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While once considered as incurable systemic disease, treatment options for liver metastases have increased over the last 30 years and safety has improved dramatically, such that for a selected group of patients the hope of cure can now be offered with radical treatment, and low morbidity interventions can be offered which prolong survival, even in patients with more widely disseminated disease. Advances have been made in selection and surgical technique for liver resection and several adjuncts to resection now exist in the form of portal vein embolization, thermal ablation and targeted drug or radiotherapy delivery options. A natural consequence of these developments has been the delivery of services within fewer specialist units, with the result that later complications of therapy may present to local hospitals, rather than directly to the specialist centres. This article will describe the current common liver-directed therapies and outline the presentation and management of their complications.

Flexible strategies have become increasingly important for making strategic decisions under uncertainty conditions, once to consider flexibility in projects to engender the option of making return-maximizing decisions, since uncertainty can be resolved over a project's lifetime. The activities related to reservoir development are inherently associated with decisions making under uncertainty conditions and flexible solutions are very advantageous, allowing the option of making return-maximizing decisions, the uncertainty is resolved over a project's lifetime. One of the technologies that fit in this context are the smart wells, since this technology has the ability to acquire relevant requested information for future decision-making, enabling the generation of a development strategy with future flexibility. However, to value its flexibility if we do not account for uncertainty when performing an optimization, the resulting strategy will have two key shortcomings: it will assign too high value to the smart wells, and it will not take advantage of the ability of the smart wells to adapt and mitigate to uncertainty. We propose a strategy that allows the valuation of flexibility under uncertainty, seeking the flow control strategy that maximizes the expected net present value, dynamically reacting to new information as it is acquired. We demonstrate the proposed approach using a tank drainage problem for which we can evaluate optimization solutions for a broad range of scenarios, including model uncertainty and the flexibility to accommodate future measurements, with a reduced time of evaluation. Then we applied this proposed approach on a reservoir model that highlights its novel aspects: asset optimization under uncertainty, flexible control based on future information, and quantification of the value of flexibility and future measurements. In addition to valuing flexibility and future information, which contributes to the selection of appropriate smart-well technology and measurements, the proposed approach delivers a decision tree that describes a flexible strategy of optimum valve settings that properly accounts for future measurements and their impact on uncertainty reduction. This approach gives a qualitative value, indicating whether the field has the potential of significant improvement using smart wells, and a quantitative valuation of the benefits of smart completions resulting in a realizable strategy to guide the control of these completions in a real field management project.

By combining Solar Cycle Lengths (SCL) and CO2 this paper predicts a global average surface temperature (GAST) anomaly of 1.5K in the year 2100 compared to 0.42K in 1996–2006. This assumes a continuing CO2 increase of 2 ppm per year and our derived form of Transient Climate Response (TCR), whose value 1.93 ± 0.26 K (K) per CO2 doubling would be 1.23 times higher if the Sun were ignored. After the CO2 effect has been subtracted out, the SCL explains a healthy 55% of the remaining variance. It also estimates that 37% of the recent warming from 1980 to 2001 was due to solar effects. We then compare with models created from Scafetta (2010, 2013) (the first of which has the best fit of all) and from radiative forcings estimated by Myhre et al. (2001) and Skeie et al. (2011). The latter confirms the solar contribution to 1980–2001 warming as 33%, in contrast to the negligible value given by Benestad & Schmidt (2009). It also gives a TCR of 1.3K if only CO2 continues to rise, and 2.0K if CH4 and NO2 also rise proportionately. Likewise this model estimates the ratio between the sensitivities of forcings from the Sun and greenhouse gases as 2.9 (versus 1.0 for Benestad & Schmidt (2009)). We develop a negative exponential model for post-forced warming to derive a ratio between Equilibrium Climate Sensitivity (ECS) and TCR, estimated to be 1.15. Two statistical novelties of the paper are the computation of the exact left tail probability of the Durbin-Watson statistic, and the demonstration of an approximate relationship between the Akaike Information Criterion and the tail probability of the F-statistic.

