Discontinuous Galerkin finite element scheme for a conserved higher-order traffic flow model by exploring Riemann solvers

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Practices, predictors and consequences of expressed breast-milk feeding in healthy full-term infants

To investigate the prevalence and predictors of expressed breast-milk feeding in healthy full-term infants and its association with total duration of breast-milk feeding. Prospective cohort study. In-patient postnatal units of four public hospitals in Hong Kong. A total of 2450 mother–infant pairs were recruited in 2006–2007 and 2011–2012 and followed up prospectively for 12 months or until breast-milk feeding had stopped. Across the first 6 months postpartum, the rate of exclusive expressed breast-milk feeding ranged from 5·1 to 8·0 % in 2006–2007 and from 18·0 to 19·8 % in 2011–2012. Factors associated with higher rate of exclusive expressed breast-milk feeding included supplementation with infant formula, lack of previous breast-milk feeding experience, having a planned caesarean section delivery and returning to work postpartum. Exclusive expressed breast-milk feeding was associated with an increased risk of early breast-milk feeding cessation when compared with direct feeding at the breast. The hazard ratio (95 % CI) ranged from 1·25 (1·04, 1·51) to 1·91 (1·34, 2·73) across the first 6 months. Mothers of healthy term infants should be encouraged and supported to feed directly at the breast. Exclusive expressed breast-milk feeding should be recommended only when medically necessary and not as a substitute for feeding directly at the breast. Further research is required to explore mothers’ reasons for exclusive expressed breast-milk feeding and to identify the health outcomes associated with this practice.postprin

Solitary wave solution to Aw-Rascle viscous model of traffic flow

A traveling wave solution to the Aw-Rascle traffic flow model that includes the relaxation and diffusion terms is investigated. The model can be approximated by the well-known Kortweg-de Vries (KdV) equation. A numerical simulation is conducted by the first-order accurate Lax-Friedrichs scheme, which is known for its ability to capture the entropy solution to hyperbolic conservation laws. Periodic boundary conditions are applied to simulate a lengthy propagation, where the profile of the derived KdV solution is taken as the initial condition to observe the change of the profile. The simulation shows good agreement between the approximated KdV solution and the numerical solution.postprin

Effect on Baby-Friendly Hospital Steps When Hospitals Implement a Policy to Pay for Infant Formula

Background: The Baby-Friendly Hospital Initiative requires hospitals to pay market price for infant formula. No studies have specifically examined the effect of hospitals paying for infant formula on breastfeeding mothers' exposure to Baby-Friendly steps. Objectives: To investigate the effect of hospitals implementing a policy of paying for infant formula on new mothers' exposure to Baby-Friendly steps and examine the effect of exposure to Baby-Friendly steps on breastfeeding rates. Methods: We used a repeated prospective cohort study design. We recruited 2 cohorts of breastfeeding mother-infant pairs (n = 2470) in the immediate postnatal period from 4 Hong Kong public hospitals and followed them by telephone up to 12 months postpartum. We assessed participants' exposure to 6 Baby-Friendly steps by extracting data from the medical record and by maternal self-report. Results: After hospitals began paying for infant formula, new mothers were more likely to experience 4 out of 6 Baby-Friendly steps. Breastfeeding initiation within the first hour increased from 28.7% to 45%, and in-hospital exclusive breastfeeding rates increased from 17.9% to 41.4%. The proportion of mothers who experienced all 6 Baby-Friendly steps increased from 4.8% to 20.5%. The risk of weaning was progressively higher among participants experiencing fewer Baby-Friendly steps. Each additional step experienced by new mothers decreased the risk of breastfeeding cessation by 8% (hazard ratio = 0.92; 95% CI, 0.89-0.95). Conclusion: After implementing a policy of paying for infant formula, breastfeeding mothers were exposed to more Baby-Friendly steps, and exposure to more steps was significantly associated with a lower risk of breastfeeding cessation.postprin

