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Background: Malpositioned central venous access devices (CVADs) can lead to significant patient injury including central vein thrombosis and dysrhythmias. Intra-cavitary electrocardiography (IC ECG) has been recommended by peak professional bodies as an accurate alternative for bedside CVAD insertion, to reduce risk of malposition and allowing immediate use of the device. Our objective was to compare the effect of IC ECG on CVAD malposition compared to traditional institutional practice for CVAD placement. Methods: Randomised controlled trial of IC ECG CVAD insertion verses traditional CVAD insertion (surface landmark measurement with post insertion x ray). Patient recruitment was from December 2016 to July 2018. The setting was a 900-bed tertiary referral hospital based in South Western Sydney, Australia. Three hundred and forty-four adult patients requiring CVAD insertion for intravenous therapy, were enrolled and randomly allocated (1:1 ratio) to either IC-ECG (n = 172) or traditional (n = 172) CVAD insertion. Our primary outcome of interest was the rate of catheters not requiring repositioning after insertion (ready for use). Secondary outcomes were comparison of procedure time and cost. Results: Of the 172 patients allocated to the IC ECG method, 170 (99%) were ready for use immediately compared to 139 of the 172 (81%) in the traditional insertion group (difference, 95% confidence interval (CI): 18%, 11.9–24.1%). The total procedure time was mean 15 min (SD 8 min) for IC ECG and mean 36 min (SD 17 min) for traditional CVAD insertion (difference–19.9 min (95% CI–14.6 to −34.4). IC ECG guided CVAD insertion had a cost reduction of AUD $62.00 per procedure. Conclusions: Using IC-ECG resulted in nearly no requirement for post-insertion repositioning of CVADs resulting in savings in time and cost and virtually eliminating the need for radiographic confirmation. Trial registration: This trial is registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au). The registration number is ACTRN12620000919910. © The Author(s) 2022.

Objectives: To review the studies, which calculated the total intensive care unit costs and indicated the main cost drivers in the intensive care by using either top-down, bottom-up approach or the combination of them. Research methodology/designs: A systematic review of papers published until October 2020 was conducted. Search was performed on PubMed, Medline, Scopus and Science Direct databases. Setting: This review i examined costs in adult intensive care units, in countries belonging to the Organisation for Economic Co-operation and Development (OECD) (medical, surgical or general adult, paediatric and neonatal were not included). Main outcome measures: Eighteen articles were included in the review. Results: Eight of the studies used the top-down costing methodology, six of them used the bottom-up approach and four of them used both of them. The mean total patient cost per day ranged from €200.75 to €4321.91 (all costs are presented in 2020 values for euro). Human resources were identified as the largest proportion of total costs. Length of stay, mechanical ventilation, continuous haemodialysis and severe illness are the main cost drivers of intensive care unit total costs. Conclusion: There are a variety of methods and study designs used to calculate costs of an intensive care unit stay.t It is necessary to evolve standardised costing methods in order to make comparisons and succeed in cost-effective management. © 2021 Elsevier Ltd

Background: Subcutaneously anchored securement devices (or subcutaneous engineered securement devices) have been introduced recently into the clinical practice, but the number of published studies is still scarce. The Italian Group of Long-Term Central Venous Access Devices (GAVeCeLT)—in collaboration with WoCoVA (World Congress on Vascular Access)—has developed a Consensus about the effectiveness, safety, and cost-effectiveness of such devices. Methods: After the definition of a panel of experts, a systematic collection and review of the literature on subcutaneously anchored securement devices was performed. The panel has been divided in two working groups, one focusing on adult patients and the other on children and neonates. Results: Although the quality of evidence is generally poor, since it is based mainly on non-controlled prospective studies, the panel has concluded that subcutaneously anchored securement devices are overall effective in reducing the risk of dislodgment and they appear to be safe in all categories of patients, being associated only with rare and negligible local adverse effects; cost-effectiveness is demonstrated—or highly likely—in specific populations of patients with long-term venous access and/or at high risk of dislodgment. Conclusion: Subcutaneously anchored securement is a very promising strategy for avoiding dislodgment. Further studies are warranted, in particular for the purpose of defining (a) the best management of the anchoring device so to avoid local problems, (b) the patient populations in which it may be considered highly cost-effective and even mandatory, (c) the possible benefit in terms of reduction of other catheter-related complications such as venous thrombosis and/or infection, and—last but not least—(d) their impact on the workload and stress level of nurses taking care of the devices. © The Author(s) 2020.

