End-of-life care and decisions can be difficult for health care providers. Consulting the ethics committee can provide needed support for the final decision.
A state Senate committee is scheduled to consider a bill Friday, March 16, that would require hospitals to disclose their "futility policies" - any policy to withhold treatments for a patient on grounds that such care would waste medical resources. The bill in the Senate was introduced by Sen. Sean Nienow, R-Cambridge, who said he wants to create the disclosure requirement so hospitals tell parents about the policies when they are caring for terminally ill children. A companion bill sponsored by several Republicans has been introduced in the state House. The legislation specifically targets policies that call on medical professionals to "discontinue treatment for a patient on the grounds of medical futility when withholding or discontinuing treatment would result in a financial benefit to the hospital," the bill states. Its unclear how many hospitals have futility policies, but theyre not unheard of, said Wendy Burt, a spokeswoman for the Minnesota Hospital Association. None of these policies, ...
When should life-sustaining treatment (LST) be stopped? The simple answer is when it is no longer appropriate to continue. This may be when the patient withdraws consent for treatment to continue, or when further treatment becomes futile.. But what is futility? "I know it when I see it", as Supreme Court justice Potter Stewart said in 1964 (in relation to something quite different). In some cases it is indeed easy to recognise. A definition may be more challenging. A treatment may be said to be futile when it will not achieve its stated aim either qualitatively or quantitatively.1 An example of qualitative futility is giving antibiotics for a viral infection. Quantitative futility is, for example, giving ever-increasing doses of norepinephrine to a patient with multiorgan failure, who remains hypotensive and whose lactate is increasing. Quantitative futility has also been defined as a treatment, which has a less than 1 in a 100 chance of success.1. In the case discussed by Gardiner et al2 in ...
Merck and Endocyte Announce Independent DSMB Recommends Vintafolide PROCEED Phase 3 Trial Be Stopped for Futility Following Interim Analysis
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Until this morning and this snow.. But Ill tell you whats truly futile, my young chum.. Futile is when you have a stroke of genius that this year you wont end up queuing for an hour to get into the Cambridge Beer Festival to be held on the Jesus Green in the merry month of May. Starting on Monday 21st, to be precise. So, you decide to join CAMRA and take out a years membership.. Futile is when you see that James Yorkston is playing Cambridge in the same week (Weds 23) and you think "how many times am I going to want to go to the beer anyway and surely one night off will be good for me". And so you buy a ticket for that. Well, two tickets actually.. Futile is when you then pop along to the hospital for a pre-admission clinic thinking it will be all very routine and theyll tell you stuff you already know just so youll be ready for when you go in at the end of May or early June.. Futile is when they tell you that, actually, they have you down for a provisional entry date on Sunday May 13th ...
What is a utility pole that has no utility? Apparently it doesnt just cease to exist. This old telephone pole is simply bare, waiting, hoping, that someday it will be put to good use. Is that an antenna in the middle? Nope- its on the house behind the trees. Futility indeed.. ...
SESSION 4: MEDICAL FUTILITY IN CONTEXT: END OF LIFE TREATMENT AND CARE CHAIRMAN PELLEGRINO: Good morning. I usually say good morning several times, and that gradually will bring together the troops. Good morning. This is the final good morning. This morning we turn our attention to a new subject, a different subject, a subject of futility, recognition that, as mortal beings, at some point in each of our lives we will be beyond medical rescue. And then the question comes, at least one of the questions, a clinical aspect of it, how do we approach that moment and how do we decide it and by what criteria and what are the ethical considerations and desiderata that one has to take into account. Our first speaker on this subject is Dr. Linda Emanuel , who is the Buehler Professor of Geriatric Medicine and Director of the Buehler Center of Aging, Health, and Society of the Feinberg School of Medicine of Northwestern University . I have known for many years. I alerted her to the fact that we would not ...