Effect of a hospital policy of not accepting free infant formula on in-hospital formula supplementation rates and breast-feeding duration

OBJECTIVE: To investigate the effect of public hospitals in Hong Kong not accepting free infant formula from manufacturers on in-hospital formula supplementation rates and breast-feeding duration. DESIGN: Prospective cohort study. SETTING: In-patient postnatal units of four public hospitals in Hong Kong. SUBJECTS: Two cohorts of breast-feeding mother-infant pairs (n 2560). Cohort 1 (n 1320) was recruited before implementation of the policy to stop accepting free infant formula and cohort 2 (n 1240) was recruited after policy implementation. Participants were followed prospectively for 12 months or until they stopped breast-feeding. RESULTS: The mean number of formula supplements given to infants in the first 24 h was 2·70 (sd 3·11) in cohort 1 and 1·17 (sd 1·94) in cohort 2 (P<0·001). The proportion of infants who were exclusively breast-fed during the hospital stay increased from 17·7 % in cohort 1 to 41·3 % in cohort 2 (P<0·001) and the risk of breast-feeding cessation was significantly lower in cohort 2 (hazard ratio=0·81; 95 % CI 0·73, 0·90). Participants who non-exclusively breast-fed during the hospital stay had a significantly higher risk of stopping any or exclusive breast-feeding. Higher levels of formula supplementation also increased the risk of breast-feeding cessation in a dose-response pattern. CONCLUSIONS: After implementation of a hospital policy to pay market price for infant formula, rates of in-hospital formula supplementation were reduced and the rates of in-hospital exclusive breast-feeding and breast-feeding duration increased.postprin

lp-Recovery of the Most Significant Subspace among Multiple Subspaces with Outliers

We assume data sampled from a mixture of d-dimensional linear subspaces with spherically symmetric distributions within each subspace and an additional outlier component with spherically symmetric distribution within the ambient space (for simplicity we may assume that all distributions are uniform on their corresponding unit spheres). We also assume mixture weights for the different components. We say that one of the underlying subspaces of the model is most significant if its mixture weight is higher than the sum of the mixture weights of all other subspaces. We study the recovery of the most significant subspace by minimizing the lp-averaged distances of data points from d-dimensional subspaces, where p>0. Unlike other lp minimization problems, this minimization is non-convex for all p>0 and thus requires different methods for its analysis. We show that if 0<p<=1, then for any fraction of outliers the most significant subspace can be recovered by lp minimization with overwhelming probability (which depends on the generating distribution and its parameters). We show that when adding small noise around the underlying subspaces the most significant subspace can be nearly recovered by lp minimization for any 0<p<=1 with an error proportional to the noise level. On the other hand, if p>1 and there is more than one underlying subspace, then with overwhelming probability the most significant subspace cannot be recovered or nearly recovered. This last result does not require spherically symmetric outliers.Comment: This is a revised version of the part of 1002.1994 that deals with single subspace recovery. V3: Improved estimates (in particular for Lemma 3.1 and for estimates relying on it), asymptotic dependence of probabilities and constants on D and d and further clarifications; for simplicity it assumes uniform distributions on spheres. V4: minor revision for the published versio

Primary cutaneous melanoma of the breast: A case report

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: Primary cutaneous melanoma of the breast is a very rare tumour, accounting for &lt; 5 % of all malignant melanomas. Case presentation: A young lady was seen in the breast clinic for a skin lesion in the right breast. Clinical examination and investigations confirmed a diagnosis of a primary cutaneous melanoma of the breast. The lesion was excised and the patient made good recovery. She has shown no signs of local recurrence and is under regular follow-up in the dermatology clinic. Conclusion: This case is educational as it shows that the treatment of breast cutaneous melanoma is similar to that for any skin parts with surgery remaining the main therapeutic option. It also shows that mastectomy is unnecessary as it does not improve the results obtained by wide local excision of melanoma. Background Primary cutaneous melanoma rarely affects the breast, accounting for less than 5 % of all malignant melanomas