Background: Status epilepticus (SE) is the most common pediatric neurological emergency. Timely treatment is crucial, yet administration of rescue medications is often delayed and under-dosed. We aim to improve SE management by ensuring that every child at risk of SE in our province has an individualized seizure action plan (SAP) outlining the steps that should be taken during SE. Methods: A survey was distributed to parents of epilepsy patients aged 1 month to 19 years. Primary outcome was percentage of patients with SAPs. Secondary outcome was parental interest in a SAP mobile application. Following chart review, univariate and multivariate analysis was performed to identify variables that predict whether patients have SAPs. Results: Of 192 participants, 61.5% have SAPs. On univariate analysis, history of prior SE and male gender increased likelihood of having a SAP. On logistic regression, Nagelkerke R2 was 0.204 and our model correctly predicted 82.2% of patients with SAPs. 83.3% of parents were interested in a SAP mobile application. Conclusions: This is one of the first studies to examine SAP prevalence in a pediatric epilepsy population. There is a need to increase the percentage of epilepsy patients with SAPs. Most parents would find a SAP mobile application valuable in their child’s management.

There has been wide-spread use of plane wave theory in muffler design in industry. However, This has led to an underestimation of acoustical performances at higher frequencies. To overcome the above drawback, the finite element and boundary element methods have been developed. Nevertheless, the time consumed in calculating the noise level is unacceptable. Moreover, considering the acoustical effect and necessity of space-constrained situation in industry, a compact design of reverse mufflers which may improve the acoustical efficiency is then proposed.

In this paper, a numerical assessment of rectangular mufflers hybridized with straight/reverse chambers using eigen function, four-pole matrix, and genetic algorithm under limited space is developed. Before the optimization is performed, an accuracy check of the mathematical models for the muffler will be carried out. Results reveal that the noise reduction will increase when the number of chambers increases. In addition, the acoustical performance of the mufflers is reversely proportional to the diameter of the inlet/outlet tubes. Also, the TL of the mufflers will be improved when using more number of target tones in the objective function. Consequently, a successful approach in searching optimal shaped rectangular straight/reverse mufflers using an eigen function and a genetic algorithm method within a constrained space has been demonstrated.

Surveillance data on the burden of pertussis in Asian adults are limited. This cross-sectional study evaluated the prevalence of serologically confirmed pertussis in adults with prolonged cough in Malaysia, Taiwan and Thailand. Adults (⩾19 years) with cough lasting for ⩾14 days without other known underlying cause were enrolled from outpatient clinics of seven public and/or private hospitals. Single blood samples for anti-pertussis toxin antibodies (anti-PT IgG) were analysed and economic impact and health-related quality of life (EQ-5D) questionnaires assessed. Sixteen (5·13%) of the 312 chronically coughing adults had serological evidence of pertussis infection within the previous 12 months (anti-PT IgG titre ⩾62·5 IU/ml). Three of them were teachers. Longer duration of cough, paroxysms (75% seroconfirmed, 48% non-seroconfirmed) and breathlessness/chest pain (63% seroconfirmed, 36% non-seroconfirmed) were associated with pertussis (P < 0·04). Of the seroconfirmed patients, the median total direct medical cost per pertussis episode in public hospitals (including physician consultations and/or emergency room visits) was US$13 in Malaysia, US$83 in Taiwan (n = 1) and US$26 in Thailand. The overall median EQ-5D index score of cases was 0·72 (range 0·42–1·00). Pertussis should be considered in the aetiology of adults with a prolonged or paroxysmal cough, and vaccination programmes considered.

The focal point of this paper is to uncover, by analyzing the higher order wave effect, an improved mechanism for space-constrained rectangular plenums using a simplified objective function in conjunction with a genetic (GA). Three kinds of rectangular mufflers hybridized with extended tubes will be assessed: Plenum A: A two-chamber plenum equipped with an extended tube; plenum B: A three-chamber plenum with two extended tubes; and plenum C: A two-chamber plenum equipped with three extended tubes. In order to shorten the numerical assessment, a simplified objective function (OBJ) is established using a boundary element model (BEM) in conjunction with the neural network model (NNM). To expediently approach an optimal plenum, the best OBJ will be numerically searched using a genetic algorithm (GA). However, before the GA operation is performed, the accuracy of the BEM is verified using analytical data. And, because the simplified objective function (OBJ) is seen to be in agreement with the BEM, the numerical cases of sound elimination relative to the various parameter sets and pure tones (300, 750, and 1300Hz) can be carried out.

Results reveal that the maximum value of the sound transmission loss (STL) can be accurately obtained at the desired frequencies. Additionally, the acoustical performance of the lower frequencies will be improved if the number of chambers and rectangular tubes are increased. However, the acoustical performance of the higher frequencies will decrease when the number of chambers and rectangular tubes are decreased. Consequently, the algorithms proposed in this study will efficiently develop optimal rectangular plenums with multiple rectangular extended tubes.

High noise levels in a multi-noise plant can be harmful to workers and can lead to both psychological and physiological problems. Consequently, noise control work on equipment such as acoustic hoods becomes vital. However, research work of shape optimization on space-constrained close-fitting acoustic hoods has been neglected.

In this paper, a sound insertion loss used for evaluating the acoustic performance of an acoustical hood will be adopted. A numerical case for depressing the noise levels at the receiving points along the boundary of three kinds of multi-equipment plants by optimally designing a shaped one-layer close-fitting acoustic hood and reallocating the equipment within a constrained space will also be introduced. Moreover, an artificial immune method (AIM) is adopted and coupled with the equations of sound attenuation and minimal variation square in conjunction with a twelve-point monitoring system.