Aim: The aim of this study was the evaluation of health-related quality of life (HRQoL) and rehabilitation costs of patients with amputated limb. Materials and Methods: This is a cross-sectional study and the study sample, which was a sample of convenience, included 100 patients with amputated limb. The tools of the survey were the Short Form Questionnaire-36 (SF-36) and the Questionnaire used for measuring rehabilitation costs in trauma patients by Stergiannis et al. Results: The sample of the study consisted of 107 patients with amputation. HRQoL significantly increased (p

Objective: The objective was to explore factors affecting stress levels in hospitalized patients after implementation of fast-track (FT) protocol in hepatopancreatobiliary surgery. Methods: This was a prospective cross-sectional study, where 90 patients were included. Exploration of environmental postoperative stress levels was conducted by serum adrenocorticotropic hormone and cortisol levels, the Intensive Care Unit Environmental Stressor Scale, and three self-reported Numeric Analog Scale questions, with regard to emotional/stress level, specifically 'How sad do you feel right now?' 'How stressed do you feel right now?' and 'How optimistic do you feel right now, about the future?' at 3 time points: (T1) Before surgery, (T2) the day of surgery, and (T3) the 3rd postoperative day. The trial profile is conformed according to the CONSORT guidelines. Statistical analysis was carried out by SPSS software version 22 (IBM SPSS software, Chicago, Illinois, USA) at a significance level of 0.05. Results: Serum cortisol T2levels were positively correlated with the day of removal the drainage tube (rho = 0.235, P = 0.027). Furthermore, serum cortisol T3levels were positively correlated with age and body mass index and negatively with the day of drainage tube removal (rho = 0.231, P = 0.028, rho = 0.235, P = 0.026, and rho = -0.279, P = 0.008, respectively). Conclusions: The findings of this study highlight that after evaluation of stress levels; nurses could interfere and reduce stress levels, knowing the factors which cause the increased stress levels, after the implementation of FT protocols. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.

