Outcomes and costs of blunt trauma in England and Wales

Background Trauma represents an important public health concern in the United Kingdom, yet the acute costs of blunt trauma injury have not been documented and analysed in detail. Knowledge of the overall costs of trauma care, and the drivers of these costs, is a prerequisite for a cost-conscious approach to improvement in standards of trauma care, including evaluation of the cost-effectiveness of new healthcare technologies. Methods Using the Trauma Audit Research Network database, we examined patient records for persons aged 18 years and older hospitalised for blunt trauma between January 2000 and December 2005. Patients were stratified by the Injury Severity Score (ISS). Results A total of 35,564 patients were identified; 60% with an ISS of 0 to 9, 17% with an ISS of 10 to 16, 12% with an ISS of 17 to 25, and 11% with an ISS of 26 to 75. The median age was 46 years and 63% of patients were men. Falls were the most common cause of injury (50%), followed by road traffic collisions (33%). Twenty-nine percent of patients were admitted to critical care for a median length of stay of 4 days. The median total hospital length of stay was 9 days, and 69% of patients underwent at least one surgical procedure. Seven percent of the patients died before discharge, with the highest proportion of deaths among those in the ISS 26–75 group (32%). The mean hospital cost per person was £9,530 (± 11,872). Costs varied significantly by Glasgow Coma Score, ISS, age, cause of injury, type of injury, hospital mortality, grade and specialty of doctor seen in the accident and emergency department, and year of admission. Conclusion The acute treatment costs of blunt trauma in England and Wales vary significantly by injury severity and survival, and public health initiatives that aim to reduce both the incidence and severity of blunt trauma are likely to produce significant savings in acute trauma care. The largest component of acute hospital cost is determined by the length of stay, and measures designed to reduce length of admissions are likely to be the most effective in reducing the costs of blunt trauma care

Space-time variation of the s and c quark masses

Space-time variation of fundamental physical constants in expanding Universe is predicted by a number of popular models. The masses of second generation quarks are larger than first generation quark masses by several orders of magnitude, therefore space-time variation in quark masses may significantly vary between each generation. We evaluate limits on variation in the s and c quark masses from Big Bang nucleosynthesis, Oklo natural nuclear reactor, Yb+, Cs and Rb clock data. The construction of 229Th nuclear clock is expected to enhance these limits by several orders of magnitude. Furthermore, constraints are obtained on an oscillating scalar or pseudoscalar cold dark matter field, as interactions of the field with quarks produce variations in quark masses

Selection from read-only memory with limited workspace

Given an unordered array of $N$ elements drawn from a totally ordered set and an integer $k$ in the range from $1$ to $N$, in the classic selection problem the task is to find the $k$-th smallest element in the array. We study the complexity of this problem in the space-restricted random-access model: The input array is stored on read-only memory, and the algorithm has access to a limited amount of workspace. We prove that the linear-time prune-and-search algorithm---presented in most textbooks on algorithms---can be modified to use $\Theta(N)$ bits instead of $\Theta(N)$ words of extra space. Prior to our work, the best known algorithm by Frederickson could perform the task with $\Theta(N)$ bits of extra space in $O(N \lg^{*} N)$ time. Our result separates the space-restricted random-access model and the multi-pass streaming model, since we can surpass the $\Omega(N \lg^{*} N)$ lower bound known for the latter model. We also generalize our algorithm for the case when the size of the workspace is $\Theta(S)$ bits, where $\lg^3{N} \leq S \leq N$. The running time of our generalized algorithm is $O(N \lg^{*}(N/S) + N (\lg N) / \lg{} S)$, slightly improving over the $O(N \lg^{*}(N (\lg N)/S) + N (\lg N) / \lg{} S)$ bound of Frederickson's algorithm. To obtain the improvements mentioned above, we developed a new data structure, called the wavelet stack, that we use for repeated pruning. We expect the wavelet stack to be a useful tool in other applications as well.Comment: 16 pages, 1 figure, Preliminary version appeared in COCOON-201

