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Dry lakes covered with a salt crust organised into beautifully patterned networks of narrow ridges are common in arid regions. Here, we consider the initial instability and the ultimate fate of buoyancy-driven convection that could lead to such patterns. Specifically, we look at convection in a deep porous medium with a constant throughflow boundary condition on a horizontal surface, which resembles the situation found below an evaporating salt lake. The system is scaled to have only one free parameter, the Rayleigh number, which characterises the relative driving force for convection. We then solve the resulting linear stability problem for the onset of convection. Further exploring the nonlinear regime of this model with pseudo-spectral numerical methods, we demonstrate how the growth of small downwelling plumes is itself unstable to coarsening, as the system develops into a dynamic steady state. In this mature state we show how the typical speeds and length scales of the convective plumes scale with forcing conditions, and the Rayleigh number. Interestingly, a robust length scale emerges for the pattern wavelength, which is largely independent of the driving parameters. Finally, we introduce a spatially inhomogeneous boundary condition – a modulated evaporation rate – to mimic any feedback between a growing salt crust and the evaporation over the dry salt lake. We show how this boundary condition can introduce phase locking of the downwelling plumes below sites of low evaporation, such as at the ridges of salt polygons.
It discusses legal methodology problems of multilevel trade and investment regulation and explores related problems of adjudication involving investment projects in the context of BRI involving more than sixty-five countries. The very limited number of investor–state arbitration proceedings initiated so far by foreign companies against China – or by Chinese companies against foreign host states – suggests that alternative dispute resolution may become one of the important ‘legal innovations’ of BRI. Yet also involvement of third parties as ‘mediators’ or ‘conciliators’ in dispute settlement proceedings raises questions of ‘justice’ and of legal methodology that are easier to resolve by embedding BRI regulations into multilateral trade, investment and UN law.
Astonishingly, Nietzsche employed the concept of irony only rarely, and when the term does occur in his writings, it usually has a negative nuance. According to the early treatise “On the Uses and Disadvantages of History for Life,” for example, irony is the attitude of the “practical pessimists,” that is, of the historical scholars who adopt the stance of déjà vu, who “cannot bring [themselves] seriously to care” about the future. Led by “a presentiment of coming disaster,” they have become “indifferent to the wellbeing of others, and to [their] own as well,” and live according to the motto: “If only the ground will go on bearing us! And if it ceases to bear us, that too is very well” (HL 7). The “ironic existence” and the “ironic self-awareness” that emerge here are, for Nietzsche, signs of “the latecomers, the last pale offspring of mightier and happier races.” This irony has, for him, a “kind of inborn gray-hairedness” and it expresses itself in a “senile occupation,” namely, that of “looking back, of reckoning up, of closing accounts, of seeking consolation through remembering what has been, in short historical culture.” Further, this “ironical overview” of the past is coupled with a “presentiment that there is really nothing to rejoice about” and that “the merriment of historical knowledge will soon be over and done with” (HL 8). For the young Nietzsche, however, knowledge was “associated with pleasure,” and the reason was that, like gymnastic exercises, it lent us a sense of our power, because in it we “[go] beyond former conceptions and their advocates,” or at least we think we go beyond them. Admittedly, he thinks that, in view of its “origin,” everything, but especially all human affairs, deserves “to be viewed ironically.” But for this very reason he thinks “irony is so superfluous in the world” (HH I, 252).
Delirium is a frequent complication in advanced cancer patients, among whom it is frequently underdiagnosed and inadequately treated. To date, evidence on risk factors and the prognostic impact of delirium on outcomes remains sparse in this patient population.
In this prospective observational cohort study at a single tertiary-care center, 1,350 cancer patients were enrolled. Simple and multiple logistic regression models were utilized to identify associations between predisposing and precipitating factors and delirium. Cox proportional-hazards models were used to estimate the effect of delirium on death rate.
In our patient cohort, the prevalence of delirium was 34.3%. Delirium was associated inter alia with prolonged hospitalization, a doubling of care requirements, increased healthcare costs, increased need for institutionalization (OR 3.22), and increased mortality (OR 8.78). Predisposing factors for delirium were impaired activity (OR 10.82), frailty (OR 4.75); hearing (OR 2.23) and visual impairment (OR 1.89), chronic pneumonitis (OR 2.62), hypertension (OR 1.46), and renal insufficiency (OR 1.82). Precipitating factors were acute renal failure (OR 7.50), pressure sores (OR 3.78), pain (OR 2.86), and cystitis (OR 1.32). On multivariate Cox regression, delirium increased the mortality risk sixfold (HR 5.66). Age ≥ 65 years and comorbidities further doubled the mortality risk of delirious patients (HR 1.77; HR 2.05).
