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Purpose: The Advanced Trauma Life Support (ATLS) course was implemented in Taiwan by the Taiwan Surgical Association in 1996. The purpose of this study was to examine whether the ATLS course increases physicians' ability to care for severely injured patients and to identify areas for improvement in running the course. Methods: We prospectively collected the demographic data of participants for the ATLS provider and refresher courses held in 2012. We analyzed the passing rates (PRs) of the courses stratified by age, sex, types of hospitals, levels of trauma centers, and participant subspecialty. We also compared the students' pre-and post-test responses to multiple-choice questions (MCQs). Statistical significance was set at p < 0.05. Results: A total of 274 and 258 participants attended the provider and refresher courses, respectively. Five hundred (94%) participants were from either medical centers or regional hospitals and 437 also worked at trauma centers. The PR was affected by the age and the levels of the trauma centers in which the participants worked but not by sex or levels of training. More post-test MCQs on initial assessment and airway management topics were answered correctly than were pretest MCQs on the same topics (p < 0.0001). By comparison, more responses to shock-management MCQs were answered incorrectly (p < 0.0001). Conclusion: The ATLS course is a critical learning experience for physicians treating trauma patients. Junior house staff and physicians working at local hospitals, particularly those in rural areas, should be encouraged to attend the ATLS course.

We present the numbers of ice model and eight-vertex model configurations (with Boltzmann factors equal to one), I(n) and E(n) respectively, on the two-dimensional Sierpinski gasket SG(n) at stage n. For the eight-vertex model, the number of configurations is E(n) = 2 3(3 n +1)/2 and the entropy per site, defined as lim v→∞ ln E(n)/v where v is the number of vertices on SG(n), is exactly equal to ln 2. For the ice model, the upper and lower bounds for the entropy per site lim v→∞ ln I(n)/v are derived in terms of the results at a certain stage. As the difference between these bounds converges quickly to zero as the calculated stage increases, the numerical value of the entropy can be evaluated with more than a hundred significant figures accurate. The corresponding result of ice model on the generalized two-dimensional Sierpinski gasket SG b (n) with b = 3 is also obtained. For the generalized vertex model on SG 3 (n), the number of configurations is 2 (8×6 n +7)/5 and the entropy per site is equal to 8 7 ln 2. The general upper and lower bounds for the entropy per site for arbitrary b are conjectured.