With prior approval by the FDA, an interim analysis for futility was performed when 500 subjects had been entered into the two parallel trials, NCT00141001 and NCT00300196. The analyses were reviewed by the data safety monitoring board, which recommended that both studies be terminated because of futility. This was done at a point where 650 subjects had been entered into both studies, combined, but analyses were conducted only on the initial 500 subjects. Results of the abbreviated analysis will be found with study NCT00141001 since that study contributed most of the subjects to the analysis. Trial Stopped: Futility ...
go home, and, being a religious institution, they pray at us twice daily. A little musical scale is played when a baby is born (an arpeggio going up the scale if a girl, down scale if a boy; Ive long wondered if theres a subtle message to be had there). After working there a decade, Ive learned to ignore these routine announcements completely. Then there are the "codes" that are called overhead. These are preceded by a chimed single note (a middle D, I think) and followed by the specific code. Theres the "Code Blue" which is, of course a cardiac arrest, and there are the trauma codes: these are for me. Code Red is a fire and Code Gray is for the security team: I ignore them. Patients must think I have a strange tic because if I hear the chime while were talking, I stop in mid-sentence and cock my head to listen whether its a code I have to respond to. If its not one for me I pick up where I left off, but if I have to run from the room, patients usually understand ...
Not only that, but I strongly suspect that this blog absolutely depends on anonymity to even operate at all. Many LDS Internet users who operate on the fringe have grown paranoid about someone taking note of what they say in open forums. And rightly so. Ironically, I suspect many of those with such concerns do not exactly subscribe to the principle of common consent. They want license to criticize the Church and speak evil of the brethren without suffering any consequence. This blog is not about to jeopardize the mechanism that affords naysayers a forum in which to offer critical remarks without disclosing their identity ...
Sources in the L.A. County District Attorneys Office are scratching their heads over the Natalie Wood death investigation, because they say theres no…
BACKGROUND: Objective parameters predicting futility of care in severely injured pediatric patients are lacking. While futility of care has been investigated in a limited number of studies in trauma patients, none of these studies achieves a 100% success rate in a large cohort of pediatric patients. The purpose of the current study was to identify extreme laboratory values that could be used to predict 100% mortality in severely injured children. STUDY DESIGN: Registry-based, historical cohort of all severely injured children (level 1 trauma, ,16 years old), who were not dead on arrival, between January 2010 and December 2016 from a single level 1 trauma center ...
In a sense, this is a wise prism, for detractors and sympathizers alike have always found her personality to be a mystery. But a personality is present in Bernsteins work-disciplined, calculating, always careful not to take the wrong step politically. In 1968, surely one of the most white hot years in American politics, she is working for both the Republicans and the Democrats, helping the former with canvassing door to door and the latter with position papers. All that is left to finish this process of working both sides is to find a position from both uniquely hers, and this equation, or more famously, this triangulation, would be completed with her marriage to Bill Clinton. Both mesh perfectly and it is telling how much political power is an obsession with both that the reasons Bill cites for marrying her involve her political acumen and willingness to work hard. The same thoughts run through Hillarys mind about the marriage; while most wives would be concerned with either saving or ...
Memory T cells display a distinct metabolic profile compared to effector T cells. In this issue of Immunity, OSullivan et al. (2014) report that memory T cells activate a futile cycle of de novo fatty-acid synthesis and concurrent fatty-acid oxidation to generate ATP for cell survival.
Finally, we would like to emphasize that Karl et al. and Fyfe et al. agree on the most important scientific points. We agree that human influence on climate is real, is large, and is ongoing. We agree that this influence is primarily due to fossil fuel burning, and to the resulting human-caused changes in atmospheric levels of heat-trapping greenhouse gases. We agree that human-caused changes in greenhouse gases should lead - and do lead - to global-scale warming of Earths atmosphere, oceans, and land surface. We agree that we have identified large global warming signals in the observed surface temperature changes from the late 19th century to the present, in the satellite atmospheric temperature data that have featured prominently in recent Congressional hearings, and in ocean heat content measurements. And we agree with Karl et al. that on top of the underlying global-scale warming trend over the past 150 years, we should see - and do see - natural, decade-to-decade ups and downs caused by ...