Significance of results
Delirium is common in cancer patients and associated with increased morbidity and mortality. Systematically categorizing predisposing and precipitating factors might yield new strategies for preventing and managing delirium in cancer patients.
Although age and pre-existent dementia are robust risk factors for developing delirium, evidence for patients older than 90 years is lacking. Therefore, this study assesses the delirium prevalence rates and sequelae in this age group.
Based on a Diagnostic and Statistical Manual (DSM)-5, Delirium Observation screening scale (DOS), and Intensive Care Delirium Screening Checklist (ICDSC) construct, in this prospective cohort study, the prevalence rates and sequelae of delirium were determined in 428 patients older than 90 years by simple logistic regressions and corresponding odds ratios (ORs).
The overall prevalence delirium rate was 45.2%, with a wide range depending upon specialty: intermediate and intensive care services (83.1%), plastic surgery and palliative care (75%), neurology (72%), internal medicine (69%) vs. dermatology (26.5%), and angiology (14.5%). Delirium occurred irrespective of age and gender; however, pre-existent dementia was the strongest delirium predictor (OR 36.05). Delirious patients were less commonly admitted from home (OR 0.47) than from assisted living (OR 2.24), indicating functional impairment. These patients were more severely ill, as indicated by emergency (OR 3.25) vs. elective admission (OR 0.3), requirement for intensive care management (OR 2.12) and ventilation (OR 5.56–8.33). At discharge, one-third did not return home (OR 0.22) and almost half were transferred to assisted living (OR 2.63), or deceased (OR 47.76).
Significance of results
At age older than 90 years, the prevalence and sequelae of delirium are substantial. In particular, functional impairment and pre-existent dementia predicted delirium and subsequently, the loss of independence and death were imminent.
Eight bryozoan species are described from the Hanchiatien Formation (lower Silurian, Telychian) of southern Chongqing, South China. Four species are new: the trepostomes Asperopora sinensis n. sp., Trematopora jiebeiensis n. sp., and Trematopora tenuis n. sp., and the fenestrate Moorephylloporina parvula n. sp. One species, the cystoporate Hennigopora sp. indet., is described in open nomenclature. Moorephylloporina parvula n. sp. is eurytopic, occurring in all types of facies within the bioherms. Erect Moorephylloporina Bassler, 1952, Trematopora Hall, 1852, and Leioclema Ulrich, 1882 formed pioneering communities on weakly cemented substrata, whereas encrusting Fistulipora M‘Coy, 1849, Hennigopora Bassler, 1952, and Asperopora Owen, 1969 occurred on hardgrounds and formed densely compact framestones. Robust branched Trematopora and Leioclema tend to occur out of the reef core (framework) where they could have formed reef-flank thickets in more agitated conditions. The generic composition of the studied fauna correlates with other localities in South China, and they show general paleobiogeographic relations to Siberia and Indiana, USA.
The Black-capped Petrel or Diablotin Pterodroma hasitata has a fragmented and declining population estimated at c.1,000 breeding pairs. On land, the species nests underground in steep ravines with dense understorey vegetation. The only confirmed breeding sites are located in the mountain ranges of Hispaniola in the Caribbean, where habitat loss and degradation are continuing threats. Other nesting populations may still remain undiscovered but, to locate them, laborious in situ nest searches must be conducted over expansive geographical areas. To focus nest-search efforts more efficiently, we analysed the environmental characteristics of Black-capped Petrel nesting habitat and modeled suitable habitat on Hispaniola using openly available environmental datasets. We used a univariate generalized linear model to compare the habitat characteristics of active Black-capped Petrel nests sites with those of potentially available sites (i.e. random pseudo-absences). Elevation, distance to coast, and the influence of tree cover and density emerged as important environmental variables. We then applied multivariate generalized linear models to these environmental variables that showed a significant relationship with petrel nesting activity. We used the top performing model of habitat suitability model to create maps of predicted suitability for Hispaniola. In addition to areas of known petrel activity, the model identified possible nesting areas for Black-capped Petrels in habitats not previously considered suitable. Based on model results, we estimated the total area of predicted suitable nesting habitat for Black-capped Petrels on Hispaniola and found that forest loss due to hurricanes, forest fires, and encroachment from agriculture had severely decreased availability of predicted suitable habitat between 2000 and 2018.
