Minor head injury in the Republic of Ireland : evaluation of written information given at discharge from emergency departments

Most patients presenting to the emergency department with minor head injuries are discharged with written information. Here the quality of minor head injury discharge leaflets in the Republic of Ireland is evaluated against a nationally accepted template. There was great variability in leaflet content. Most provided minimal information on emergency symptoms but 60% contained no information on post-concussional symptoms. No leaflet was available in audio-format or languages other than English. Information provided in minor head injury leaflets should be improved and standardised across Ireland

Multi-objective engineering shape optimization using differential evolution interfaced to the Nimrod/O tool

This paper presents an enhancement of the Nimrod/O optimization tool by interfacing DEMO, an external multiobjective optimization algorithm. DEMO is a variant of differential evolution – an algorithm that has attained much popularity in the research community, and this work represents the first time that true multiobjective optimizations have been performed with Nimrod/O. A modification to the DEMO code enables multiple objectives to be evaluated concurrently. With Nimrod/O’s support for parallelism, this can reduce the wall-clock time significantly for compute intensive objective function evaluations. We describe the usage and implementation of the interface and present two optimizations. The first is a two objective mathematical function in which the Pareto front is successfully found after only 30 generations. The second test case is the three-objective shape optimization of a rib-reinforced wall bracket using the Finite Element software, Code_Aster. The interfacing of the already successful packages of Nimrod/O and DEMO yields a solution that we believe can benefit a wide community, both industrial and academic

The assessment of circulating volume using inferior vena cava collapse index and carotid Doppler velocity time integral in healthy volunteers: a pilot study

International audienceBackground: Assessment of circulating volume and the requirement for fluid replacement are fundamental to resuscitation but remain largely empirical. Passive leg raise (PLR) may determine fluid responders while avoiding potential fluid overload. We hypothesised that inferior vena cava collapse index (IVCCI) and carotid artery blood flow would change predictably in response to PLR, potentially providing a non-invasive tool to assess circulating volume and identifying fluid responsive patients.Methods: We conducted a prospective proof of concept pilot study on fasted healthy volunteers. One operator measured IVC diameter during quiet respiration and sniff, and carotid artery flow. Stroke volume (SV) was also measured using suprasternal Doppler. Our primary endpoint was change in IVCCI after PLR. We also studied changes in IVCCI after “sniff”, and correlation between carotid artery flow and SV.Results: Passive leg raise was associated with significant reduction in the mean inferior vena cava collapsibility index from 0.24 to 0.17 (p < 0.01). Mean stroke volume increased from 56.0 to 69.2 mL (p < 0.01). There was no significant change in common carotid artery blood flow. Changes in physiology consequent upon passive leg raise normalised rapidly.Discussion: Passive leg raise is associated with a decrease of IVCCI and increase in stroke volume. However, the wide range of values observed suggests that factors other than circulating volume predominate in determining the proportion of collapse with respiration.Conclusion: In contrast to other studies, we did not find that carotid blood flow increased with passive leg raise. Rapid normalisation of post-PLR physiology may account for this

A Framework for Proving Hilbert's Double Integral Inequality and Related Results

The classical Hilbert and Hardy integral inequalities are derived within a functional analytic framework. That framework is further used to generate a new inequality, sharper than Hilbert's

The Best Constant in an Inequality of Ostrowski Type

We prove that the constant ½ in Dragomir-Wang's inequality [2] is best

Prevalence of High-Risk Disordered Eating Amongst Adolescents and Young Adults in the Middle East: A Scoping Review

High-risk disordered eating (HRDE) negatively affects physical, mental, and social wellbeing. This scoping review aimed to estimate the prevalence of HRDE amongst adolescents and young adults in the Middle East. MEDLINE database was searched for studies published in English or Arabic from 1 January 2000 to 30 September 2020, estimating HRDE prevalence (using the Eating Attitudes Test 26 or 40 item questionnaire) in the Middle East. Two reviewers independently screened abstracts and full texts of potentially eligible records, followed by data extraction from eligible studies. Nineteen studies (n = 16,288; 65.8% female) from Egypt, Iran, Israel, Jordan, Kuwait, Libya, Oman, Palestine, Saudi Arabia, Syria, Turkey, and the United Arab Emirates were included. Prevalence of HRDE varied considerably across countries and was lowest amongst adolescents in Israel (F 8.2%; M 2.8%) and highest amongst university students in Egypt (F 75.8%; M 69.6%). Prevalence of high-risk for anorexia nervosa ranged from 0.0% in Jordan to 9.5% in Oman; high-risk for bulimia nervosa from 0.6% in Jordan to 1.0% in the United Arab Emirates; and high-risk for binge eating disorder was 1.0% and 1.8% in Turkey and Jordan, respectively. Future studies should employ a standardized two-stage design with clinical diagnosis to verify the prevalence of abnormal eating behaviours in the Middle East

RSCS: a parallel simplex algorithm for the Nimrod/O optimization toolset

This paper describes a method of parallelisation of the popular Nelder-Mead simplex optimization algorithms that can lead to enhanced performance on parallel and distributed computing resources. A reducing set of simplex vertices are used to derive search directions generally closely aligned with the local gradient. When tested on a range of problems drawn from real-world applications in science and engineering, this reducing set concurrent simplex (RSCS) variant of the Nelder-Mead algorithm compared favourably with the original algorithm, and also with the inherently parallel multidirectional search algorithm (MDS). All algorithms were implemented and tested in a general-purpose, grid-enabled optimization toolset

RSCS: A parallel simplex algorithm for the Nimrod/O optimization toolset

This paper describes a method of parallelisation of the popular Nelder-Mead simplex optimization algorithms that can lead to enhanced performance on parallel and distributed computing resources. A reducing set of simplex vertices are used to derive search directions generally closely aligned with the local gradient. When tested on a range of problems drawn from real-world applications in science and engineering, this reducing set concurrent simplex (RSCS) variant of the Nelder-Mead algorithm compared favourably with the original algorithm, and also with the inherently parallel multidirectional search algorithm (MDS). All algorithms were implemented and tested in a general-purpose, grid-enabled optimization toolset