Outcomes and costs of penetrating trauma injury in England and Wales

The official published version of the article can be found at the link below.Background: Penetrating trauma injury is generally associated with higher short-term mortality than blunt trauma, and results in substantial societal costs given the young age of those typically injured. Little information exists on the patient and treatment characteristics for penetrating trauma in England and Wales, and the acute outcomes and costs of care have not been documented and analysed in detail.Methods: Using the Trauma Audit Research Network (TARN) database, we examined patient records for persons aged 18+ years hospitalised for penetrating trauma injury between January 2000 and December 2005. Patients were stratified by injury severity score (ISS).Results: 1365 patients were identified; 16% with ISS 1-8, 50% ISS 9-15, 15% ISS 16-24, 16% ISS 25-34, and 4% with ISS 35-75. The median age was 30 years and 91% of patients were men. Over 90% of the injuries occurred in alleged assaults. Stabbings were the most common cause of injury (73%), followed by shootings (19%). Forty-seven percent were admitted to critical care for a median length of stay of 2 days; median total hospital length of stay was 7 days. Sixty-nine percent of patients underwent at least one surgical procedure. Eight percent of the patients died before discharge, with a mean time to death of 1.6 days (S.D. 4.0). Mortality ranged from 0% among patients with ISS 1-8 to 55% in patients with ISS > 34. The mean hospital cost per patient was 7983 pound, ranging from 6035 pound in patients with ISS 9-15 to El 6,438 among patients with ISS > 34. Costs varied significantly by ISS, hospital mortality, cause and body region of injury.Conclusion: The acute treatment costs of penetrating trauma injury in England and Wales vary by patient, injury and treatment characteristics. Measures designed toreduce the incidence and severity of penetrating trauma may result in significant hospital cost savings. (C) 2008 Elsevier Ltd. All rights reserved.This study was funded by Novo Nordisk A/S

Input-to-state stability of infinite-dimensional control systems

We develop tools for investigation of input-to-state stability (ISS) of infinite-dimensional control systems. We show that for certain classes of admissible inputs the existence of an ISS-Lyapunov function implies the input-to-state stability of a system. Then for the case of systems described by abstract equations in Banach spaces we develop two methods of construction of local and global ISS-Lyapunov functions. We prove a linearization principle that allows a construction of a local ISS-Lyapunov function for a system which linear approximation is ISS. In order to study interconnections of nonlinear infinite-dimensional systems, we generalize the small-gain theorem to the case of infinite-dimensional systems and provide a way to construct an ISS-Lyapunov function for an entire interconnection, if ISS-Lyapunov functions for subsystems are known and the small-gain condition is satisfied. We illustrate the theory on examples of linear and semilinear reaction-diffusion equations.Comment: 33 page

Problems in the context evaluation of individualized courses

From 1970 to 1974 an Individualized Study System (ISS) for mathematics courses for first year engineering students was developed. Because of changes in the curriculum, new courses had to be developed from August 1974. The context evaluation of these new courses (ISS-calculus) consisted mainly of the evaluation of the mathematics courses developed during the preceding years. After a year the Department decided to suspend ISS as a teaching system for calculus partly because of dissatisfaction of the teachers with ISS-calculus.\ud This paper consists of two parts. Part one (sections 1,2) is a case study and summarizes the development of the system from 1970 to 1975. It examines in detail the problems encountered in this development with special attention to the role of the executive teacher. The organization of an ISS-course and the planning decisions to be taken become more complex according to the number of executive teachers. In part two (sections 3,4) we provide a classification of ISS courses to illustrate the complexity of the system and we offer some general advice on the management of individualized study systems

Norepinephrine Involvement in the Intermittent Swim Stress-Induced Deficit in Spatial Learning and Memory

Learning and memory impairments are often caused by stress disorders including depression. The present study investigated the involvement of norepinephrine in the swim stress-induced deficits of spatial learning and memory. Exposure to intermittent swim stress (ISS) followed by learning and memory tests in the Morris water maze (MWM) were used to investigate this relationship. The ISS paradigm consists of intermittent exposure to cold water, producing stress responses in rats. Reboxetine, a norepinephrine selective reuptake inhibitor (NSRI), was employed to investigate whether this compound reverses the ISS-induced deficit. In other words, rats exposed to the ISS, were hypothesized to experience impaired learning and subsequent deficits in memory while rats treated with reboxetine that are also exposed to stress will not experience these deficits. In order to provide further evidence that reboxetine reverses the affect of the ISS on spatial learning and memory, a 24-hour post-stress assessment in the MWM in one single massed session of 18 trials (9 blocks of 2 trials each) on the day following the ISS was performed. This provided verification that ISS-induced deficits in spatial learning and memory are sensitive to the effects of reboxetine thereby implicating that norepinephrine is a crucial contributor to this phenomenon. It was hypothesized that if norepinephrine is involved in depressive behaviors caused by stress, then reboxetine will attenuate any deficits produced by the ISS paradigm in the learning and memory trials performed in the MWM

Linking axionlike dark matter to neutrino masses

We present a framework linking axionlike particles (ALPs) to neutrino masses through the minimal inverse seesaw (ISS) mechanism in order to explain the dark matter (DM) puzzle. Specifically, we explore three minimal ISS cases where mass scales are generated through gravity-induced operators involving a scalar field hosting ALPs. In all of these cases, we find gravity-stable models providing the observed DM relic density and, simultaneously, consistent with the phenomenology of neutrinos and ALPs. Remarkably, in one of the ISS cases, the DM can be made of ALPs and sterile neutrinos. Furthermore, other considered ISS cases have ALPs with parameters inside regions to be explored by proposed ALPs experiments.Comment: 1 figure, 14 page