Person-centred care requires improved documentation of nursing home resident wellbeing, e.g. by nursing staff proxy assessments. Previous studies mainly focused on proxy self-report agreement of quality of life of people with dementia, using lengthy questionnaires. This is the first study to investigate how well nursing staff assess residents’ wellbeing after training, using a single-question assessment method of happiness and engagement. We conducted a cross-sectional mixed-method study, including proxy assessments from 49 nursing staff, and self-reports from 49 nursing home residents without dementia (mean age 85). We explored agreement between colleagues, and between proxy assessments and self-reports, and potential nursing staff characteristics associated to this (age, experience, hours worked per week). Brief written motivations were evaluated on nursing staffs’ understanding of the happiness and engagement concepts. The results showed low agreement between colleagues, and low agreement between proxy assessments and self-reports. Nursing staff assessed happiness and engagement substantially higher than residents’ self-reports. Hours worked per week was related to happiness proxy assessments, but none of the included nursing staff characteristics were related to proxy self-report agreement. Nursing staff interpreted the concepts in diverse ways. Overestimating resident wellbeing when using this single-assessment method may undermine subsequent efforts to improve wellbeing. We could not identify which nursing staff could best provide wellbeing assessments. For now, proxy wellbeing assessments should always be combined with regular self-reports whenever possible.
Patients with terminal illness are at high risk of developing delirium, in particular, those with multiple predisposing and precipitating risk factors. Delirium in palliative care is largely under-researched, and few studies have systematically assessed key aspects of delirium in elderly, palliative-care patients.
In this prospective, observational cohort study at a tertiary care center, 229 delirious palliative-care patients stratified by age: <65 (N = 105) and ≥65 years (N = 124), were analyzed with logistic regression models to identify associations with respect to predisposing and precipitating factors.
In 88% of the patients, the underlying diagnosis was cancer. Mortality rate and median time to death did not differ significantly between the two age groups. No inter-group differences were detected with respect to gender, care requirements, length of hospital stay, or medical costs. In patients ≥65 years, exclusively predisposing factors were relevant for delirium, including hearing impairment [odds ratio (OR) 3.64; confidence interval (CI) 1.90–6.99; P < 0.001], hypertonia (OR 3.57; CI 1.84–6.92; P < 0.001), and chronic kidney disease (OR 4.84; CI 1.19–19.72; P = 0.028). In contrast, in patients <65 years, only precipitating factors were relevant for delirium, including cerebral edema (OR 0.02; CI 0.01–0.43; P = 0.012).
Significance of results
The results of this study demonstrate that death in delirious palliative-care patients occurs irrespective of age. The multifactorial nature and adverse outcomes of delirium across all age in these patients require clinical recognition. Potentially reversible factors should be detected early to prevent or mitigate delirium and its poor survival outcomes.
The general in-hospital mortality and interrelationship with delirium are vastly understudied. Therefore, this study aimed to assess the rates of in-hospital mortality and terminal delirium.
In this prospective cohort study of 28,860 patients from 37 services including 718 in-hospital deaths, mortality rates and prevalence of terminal delirium were determined with simple logistic regressions and their respective odds ratios (ORs).
Although overall in-hospital mortality was low (2.5%), substantial variance between services became apparent: Across intensive care services the rate was 10.8% with a 5.8-fold increased risk, across medical services rates were 4.4% and 2.4-fold, whereas at the opposite end, across surgical services rates were 0.7% and 87% reduction, respectively. The highest in-hospital mortality rate occurred on the palliative care services (27.3%, OR 19.45). The general prevalence of terminal delirium was 90.7% and ranged from 83.2% to 100%. Only across intensive care services (98.1%, OR 7.48), specifically medical intensive care (98.1%, OR 7.48) and regular medical services (95.8%, OR 4.12) rates of terminal delirium were increased. In contrast, across medical services (86.4%, OR 0.32) and in particular oncology (73.9%, OR 0.25), pulmonology (72%, OR 0.31) and cardiology (63.2%, OR 0.4) rates were decreased. For the remaining services, rates of terminal delirium were the same.
Significance of results
Although in-hospital mortality was low, the interrelationship with delirium was vast: most patients were delirious at the end of life. The implications of terminal delirium merit further studies.
This collection is the product of a conference entitled ‘Counting Votes and Weighing Opinions – Collective Judging in Comparative Perspective‘, held at All Souls College, Oxford, on 20 and 21 July 2017. The event was co-organised by the editors (both University of Oxford) together with Professor Beate Gsell (Ludwig-Maximilians-Universität München) and Professor Thomas Rüfner (Universität Trier). Our co-organisers regularly sit on cases heard by Higher Regional Courts of Appeal in Germany (Oberlandesgericht München and Koblenz, respectively).
