New Complexity Results and Algorithms for the Minimum Tollbooth Problem

The inefficiency of the Wardrop equilibrium of nonatomic routing games can be eliminated by placing tolls on the edges of a network so that the socially optimal flow is induced as an equilibrium flow. A solution where the minimum number of edges are tolled may be preferable over others due to its ease of implementation in real networks. In this paper we consider the minimum tollbooth (MINTB) problem, which seeks social optimum inducing tolls with minimum support. We prove for single commodity networks with linear latencies that the problem is NP-hard to approximate within a factor of $1.1377$ through a reduction from the minimum vertex cover problem. Insights from network design motivate us to formulate a new variation of the problem where, in addition to placing tolls, it is allowed to remove unused edges by the social optimum. We prove that this new problem remains NP-hard even for single commodity networks with linear latencies, using a reduction from the partition problem. On the positive side, we give the first exact polynomial solution to the MINTB problem in an important class of graphs---series-parallel graphs. Our algorithm solves MINTB by first tabulating the candidate solutions for subgraphs of the series-parallel network and then combining them optimally

QUASI-INVARIANCE OF PRODUCT MEASURES UNDER LIE GROUP PERTURBATIONS - FISHER INFORMATION AND L(2)-DIFFERENTIABILITY

A sequence of measures on a topological space is pert-bed by a sequence of elements of a Lie group acting on that space. Criteria are given for the singularity and equivalence of the corresponding product measures. These criteria extend the results of Shepp and Steele. In particular, Fisher information comes into the scene and its role is further clarified.2031420143

Shot Noise in Mesoscopic Diffusive Andreev Wires

We study shot noise in mesoscopic diffusive wires between a normal and a superconducting terminal. We particularly focus on the regime, in which the proximity-induced reentrance effect is important. We will examine the difference between a simple Boltzmann-Langevin description, which neglects induced correlations beyond the simple conductivity correction, and a full quantum calculation. In the latter approach, it turns out that two Andreev pairs propagating coherently into the normal metal are anti-correlated for E<E_c, where E_c=D/L^2 is the Thouless energy. In a fork geometry the flux-sensitive suppression of the effective charge was confirmed experimentally.Comment: 12 pages, proceedings of the NATO ARW MQO, Bled, Sloveni

The Scandinavian ACL registries 2004–2007: baseline epidemiology

Background and purpose No prospective surveillance systems have been available for monitoring the outcome of cruciate ligament surgery in Scandinavia (Denmark, Norway, and Sweden). In the present paper we describe the Scandinavian ACL registries including their main function, similarities, and preliminary baseline results

Oscillations of aqueous PEDOT:PSS fluid droplets and the properties of complex fluids in drop-on-demand inkjet printing

Shear-thinning aqueous poly(3,4-ethylenedioxythiophene): poly(styrene sulphonate) (PEDOT:PSS) fluids were studied under the conditions of drop-on-demand inkjet printing. Ligament retraction caused oscillation of the resulting drops, from which values of surface tension and viscosity were derived. Effective viscosities of <4 mPa s at drop oscillation frequencies of 13–33 kHz were consistent with conventional high-frequency rheometry, with only a small possible contribution from viscoelasticity with a relaxation time of about 6 μs. Strong evidence was found that the viscosity, reduced by shear-thinning in the printhead nozzle, recovered as the drop formed. The low viscosity values measured for the drops in flight were associated with the strong oscillation induced by ligament retraction, while for a weakly perturbed drop the viscosity remained high. Surface tension values in the presence of surfactant were significantly higher than the equilibrium values, and consistent with the surface age of the drops. [Graphical abstract - see article]This work was supported by EPSRC and a consortium of industrial partners (EPSRC Grant no. EP/H018913/1: Innovation in industrial inkjet technology). The high-speed camera and high power flash lamp were provided by the EPSRC Engineering Instrument Pool and we thank Adrian Walker for his help.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.jnnfm.2015.05.00

Pain outcomes in patients with bone metastases from advanced cancer: assessment and management with bone-targeting agents

Bone metastases in advanced cancer frequently cause painful complications that impair patient physical activity and negatively affect quality of life. Pain is often underreported and poorly managed in these patients. The most commonly used pain assessment instruments are visual analogue scales, a single-item measure, and the Brief Pain Inventory Questionnaire-Short Form. The World Health Organization analgesic ladder and the Analgesic Quantification Algorithm are used to evaluate analgesic use. Bone-targeting agents, such as denosumab or bisphosphonates, prevent skeletal complications (i.e., radiation to bone, pathologic fractures, surgery to bone, and spinal cord compression) and can also improve pain outcomes in patients with metastatic bone disease. We have reviewed pain outcomes and analgesic use and reported pain data from an integrated analysis of randomized controlled studies of denosumab versus the bisphosphonate zoledronic acid (ZA) in patients with bone metastases from advanced solid tumors. Intravenous bisphosphonates improved pain outcomes in patients with bone metastases from solid tumors. Compared with ZA, denosumab further prevented pain worsening and delayed the need for treatment with strong opioids. In patients with no or mild pain at baseline, denosumab reduced the risk of increasing pain severity and delayed pain worsening along with the time to increased pain interference compared with ZA, suggesting that use of denosumab (with appropriate calcium and vitamin D supplementation) before patients develop bone pain may improve outcomes. These data also support the use of validated pain assessments to optimize treatment and reduce the burden of pain associated with metastatic bone disease