Στην έρευνα αυτή εξετάσθηκαν δημογραφικά στοιχεία, ζωοτεχνικά χαρακτηριστικά και παράμετροι της ποιότητας του γάλακτος σε εκτροφές γαλακτοπαραγωγικών προβάτων, στην περιοχή της βορειοδυτικής Πελοποννήσου. Η έρευνα περιέλαβε 128 εκτροφείς προβάτων και διεξήχθη με χρήση προσχεδιασμένου ερωτηματολογίου. Οι παραγωγοί στους οποίους έγινε η έρευνα, ήταν υπό τον έλεγχο του ΕΛΓΟ «Δήμητρα» και παρέδιδαν το γάλα σε μη αυτοελεγχόμενες τυροκομικές μονάδες. Από τα στοιχεία της έρευνας προέκυψαν τα πιο κάτω δεδομένα. Το 23.26% των κτηνοτρόφων ήταν από 31 έως40 ετών. Τo 64% αυτών ήταν απόφοιτοι δευτεροβάθμιας εκπαίδευσης και είχαν παρακολουθήσει κάποια ενημερωτικά σεμινάρια γεωργικού και κτηνοτροφικού περιεχομένου ως «Νέοι αγρότες» (17%) ή από ενημερώσεις κτηνιάτρων της κτηνιατρικής υπηρεσίας της περιοχής τους (11%). Το μέσο μέγεθος της εκτροφής ήταν 148 πρόβατα. Στο 77% των ερωτηθέντων οι υποδομές ήταν παραδοσιακού τύπου.Πολύ περιορισμένη ήταν η τεχνολογική διείσδυση στο θέμα της άμελξης αφού στο 83% διεξαγόταν με παραδοσιακό τρόπο. Σε ότι αφορά την ποιότητα του γάλακτος, από τα δεδομένα των μετρήσεων που μας παραχωρήθηκαν από το εργαστήριο ποιοτικού ελέγχου του ΕΛΓΟ «Δήμητρα», υπολογίστηκαν οι μέσες τιμές της (%) περιεκτικότητας σε λίπος, πρωτεΐνη, λακτόζη και στο στερεό υπόλοιπο άνευ λίπους, στα 6.54 ± 0.88, 5. 56 ± 0.36, 4.59 ± 0.23 και 10.95 ± 0.42 αντίστοιχα. Επιπλέον, η μέση τιμή του συνολικού μικροβιακού φορτίου βρέθηκε στο 5.38 ± 0.55 log cfu/ml και η μέση τιμή του pH των εξετασθέντων δειγμάτων γάλακτος ήταν στο 6.71 ± 0.11. Από την επεξεργασία των απαντήσεων στις ερωτήσεις που απευθύνθηκαν στους κτηνοτρόφους, προέκυψε ότι σε γενικές γραμμές, οι εκτροφείς των προβάτων είχαν καλή αντίληψη σε θέματα που αφορούσαν την ολοκληρωμένη διαχείριση και η προοπτική για την εκτροφή προβάτων στο μέλλον φάνηκε να είναι αισιόδοξη. Ως αντίκτυπος της μελέτης αυτής φάνηκε ότι ενισχύθηκε η εμπιστοσύνη των κτηνοτρόφων στα εκπαιδευτικά ιδρύματα και από τη συζήτηση μαζί τους προέκυψε ότι είναι δεκτικοί σε αλλαγές και επιζητούν την ενημέρωση και τη γενικότερη υποστήριξη., In this study the demographic features, various farm characteristics and milk quality parameters were investigated in sheep farms (n =128) from the North West Peloponnese region, using a prescreen questionnaire. The interviewed sheep farmers were under the control of the regional milk control laboratory of the Hellenic Milk Organization ELGO «Dimitra», which provided us with the corresponding milk quality data for the first quarter of 2014. Our findings regarding the demographic data demonstrated that 23% of farmers were 31-40 years old, 64% of them were high school graduates and 28% had received relevant farming general training; namely 17% of them has designated as “young farmers” in the frame of Third Axis of the Operational Program «Rural Development-Regeneration of the Countryside 2000-2006» and 11% have attended briefings by veterinarians and agriculturists. Ιn terms of farm characteristics, it has been revealed that the mean flock size was 148 sheep and regarding the farming system, the majority of the farms (89.15%) applied a mixed extensive / indoors system. Additionally, regarding building infrastructures and the way of milking, there was limited technological penetration, since the buildings were old-style (77%) and the milking procedure was performed by hands (83%). Concerning the milk composition, the measurements showed mean values of (%) content of fat, protein, lactose and non-fat dry matter (NFDM) at 6.54±0.88, 5.56±0.36, 4.59±0.23 and 10.95±0.42, respectively. Furthermore, the mean value of the total bacterial count (TBC) was found 5.38±0.55 log cfu/ml and the pH value at 6.71±0.11. In general, sheep farmers had a good perception of the integrated management and their prospect for sheep farming was optimistic. The impact of this study is that farmers increase their trust to the educational institutions and are prompted to become more receptive to new adaptive trends.

Objective Considering that inadvertent hypothermia (IH) is common in Intensive Care Unit (ICU) patients and can be followed by severe complications, this systematic review identified, appraised and synthesised the published literature about the association between IH and mortality in adults admitted to the ICU. Data sources By using key terms, literature searches were conducted in Pubmed, CINAHL, Cochrane Library, Web of Science and EMBASE. Review methods According to PRISMA guidelines, articles published between 1980–2016 in English-language, peer-reviewed journals were considered. IH was defined as core temperature of

Ziele: Es gibt derzeit keine allgemein gültige Definition die anhand von eindeutigen Parametern ein Karpaltunnelsyndromrezidiv (KSR) beschreibt und zu diesem Thema exisitiert kein systematischer Review. Ziel dieser Arbeit ist anhand einer systematischen Literaturrecherche die Parameter zu bestimmen,[zum vollständigen Text gelangen Sie über die oben angegebene URL], 48. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 55. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie, 22. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

Introduction True Left-sided gallbladder (LSG) is a rare anatomical variation with a prevalence of 0.3%. Mainly discovered during the operation, its surgical approach in the laparoscopic setting may be challenging even for an experienced surgeon. Presentation of case LSG was unexpectedly discovered in a young man during laparoscopic cholecystectomy. There were no pre-operative indications of this sinistroposition. The laparoscopic cholecystectomy was performed with minor surgical modifications and it was uneventful. A meticulous review of recent literature about LSGs was conducted as well. Discussion LSG is a scarce anatomical aberration that is difficultly identified pre-operatively. Surgeons should be aware of this aberration and of its accompanying anatomical variations in order to perform a safe laparoscopic cholecystectomy. Conclusion Surgeons, by placing the patient to left-side up position, are able to expose the Calot's triangle and possible accompanying anatomical anomalies and thus perform a safe laparoscopic cholecystectomy without difficult surgical modifications. © 2017 The Authors