Background The generation of errors during the medication administration process is a common topic of exploration within the nursing education and simulation literature. The recent wide-scale adoption of electronic medication administration record (eMAR) systems has generated a need to explore how nursing students administer medications using this form of technology within simulation. Therefore, a quality improvement project was conducted to assess the types of errors generated by nursing students using eMAR technology in high-fidelity simulation. Method Observational and interview methods were used to collect quantitative and qualitative data related to nursing students' use of eMAR during a simulated clinical scenario of medication administration to a stable medical–surgical patient. Collected quantitative and qualitative data were triangulated to develop insights related to where and why nursing students make errors during administration practices involving eMAR technology. Results Overall, 25 students participated in this quality improvement project. The majority of errors generated by these students were directly related to tasks or procedures highly mediated by some element of the eMAR system, including medication order verification (n = 19, 76%), barcode scanning (n = 16, 64%), and administration errors (n = 20, 80%). Qualitatively, several participants outlined uncertainty related to their use of the technology or admitted that they felt ill prepared in terms of their background knowledge or skills to administer medications using the electronic system. Conclusions Students generated a variety of errors during the medication administration process involving eMAR technology, likely due to a range of individual, contextual, and eMAR factors. Further, although students completed online learning activities prior to the eMAR simulation, the fidelity of these learning activities was probably insufficient to adequately prepare students to effectively use the eMAR system.

Podcasting is used in higher education so various digital resources can be shared with students. This review aims to synthesise evidence on podcasting in nursing and midwifery education. PubMed, MEDLINE, CINAHL, Scopus and ERIC databases were searched using key terms. 242 articles were found and screened. Data extraction, quality assessment and data analysis, underpinned by a Social Media Learning Model, were conducted on relevant studies. Twenty-six studies were included in the review. Three themes emerged; 1) learning and other outcomes, 2) antecedents to learning, and 3) learning process. Students seemed to acquire new knowledge and skills by using podcasts and it also appeared to improve clinical confidence. The organisation of podcasting, digital literacy and e-Professionalism, the personal motivation of learners, and flexible access to the technology seemed to impact the delivery of this educational intervention. Mechanisms that appeared to affect the learning process were the speed of exchange, the type of social media user, the timeframe, quality of information, the functionality of podcasts and other learning activities. This review synthesised evidence on podcasting in nursing and midwifery education. The technology was seen as a positive learning tool but more robust research examining its efficacy in improving learning outcomes is needed., Highlights • Podcasting is being used in nursing and midwifery education to support learning. • Review findings suggest podcasting may improve learning outcomes. • Newer generations of students seem to like technology enhanced learning resources. • More robust studies are needed to determine the efficacy of this pedagogical tool. • The Social Media Learning Model could help inform future teaching and learning.

Darwiche and Pearl's seminal 1997 article outlined a number of baseline principles for a logic of iterated belief revision. These principles, the DP postulates, have been supplemented in a number of alternative ways. Most of the suggestions made have resulted in a form of `reductionism' that identifies belief states with orderings of worlds. However, this position has recently been criticised as being unacceptably strong. Other proposals, such as the popular principle (P), aka `Independence', characteristic of `admissible' revision operators, remain commendably more modest. In this paper, we supplement both the DP postulates and (P) with a number of novel conditions. While the DP postulates constrain the relation between a prior and a posterior conditional belief set, our new principles notably govern the relation between two posterior conditional belief sets obtained from a common prior by different revisions. We show that operators from the resulting family, which subsumes both lexicographic and restrained revision, can be represented as relating belief states that are associated with a `proper ordinal interval' (POI) assignment, a structure more fine-grained than a simple ordering of worlds. We close the paper by noting that these operators satisfy iterated versions of a large number of AGM era postulates, including Superexpansion, that are not sound for admissible operators in general., Extended version of a paper accepted to KR 2018. 40 pages

Many belief change formalisms employ plausibility orderings over the set of possible worlds to determine how the beliefs of an agent ought to be modified after the receipt of a new epistemic input. While most such possible world semantics rely on a single ordering, we investigate the use of an additional preference ordering—representing, for instance, the epistemic context the agent finds itself in—to guide the process of belief change. We show that the resultant formalism provides a unifying semantics for a wide variety of belief change operators. By varying the conditions placed on the second ordering, different families of known belief change operators can be captured, including AGM belief contraction and revision, Rott and Pagnucco's severe withdrawal, the systematic withdrawal of Meyer et al., as well as the linear liberation and σ-liberation operators of Booth et al. Our approach also identifies novel classes of belief change operators worthy of further investigation.