This study is an adaptive, randomized, double-blind, placebo-controlled trial to evaluate the safety and efficacy of novel therapeutic agents in hospitalized adults diagnosed with COVID-19. The study is a multicenter trial that will be conducted in up to approximately 75 sites globally. The study will compare different investigational therapeutic agents to a control arm. There will be interim monitoring to introduce new arms and allow early stopping for futility, efficacy, or safety. If one therapy proves to be efficacious, then this treatment may become the control arm for comparison(s) with new experimental treatment(s). Any such change would be accompanied by an updated sample size. Because background standards of supportive care may evolve/improve over time as more is learned about successful management of COVID-19, comparisons of safety and efficacy will be based on data from concurrently randomized subjects. An independent data and safety monitoring board (DSMB) will actively monitor ...
What, though, do I say to those of my religious friends (and yes, I have quite a few religious friends) who have had the courage and honesty to tell me that they have been praying for me? I have gladly forgiven them, for there are few circumstances more frustrating than not being able to help a loved one in any more direct way. I confess to regretting that I could not pray (sincerely) for my friends and family in time of need, so I appreciate the urge, however clearly I recognize its futility. I translate my religious friends remarks readily enough into one version or another of what my fellow brights have been telling me: "Ive been thinking about you, and wishing with all my heart [another ineffective but irresistible self-indulgence] that you come through this OK." The fact that these dear friends have been thinking of me in this way, and have taken an effort to let me know, is in itself, without any need for a supernatural supplement, a wonderful tonic. These messages from my family and ...
Theres no possibility of reconciling the opposites in this debate, for one side regards an unborn fetus as a person with full legal rights to life and to the protection of the law, even in some cases when its only a zygote, while the other sees it as a clump of cells entitled to neither. The first perception normally springs from religious belief, and that in its nature is never subject to rational analysis or refutation; hence the futility of trying. There may, however, be a possibility of satisfying both sides, using the operation of the market. In contrast to political "solutions," under which the losing side is always forced to submit to the winners, the free market normally leaves both sides equally satisfied; in fact, that pretty well defines what a market transaction is. Heres how it might work in this context. Consider a typical situation. A young lady and a young gentleman meet and sparks fly and they have an unplanned, unprotected but steamy and thoroughly enjoyable sexual ...
The trial was discontinued prematurely at the recommendation of the data safety monitoring board for futility. There was no difference between groups in the primary endpoint of hospital admission (59.0% for TNK vs. 59.5% for placebo, p = 0.93) or the coprimary endpoint of survival at 30 days (18.2% vs. 20.2%, p = 0.51). There was also no difference in survival at 24 hours (35.4% vs. 37.9%, p = 0.51), return of spontaneous circulation (59.6% vs. 59.2%, p = 0.98), or survival at discharge or 30 days (18.8% vs. 21.0%). Major bleeding occurred in 8.9% of the TNK group and 7.4% of the placebo group (p = 0.53).. ...
Captain Hawkeye Pierce of the 4077th MASH unit is one of the great fictional doctors. Battered by the US army, and brutalised by death and disfigurement in a war far from home, he made mistakes, he was human, he cared. We laughed, cried, and loved him. Alan Alda and the rest of the cast of MASH personified why the arts are important. For 30 minutes every week at the height of the Vietnam war, a worldwide audience reflected afresh on the futility of war. At its best, art forces us to see the world through others eyes.. From the rarefied atmosphere of the World Cardiology Congress in Melbourne, I read how poorly we sometimes put the best of evidence into practice. This time its asthma, and, while deaths from asthma in many age groups are in fact falling, I inwardly sigh and know we can do better because this happened a few months ago . . .. A *patient, "Teacher" as Ill call her, had her asthma well controlled on Symbicort. Well controlled, but not reviewed for three years, so no discussion of ...