Childhood obesity is associated with numerous respiratory disorders, which may be aggravated when general anesthesia is administered. This systematic review aimed to investigate and synthesize the published literature on the associations between childhood obesity and perioperative adverse respiratory events (PAREs). By using key terms, observational studies published between 1990 and 2014 in English-language journals indexed by Cumulative Index for Nursing and Allied Health Literature, PubMed, Web of Science, Cochrane Database, and EMBASE were searched for reports of relevant associations. Nine articles were considered eligible for inclusion. In all studies, significant univariate and multivariate associations were reported between obesity and increased risk for PAREs in pediatric patients, mainly for hypoxemia, upper airway obstruction, and difficult mask ventilation. Appropriate strategies for preventing PAREs in obese children need to be followed by health care professionals. Multicenter studies are also recommended for ensuring high generalizability of reported associations and elucidating underlying mechanisms that link obesity to PAREs. © 2016 American Society of PeriAnesthesia Nurses.

Background: Despite the expansion of capnography use, instruments for evaluating healthcare professionals' knowledge about capnography are missing from international literature. Objectives: To develop and validate an instrument for evaluating nurses' knowledge about capnography, named the "Nurses' Knowledge about Capnography Test" (NKCT). Method: A literature review was performed to formulate instrument items. Thirty-six items were initially developed, which covered principles of capnography function, conditions affecting end-tidal CO2 pressure and capnography waveform, and indications for capnography use. Six items were deleted after content validity and intra-rater reliability evaluation. The final 30-item instrument was completed by 103 anesthesiology department nurses employed in six hospitals of Greece, to test its internal consistency, item difficulty and discrimination, and construct validity. Results: Kuder-Richardson 20 coefficient was 0.79. Ten items were found to be of high difficulty, while item discrimination was low for two of them. Instrument scores were found significantly higher among participants with higher educational level and longer experience in capnography use. Conclusion: NKCT is a psychometrically comprehensive instrument for evaluating nurses' knowledge about capnography, which is recommended to be re-validated beyond the anesthesiology department and be used for the assessment of educational programs on capnography. © 2014 Australian College of Nursing Ltd.

Presented at the 19th International Conference on Chelation, London, UK, 13-16 November 2009Preliminary spectrophotometric and potentiometric studies have shown that hydroxycarbamide or hydroxyurea (HU) can interact with copper(II) [Cu(II)], iron(II) [Fe(II)] and Fe(III) ions and form complexes, for example, a ratio of 1 HU:1 metal at pH 5. The affinity for Cu (log β1 = 3.1) and Fe (log β1 = 5) by HU is much lower than that of the Fe and Cu chelating drug deferiprone (L1), which is used for the treatment of iron overload. It is anticipated that under certain conditions of high concentrations of these metal ions such as in transfusional iron overload, the therapeutic, pharmacological and toxicological properties of HU could be affected. It is also suggested that excess chelatable and labile forms of Fe or Cu ions, such as non transferrin-bound iron (NTBI) or intracellular low molecular weight labile iron, are among the main factors that may cause variations in the therapeutic response to HU in cancer, sickle cell anemia, thalassemia intermedia and other groups of patients. Further studies are needed to clarify the interaction mechanisms of HU with metal ions in vitro, in vivo and in clinical conditions. Copyright © Informa Healthcare USA, Inc. 35 3 237 246 Cited By :7

Undertreatment of postoperative pain can aggravate patient outcomes and is associated with attending nurses' knowledge deficits or negative attitudes toward pain. The aim of this study was to investigate knowledge and attitudes toward postoperative pain of surgical department nurses and to identify predictors of their knowledge and attitudes. This was a descriptive, cross-sectional survey that took place in the departments of general surgery, orthopedics, neurosurgery, ear-nose-throat surgery, and obstetrics/gynecology at five Greek hospitals. Participants were a convenience sample of registered and assistant nurses. Nurses were asked to complete a three-section questionnaire, which included demographics, a Knowledge and Attitudes Survey Regarding Pain (KASRP) tool modified for postoperative pain, and seven questions capturing personal characteristics, working conditions, and feelings about work. One hundred eighty-two questionnaires were completed. Average scores were 45.35% for modified KASRP tool; 28.57% for pain assessment; 55.44% for general pain management; and 47.13% for use of analgesics. Four of the five most commonly missed items referred to use of analgesics. More previous personal experience of postoperative pain (. p = .002) and being a registered nurse (. p = .015) predicted higher modified KASRP tool score. Participation in continuing education programs and department of employment were also associated with differences in the modified tool score. The knowledge deficits and negative attitudes of the nurses toward postoperative pain highlight the role of pregraduate and continuing education, appropriately specialized for each surgical department, in the development of empathy toward patients in pain and of clinical competency regarding pain assessment and administration of analgesics. © 2015 American Society for Pain Management Nursing.

