Withholding, discontinuing and withdrawing medications in dementia patients at the end of life:a neglected problem in the disadvantaged dying?

Recent years have seen a growing recognition that dementia is a terminal illness and that patients with advanced dementia nearing the end of life do not currently receive adequate palliative care. However, research into palliative care for these patients has thus far been limited. Furthermore, there has been little discussion in the literature regarding medication use in patients with advanced dementia who are nearing the end of life, and discontinuation of medication has not been well studied despite its potential to reduce the burden on the patient and to improve quality of life. There is limited, and sometimes contradictory, evidence available in the literature to guide evidence-based discontinuation of drugs such as acetylcholinesterase inhibitors, antipsychotic agents, HMG-CoA reductase inhibitors (statins), antibacterials, antihypertensives, antihyperglycaemic drugs and anticoagulants. Furthermore, end-of-life care of patients with advanced dementia may be complicated by difficulties in accurately estimating life expectancy, ethical considerations regarding withholding or withdrawing treatment, and the wishes of the patient and/or their family. Significant research must be undertaken in the area of medication discontinuation in patients with advanced dementia nearing the end of life to determine how physicians currently decide whether medications should be discontinued, and also to develop the evidence base and provide guidance on systematic medication discontinuation.

New Results for the MAP Problem in Bayesian Networks

This paper presents new results for the (partial) maximum a posteriori (MAP) problem in Bayesian networks, which is the problem of querying the most probable state configuration of some of the network variables given evidence. First, it is demonstrated that the problem remains hard even in networks with very simple topology, such as binary polytrees and simple trees (including the Naive Bayes structure). Such proofs extend previous complexity results for the problem. Inapproximability results are also derived in the case of trees if the number of states per variable is not bounded. Although the problem is shown to be hard and inapproximable even in very simple scenarios, a new exact algorithm is described that is empirically fast in networks of bounded treewidth and bounded number of states per variable. The same algorithm is used as basis of a Fully Polynomial Time Approximation Scheme for MAP under such assumptions. Approximation schemes were generally thought to be impossible for this problem, but we show otherwise for classes of networks that are important in practice. The algorithms are extensively tested using some well-known networks as well as random generated cases to show their effectiveness.

An optimal scheduling problem in distribution networks considering V2G

This paper addresses the problem of energy resource scheduling. An aggregator will manage all distributed resources connected to its distribution network, including distributed generation based on renewable energy resources, demand response, storage systems, and electrical gridable vehicles. The use of gridable vehicles will have a significant impact on power systems management, especially in distribution networks. Therefore, the inclusion of vehicles in the optimal scheduling problem will be very important in future network management. The proposed particle swarm optimization approach is compared with a reference methodology based on mixed integer non-linear programming, implemented in GAMS, to evaluate the effectiveness of the proposed methodology. The paper includes a case study that consider a 32 bus distribution network with 66 distributed generators, 32 loads and 50 electric vehicles.

Heuristics for the Critical Node Detection Problem in Large Complex Networks

Complex networks have recently attracted a significant amount of research attention due to their ability to model real world phenomena. One important problem often encountered is to limit diffusive processes spread over the network, for example mitigating pandemic disease or computer virus spread. A number of problem formulations have been proposed that aim to solve such problems based on desired network characteristics, such as maintaining the largest network component after node removal. The recently formulated critical node detection problem aims to remove a small subset of vertices from the network such that the residual network has minimum pairwise connectivity. Unfortunately, the problem is NP-hard and also the number of constraints is cubic in number of vertices, making very large scale problems impossible to solve with traditional mathematical programming techniques. Even many approximation algorithm strategies such as dynamic programming, evolutionary algorithms, etc. all are unusable for networks that contain thousands to millions of vertices. A computationally efficient and simple approach is required in such circumstances, but none currently exist. In this thesis, such an algorithm is proposed. The methodology is based on a depth-first search traversal of the network, and a specially designed ranking function that considers information local to each vertex. Due to the variety of network structures, a number of characteristics must be taken into consideration and combined into a single rank that measures the utility of removing each vertex. Since removing a vertex in sequential fashion impacts the network structure, an efficient post-processing algorithm is also proposed to quickly re-rank vertices. Experiments on a range of common complex network models with varying number of vertices are considered, in addition to real world networks. The proposed algorithm, DFSH, is shown to be highly competitive and often outperforms existing strategies such as Google PageRank for minimizing pairwise connectivity.

