Carbon Nanotubes for Radiation-Tolerant Electronics.

Electronics for space applications have stringent requirements on both performance and radiation tolerance. The constant exposure to cosmic radiation damages and eventually destroys electronics, limiting the lifespan of all space-bound missions. Thus, as space missions grow increasingly ambitious in distance away from Earth, and therefore time in space, the electronics driving them must likewise grow increasingly radiation-tolerant. In this work, we show how carbon nanotube (CNT) field-effect transistors (CNFETs), a leading candidate for energy-efficient electronics, can be strategically engineered to simultaneously realize a robust radiation-tolerant technology. We demonstrate radiation-tolerant CNFETs by leveraging both extrinsic CNFET benefits owing to CNFET device geometries enabled by their low-temperature fabrication, as well as intrinsic CNFET benefits owing to CNTs' inherent material properties. By performing a comprehensive study and optimization of CNFET device geometries, we demonstrate record CNFET total ionizing dose (TID) tolerance (above 10 Mrad(Si)) and show transient upset testing on complementary metal-oxide-semiconductor (CMOS) CNFET-based 6T SRAM memories via X-ray prompt dose testing (threshold dose rate = 1.3 × 1010 rad(Si)/s). Taken together, this work demonstrates CNFETs' potential as a technology for next-generation space applications.

International Association for Hospice and Palliative Care (IAHPC) List of Essential Practices in Palliative Care.

The objective of this study was to identify, through a consensus process, the essential practices in primary palliative care. A three-phase study was designed. Phase 1 methods included development of a working group; a literature review; development of a baseline list of practices; and identification of levels of intervention. In Phase 2, physicians, nurses, and nurse aides (n = 425) from 63 countries were asked in three Delphi rounds to rate the baseline practices as essential or nonessential and select the appropriate levels of intervention for each. In Phase 3, representatives of 45 palliative care organizations were asked to select and rank the 10 most important practices resulting from Phase 2. Scores (1-10) were assigned to each, based on the selected level of importance. Results of Phase 1 were a baseline list of 140 practices. Three levels of intervention were identified: Identification/Evaluation; Diagnosis; and Treatment/Solution measures. In Phase 2, the response rates (RR) for the Delphi rounds were 96.5%, 73.6%, and 71.8%, respectively. A consensus point (≥80% agreement) was applied, resulting in 62 practices. In Phase 3, RR was 100%. Forty-nine practices were selected and ranked. "Evaluation, Diagnosis and Treatment of Pain" scored the highest (352 points). The working group (WG) arranged the resulting practices in four categories: Physical care needs, Psychological/Emotional/Spiritual care needs, Care Planning and Coordination, and Communication. The IAHPC List of Essential Practices in Palliative care may help define appropriate primary palliative care and improve the quality of care delivered globally. Further studies are needed to evaluate their uptake and impact.

Notoriety to respectability: a short history of arsenic prior to its present day use in haematology.

This paper looks at arsenic, and in particular the trioxide, from the days of the ancient Chinese, Egyptians, Greeks and Romans, through the 17th-20th centuries to its adoption by today's haematologists. It looks at its commercial and medical uses, past and present, its notoriety as a poison, it's reputation as a 'tonic' and therapeutic agent, many of the famous people associated with it including Thomas Fowler, William Withering and Robert Christison, and the promise an 18th century panacea now offers 21st century patients under the care of today's haematologists and tomorrow's oncologists.

Palliative medicine in Britain.

In Britain, Palliative Medicine was recognized as a subspecialty of Internal Medicine exactly 20 years after Cicely Saunders founded St Christopher's, at exactly the same time that government was at last recognizing the worth and the needs of general practice. Both had far-reaching effects and implications for patients, doctors, and the future of medicine. For Palliative Medicine it meant units wishing to train specialists going through a rigorous selection process; the development of an equally rigorous training program for the doctors who had already gained a higher qualification before starting Palliative Medicine, demonstrating the need for and benefits of palliative medicine to the sceptics in the profession and, now, continuing to recruit the staff for the steadily increasing number of new services. Today there are more Palliative Medicine consultants/specialists than there are oncologists and neurologists combined, with Hospital Palliative Care Teams in every major hospital and cancer center. With nine Chairs in Palliative Medicine, there is now a drive for research and professional education. The specialty faces major challenges, however, ranging from training to care for patients with non-malignant disease to enabling patients to die in the place of their choice-something that rarely happens today; from defining what is distinctive or unique about palliative medicine to clarifying the respective place of general practice and the specialty. Most would agree that the biggest challenge for the young, thriving specialty is how to share its principles with other doctors wherever they work.

The International Association for Hospice and Palliative Care list of essential medicines for palliative care.

The World Health Organization (WHO) requested that the International Association for Hospice and Palliative Care (IAHPC) develop a list of essential drugs for palliative care to be included in the WHO list of essential drugs. This report describes the process by which this specialized list was developed and the outcomes of that process.

Ensuring palliative medicine availability: the development of the IAHPC list of essential medicines for palliative care.

In response to a request from the World Health Organization (WHO), the International Association for Hospice and Palliative Care (IAHPC) developed a List of Essential Medicines for Palliative Care based on the consensus of palliative care workers from around the world. IAHPC designed a process of five steps, which included developing a set of ethical guidelines; identifying the most common symptoms in palliative care; identifying a list of medications to treat those symptoms; carrying out a survey using a modified Delphi process with participants from developed and developing countries; and convening a meeting of representatives from regional, international, and scientific organizations to develop the final list. Twenty-one symptoms were identified as the most common in palliative care, and an initial list of 120 medications resulted from the initial survey. Seventy-one participants from developing and developed countries responded to the Delphi survey and agreed on the effectiveness and safety of 48 medications for 18 of the 21 symptoms. The final step included discussions among representatives from 26 organizations, which led to the finalization of the list. The IAHPC List of Essential Medicines for Palliative Care includes 33 medications, of which 14 are already included in the WHO Model List. The participants agreed that there is too little evidence to recommend medications for five of the symptoms and suggested that further research be carried out to solve this need. The IAHPC and all the organizations involved in this process welcome suggestions on ways to continue to improve the List of Essential Medicines for Palliative Care and to improve access to medications for patients in need.