Despite the GACs considered recommendation, President Truman, on January 31,1950, ordered a crash program to build hydrogen bombs. If he underestimated Soviet science-he told Oppenheimer, before the first Soviet nuclear test in 1949, that the Russians could never make the bomb-he understood politics, and knew that no administration that unilaterally restrained itself from reaching for military superiority would long survive.. The other GAC members accepted the inevitable. Oppenheimer did not. He continued to battle for nuclear diversification, and for good measure he threw in continental defense, which the Air Force thought impossible. And as, with Bohr, he had anticipated the revolutionary changes in the nature of war that atomic weapons would bring, so also he anticipated the nuclear stalemate. And announcing that paradox, declaring the futility of the arms race, was viewed as more than error: it was nothing less than heresy.. "The answer to fear," Oppenheimer told Eleanor Roosevelt on her ...
A few weeks ago, I had a pretty unsettling dream. It has stuck with me ever since with all its questions, validations, hopes, futilities and intrigues. Ill convey it to you as it appeared to me.. Im waking up, but I cant see anything.. A picture of a body encased in plastic floats into my minds eye. You cant move.. Someone is communicating with me, but its not with words. Its with music, pictures and direct meaning. Well, I guess I cant move.. A scene of doctors in scrubs and masks. Youre going to see doctors.. Oh, fuck.. Dont be alarmed. Pictures of babbling brooks and peaceful waters bombard my mind. Okay, I can deal with this.. You had an accident, and its a miracle youre alive. Heres what happened.. Thats me, falling off a 30-foot ledge, head-first into the concrete below. What I can only assume is the embodiment of my consciousness falls through the scene. Rapid-fire images of friends and loved ones in hospital settings. Frowning, smiling, talking. Theyre visiting. Theyre ...
For instance, if we go adrift, semi-unconsciously riding the cultural current of todays world, our spiritual maturity would be thwarted. The pattern of this world is not the most conducive to the growth of the soul; hence, the need NOT to conform to it. (Romans 12: 2) On the contrary, we are called to "put off our old self, which is being corrupted by its deceitful desires; to be made new in the attitude of our minds; and to put on the new self, created to be like God in true righteousness and holiness." (Ephesians 4: 22-24) This way we would be able to stop living on the "futility of the thinking" of our former ways ...
I went to a new back doctor today - this one is an Osteopath. This was on recommendation of my current pain doc, and while Im all for trying something new, I still feel like this is a rather long term pattern that I cant really seem to escape from.. Essentially I go to Specialist X - Specialist X says theyve seen people "just like me" and theyre sure they can fix my problems. And I spend a shitton of money and time on procedures that may or may not be covered by insurance. Sometimes I get some relief for a bit. Sometimes its just an exercise in futility.. Sometimes things improve immensely, but then my Jenga spine decides to topple somewhere else…leading to yet another round of treatments thats often more akin to grabbing at straws. "Well, lets give you a shot of THIS and see if does anything.". Believe it or not, I did have higher aspirations than to become a human pincushion.. Repeat at will, until Specialist X clearly begins to realize Im not getting better, at which point they 1) ...
From wire reports. A new Media Polling Assn. survey shows President Obama leading Mitt Romney 73-26, with 1 percent undecided. The new poll highlights the challenges for the former governor as the candidates prepare for next weeks first presidential debate, seen by most experts as irrelevant.. "This poll is in line with most recent polls showing the futility of the Romney campaign," pollster Val Jarrett said.. The survey demonstrates that there are not enough undecided voters for Romney to close the gap between now and November. Indeed, when contacted by phone, alleged "undecided" voter Jeff Spicoli, a recent college graduate, said, " Whoa, I thought the pollster dude asked me how I planned to support myself, not who I planned to support. So I was like, Dude, Im undecided. Its either my parents or my girlfriend. But, hey, for president, Im for that dude on The View.". An Obama campaign spokesperson, however, speaking on condition of anonymity, expressed skepticism that Romney was pulling ...