Studies on some generalizations of line graph and the power domination problem in graphs

Department of Mathematics, Cochin University of Science and Technology

Isp Knowledge Portal : A Resource Discovery Tool In Optics

The need to structure knowledge is as important now as it ever has been. This paper has tried to study the ISP knowledge portal to explore how knowledge on various resources and topics in photonics and related areas are organized in the knowledge portal of International School of Photonics, CUSAT. The study revealed that ISP knowledge portal is one of the best portals in the filed. It provides a model for building an effective knowledge portal in other fields

Application of discriminant function analysis and change-point problem in dating volcanic ashes

The application of Discriminant function analysis (DFA) is not a new idea in the study of tephrochrology. In this paper, DFA is applied to compositional datasets of two different types of tephras from Mountain Ruapehu in New Zealand and Mountain Rainier in USA. The canonical variables from the analysis are further investigated with a statistical methodology of change-point problems in order to gain a better understanding of the change in compositional pattern over time. Finally, a special case of segmented regression has been proposed to model both the time of change and the change in pattern. This model can be used to estimate the age for the unknown tephras using Bayesian statistical calibration

SB.TV's successful yet unconventional establishment of a Brand based solely on Social Network Success may present a problem in long-term survival

Research Proposal in SB.TV case study. New dimension to brand model for Web 2.0 success

The point source method for inverse scattering in the time domain

Many recent inverse scattering techniques have been designed for single frequency scattered fields in the frequency domain. In practice, however, the data is collected in the time domain. Frequency domain inverse scattering algorithms obviously apply to time-harmonic scattering, or nearly time-harmonic scattering, through application of the Fourier transform. Fourier transform techniques can also be applied to non-time-harmonic scattering from pulses. Our goal here is twofold: first, to establish conditions on the time-dependent waves that provide a correspondence between time domain and frequency domain inverse scattering via Fourier transforms without recourse to the conventional limiting amplitude principle; secondly, we apply the analysis in the first part of this work toward the extension of a particular scattering technique, namely the point source method, to scattering from the requisite pulses. Numerical examples illustrate the method and suggest that reconstructions from admissible pulses deliver superior reconstructions compared to straight averaging of multi-frequency data. Copyright (C) 2006 John Wiley & Sons, Ltd.

A parallel genetic algorithm for the Steiner Problem in Networks

This paper presents a parallel genetic algorithm to the Steiner Problem in Networks. Several previous papers have proposed the adoption of GAs and others metaheuristics to solve the SPN demonstrating the validity of their approaches. This work differs from them for two main reasons: the dimension and the characteristics of the networks adopted in the experiments and the aim from which it has been originated. The reason that aimed this work was namely to build a comparison term for validating deterministic and computationally inexpensive algorithms which can be used in practical engineering applications, such as the multicast transmission in the Internet. On the other hand, the large dimensions of our sample networks require the adoption of a parallel implementation of the Steiner GA, which is able to deal with such large problem instances.

'A load too heavy': Critical reflections on the child labor problem in Africa's small-scale mining sector

This paper provides an extended analysis of the child labor problem in the artisanal and small-scale mining (ASM) sector, focusing specifically on the situation in sub-Saharan Africa. In recent years, the issue of child labor in ASM has garnered significant attention from the International Labor Organization (ILO), which has been particularly active in raising public awareness of the problem; and, has proceeded to implement policies and collaborative project work aimed at Curtailing children's participation in ASM activities in a number of African countries. The analysis concludes with a critical appraisal of an ILO project recently launched in the Talensi-Nabdam District in the Upper East Region of Ghana, which sheds light on how the child labor problem is being tackled in practice in ASM communities in sub-Saharan Africa. (c) 2008 Elsevier Ltd. All rights reserved.