Continuing professional development: Medico-legal aspects of epilepsy

AbstractGenerally protection against possible litigation and good clinical practice go hand in hand. Situations in which the law has special relevance for people with epilepsy, those who work with them, and their clinicians are reviewed with special reference to the topics of driving, employment, duties of social carers, the clinician’s everyday role, the responsibilities of researchers and epilepsy and the criminal law. What constitutes professional negligence is discussed, with special reference to the United Kingdom. Clinicians are advised to think clearly, write clearly, communicate clearly and have a good relationship with their patients

IN-SYNC. VII. Evidence for a decreasing spectroscopic binary fraction from 1 to 100 Myr within the IN-SYNC sample

We study the occurrence of spectroscopic binaries in young star-forming regions using the INfrared Spectroscopy of Young Nebulous Clusters(IN-SYNC) survey, carried out in SDSS-III with the APOGEE spectrograph. Multi-epoch observations of thousands of low-mass stars in Orion A, NGC 2264, NGC 1333, IC 348, and the Pleiades have been carried out, yielding H-band spectra with a nominal resolution of R=22,500 for sources with H $\le$ 12 mag. Radial velocity precisions of $\sim$0.3 $km\:s^{-1}$ were achieved, which we use to identify radial velocity variations indicative of undetected companions. We use Monte Carlo simulations to assess the types of spectroscopic binaries to which we are sensitive, finding sensitivity to binaries with orbital periods $< 10^{4}$ d, for stars with $2500 {\rm K} \le T_\mathrm{eff} \le 6000 {\rm K}$ and $\it{v} \sin \it{i}$ $\le$ 100 $km\:s^{-1}$. Using Bayesian inference, we find evidence for a decline in the spectroscopic binary fraction, by a factor of 3-4 from the age of our pre-main-sequence sample to the Pleiades age . The significance of this decline is weakened if spot-induced radial-velocity jitter is strong in the sample, and is only marginally significant when comparing any one of the pre-main-sequence clusters against the Pleiades. However, the same decline in both sense and magnitude is found for each of the five pre-main-sequence clusters, and the decline reaches statistical significance of greater than 95% confidence when considering the pre-main-sequence clusters jointly. Our results suggest that dynamical processes disrupt the widest spectroscopic binaries ($P_{\rm orb} \approx 10^3 - 10^4$ d) as clusters age, indicating that this occurs early in the stars' evolution, while they still reside within their nascent clusters.Comment: 21 pages, 9 Figure

An Examination of the Stiffness Terms Needed to Model the Dynamics of an Eddy Current based Maglev Vehicle

This paper re-examines the basis for each eddy current stiffness term computed from prior published steady-state eddy current models. The paper corrects prior analysis work by confirming, through the use of 2-D and 3-D dynamic finite element analysis modelling, that when a magnetic source is moving over an infinite-wide and infinite-long conductive sheet guideway the steady-state lateral and translational stiffness terms will be zero and only the vertical coupled stiffness terms need to be modelled. Using these observations, a much simplified 6 degrees-of-freedom (DoF) linearized eddy current dynamic force model can be used to compute the steady-state force changes in eddy current based maglev vehicles when operating over a wide uniform conductive track

Management education and the ethical mindset: Responsibility to whom and for what?

Paper presented at the European Business Ethics Network (UK) Conference, Ethics in Crisis: a call for alternatives, April 7-9, 2010 at Queen Mary, University of London. Final version published by Springer in Journal of Business Ethics. Original title: Management education and the ethical mindset: Responsibility to whom and for what? Available online at http://www.springer.com/This paper offers an analysis of leadership responsibility associated with differing models of the firm. Following a critique of the classical economic and conventional stakeholder theories of the firm, we proposes an interactive stakeholder theory that better facilitates the kind of ethical responsibility demanded by twenty-first century challenges. Our analysis also leads us to conclude that leadership education and development is in need of urgent reform. The first part of the paper focuses on what it means to lead responsibly, and argues that leading is essentially the practice of responsibility. The second part of the paper challenges standard assumptions about the ‘business of business’, while the third section examines in more depth how leadership education might be configured as a preparation for the enactment of responsible leadership. KEYWORDS: responsible leadership, ethics, leadership education, mindsets, stakeholder theor