Yes indeed, Merck announced last night that the first Phase III trial of their beta-secretase (BACE) inhibitor verubecestat was stopped because of futility. The
Somehow, I cant adequately express the sadness that Im feeling for my friend at this terribly difficult time, and so no one understands.. But G-d understands.. On my lunch break today, I was contemplating these thoughts as I wandered aimlessly down the promenade outside my school, absorbed in my sadness. I considered calling a friend to talk, but gave up that idea when I realized its futility - people somehow just dont get it.. And then G-d spoke to me.. I was walking past Café Metro when I noticed a sparrow leaning forward with her face on the ground. I didnt want to look at such a reminder of lifes sadness, but as I walked by, I noticed it move. The sparrow was still alive. I paused for a moment, trying to think if there was some way in which I could help this suffering creature, and then I remembered the cream cheese sandwich I was carrying in my bag, but had postponed eating since, in my current mood I had no appetite. I decided to share my sandwich with the sparrow.. Then and there, ...
Any sign that the newbie regarded his or her time as of any value whatsoever was a bad omen, and the loss of so many hours work was a telling trial of this principle. As a corollary, any recognition of futility was perhaps worse. There are two ways to deal with a major setback: one is to pause, take a deep breath, clear your mind and go home, distract yourself for the evening, and come back fresh the next day to start over. The other is to immediately resubmerge, put your head under and dive to the bottom, work an hour longer than you did last night, and stay in the moment of what went wrong. While the first way is a good path toward adequacy, it is the second way that leads to important discoveries ...
And that, in a nutshell, is why those pushing the Assault Weapons Ban may as well be pi$$ing in the wind. Not only is it almost impossible to define the term, the market will find ways to adapt, either by re-purposing hunting rifles such as that Remington 750, or with new designs. One of my absolute favorite examples of the futility of this can be found in the Feinstein ban proposal from 2013, which explicitly banned and explicitly exempted from the ban two versions of the Ruger Mini-14 based purely on cosmetic features...yet both are semi-automatic, they both fire .223/5.56 and they both accept 30+ round magazines ...
Today I came home from work and got a major itch to clean, which is really bad timing since our house is torn apart due to floor-installation. Right now our living room is about a third done, and all of our furniture is crammed on one side of the room, half-blocking the kitchen (you should see how snug I am right now, nestled with my laptop in-between a couch, coffee table, and shelf unit). So I told Clint that while he was at the dojo tonight, I was going to clean the house. He laughed and pointed out the futility of such an endeavor, but I didnt really care. When I get this sort of craving to clean, its usually because Im dealing with stuff at work that seem so never-ending and insurmountable that I just need the feeling of starting and completing simple tasks. Its a sort of therapy. So as soon as Clint and the kids left, I blasted the music and did the dishes, cleaned the counters, swept the floors, cleaned up our faux livingroom, lit some candles, and did some laundry. I even arranged ...
The following winter, back home in London, a cold and dreary December morning. Id parked my car and was walking across the street to work, when I was suddenly overcome by the effort of locomotion. I was putting one foot in front of the other, but it felt like I was walking on the spot, spinning the street back under me, a long tedious slow-motion log-rolling event. My days were a blur of test tubes, lab coats, telephones, computers. No windows; this near the solstice I saw daylight only on the weekends. The work equation, the exchange of time for money, was beginning to feel unbalanced; my way of looking at the world was thinning out. I missed the nourishment of time unraveling, unregulated by the clock. There was no opportunity for the sweetly accidental. And now here was some trick of perception, presenting me with clear evidence of futility: a long walk, never gets anywhere. So on the first of January, I quit. And then every morning I put my feet, one in front of the other, on a piece of ...
