The Liverpool Care Pathway

For many practising doctors, especially in general practice or in general internal medicine, decisions at the end of life are often some of the most difficult. Not only is decision making difficult, but implementation may create a further set of problems. Most of us are orientated to doing something – usually something that is active, promoting life or health. Many end of life decisions demand something different: the acceptance that life is coming to an end and that the quality of the final phase of the patient’s illness is to offer a good death. The doctor must reorientate his or her thinking to a different, less distinct target. Reference to the the development of the Liverpool Care Pathway for the dying patient (LCP).peer-reviewe

Analysis of quantification methods used for cell viability, cell morphology, and synaptic formation in modeling HIV associated dementia in primary neuronal cultures.

Change is inevitable, changes in neuronal function occur in physiologic and pathologic processes. The ability to reliably analyze and quantify those changes in neuronal morphology and function has been an important part of technical developments in Neuroscience. A key innovation in the Neuroscience was the development of primary neuronal cultures. Primary neuronal cultures allow neurons to be dissociated and studied as individual components. The study of specific pathologic processes associated with neurodegeneration have benefited greatly from the development and characterization of dissociated primary neuronal cultures. Human Immunodeficiency Virus can lead to a neurodegenerative process. Establishing a consistent model for studying the effects of HIV infection in the brain has provided a unique challenge. The use of analysis of quantification of neuronal changes in dissociated primary neurons modeling HIV dementia has proven useful. As the study of this disorder continues the characterization of the model system will become increasing important. This review will focus on analysis of specific techniques used to quantify specific changes in neurons in this model system. As this field moves forward it will be important to specifically focus on techniques involved in cell viability, morphologic changes, and synaptic formatio

The Impacts of the New Zealand Emissions Trading Scheme on Economic and Environmental Factors

New Zealand implemented an emissions trading scheme, the NZ ETS, to regulate the production of Greenhouse Gases. This ETS is the first of its kind to include the agricultural sector, as is expected to significantly raise costs to both producers and consumers. The aim of the paper is to assess the potential impact of the New Zealand ETS on the economy and the environment. The paper reports first on the development and nature of the legislation itself, and then continues by mapping the cost of the ETS on producers, and then furthermore the transfer of these costs as increased prices. Then by utilising the Lincoln Trade and Environment Model, or LTEM, a partial equilibrium model which forecasts international trade and domestic production and consumption of agricultural commodities, a number of scenarios revolving around the NZ ETS are projected. The paper finally presents the results gathered from the LTEM, showing the impact of the NZ ETS on both the production of agricultural commodities, and the production of GHGs by the industry. These results demonstrate the potential cost of the NZ ETS on the agricultural sector, and its ability to reduce emissionsEnvironmental Economics and Policy,

On exceptional groups of order p^5

A finite group G is exceptional if it has a quotient Q whose minimal faithful permutation degree is greater than that of G. We say that Q is a distinguished quotient. The smallest examples of exceptional p-groups have order p^5. For an odd prime p, we classify all pairs (G,Q) where G has order p^5 and Q is a distinguished quotient. (The case p=2 has already been treated by Easdown and Praeger.) We establish the striking asymptotic result that as p increases, the proportion of groups of order p^5 with at least one exceptional quotient tends to 1/2.Comment: 23 page