Effects of the long-range neutrino-mediated force in atomic phenomena

As known, electron vacuum polarization by nuclear Coulomb field produces Uehling potential with the range $\hbar/2m_e c$. Similarly, neutrino vacuum polarization by $Z$ boson field produces long range potential $\sim G_F^2/r^5$ with a very large range $\hbar/2m_{\nu}c$. Measurements of macroscopic effects produced by potential $G_{eff}^2/r^5$ give limits on the effective interaction constant $G_{eff}$ which exceed Fermi constant $G_F$ by many orders of magnitude, while limits from spectroscopy of simple atomic systems are approaching the standard model predictions. In the present paper we consider limits on $G_{eff}$ from muonium, positronium, hydrogen and deuterium spectra and isotope shift in hydrogen and heavy atoms including corrections leading to the King plot non-linearity.Comment: 8 pages, 3 figures, 4 table

Leadership for success in transforming medical abortion policy in Canada.

OBJECTIVES: Mifepristone was approved for use in medical abortion by Health Canada in 2015. Approval was accompanied by regulations that prohibited pharmacist dispensing of the medication. Reproductive health advocates in Canada recognized this regulation would limit access to medical abortion and successfully worked to have this regulation removed in 2017. The purpose of this study was to assess the leadership involved in changing these regulations so that the success may be replicated by other groups advocating for health policy change. METHODS: This study involved a mixed methods instrumental design in the context of British Columbia, Canada. Our data collection included: a) interviews with seven key individuals, representing the organizations that worked in concert for change to Canadian mifepristone regulations, and b) document analysis of press articles, correspondence, briefing notes, and meeting minutes. We conducted a thematic analysis of transcripts of audio-recorded interviews. We identified strengths and weaknesses of the team dynamic using the Develop Coalitions, Achieve Results and Systems Transformation domains of the LEADS Framework. RESULTS: Our analysis of participant interviews indicates that autonomy, shared values, and clarity in communication were integral to the success of the group's work. Analysis using the LEADS Framework showed that individuals possessed many of the capabilities identified as being necessary for successful health policy leadership. A lack of post-project assessment was identified as a possible limitation and could be incorporated in future work to strengthen dynamics especially when a desired outcome is not achieved. Document analysis provided a clear time-line of the work completed and suggested that strong communication between team members was another key to success. CONCLUSIONS: The results of our analysis of the interviews and documents provide valuable insight into the workings of a successful group committed to a common goal. The existing collegial and trusting relationships between key stakeholders allowed for interdisciplinary collaboration, rapid mobilization, and identification of issues that facilitated successful Canadian global-first deregulation of mifepristone dispensing

Typical entanglement in multi-qubit systems

Quantum entanglement and its paradoxical properties hold the key to an information processing revolution. Much attention has focused recently on the challenging problem of characterizing entanglement. Entanglement for a two qubit system is reasonably well understood, however, the nature and properties of multiple qubit systems are largely unexplored. We have found that typical pure states of N qubits are highly entangled but have decreasing amounts of pairwise entanglement as N increases. Above 6 qubits very few states have any pairwise entanglement, and generally, m-way entanglement disappears from a typical pure state of N qubits for N >~ 2m + 3

A Faster Implementation of Online Run-Length Burrows-Wheeler Transform

Run-length encoding Burrows-Wheeler Transformed strings, resulting in Run-Length BWT (RLBWT), is a powerful tool for processing highly repetitive strings. We propose a new algorithm for online RLBWT working in run-compressed space, which runs in $O(n\lg r)$ time and $O(r\lg n)$ bits of space, where $n$ is the length of input string $S$ received so far and $r$ is the number of runs in the BWT of the reversed $S$. We improve the state-of-the-art algorithm for online RLBWT in terms of empirical construction time. Adopting the dynamic list for maintaining a total order, we can replace rank queries in a dynamic wavelet tree on a run-length compressed string by the direct comparison of labels in a dynamic list. The empirical result for various benchmarks show the efficiency of our algorithm, especially for highly repetitive strings.Comment: In Proc. IWOCA201

High-sensitivity force measurement using entangled probes

We show the possibility to improve the measurement sensitivity of a weak force by using two meters in an entangled state. This latter can be achieved by exploiting radiation pressure effects.Comment: ReVTeX file, 11 pages, 2 eps figure