The aim of the conference was to bring together distinguished judges and academics from around the world to discuss the mechanisms, processes and challenges of collective decision-making by judicial bodies. Participants came from a mix of civil law and common law jurisdictions. Judges from national, supranational and international courts reported on their respective practices and experiences, leading to an exchange of views on the pros and cons of various different approaches. Lord Neuberger of Abbotsbury, who was at the time of the conference about to step down as President of the UK Supreme Court, in a closing speech elegantly pulled together all the various red threads that had emerged over two days of intense debate.
Most of contributions contained in this book are updated, amended and in a few cases significantly expanded versions of the papers delivered at the conference. For the purposes of this publication, we have ordered them by the type of jurisdiction they pertain to. The book commences with an ‘impulse paper‘ prepared by Wolfgang Ernst that also initiated the conference itself. The chapters include two (by Professor Gertrude Lübbe-Wolffand by Judge Theodor Meron, co-authored by Christos Ravanides) which would have been given at the conference had not circumstances beyond the speakers‘ control prevented them from attending. Towards the end of the book, we have added a part containing ‘voices from the audience‘. It encompasses contributions by conference attendees who kindly agreed to provide insight into their own experience of collective judging in other bodies, or who offered reflections and comments on the conference topic from an academic perspective. The book concludes with some remarks by the organisers, flagging aspects we found particularly interesting and which we think could inform future ‘court design‘.
JUDICIAL MAJORITARIANISM AS A ‘GROUP CHOICE‘ ISSUE
This chapter tries to identify key issues of judicial majoritarianism as a basis for discussion. Rather than promoting an ultimate master plan, it focusses on asking questions and reporting practical models, which are in use or have been proposed. The issues and model solutions set out here are extracted from a comparative survey of legal history, published in 2016. Participants in the 2017 ‘Collective Judging‘ Conference were given this chapter for inspiration; it is published here with only a few alterations.
Collegiate courts must overcome disagreement between judges in order to see a pending case decided. One can look at the decision-making process from various perspectives, for example that of collective choice theory or that of psychological group dynamics. For the lawyer, a more obvious aspect lies in the procedural rules pertaining to the collegiate decision-making exercise. While the legal aspect may not be easily separable from potential other aspects, it suggests itself as the focus for a comparative survey. There is a great variety of approaches to what seems to be the core problem of collegiate courts: How to arrive at a decision in spite of judges‘ disagreement? Insofar as judicial majority-seeking takes place in a conference of judges, the competences and procedures of such conferences are pertinent issues. Similar problems exist for tribunals of arbiters, although in terms of group psychology they may differ considerably from permanent courts since the latter can operate, at least for a while, with a stable composition of judges.
The method by which several judges‘ opinions are ‘fused‘ in deciding the case at hand, and also in shaping the law of the land, is a decisive moment in the exercise of judicial power. It deserves no less attention than the doctrine of statutory interpretation. The intellectual operations needed in this respect are not at all self-evident.
THE JUDGES‘ CONFERENCE FROM A COMPARATIVE PERSPECTIVE
From a comparative perspective, we find the majority requirement applied in two very different modes. In Anglo-American judicial systems, the case at hand is decided by the majority of opinions, the order made by the court being determined by looking at the constituent individual judges‘ end results only.
This book provides insight into modern collective judicial decision-making. Courts all over the world sit in panels of several judges, yet the processes by which these judges produce the courts' decisions differ markedly. Judges from some of the world's most notable judicial bodies, in both the civilian and the common law tradition and from supra-/international courts, share their experiences and reflect on the challenges to which their collective endeavour gives rise. They address matters such as the question of panel constitution, the operation of rapporteur systems, pre- and post-hearing conferences, the hearing procedure itself, the nature of the interaction between the judicial panel and parties' advocates, the extent to which a unitary judgment of the court or at least a single majority judgment is required or deemed desirable, and how it is ultimately arrived at through different voting mechanisms. The judicial views are supplemented by a number of academic commentaries. Collective Judging in Comparative Perspective serves as an inspiration for future court design. Sir Jack Beatson (formerly Court of Appeal of England and Wales) Thomas von Danwitz (Court of Justice of the European Union) Matthew Dyson (University of Oxford) Harry T Edwards (United States Court of Appeals for the DC Circuit) Wolfgang Ernst (University of Oxford) Kevin Garnett QC (formerly Boards of Appeal of the European Patent Office) Msgr Markus Graulich (Pontifical Council for Legislative Text) Beate Gsell (Ludwig-Maximilians-Universität Munich) Birke Häcker (University of Oxford) Dominique Hascher (Cour de cassation) Sir Launcelot Henderson (Court of Appeal of England and Wales) Rchard Hyland (Rutgers Law School) Susan Kiefel AC (High Court of Australia) Georg Kodek (Austrian Supreme Court) James Lee (King's College London) Sir Keith Lindblom (Court of Appeal of England and Wales) Gertrude Lübbe-Wolff (formerly German Federal Constitutional Court) Theodor Meron (International Residual Mechanism for Criminal Tribunals) Angelika Nussberger (formerly European Court of Human Rights) Akira Ojima (Chief Judicial Research Official, Supreme Court of Japan) Naoki Onishi (Otsu District Court, Japan) Christos Ravanides (Office of Legal Affairs, United Nations) Lord Reed of Allermuir (Supreme Court of the United Kingdom) Thomas Rüfner (University of Trier) Johanna Schmidt-Räntsch (German Federal Court of Justice) Thomas Stadelmann (Swiss Supreme Court) Wolfgang Ernst is Regius Professor of Civil Law, University of Oxford, and Fellow of All Souls College.Birke Häcker is the Professor of Comparative Law, University of Oxford, and Fellow of Brasenose College.