Consequently, this paper provides a quick and effective method for reducing the noise impact around a plant by optimally designing a shaped one-layer close-fitting acoustic hood and reallocating equipment within the AIM searching technique.

This paper presents the optimal design of an electromagnetic vibration-based generator using the simulated annealing method (SA). To optimally extract the vibrational energy of a system vibrating at a specific frequency, the selected mass and spring stiffness of a resonant vibration is required. The relationship between induced energy and the generator's structure, its permanent magnet height and diameter, number of turns, and wire diameter in a single air coil are discussed. Also, a prototype of the vibrationbased electrical generator is built and tested via a shaker excited at resonance frequency and input amplitude of 0.06mm. Consequently, results reveal that the design parameters (permanent magnet height and diameter, number of turns, and wire diameter) play essential roles in maximizing electrical power.

Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.

Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure.

Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics.

Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.

Research on new techniques of multi-chamber mufflers equipped with a side inlet and internal nonperforated intruding tubes has been discussed in recent literature; however, the research work of multichamber mufflers in conjunction with side inlet and open-ended perforated intruding tubes which may efficiently increase the acoustical performance has been neglected. Therefore, the main purpose of this paper is to optimize the best design shape of multi-chamber side mufflers with open-ended perforated intruding tubes within a limited space.

In this paper, the four-pole system matrix in evaluating the acoustic performance is also deduced in conjunction with a simulated algorithm (SA). Results reveal that the maximum sound transmission loss (STL) is precisely located at the desired target tone. In addition, the acoustical performance of mufflers conjugated with perforated intruding tubes is superior to those equipped with non-perforated tubes. Additionally, the noise reduction ability for a three-chamber side muffler with a non-perforated intruding tube and a two-chamber side muffler with perforated intruding tubes are equivalent. Moreover, mufflers with more chambers will increase the acoustic performance for both pure tone and broadband noise.

Reliable estimates of the burden of 2009 pandemic influenza A(pH1N1) cannot be easily obtained because only a small fraction of infections were confirmed by laboratory tests in a timely manner. In this study we developed a Poisson prediction modelling approach to estimate the excess mortality associated with pH1N1 in 2009 and seasonal influenza in 1998–2008 in the subtropical city Hong Kong. The results suggested that there were 127 all-cause excess deaths associated with pH1N1, including 115 with cardiovascular and respiratory disease, and 22 with pneumonia and influenza. The excess mortality rates associated with pH1N1 were highest in the population aged ⩾65 years. The mortality burden of influenza during the whole of 2009 was comparable to those in the preceding ten inter-pandemic years. The estimates of excess deaths were more than twofold higher than the reported fatal cases with laboratory-confirmed pH1N1 infection.

Research on new techniques of side-inlet/outlet mufflers equipped with internal non-perforated intruding tubes has been discussed in recent literature; however, the research work of multi-chamber sideinlet/outlet mufflers in conjunction with cross-flow tubes and open-ended perforated intruding tubes which may efficiently increase the acoustical performance is rare. Therefore, the main purpose of this paper is not only to analyze the sound transmission loss (STL) of three kinds of side-inlet/outlet mufflers (a three-chamber muffler with cross-flow tubes, a five-chamber muffler with cross-flow tubes and a nonperforated tube, and a five-chamber muffler with cross-flow tubes and a perforated tube) but also to optimize their best design shape within a limited space.

In this paper, both the generalized decoupling technique and plane wave theory in solving the coupled acoustical problem are used. A four-pole system matrix in evaluating the acoustic performance is also deduced in conjunction with a simulated algorithm (SA). A numerical case in finding the optimal STL of mufflers, which is constrained within a basement with a side-inlet/outlet, at targeted tones has been introduced. Before the optimization is carried out, an accuracy check of the mathematical model is performed. Results reveal that the maximal STL is precisely located at the desired target tone. Moreover, it has been seen that mufflers with more chambers will increase the acoustic performance for both pure tone and broadband noise. Additionally, the acoustical performance of mufflers conjugated with perforated intruding tubes is superior to those equipped with non-perforated tubes.

Consequently, the approach used for seeking the optimal design of the STL proposed in this study is indeed easy and quite effective.

Rose geranium (Pelargonium graveolens, Geraniaceae) has anti-cancer and anti-inflammatory properties, and promotes wound healing. Similarly, Ganoderma tsugae (Ganodermataceae), Codonopsis pilosula (Campanulaceae) and Angelica sinensis (Apiaceae) are traditional Chinese herbs associated with immunomodulatory functions. In the present study, a randomised, double-blind, placebo-controlled study was conducted to examine whether the Chinese medicinal herb complex, RG-CMH, which represents a mixture of rose geranium and extracts of G. tsugae, C. pilosula and A. sinensis, can improve the immune cell count of cancer patients receiving chemotherapy and/or radiotherapy to prevent leucopenia and immune impairment that usually occurs during cancer therapy. A total of fifty-eight breast cancer patients who received chemotherapy or radiotherapy were enrolled. Immune cell levels in patient serum were determined before, and following, 6 weeks of cancer treatment for patients receiving either an RG-CMH or a placebo. Administration of RG-CMH was associated with a significant reduction in levels of leucocytes from 31·5 % for the placebo group to 13·4 % for the RG-CMH group. Similarly, levels of neutrophils significantly decreased from 35·6 % for the placebo group to 11·0 % for the RG-CMH group. RG-CMH intervention was also associated with a decrease in levels of T cells, helper T cells, cytotoxic T cells and natural killer cells compared with the placebo group. However, these differences between the two groups were not statistically significant. In conclusion, administration of RG-CMH to patients receiving chemotherapy/radiotherapy may have the capacity to delay, or ease, the reduction in levels of leucocytes and neutrophils that are experienced by patients during cancer treatment.