Aims and objectives: To investigate the attitudes of nurses caring for hospitalised adult patients towards fever and antipyresis and to identify the predictors of these attitudes. Background: Fever is a host defence mechanism, whose harmful effects are limited to specific patients. Findings about antipyretic treatment have further challenged the need for routine or aggressive fever suppression. Unfortunately, nurses continue to be fever phobic, while their attitudes towards fever and antipyresis considerably affect antipyretic practice. Design: Prospective, cross-sectional, multicentre survey. Methods: A convenience sample of registered and assistant nurses employed in surgical/medical wards and intensive care units of nine Greek hospitals was enrolled. The developed questionnaire included 10 multiple-choice, knowledge-evaluating items about fever and antipyresis, 10 Likert-type attitude-evaluating items towards fever and 10 towards antipyresis. Multiple linear regression analysis was used to identify the predictors of attitudes towards fever and antipyresis. Results: The attitudes of the 458 participants were found to be relatively positive towards both fever and antipyresis. Lower fever/antipyresis knowledge score predicted both negative attitude towards fever (p = 0·001) and positive attitude towards antipyresis (p < 0·001), while longer professional experience predicted positive attitude towards antipyresis (p = 0·002). Conclusions: Advancing nurses' evidence-based knowledge about fever and antipyresis is expected to limit their tendency to overtreat fever and favour fever care based on the assessment of actual patient demands. Relevance to clinical practice: These findings highlight the need for continuing education programmes to eliminate fever phobia and improve nurses' competency for individualised fever care. © 2014 John Wiley & Sons Ltd.

Aims and objectives: To investigate and synthesise published literature on the associations between residual neuromuscular blockade and critical respiratory events of postoperative adult patients in the postanaesthesia care unit. Background: Residual neuromuscular blockade continues to be common among patients transferred to the postanaesthesia care unit after general anaesthesia, while negative effects of residual neuromuscular blockade on respiratory function have been demonstrated in laboratory volunteers. Design: Literature review. Methods: Using key terms, a search was conducted in Cumulative Index for Nursing and Allied Health Literature, PubMed, Web of Science, Cochrane Database and EMBASE (January 1990-May 2013) for clinical trials or observational studies on the associations between residual neuromuscular blockade and critical respiratory events, published in English-language journals. Results: Nine articles met the inclusion criteria. Residual neuromuscular blockade definition threshold differed between studies. Among critical respiratory events, only hypoxaemia was investigated in all included studies. Residual neuromuscular blockade was significantly associated with increased incidence of hypoxaemia during postanaesthesia care unit stay in most studies, while associations with the rest of the critical respiratory events were inconclusive. Conclusions: Although limited, existing research has provided evidence that patients with residual neuromuscular blockade are at high risk of early postoperative hypoxaemia. Further studies are needed to investigate independent associations between residual neuromuscular blockade and critical respiratory events, along with causality of these associations. The clinical importance of residual neuromuscular blockade for groups at high risk of critical respiratory events should also be investigated. Relevance to clinical practice: Healthcare professionals have to be aware of the increased risk of hypoxaemia in patients with residual neuromuscular blockade. Efforts to decrease residual neuromuscular blockade incidence, combined with identification and appropriate evaluation of patients with residual neuromuscular blockade during postanaesthesia care unit stay, are recommended. © 2014 John Wiley & Sons Ltd.

