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This article clarifies the control a State should have over an armed group for the triggering act of an international armed conflict and for the internationalization of non-international armed conflicts in international humanitarian law. It explains the reasons for the distinction between these two types of attribution and details the specificities of each test, with an innovative approach. The author proposes new control tests for both triggering and internationalization, rejecting the effective and overall control tests regarding internationalization proposed by the International Court of Justice and the International Criminal Tribunal for the former Yugoslavia. For instance, regarding the internationalization of a non-international armed conflict, a general and strict control test is proposed. Finally, this article addresses specific issues like the difficult question of the control required for an occupation through an armed group.
Carbon monoxide (CO) can cause mass intoxication, but no standard triage algorithm specifically addresses CO poisoning. The roles of some recent diagnostic tools in triage as well as treatment with hyperbaric oxygen are controversial. We describe a mass casualty case of CO poisoning involving 77 patients, with a focus on the triage and treatment options decided on-site. The reasons for choosing these options are reviewed, and the pitfalls that occurred and the lessons learned from this major incident are described. We discuss the potential to improve the management of such an event and strategies to accomplish this, including simplifying triage and administering oxygen to all exposed persons for 6 h. (Disaster Med Public Health Preparedness. 2018; 12: 373–378)
The concept of response time with minimal interval is intimately related to the practice of emergency medicine. The factors influencing this time interval are poorly understood.
In a process of improvement of response time, the impact of the patient’s age on ambulance departure intervals was investigated.
This was a 3-year observational study. Departure intervals of ambulances, according to age of patients, were analyzed and a multivariate analysis, according to time of day and suspected medical problem, was performed.
A total of 44,113 missions were included, 2,417 (5.5%) in the pediatric group. Mean departure delay for the adult group was 152.9 seconds, whereas it was 149.3 seconds for the pediatric group (P =.018).
A statistically significant departure interval difference between missions for children and adults was found. The difference, however, probably was not significant from a clinical point of view (four seconds).
SchneggB, PasquierM, CarronPN, YersinB, DamiF. Prehospital Emergency Medical Services Departure Interval: Does Patient Age Matter?Prehosp Disaster Med. 2016;31(6):608–613.
The success of a systematic review depends on the availability, accessibility and quality of literature related to the review question. This paper presents the literature found in four systematic reviews conducted for a selection of zoonotic hazards in four livestock value chains in Africa, as well as setting out the challenges in conducting the reviews. The protocol was designed following international standards, and addressed four questions around prevalence, risk factors, control options and impact of various hazards and populations. Searches were conducted in four online databases. Articles were screened for relevance, and quality was assessed before data extraction. Literature on zoonotic hazards was in general scarce and access to full articles was limited. Overall, 25–40% of papers were considered poor quality. The diversity of approaches and designs in the studies compromised the ability to generate summarized estimates. We found that the emphasis of veterinary research has been on livestock problems rather than public health issues, although this seems to be shifting in the last decade; we also found there are limited studies on impact and control. While increasing literature is being published around zoonoses in Africa, this is still inadequate to appropriately inform policy and guide research efforts.
Influenza is a major concern for Emergency Medical Services (EMS); EMS workers’ (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting.
The influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated.
A survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected.
Response rate was 95%. The EMS-Ws were predominantly male (n=45; 73%), in good health (87%), with a mean age of 36 (SD=7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI+/SI+), 19% for PI only (PI+/SI-), 1.6% for SI only (PI-/SI+), and 39% were not vaccinated against either (PI-/SI-). Women’s vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI+/SI+ EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI- (P=.001) and 25% for PI+/SI- (P=.001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P=.001). Thirty percent of the PI+/SI+ EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI- and PI+/SI- groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness.
Average vaccination rate in this study’s EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a “pandemic effect.” These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.
CarronPN. Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services. Prehosp Disaster Med. 2016;31(2):155–162.
We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident. (Disaster Med Public Health Preparedness. 2015;9:440–443)
In order to model and predict the alteration of medieval potash-containing stained glass, it is necessary to understand the mechanisms of alteration layer formation at the glass surface and its role on the evolution of alteration kinetics. Moreover, the alteration layers observed on stained glasses are particular, as they are often fractured and heterogeneous in terms of thickness, with the appearance of pits and the detachment of scales. Contrary to silicate glasses altered in aqueous environment where the gel layer has a protective role, cracks and scales are harmful to the durability of stained glasses altered in air. In order to address these mechanistic issues, a program of experiments in the laboratory and in the field were performed. The fracturing was shown to be caused by the growth of the alteration layers and amplified by the alternation of humid and dry periods changing the density of hydrated layers. The pitting is initiated by defects at the glass surface and increased in external atmospheric medium as these defects fix the precipitated salts. However, despite fracturing and pitting, the development of an altered layer imposes a diffusive transport of the solution between the external medium and the bulk glass.
