Caesarean section and mortality

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Who named it in anaesthesia?

The history of modern anaesthesia started on October 16, 1846 when WTG Morton demonstrated ether anaesthesia in Massachusetts General Hospital in USA. For about one month the new born branch of medicine was without a name. The word anaesthesia as we know of now as a science and art was suggested by Oliver Holmes Wendell in November 1846. New discoveries and inventions followed. Most of them needed new names or terminologies. Some of them were named by the people who discovered them, some by the people who did studies later. Few words existed before 1846 and majority naturally came after. A peep is made into the glorious past of anaesthesia which is one of mankind’s greatest discoveries. This article salutes the great personalities who coined those words, which millions of tongues speak daily around the globe.Keywords: anaesthesia, balanced anaesthesia, dissociative anaesthesia, history, spinal anaesthesi

An Integer Programming Approach to the Student-Project Allocation Problem with Preferences over Projects

The Student-Project Allocation problem with preferences over Projects (SPA-P) involves sets of students, projects and lecturers, where the students and lecturers each have preferences over the projects. In this context, we typically seek a stable matching of students to projects (and lecturers). However, these stable matchings can have different sizes, and the problem of finding a maximum stable matching (MAX-SPA-P) is NP-hard. There are two known approximation algorithms for MAX-SPA-P, with performance guarantees of 2 and 32 . In this paper, we describe an Integer Programming (IP) model to enable MAX-SPA-P to be solved optimally. Following this, we present results arising from an empirical analysis that investigates how the solution produced by the approximation algorithms compares to the optimal solution obtained from the IP model, with respect to the size of the stable matchings constructed, on instances that are both randomly-generated and derived from real datasets. Our main finding is that the 32 -approximation algorithm finds stable matchings that are very close to having maximum cardinality

Fracture of complex metallic alloys: An atomistic study of model systems

Molecular dynamics simulations of crack propagation are performed for two extreme cases of complex metallic alloys (CMAs): In a model quasicrystal the structure is determined by clusters of atoms, whereas the model C15 Laves phase is a simple periodic stacking of a unit cell. The simulations reveal that the basic building units of the structures also govern their fracture behaviour. Atoms in the Laves phase play a comparable role to the clusters in the quasicrystal. Although the latter are not rigid units, they have to be regarded as significant physical entities.Comment: 6 pages, 4 figures, for associated avi file, see http://www.itap.physik.uni-stuttgart.de/~frohmut/MOVIES/C15.LJ.011.100.av

Individual risk factors predictive of venous thromboembolism in patients with temporary lower limb immobilisation due to injury: a systematic review

BACKGROUND: Patients immobilised after lower limb injury are at risk of venous thromboembolism (VTE). There is international variation in the use of thromboprophylaxis for such patients. Risk based strategies have been adopted to aid decision making in many settings. The accuracy of these strategies is unclear. OBJECTIVES: A systematic review was undertaken to identify all individual patient identifiable risk factors linked to any VTE outcome following lower limb immobilisation. METHODS: Several electronic databases were searched from inception to May 2017. Any studies which included a measurement of VTE patient outcome in adults requiring temporary immobilisation (e.g. leg cast or brace in an ambulatory setting) for an isolated lower limb injury and reported risk factor variables were included. Descriptive statistics and thematic analysis were used to synthesise the evidence. RESULTS: Our database search returned 4771 citations, of which 15 studies reporting outcome data on 80,678 patients were eligible for analysis. Risk factor associations were reported through regression analyses, non-parametric tests and descriptive statistics. All studies were assessed as at moderate or serious risk of bias using the ROBINS-I risk of bias tool. Advancing age and injury type were the only individual risk factors demonstrating a reproducible association with increased symptomatic and/or asymptomatic VTE rates. Several risk factors currently used in scoring tools did not appear to be robustly evaluated for subsequent association with VTE, within these studies. CONCLUSIONS: Clinicians should be aware of the limited evidence to support individual risk factors in guiding thromboprophylaxis use for this patient cohort

Travelling on Graphs with Small Highway Dimension

We study the Travelling Salesperson (TSP) and the Steiner Tree problem (STP) in graphs of low highway dimension. This graph parameter was introduced by Abraham et al. [SODA 2010] as a model for transportation networks, on which TSP and STP naturally occur for various applications in logistics. It was previously shown [Feldmann et al. ICALP 2015] that these problems admit a quasi-polynomial time approximation scheme (QPTAS) on graphs of constant highway dimension. We demonstrate that a significant improvement is possible in the special case when the highway dimension is 1, for which we present a fully-polynomial time approximation scheme (FPTAS). We also prove that STP is weakly NP-hard for these restricted graphs. For TSP we show NP-hardness for graphs of highway dimension 6, which answers an open problem posed in [Feldmann et al. ICALP 2015]

Lifestyle Intervention Using an Internet-Based Curriculum with Cell Phone Reminders for Obese Chinese Teens: A Randomized Controlled Study

Objectives Obesity is an increasing public health problem affecting young people. The causes of obesity are multi-factorial among Chinese youth including lack of physical activity and poor eating habits. The use of an internet curriculum and cell phone reminders and texting may be an innovative means of increasing follow up and compliance with obese teens. The objectives of this study were to determine the feasibility of using an adapted internet curriculum and existing nutritional program along with cell phone follow up for obese Chinese teens. Design and Methods This was a randomized controlled study involving obese teens receiving care at a paediatric obesity clinic of a tertiary care hospital in Hong Kong. Forty-eight subjects aged 12 to 18 years were randomized into three groups. The control group received usual care visits with a physician in the obesity clinic every three months. The first intervention (IT) group received usual care visits every three months plus a 12-week internet-based curriculum with cell phone calls/texts reminders. The second intervention group received usual care visits every three months plus four nutritional counselling sessions. Results The use of the internet-based curriculum was shown to be feasible as evidenced by the high recruitment rate, internet log-in rate, compliance with completing the curriculum and responses to phone reminders. No significant differences in weight were found between IT, sLMP and control groups. Conclusion An internet-based curriculum with cell phone reminders as a supplement to usual care of obesity is feasible. Further study is required to determine whether an internet plus text intervention can be both an effective and a cost-effective adjunct to changing weight in obese youth. Trial Registration Chinese Clinical Trial Registry ChiCTR-TRC-12002624published_or_final_versio

On domain walls in a Ginzburg-Landau non-linear S^2-sigma model

The domain wall solutions of a Ginzburg-Landau non-linear $S^2$-sigma hybrid model are unveiled. There are three types of basic topological walls and two types of degenerate families of composite - one topological, the other non-topological- walls. The domain wall solutions are identified as the finite action trajectories (in infinite time) of a related mechanical system that is Hamilton-Jacobi separable in sphero-conical coordinates. The physical and mathematical features of these domain walls are thoroughly discussed.Comment: 26 pages, 18 figure