Computational periscopy with an ordinary digital camera

Computing the amounts of light arriving from different directions enables a diffusely reflecting surface to play the part of a mirror in a periscope—that is, perform non-line-of-sight imaging around an obstruction. Because computational periscopy has so far depended on light-travel distances being proportional to the times of flight, it has mostly been performed with expensive, specialized ultrafast optical systems^1,2,3,4,5,6,7,8,9,10,11,12. Here we introduce a two-dimensional computational periscopy technique that requires only a single photograph captured with an ordinary digital camera. Our technique recovers the position of an opaque object and the scene behind (but not completely obscured by) the object, when both the object and scene are outside the line of sight of the camera, without requiring controlled or time-varying illumination. Such recovery is based on the visible penumbra of the opaque object having a linear dependence on the hidden scene that can be modelled through ray optics. Non-line-of-sight imaging using inexpensive, ubiquitous equipment may have considerable value in monitoring hazardous environments, navigation and detecting hidden adversaries.We thank F. Durand, W. T. Freeman, Y. Ma, J. Rapp, J. H. Shapiro, A. Torralba, F. N. C. Wong and G. W. Wornell for discussions. This work was supported by the Defense Advanced Research Projects Agency (DARPA) REVEAL Program contract number HR0011-16-C-0030. (HR0011-16-C-0030 - Defense Advanced Research Projects Agency (DARPA) REVEAL Program)Accepted manuscrip

Bank equity stakes in borrowing firms and financial distress

The authors derive optimal financial claim for a bank when the borrowing firm's uninformed stakeholders depend on the bank to establish whether the firm is distressed and whether concessions by stakeholders are necessary. The bank's financial claim is designed to ensure that it cannot collude with a healthy firm's owners to seek unnecessary concessions or to collude with a distressed firm's owners to claim that the firm is healthy. To prove that a request for concessions has not come from a healthy firm/bank coalition, the bank must hold either a very small or a very large equity stake when the firm enters distress. To prove that a distressed firm and the bank have not colluded to claim that the firm is healthy, the bank may need to hold equity under routine financial conditions.Bank loans ; Bank investments ; Investments

Elasticity, fluctuations and vortex pinning in ferromagnetic superconductors: A "columnar elastic glass"

We study the elasticity, fluctuations and pinning of a putative spontaneous vortex solid in ferromagnetic superconductors. Using a rigorous thermodynamic argument, we show that in the idealized case of vanishing crystalline pinning anisotropy the long-wavelength tilt modulus of such a vortex solid vanishes identically, as guaranteed by the underlying rotational invariance. The vanishing of the tilt modulus means that, to lowest order, the associated tension elasticity is replaced by the softer, curvature elasticity. The effect of this is to make the spontaneous vortex solid qualitatively more susceptible to the disordering effects of thermal fluctuations and random pinning. We study these effects, taking into account the nonlinear elasticity, that, in three dimensions, is important at sufficiently long length scales, and showing that a ``columnar elastic glass'' phase of vortices results. This phase is controlled by a previously unstudied zero-temperature fixed point and it is characterized by elastic moduli that have universal strong wave-vector dependence out to arbitrarily long length scales, leading to non-Hookean elasticity. We argue that, although translationally disordered for weak disorder, the columnar elastic glass is stable against the proliferation of dislocations and is therefore a topologically ordered {\em elastic} glass. As a result, the phenomenology of the spontaneous vortex state of isotropic magnetic superconductors differs qualitatively from a conventional, external-field-induced mixed state. For example, for weak external fields $H$, the magnetic induction scales {\em universally} like $B(H)\sim B(0)+ c H^{\alpha}$, with $\alpha\approx 0.72$.Comment: Minor editorial changes, version to be published in PRB, 39 pages, 7 figure

"Soft" Anharmonic Vortex Glass in Ferromagnetic Superconductors

Ferromagnetic order in superconductors can induce a {\em spontaneous} vortex (SV) state. For external field ${\bf H}=0$, rotational symmetry guarantees a vanishing tilt modulus of the SV solid, leading to drastically different behavior than that of a conventional, external-field-induced vortex solid. We show that quenched disorder and anharmonic effects lead to elastic moduli that are wavevector-dependent out to arbitrarily long length scales, and non-Hookean elasticity. The latter implies that for weak external fields $H$, the magnetic induction scales {\em universally} like $B(H)\sim B(0)+ c H^{\alpha}$, with $\alpha\approx 0.72$. For weak disorder, we predict the SV solid is a topologically ordered vortex glass, in the ``columnar elastic glass'' universality class.Comment: minor corrections; version published in PR