Modulation of medical condition likelihood by patient history similarity

Introduction: We describe an analysis that modulates the simple population prevalence derived likelihood of a particular condition occurring in an individual by matching the individual with other individuals with similar clinical histories and determining the prevalence of the condition within the matched group. Methods: We have taken clinical event codes and dates from anonymised longitudinal primary care records for 25,979 patients with 749,053 recorded clinical events. Using a nearest neighbour approach, for each patient, the likelihood of a condition occurring was adjusted from the population prevalence to the prevalence of the condition within those patients with the closest matching clinical history. Results: For conditions investigated, the nearest method performed well in comparison with standard logistic regression. Conclusions: Results indicate that it may be possible to use histories to identify ‘similar’ patients and thus to modulate future likelihoods of a condition occurring

Modulation of Medical Condition Likelihood by Patient History Similarity

Introduction: We describe an analysis that modulates the simple population prevalence derived likelihood of a particular condition occurring in an individual by matching the individual with other individuals with similar clinical histories and determining the prevalence of the condition within the matched group. Methods: We have taken clinical event codes and dates from anonymised longitudinal primary care records for 25,979 patients with 749,053 recorded clinical events. Using a nearest neighbour approach, for each patient, the likelihood of a condition occurring was adjusted from the population prevalence to the prevalence of the condition within those patients with the closest matching clinical history. Results: For conditions investigated, the nearest method performed well in comparison with standard logistic regression. Conclusions: Results indicate that it may be possible to use histories to identify \u27similar\u27 patients and thus to modulate future likelihoods of a condition occurring

Quantum Sensing of Single Phonons via Phonon Drag in Two-Dimensional Materials

The capacity to electrically detect phonons, ultimately at the single-phonon limit, is a key requirement for many schemes for phonon-based quantum computing, so-called quantum phononics. Here, we predict that by exploiting the strong coupling of their electrons to surface-polar phonons, van der Waals heterostructures can offer a suitable platform for phonon sensing, capable of resolving energy transfer at the single-phonon level. The geometry we consider is one in which a drag momentum is exerted on electrons in a graphene layer, by a single out-of-equilibrium phonon in a dielectric layer of hexagonal boron nitride, giving rise to a measurable induced voltage ($V_{\rm drag}$). Our numerical solution of the Boltzmann Transport Equation shows that this drag voltage can reach a level of a few hundred microvolts per phonon, well above experimental detection limits. Furthermore, we predict that $V_{\rm drag}$ should be highly insensitive to the mobility of carriers in the graphene layer and to increasing the temperature to at least 300 K, offering the potential of a versatile material platform for single-phonon sensing.Comment: 13 pages, 6 figure

Supporting Cells Eliminate Dying Sensory Hair Cells to Maintain Epithelial Integrity in the Avian Inner Ear

Epithelial homeostasis is essential for sensory transduction in the auditory and vestibular organs of the inner ear, but how it is maintained during trauma is poorly understood. To examine potential repair mechanisms, we expressed beta-actin-enhanced green fluorescent protein (EGFP) in the chick inner ear and used live-cell imaging to study how sensory epithelia responded during aminoglycoside-induced hair cell trauma. We found that glial-like supporting cells used two independent mechanisms to rapidly eliminate dying hair cells. Supporting cells assembled an actin cable at the luminal surface that extended around the pericuticular junction and constricted to excise the stereocilia bundle and cuticular plate from the hair cell soma. Hair bundle excision could occur within 3 min of actin-cable formation. After bundle excision, typically with a delay of up to 2-3 h, supporting cells engulfed and phagocytosed the remaining bundle-less hair cell. Dual-channel recordings with beta-actin-EGFP and vital dyes revealed phagocytosis was concurrent with loss of hair cell integrity. We conclude that supporting cells repaired the epithelial barrier before hair cell plasmalemmal integrity was lost and that supporting cell activity was closely linked to hair cell death. Treatment with the Rho-kinase inhibitor Y-27632 did not prevent bundle excision but prolonged phagocytic engulfment and resulted in hair cell corpses accumulating within the epithelium. Our data show that supporting cells not only maintain epithelial integrity during trauma but suggest they may also be an integral part of the hair cell death process itself