Factors associated with grade 1 hypertension: implications for hypertension care based on the Dietary Approaches to Stop Hypertension (DASH) in primary care settings

Background: A Reference Framework for Hypertension Care was recently developed by Hong Kong government to emphasise the importance of primary care for subjects with high blood pressure (BP). The Dietary Approaches to Stop Hypertension (DASH) interventional regime was recommended for patients aged 40–70 years with grade 1 hypertension (having systolic BP of 140-159 mmHg and/or diastolic BP of 90-99 mmHg). This study explored factors associated with grade 1 hypertension among subjects screened in primary care settings. Methods: The study sample consisted of community dwellers (N = 10,693) enrolled in a primary care programme in which participants overall had similar characteristics when compared to the Hong Kong population census. Invitation phone calls were given by trained researchers to a randomly selected subjects (N = 2,673, [50% of total subjects aged 40–70 years]) between January and June 2013. BP and body mass index (BMI) were measured by trained clinical professionals according to a standard protocol. Interviewer-administered survey questionnaires were used to collect self-report information on socio-demographics, family history, and lifestyle characteristics. Multiple logistic regression analysis was performed to explore factors associated with grade 1 hypertension. Adjusted odds ratios (aORs) were estimated with 95% confidence intervals (CI). Results A total of 679 out of 2,673 subjects agreed to participate in the screening and completed the baseline assessment (100% completion rate), among which, 320 subjects (47.1%, [320/679]) were grade 1 hypertensive. Unhealthy diet (aOR = 2.19, 95%CI 1.04-4.62), irregular meals (aOR = 1.47, 95%CI 1.11-1.95), BMI &gt;27.5 kg/m2 (aOR = 1.87, 95%CI 1.53-2.27), duration of cigarette smoking (aOR = 1.83 per year), increased daily cigarette consumption (aOR = 1.59 per pack [20 cigarettes per pack]), duration of alcohol drinking (aOR = 1.65 per year), and higher frequency of weekly binge drinking (aOR = 1.87 per occasion) were independently associated with grade 1 hypertension. The increase in the number of risk factors combined significantly correlated with higher predicted probability of grade 1 hypertension. Conclusions: Dietary-intake factors were significantly associated with grade 1 hypertension, echoing the recommendation in the Reference Framework on incorporating dietary-related intervention based on the DASH approach for hypertension care in primary care settings. The association between aggregate risk factors and grade 1 hypertension should also be taken into consideration in long-term preventive strategy

Impact of the Covid-19 Pandemic on ALS Care in the UK

The Covid-19 pandemic has impacted healthcare. Our aim was to identify how amyotrophic lateral sclerosis (ALS) care in the UK has been affected by the pandemic by exploring the experiences of people living with ALS (plwALS), healthcare professionals (HCPs) working with plwALS, and ALS care centers. Three surveys were carried out to explore the experiences of plwALS, HCPs and ALS care centers during the pandemic. Quantitative data were analyzed using descriptive and inferential statistics and triangulated with the qualitative data which were analyzed thematically. Responses from 53 plwALS, 73 HCPs and 23 ALS care centers were analyzed. Five main themes were identified: keeping safe, losses, negative emotions, delivering care and alternative care delivery in a pandemic. PlwALS and HCPs felt that care was sub-optimal as a result of the pandemic. Changes to care included longer waiting times and face-to-face appointments being canceled or replaced by virtual consultations. While benefits of virtual consultations were reported, concerns were raised about incomplete clinical assessments and the disruption of provision of testing and interventions. ALS care has changed as a result of the pandemic. Patients have had a lack of face-to-face contact with HCPs and have experienced delays to investigations and treatments. PlwALS and HCPs were concerned about the impact of this change, but the long-term implications remain unclear. We propose recommendations for HCPs caring for plwALS, that will promote continuity of evidenced based care in the context of a pandemic

Antipsychotic dose escalation as a trigger for Neuroleptic Malignant Syndrome (NMS): literature review and case series report

Background: “Neuroleptic malignant syndrome” (NMS) is a potentially fatal idiosyncratic reaction to any medication which affects the central dopaminergic system. Between 0.5% and 1% of patients exposed to antipsychotics develop the condition. Mortality rates may be as high as 55% and many risk factors have been reported. Although rapid escalation of antipsychotic dose is thought to be an important risk factor, to date it has not been the focus of a published case series or scientifically defined. &lt;p/&gt;Aims: To identify cases of NMS and review risk factors for its development with a particular focus on rapid dose escalation in the 30 days prior to onset. &lt;p/&gt;Methodology: A review of the literature on rapid dose escalation was undertaken and a pragmatic definition of “rapid dose escalation” was made. NMS cases were defined using DSM-IV criteria and systematically identified within a secondary care mental health service. A ratio of titration rate was calculated for each NMS patient and “rapid escalators” and “non rapid escalators” were compared. &lt;p/&gt;Results: 13 cases of NMS were identified. A progressive mean dose increase 15 days prior to the confirmed episode of NMS was observed (241.7mg/day during days 1-15 to 346.9mg/day during days 16-30) and the mean ratio of dose escalation for NMS patients was 1.4. Rapid dose escalation was seen in 5/13 cases and non rapid escalators had markedly higher daily cumulative antipsychotic dose compared to rapid escalators. &lt;p/&gt;Conclusions: Rapid dose escalation occurred in less than half of this case series (n=5, 38.5%), although there is currently no consensus on the precise definition of rapid dose escalation. Cumulative antipsychotic dose – alongside other known risk factors - may also be important in the development of NMS