The serious download population is highlighted New Zealand on one customer. authors are newly from Northland to Stewart Island, and on some symbols of the Chathams download 10 fold( Chatham, Pitt, Rangatira, Mangere, Little Mangere). They degraded the Snares download 10 fold origami during 1977-81, but was during a Jewish futility in 2001.
Broocks G, Rajput F, Hanning U, Faizy TD, Leischner H, Schön G, et al. Highest Lesion Growth Rates in Patients With Hyperacute Stroke: When Time Is Brain Particularly Matters. Stroke. 2018;50:189-192.. Infarct growth has become a topic of intense discussion in the current endovascular era, mainly due to its likely impact on stroke care models. A core theme of these models is decision to transport or treat eligible patients immediately, but also to limit futile transfers (drip-and-ship patient) and futile recanalization (mothership patient). The big question is: Which patient will grow their infarct during transfer and thus become ineligible for intervention on arrival to a comprehensive stroke center (futile transfers), and who will grow their infarct after imaging to derive no or minimal benefit from recanalization (futile recanalization)? Various clinical and imaging predictors have been proposed to predict infarct growth, including age, time, collateral status, etc. The study by Broocks et ...
It looks like the concept of "managed care" is only possible when terms like "medically futile" and "terminal" are defined by Medicare and Medicaid AND their private partner, big INSURANCE while the public debate over what defines "terminal" and "medical futility" continues to hide actual practices such as the involuntary euthanasia of the elderly and the disabled and the poor to preserve the private profits of big insurance and big hospital. This is done by means of unilateral covert and overt(default) DNR Code status that is extrapolated into the medical charts of the elderly, the disabled, and the poor. RATIONING has been going on for many years and is manifested in the form of reimbursement protocols developed by Medicare/Medicaid, as influenced by their senior partner, Big Insurance, that, in reality, have for many years been RATIONING treatments for the elderly, the disabled, and the poor to protect the profits of the for-profit sector of our healthcare industry that is dominated by the ...
Patients were included if they had a febrile infection of the bronchial tree, the gut, or the urinary tract within the last 6 months and at least one of the following: impaired global or regional left ventricular systolic function, increased serum concentrations of myocardial necrosis markers, pericardial effusion of unclear reason, VT or NS-VT, or VF of unknown origin. Subjects with familial cardiomyopathy were excluded. Samples for virus serology were collected before EMBs and in 30 patients second samples were drawn 7-28 days after the initial sample. Acute viral infection with enterovirus, adenovirus, parvovirus B19, cytomegalovirus, human herpesvirus, and Epstein-Barr virus was diagnosed by demonstrating IgM or IgA in the initial samples or IgG seroconversion during the follow-up. Before EMB each individual underwent left heart catheterization with coronary angiography. Cardiac MRI and echocardiography were performed before EMB to choose the optimal biopsy site. Histopathological and ...
This study is a multicenter, double-blind, randomized, adaptive, parallel groups, placebo controlled 3-stage study in patients with SMA type 2 or non ambulant type 3.. Stage 1 DMC 3-month safety assessment: An independent Data Monitoring Committee (DMC)will assess the safety of olesoxime every 3 months.. Stage 2 Efficacy/futility analyses at one year: A first interim efficacy analysis will be performed after all patients have been treated for one year (52 weeks) in order to assess the need to continue the study to reach the planned objective. In the event of positive and significant results in favor of olesoxime, the study will be considered as successful and all patients will be switched to olesoxime to allow the assessment of the sustainability of the treatment effect and safety. If the results are significantly in favor of placebo, the study will be discontinued for failure (futility).. Stage 3 Efficacy and safety analysis at two years: The expected study duration is of 2 years (104 weeks) to ...