Aims and objectives. To evaluate pulse oximetry knowledge of nurses employed in the Intensive Care Unit (ICU), Anesthesiology Department (AD) and Emergency Department (ED) and to compare knowledge among these departments/units. Background. Although pulse oximetry has been widely used in clinical practice, previous studies have reported knowledge deficits among nurses, which may adversely affect patient outcomes. Design. Prospective, cross-sectional, multicentre study. Methods. All nurses employed in the ICU, AD and ED of six hospitals were asked to complete in private a 21-item, knowledge-evaluating questionnaire, which was evaluated for content-related validity and reliability. Results. Two hundred and seven questionnaires were completed (a response rate of 74·5%). Mean pulse oximetry knowledge score was 12·8±3·2, with ICU nurses having significantly higher scores than ED nurses (p=0·001) and those with more than 10years of experience having significantly higher scores than less experienced ones (p=0·015). Correct responses did not exceed 50% for six questionnaire items, five of which covered principles of pulse oximetry function. ICU nurses had significantly more correct responses in five items compared to ED nurses, and in two of them compared to AD nurses. Conclusions. Longer professional experience and being employed in the ICU were associated with higher pulse oximetry knowledge of Greek nurses. Considering knowledge deficits and differences among nurses, pulse oximetry knowledge seems to mainly develop through clinical experience. Relevance to clinical practice. These findings highlight the need for pregraduate education to follow clinical advances, and especially for the implementation of high-quality, continuing education programmes to provide systematic learning and support professional development of nurses. © 2012 Blackwell Publishing Ltd.

In this paper we compute the minimal polynomials of Ramanujan values 27 tn -12 for discriminants D ≡ 5 (mod 24). Our method is based on Shimura Reciprocity Law as which was made computationally explicit by Gee and Stevenhagen in [Generating class fields using Shimura reciprocity, in Algorithmic Number Theory, Lecture Notes in Computer Science, Vol. 1423 (Springer, Berlin, 1998), pp. 441453; MR MR1726092 (2000m:11112)]. However, since these Ramanujan values are not class invariants, we present a modification of the method used in [Generating class fields using Shimura reciprocity, in Algorithmic Number Theory, Lecture Notes in Computer Science, Vol. 1423 (Springer, Berlin, 1998), pp. 441453; MR MR1726092 (2000m:11112)] which can be applied on modular functions that do not necessarily yield class invariants. © 2012 World Scientific Publishing Company.

INTRODUCTION: The presence of the appendix in a femoral hernia sac is known as de Garengeot's hernia. We report a rare case of an elderly woman with femoral hernia appendicitis and discuss the surgical pitfalls and considerations through a literature review. PRESENTATION OF CASE: An 83-year-old woman presented with fever and right lower quadrant abdominal pain. Clinical examination revealed a femoral hernia. Ultrasonography confirmed bowel was present in the hernia sac. In the operation room, an acutely inflamed appendix was recognized within the sac. The patient underwent appendectomy and hernia repair with sutures. DISCUSSION: Acute appendicitis within a femoral hernia is rare and multiple dilemmas exist regarding its treatment. An incision below the inguinal ligament is a reasonable choice in order to access the hernia sac. A mesh should be placed in non-infectious appendectomy while herniorrhaphy is preferred in cases of appendicitis. CONCLUSION: The presence of the vermiform appendix in a femoral hernia sac is rare but the surgeon should be aware of this clinical entity. Prompt diagnosis and appropriate surgical treatment is the key to avoid complications. © 2012 Surgical Associates Ltd. Published by Elsevier Ltd.

In this article, Ramanujan-Weber class invariants and its analogue are used to derive birthday elliptic curves. © 2012 Elsevier Inc.

Class invariants are singular values of modular functions which generate the class fields of imaginary quadratic number fields. Their minimal polynomials, called class polynomials, are uniquely determined by a discriminant -D < 0 and are used in many applications, including the generation of elliptic curves. In all these applications, it is desirable that the size of the polynomials is as small as possible. Among all known class polynomials, Weber polynomials constructed with discriminants -D ≡ 1 (mod 8) have the smallest height and require the least precision for their construction. In this paper, we will show that this fact does not necessarily lead to the most efficient computations, since the congruences modulo 8 of the discriminants affect the degrees of the polynomials. © 2011 AIMS-SDU.

Commissioned White Paper Report for Philips International.

Blunt traumatic injury and acute dissection of thoracic aorta is increasing in incidence in seriously multi-trauma patients, remaining highly lethal. Early identification and repair is the key to a successful outcome. We report an unusual case of a 62-year-old man involved in a motor vehicle accident after subarachnoid hemorrhage due to an intracranial artery aneurysm rupture. The post-traumatic aorta dissection was overlooked during the initial evaluation and was found incidentally later during an attempt for endovascular treatment of the intracranial aneurysm. The pitfalls in the diagnostic approach of this patient are discussed and the paramount importance of the correct interpretation of all the available clinical and investigational findings in multiple injured patients are highlighted. © 2009 Mitsos et al; licensee Cases Network Ltd.