When we first conceived the conference documented in this volume, we started with quite a narrow focus. We wanted to compare ‘group choice’ mechanisms employed by a selection of important courts around the world. We thereby hoped to learn more about voting processes and their formal frameworks, and possibly to explore the equivalent in judiciaries where such processes are not a formal part of the collegiate decision-making process. In short, we were primarily after the ‘rules of voting’ in collegiate courts. We did indeed learn much about such processes. Yet the most enlightening product of the conference was arguably a broadening of our perspective: We began to understand better the interconnectedness of a range of different elements, all of which impact the quality of collegiate decision-making in a much more direct or significant way than we had anticipated.
The size of the collegiate body, for instance, appears to be a decisive factor within the decision-making process, in that it is liable either to encourage or to inhibit a free exchange of views. The larger the number of judges involved, the more formal their contributions tend to become. Very large benches also tend to emphasise the role of the presiding judge and the rapporteur, right up to a point where all other members of the panel risk losing the chance to influence the decision-making process effectively. Though a smaller body does not necessarily guarantee a free exchange of arguments, it seems to us that ‘going big’ is almost certainly detrimental to a culture of substantive debate. The practice of some judiciaries to compose larger benches for cases deemed to be a greater ‘importance’ than others may therefore actually have an adverse effect on the quality of intra-court exchanges.
One feature of collegiate decision-making which we had thitherto not sufficiently appreciated was the fact that ‘trilaterality’ of proceedings can make for intellectually highly productive interactions: The judges of a bench interact not only with one another, but also with both of the parties. When one compares appellate and supreme courts of various jurisdictions, one finds a striking difference regarding the involvement of parties and their lawyers in the exchange of legal arguments which set the stage for the ultimate decisionmaking.
The Austrian general rules on prescription can be found in the fourth chapter (‘Hauptstück‘) of the third part of the Austrian Civil Code (Allgemeines Bürgerliches Gesetzbuch, ABGB), therefore in the code's last substantive segment. It is entitled‘Von der Verjährung und Ersitzung‘(‘Of extinctive and acquisitive prescription‘) and therefore combines the possible effect of the passage of time on rights and claims combined. § § 1451 ff ABGB therefore not only address the loss of a claim (as will be the prime focus in the following), but also the accrual of a right by another after fulfilling certain criteria over a specific period of time.
§ 1451 ABGB defines prescription as‘the loss of a right which has not been exercised over a period defined by law ‘. If this loss coincides with the passage of the right to another due to the latter's qualified possession, the ABGB speaks of acquisitive prescription, thereby making it a mere sub-category of the former (§ 1452 ABGB). This sub-category is addressed in § § 1453– 1477, whereas § § 1478 ff ABGB focus on cases where someone‘just‘loses a right, but no-one else acquires it instead (extinctive prescription, or– as § 1478 ABGB calls it–‘eigentliche Verjährung ‘, which literally translates as‘actual prescription‘). Still, this second part of the rules on (extinctive) prescription include references to the former, and both types of prescription are addressed in the third part of the ABGB rules thereupon (§ § 1493 ff ABGB), which inter alia deal with general aspects such as postponement and the effect of prescription.
The ABGB addresses the prescription of tort claims specifically in § § 1489 f ABGB. Other statutes with tort law content either refer back to these provisions or include specific rules on prescription, which either essentially mirror the ABGB provisions (eg § 20 AtomHG, § 17 para 1 EKHG, § 55 ForstG, § 8 RHPflG) or include at least partial deviations therefrom (eg § 6 AHG, § 37h KartellG, § 5 OrgHG, § 13 PHG, § 5 PolBEG).