In the context of the preservation of the cultural heritage, it is important to understand the alteration mechanisms of the materials constituting historical monuments and architecture. Limestone especially is widely used in many French monuments exposed to an urban aggressive atmosphere affecting their durability. To better understand the alteration mechanisms, the first step is to characterize at different scales the stone material properties. In one hand, the pore network that drives the fluids transfer inside the materials was characterized. And on the other hand, the alteration layer formed on several decades aged materials was studied. Results on this fine-scale characterization are discussed.
The sufficient statistics of the one-point probability density function of the dark matter density field is worked out using cosmological perturbation theory and tested to the Millennium simulation density field. The logarithmic transformation is recovered for spectral index close to -1 as a special case of the family of power transformations. We then discuss how these transforms should be modified in the case of noisy tracers of the field and focus on the case of Poisson sampling. This gives us optimal local transformations to apply to galaxy survey data prior the extraction of the spectrum in order to capture most efficiently the information encoded in large scale structures.
We study Fredholm properties and index formulas for Dirac operators over complete Riemannian manifolds with straight ends. An important class of examples of such manifolds are complete Riemannian manifolds with pinched negative sectional curvature and finite volume.
We have measured the infrared (IR) reflectance and Raman spectra of electron doped and undoped Nd2CuO4 and Pr2CuO4. Utilizing the results from doped ceramics and undoped ab plane oriented single crystals, we observe and assign all the IR active phonons (3A2u + 4Eu) predicted by group theory. We have also observed the Raman active modes involving atom motion along the c axis. We compare our results to those found in the related hole superconductors based upon La2CuO4.
We report far infrared reflectance measurements of RBa2Cu3Ox, where R-Y, Er and Nd and 6<×<7 for YBa2Cu3Ox. Based on these measurements we assign the observed phonon features. In particular, one vibration is clearly identified as an R vibration, while the lowest energy mode (near 151 cm-1) is associated with the linear Cu-O chains.
The predictability of models describing long-term nuclear glass behavior in a geological repository can be tested by means of natural or archaeological analogs. This study covers fractured archaeological glass blocks from a shipwreck discovered near the Mediterranean island of Embiez (France). The blocks were examined mainly because of their morphological analogy with nuclear glasses. Fractured after production (as in the case of nuclear glass), these blocks had been leached for 1800 years in seawater. The laboratory investigation led to the development and subsequent validation on archaeological objects of a geochemical model capable of accurately simulating the coupling between chemistry and transport to account for the alteration state of the cracks according to their geometric characteristics. Laboratory experiments allowed us to determine the kinetic and thermodynamic parameters for modeling glass alteration. The model was then tested against short-term experiments before simulating the crack alteration over 1800 years. We show that cracks in the outer regions of the block are the most severely altered because of rapid solution renewal, whereas internal cracks are very slightly altered because of a rate-limiting effect of water transport due to the formation of secondary phases. This study also establishes a direct link between data obtained at lab scale and the long-term evolution of a complex system in a natural environment, indicating that the key phenomena have been identified experimentally. The analogous behavior of archaeological and nuclear glass during leaching experiments and the similarities in their crack networks allow us to consider applying the model to nuclear glasses under geological repository conditions. This study clearly shows that the internal crack network does not play a major role in the overall long-term alteration of archeological glass blocks. The issue of the transposition studies will be to determine whether this conclusion can be generalized to nuclear glasses.
The mechanical properties of a CuCr1Zr alloy were measured with the help of a Gleeble
3500 machine at temperatures ranging from 250 °C to 1000 °C. Some tensile tests were also
performed at 20 °C. The measured data were first used to determine the thermal linear
coefficient at different temperatures. The measured curves were then simulated with an
elasto-visco-plastic constitutive model assuming that the material behaviour was
isotropic. This law requires the knowledge of temperature dependent parameters that were
determined by inverse method. This work represents a part of a PhD study on hot tearing
susceptibility during welding.
We show that on the Hilbert scheme of n points on ℂ2, the hyperkähler metric constructed by Nakajima via hyperkähler reduction is the quasi-asymptotically locally Euclidean (QALE) metric constructed by Joyce.