Purpose: Tivozanib, a selective inhibitor of VEGFR-1, -2, and -3, plus mFOLFOX6 in an advanced gastrointestinal cancer phase Ib study had encouraging antineoplastic activity and a tolerable safety profile. This randomized, open-label, phase II trial of tivozanib/mFOLFOX6 versus bevacizumab/mFOLFOX6 in patients with previously untreated metastatic colorectal cancer (mCRC) evaluated tivozanib activity versus bevacizumab.. Experimental Design: Treatment-naïve patients received mFOLFOX6 every 2 weeks of each 28-day cycle plus either tivozanib orally 1.5 mg once daily for 21 days or bevacizumab intravenously 5 mg/kg every 2 weeks. Investigator-assessed progression-free survival (PFS) was the primary endpoint; some secondary endpoints included safety, overall survival, overall response rate (ORR), duration of response, time to treatment failure, and biomarker subgroup analyses.. Results: A prespecified interim futility analysis demonstrated that the futility boundary for superiority of ...
Many studies suggest there is an increasing rate of inpatient mortality in traumatic brain injury (TBI) cases (3,4). We are in desperate need of clinicians who can translate the advances in bench research into clinical results. However, for many of us our experiences with neurotrauma as residents invoke pessimism and skepticism for the future of the field. Eventually, most of us select more lucrative neurosurgical specialties where we can intervene early in the disease process and restore function rather than play a reactive role with limited hopes of repairing damage already incurred. This lack of enthusiasm for traumatic brain and spinal cord injury unfortunately perpetuates a cycle of lackluster results.. For neurosurgeons, the care of a neurotrauma patient requires immediacy and lacks convenience. It can be difficult to maintain any semblance of a regular schedule, and weekends and evenings are rarely spared. This becomes perfectly evident during residency when the exhilaration of an ...
And second, apart from the gospel, we have sin leading to death, a portrait not only of the deeply entrenched sinfulness of our hearts, but of futility. When I read through the whole letter a couple of days ago I saw this theme recurring: on the one hand, talk of fruitfulness and harvest, on the other, futility and death. Very stark contrasts ...
Ranking academic journals is one of the more contentious aspects of research assessment, and a foundation stone for university rankings. Because peoples careers and aspirations are on the line, it was only a matter of time before someone challenged the findings. Their implications go far beyond recent events in Australia (see more ...
Take Benneths clathrates. If the original molecule is surrounded by a lattice of hydrogen bonded water molecules, then we are left with a much larger supra-molecule. But large molecules will be diluted out faster than small molecules. Such structures make the dilution problem worse not better.. For the homeopaths who are paying attention and have read this far, imagine a dustbin full of marbles. Take 90% of them out and fill with water. Now take 90% of the remaining marbles out and repeat. With, say, 10,000 marbles in the bin originally, after 5 dilutions, we can be sure we have no marbles left. Now repeat with tennis balls (clathrates). There may be only room for a few hundred tennis balls originally now and 2 or 3 dilutions will get rid of them all. Bigger structures dilute out faster.. The second objection is also quite simple. If the remedies do contain such novel structures, then it ought to be possible to measure them. But as we have seen, we have no data to support any novel entity in ...
Take Benneths clathrates. If the original molecule is surrounded by a lattice of hydrogen bonded water molecules, then we are left with a much larger supra-molecule. But large molecules will be diluted out faster than small molecules. Such structures make the dilution problem worse not better.. For the homeopaths who are paying attention and have read this far, imagine a dustbin full of marbles. Take 90% of them out and fill with water. Now take 90% of the remaining marbles out and repeat. With, say, 10,000 marbles in the bin originally, after 5 dilutions, we can be sure we have no marbles left. Now repeat with tennis balls (clathrates). There may be only room for a few hundred tennis balls originally now and 2 or 3 dilutions will get rid of them all. Bigger structures dilute out faster.. The second objection is also quite simple. If the remedies do contain such novel structures, then it ought to be possible to measure them. But as we have seen, we have no data to support any novel entity in ...
