginning in 2013, the Bolch Judicial Institute (then the Center for Judicial Studies) sought to address this issue through a series of annual bench-bar conferences. From these conferences came the Guidelines and Best Practices for Large and Mass-Tort MDLs document, which is designed to help judges and legal practitioners understand and efficiently navigate complex MDL procedures. As with any group product of this nature, where some consensus must be reached, the drafters and other participants are not individually responsible for any particular statement or provision, and may or may not agree with any particular statement or provision. The document does not necessarily represent the views of the Duke Law faculty or the Law School or University

Data-driven decoding of quantum error correcting codes using graph neural networks

To leverage the full potential of quantum error-correcting stabilizer codes it is crucial to have an efficient and accurate decoder. Accurate, maximum likelihood, decoders are computationally very expensive whereas decoders based on more efficient algorithms give sub-optimal performance. In addition, the accuracy will depend on the quality of models and estimates of error rates for idling qubits, gates, measurements, and resets, and will typically assume symmetric error channels. In this work, instead, we explore a model-free, data-driven, approach to decoding, using a graph neural network (GNN). The decoding problem is formulated as a graph classification task in which a set of stabilizer measurements is mapped to an annotated detector graph for which the neural network predicts the most likely logical error class. We show that the GNN-based decoder can outperform a matching decoder for circuit level noise on the surface code given only simulated experimental data, even if the matching decoder is given full information of the underlying error model. Although training is computationally demanding, inference is fast and scales approximately linearly with the space-time volume of the code. We also find that we can use large, but more limited, datasets of real experimental data [Google Quantum AI, Nature {\bf 614}, 676 (2023)] for the repetition code, giving decoding accuracies that are on par with minimum weight perfect matching. The results show that a purely data-driven approach to decoding may be a viable future option for practical quantum error correction, which is competitive in terms of speed, accuracy, and versatility.Comment: 15 pages, 12 figure

Error-rate-agnostic decoding of topological stabilizer codes

Efficient high-performance decoding of topological stabilizer codes has the potential to crucially improve the balance between logical failure rates and the number and individual error rates of the constituent qubits. High-threshold maximum-likelihood decoders require an explicit error model for Pauli errors to decode a specific syndrome, whereas lower-threshold heuristic approaches such as minimum weight matching are "error agnostic". Here we consider an intermediate approach, formulating a decoder that depends on the bias, i.e., the relative probability of phase-flip to bit-flip errors, but is agnostic to error rate. Our decoder is based on counting the number and effective weight of the most likely error chains in each equivalence class of a given syndrome. We use Metropolis-based Monte Carlo sampling to explore the space of error chains and find unique chains, that are efficiently identified using a hash table. Using the error-rate invariance the decoder can sample chains effectively at an error rate which is higher than the physical error rate and without the need for "thermalization" between chains in different equivalence classes. Applied to the surface code and the XZZX code, the decoder matches maximum-likelihood decoders for moderate code sizes or low error rates. We anticipate that, because of the compressed information content per syndrome, it can be taken full advantage of in combination with machine-learning methods to extrapolate Monte Carlo-generated data.Comment: 15 pages, 9 figures; V2 Added analysis of low error-rate performanc

Two modes of acupuncture as a treatment for hot flushes in men with prostate cancer – a prospective multicenter study with long-term follow-up. Eur Urol

Ö stergö tland, Norrkö ping and Linkö ping, Sweden e u r o p e a n u r o l o g y 5 5 ( 2 0 0 9 ) 1 5 6 -1 6 3 a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m 3) at baseline in the EA group to 4.1 (IQR, 2.0-6.5) ( p = 0.012) after 12 wk, and from 5.7 (IQR, 5.1-9.5) in the TA group to 3.4 (IQR1.8-6.3) ( p = 0.001). Distress by flushes decreased from 8.2 (IQR, 6.5-10.7) in the EA group to 3.3 (IQR, 0.3-8.1) ( p = 0.003), and from 7.6 (IQR, 4.7-8.3) to 3.4 (IQR, 2.0-5.6) ( p = 0.001) in the TA group after 12 wk, (78% and 73% reduction in ''hot flush score,'' respectively). The effect lasted up to 9 mo after treatment ended. CGRP did not change significantly. Few, minor side effects were reported. Article info Limitations: small number of patients; no placebo control, instead a small group controlled for 6 wk pretreatment. Conclusions: EA and TA lowered number of and distress from hot flushes. The hot flush score decreased 78% and 73%, respectively, in line with or better than medical regimens for these symptoms. Acupuncture should be considered an alternative treatment for these symptoms, but further evaluation is needed, preferably with a non-or placebo-treated control group

Алгоритм генерации порождающих полиномов М-последовательностей

Тез. докл. XI Междунар. науч.-техн. конф. (науч. чтения, посвящ. П. О. Сухому), Гомель, 20-21 октября 2016 г

Increased Risk of Recurrence After Hormone Replacement Therapy in Breast Cancer Survivors

Background Hormone replacement therapy (HT) is known to increase the risk of breast cancer in healthy women, but its effect on breast cancer risk in breast cancer survivors is less clear. The randomized HABITS study, which compared HT for menopausal symptoms with best management without hormones among women with previously treated breast cancer, was stopped early due to suspicions of an increased risk of new breast cancer events following HT. We present results after extended follow-up. Methods HABITS was a randomized, non-placebo-controlled noninferiority trial that aimed to be at a power of 80% to detect a 36% increase in the hazard ratio (HR) for a new breast cancer event following HT. Cox models were used to estimate relative risks of a breast cancer event, the maximum likelihood method was used to calculate 95% confidence intervals (CIs), and χ2 tests were used to assess statistical significance, with all P values based on two-sided tests. The absolute risk of a new breast cancer event was estimated with the cumulative incidence function. Most patients who received HT were prescribed continuous combined or sequential estradiol hemihydrate and norethisterone. Results Of the 447 women randomly assigned, 442 could be followed for a median of 4 years. Thirty-nine of the 221 women in the HT arm and 17 of the 221 women in the control arm experienced a new breast cancer event (HR = 2.4, 95% CI = 1.3 to 4.2). Cumulative incidences at 5 years were 22.2% in the HT arm and 8.0% in the control arm. By the end of follow-up, six women in the HT arm had died of breast cancer and six were alive with distant metastases. In the control arm, five women had died of breast cancer and four had metastatic breast cancer (P = .51, log-rank test). Conclusion After extended follow-up, there was a clinically and statistically significant increased risk of a new breast cancer event in survivors who took H