It has been hypothesized that peripherally restricted NMDA receptor antagonists may be effective analgesics for osteoarthritis pain. A class of novel quinoxalinedione atropisomers, first discovered for an NMDA receptor antagonist program for the treatment of stroke, was evaluated and further optimized with the goal of finding peripherally restricted NMDA receptor antagonists.

An intelligent agent may receive information about its environment from several different sources. How should the agent merge these items of information into a single, consistent piece? Taking our lead from the contraction+expansion approach to belief revision, we envisage a two-stage approach to this problem. The first stage consists of weakening the individual pieces of information into a form in which they can be consistently added together. The second, trivial, stage then consists of simply adding together the information thus obtained. This paper is devoted mainly to the first stage of this process, which we call social contraction. We consider both a postulational and a procedural approach to social contraction. The latter builds on the author's framework of belief negotiation models. With the help of Spohn-type rankings we provide two possible instantiations of this extended framework. This leads to two interesting concrete families of social contraction functions.

Represented Coxeter matroids of types $C_n$ and $D_n$, that is, symplectic and orthogonal matroids arising from totally isotropic subspaces of symplectic or (even-dimensional) orthogonal spaces, may also be represented in buildings of type $C_n$ and $D_n$, respectively. Indeed, the particular buildings involved are those arising from the flags or oriflammes, respectively, of totally isotropic subspaces. There are also buildings of type $B_n$ arising from flags of totally isotropic subspaces in odd-dimensional orthogonal space. Coxeter matroids of type $B_n$ are the same as those of type $C_n$ (since they depend only upon the reflection group, not the root system). However, buildings of type $B_n$ are distinct from those of the other types. The matroids representable in odd dimensional orthogonal space (and therefore in the building of type $B_n$) turn out to be a special case of symplectic (flag) matroids, those whose top component, or Lagrangian matroid, is a union of two Lagrangian orthogonal matroids. These two matroids are called a Lagrangian pair, and they are the combinatorial manifestation of the ``fork'' at the top of an oriflamme (or of the fork at the end of the Coxeter diagram of $D_n$). Here we give a number of equivalent characterizations of Lagrangian pairs, and prove some rather strong properties of them., Requires amssymb.sty; 12 pages, 2 LaTeX figures

Characterisations of symplectic and orthogonal Lagrangian matroids in terms of basis exchange are well known. We define circuits of Lagrangian matroids in a natural way and characterise Lagrangian matroids in terms of circuit axioms. We go on to characterise orthogonal Lagrangian matroids in terms of circuits, and prove a result that may be useful in establishing orientations in terms of circuits.

In this paper we extend the theory of oriented matroids to Lagrangian orthogonal matroids and their representations, and give a completely natural transformation from a representation of a classical oriented matroid to a representation of the same oriented matroid considered as a Lagrangian orthogonal matroid. Classical concepts of orientation and this extension may both be thought of as stratifications of thin Schubert cells into unions of connected components., Comment: 13 pages. To appear in the European Journal of Combinatorics

The development of seafood (shrimp) manufacture in the United States is changing toward increased isolation of the growing-out facilities. Such a change minimizes a) overhead for discharge permits and pollution abatement costs, b) crop loss by disease and toxic substances from the environment c) and breaks the seashore umbilical cord. Isolation will require increased capital and operating expense. The increased costs must be balanced by reducing operating costs. Three large cost-based factors are operating labor, ration cost and energy cost for pumping and environmental control. A portion of the labor and ration costs can be reduced by using direct digital control the environmental and feeding subsystems. The shrimp ration must be optimized to provide the growing shrimp with the correct balance of nutrients at their current stage in life. It is necessary to deliver the ration in the correct amount to maintain optimum growth. These criteria require a detailed growth model that relates essential nutritional requirements to size of shrimp. The size and number of the shrimp may be determined by video remote sensing. The dissolved oxygen, salinity and pH are monitored and controlled at levels which will not inhibit growth nor inefficiently utilize ration nutrients. Critical metabolites are monitored and removed from the shrimp growout environment to a photosynthetic water recycle unit.

In this paper, we discuss a system for performing process optimization, and its application to the optimization of a 0.5?m CMOS process. The approach includes an initial Target-Oriented experimental design strategy, elimination of ineffective parameters, a second set of experiments to determine a set of approximating models for each response, detection of appropriate transformations of input factors which improve the accuracy of the models, and optimization with respect to a set of constraints.