The TORONTO STARs Daniel Girard conducted a Q&A with new Toronto FC President & GM Kevin Payne about his plans for the club heading into Thursdays MLS SuperDraft. Below are excerpts from the conversation: Q : Why is the so-called culture change at TFC so important to you? Payne
2010 PURULENT JACUZZI Vanished In The Cosmic Futility CD http://www.myspace.com/pjacuzzi купить CD 1 Intro 2 The Endless Anesthesia 3 Beyond The ...
This study describes the implementation of minimal sufficient balance randomization, a covariate adaptive randomization strategy, in the ESCAPE trial. Our results demonstrate that overall group balance was achieved in dynamically allocating subjects to treatment arms in the ESCAPE trial both at the time of the interim analysis and at the time that the trial was stopped. This suggests that this covariate adaptive randomization strategy can assist data and safety monitoring boards to make reliable decisions about futility or efficacy in a randomized controlled trial.. Similar to all adaptive trial design approaches, the integrity of this approach relies upon the immediate availability and accuracy of data used, and, in this case, data on the covariates used to implement the randomized minimization approach. Because of the nature of stroke treatment, fast treatment decisions are necessarily taken without certainty on all preclinical data. For example, a patients age might be determined just upon ...
Stealth euthanasia. Most hospitals have now quietly instituted "Futility of Care" policies that allow and encourage the doctors to decided whether or not someone should continue to be treated merely based upon the doctors opinion of how long a productive life they have left. These silent killings, chalked up to various medical reasons, are now commonplace in Americas hospitals. The single most dangerous place for an American to be, after an abortion clinic, is now in a hospital. ...
Furthermore, getting a law degree of any kind shockingly does not allow you to go straight ahead and practise law. Whether its the traditional LLB, the relatively new BA in Law or a joint honors such as Law with Philosophy you will still have to undertake an additional qualification. They are the LPC for aspiring solicitors and the BPTC for budding barristers. So, you do not need to actually have a law degree to become either a barrister or a solicitor. You could take any degree and then all that is required if one gets the sudden uncontrollable urge to become a lawyer is to complete the law conversion course (known as the GDL) and then to choose between the BPTC and the LPC.. The striking futility of not being able to practise law with a law degree was debated at Cambridge in 2013 with the Lord Sumption vs Professor Virgo debate: Should prospective lawyers study law at university? Yet it is not all doom and gloom and although I cannot speak for eternity, it is pretty definite that for the ...
The primary responsibility of stopping the Oromo eviction is that of the Oromo people themselves. We should make it absolutely clear to those who will uproot us from our homeland that they are engaged in a dangerous enterprise that can backfire. Non-Oromos should know that we have nothing against those who respect our human rights and will live with us in peace, but will not accept uprooting and humiliation anymore. This cannot be done by paper work or appeals to the international community alone. That is necessary, but not enough. We know from experience the futility of appealing to others to have Oromo rights respected. That means, we should engage in a real struggle to gain respect and security in our own country. Here, struggle means concrete action on the spot. It means organised peaceful demonstration and protest in Finfinnee itself. Indeed, solidarity demonstrations can be staged in cities around the world by Oromos in the diaspora, but it would be futile to make appeals abroad until and ...
Duchamp: I would have wanted to work, but deep down Im enormously lazy. I like living, breathing, better than working. I dont think that the work Ive done can have any social importance whatsoever in the future. Therefore if you wish, my art would be that of living: each second, each breath is a work which is inscribed nowhere, which is neither visual nor cerebral. It is a sort of constant euphoria.. Bright: I would have wanted to work, but deep down Im enormously lazy. I like living, breathing, better than working. I dont think that the work Ive done can have any social importance whatsoever in the future. Therefore if you wish, my art would be that of living: each second, each breath is a work which is inscribed nowhere, which is neither visual nor cerebral. It is a sort of constant futility.. ...