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Uncontrolled bleeding is a leading cause of preventable death in trauma. The “Stop the Bleed” campaign has trained over 130,000 lay people in the US to act to control bleeding. Current hemorrhage control courses, the most well-known being the American College of Surgeon’s Basic Bleeding Control (ACS B-con) course, require in-person training. Scaling this course nationwide is time and resource intensive. Furthermore, groups have advocated that young people, who are disproportionately affected by physical trauma, be universally trained in hemorrhage control.
Compare the effectiveness of teaching the ACS B-con course to high school (HS) students utilizing three different delivery mechanisms: in-person live, video-recorded, and virtual-live training.
432 students (aged 15-18) will be recruited from two HS settings: 300 from a local HS and 132 from a national online HS platform. Local HS students will be randomized into two arms: a control arm (in-person live training) and virtual training through a pre-recorded lecture. Online HS students will undergo virtual-live training. The primary outcome is correct tourniquet application following training. Secondary outcomes are the acquisition of personal resilience-associated traits using a validated instrument, motivation for further training, and perception of the importance of live training. Tourniquet application data will be assessed using a non-inferiority design using two pairwise comparisons of the intervention arms to the control (in-person). Pre- to post-training survey data will be assessed using paired univariates tests. Sub-analysis of the impact of demographic variables on these relationships will be assessed.
In addition to integration of cardiopulmonary resuscitation courses into HS curricula, there is momentum to develop effective programs to educate HS students to provide care for the injured and control bleeding before first responders arrive. This trial will help determine the most effective delivery mechanism to teach a hemorrhage control course to HS students at scale.
We analyse the importance of legitimacy on public policy support by comparing how drivers of public policy attitudes evolve across the policy process consisting of the input (the processes forgoing acquisition of power and the procedures permeating political decisionmaking), throughput (the inclusion of and interactions between actors in a governance system) and output (the substantive consequences of those decisions) stages. Using unique panel data through three phases of the implementation of a congestion tax in the Swedish city of Gothenburg, we find that legitimacy is indeed important in explaining policy support. Moreover, we find a lingering effect where support in one phase depends on legitimacy both in the present and in previous phases. Hence, our study takes us one step further on the road to understand the complicated dynamic mechanisms behind the interactions between policymaking, policy support, and the legitimacy and approval of politicians and political processes.
We introduce a modified Galton‒Watson process using the framework of an infinite system of particles labelled by (x,t), where x is the rank of the particle born at time t. The key assumption concerning the offspring numbers of different particles is that they are independent, but their distributions may depend on the particle label (x,t). For the associated system of coupled monotone Markov chains, we address the issue of pathwise duality elucidated by a remarkable graphical representation in which the trajectories of the primary Markov chains and their duals coalesce to form forest graphs on a two-dimensional grid.
BON+ is an applicative theory and closely related to the first order parts of the standard systems of explicit mathematics. As such it is also a natural framework for abstract computations. In this article we analyze this aspect of BON+ more closely. First a point is made for introducing a new operation τN, called truncation, to obtain a natural formalization of partial recursive functions in our applicative framework. Then we introduce the operational versions of a series of notions that are all equivalent to semi-decidability in ordinary recursion theory on the natural numbers, and study their mutual relationships over BON+ with τN.
The experimental study of damage to tungsten (W), molybdenum (Mo), and silicon carbide (SiC) surfaces induced by focused extreme ultraviolet laser radiation (λ ~ 47 nm/~1.5 ns/21–40 µJ) is presented. It was found that W and Mo behaved similarly: during the first shot, the damaged area is covered by melted and re-solidified material, in which circular holes appear – residua of just opened pores/bubbles, from which pressurized gas/vapors escaped. Next cracks and ruptures appear and the W has a tendency to delaminate its surface layer. Contrary, single-crystalline SiC has negligible porosity and sublimates; therefore, no escape of “pressurized” gas and no accompanying effects take place. Moreover, SiC at sublimating temperature decomposes to elements; therefore, the smooth crater morphology can be related to local laser energy density above ablation threshold. When more shots are accumulated, in all three investigated materials, the crater depth increases non-linearly with number of these shots. The surface morphology was investigated by an atomic force microscope, the surface structure was imaged by a scanning electron microscope (SEM), and the structure below the surface was visualized by SEM directed into a trench that is milled by focused ion beam. Additionally, structural changes in SiC were revealed by Raman spectroscopy.
Starting points of this article are fixed point axioms for set-bounded monotone Σ1 definable operators in the context of Kripke–Platek set theory
. We analyze their relationship to other principles such as maximal iterations, bounded proper injections, and Σ1 subset-bounded separation. One of our main results states that in
$KP + (V\, = \,L)$
all these principles are equivalent to Σ1 separation.
Alam Srinivas, independent journalist, writer and media researcher, has written for leading media publications such as www.bbc.com, Times of India, India Today and San Jose Mercury News.,
Débora Medeiros, journalist and PhD student at the Institute of Communication and Media Studies at the Free University of Berlin, Germany.,
Tinus De Jager, head of the journalism section at Monash South Africa. He has researched and published on traditional media platforms and social media and continues to do research in the area, with a specific focus on the media in South Africa and Africa.
There is an emerging consensus that the four institutional pillars of democracy – legislature, executive, judiciary and media – function differently, albeit in varying fashion, among the nations bracketed as ‘emerging’ or ‘developing’. Initially the intention of this chapter was to include all BRICS countries – Brazil, Russia, India, China and South Africa – but after preliminary research, it was concluded that the legislature and executive branches in Russia and China possess significantly more powers than in the other BRICS countries (Wahl- Jorgensen and Hanitzsch 2009). The judiciaries in China and Russia are not, at this point in time, independent enough to make for a fair comparison with the other BRICS countries (ibid). Such political and legal realities severely impinge upon the independent and free functioning of the media, especially investigative journalism, in Russia and China (Josephi 2011). It was therefore decided to limit this chapter to the BISA countries – Brazil, India and South Africa.
The relationship between actions by the state, such as new laws, and journalism has become even more pertinent and crucial in the post– 9/11 period, when most countries, whether developed, developing or least- developed, have sought to tackle real or percieved terror- related attacks against them and terror activities on their soils. Like others, BISA too have enacted dozens of new laws, the executives in these nations have interpreted them in different ways and the respective judiciaries have set contrary and contradictory precedents. Therefore, it is imperative to study and analyse how laws pertaining to general security, and national security in particular in the past 15 years have impeded or aided investigative journalism in their respective countries. Is investigative journalism encouraged or oppressed by the new laws in these nations?
If the answer to the question is that investigative journalists are under threat or cowed by the state, its laws and their interpretations, this is a major threat to independent media and its professionals. In two of the three BISA nations, Brazil and India, there are several reports of state- inspired or statedriven violence against journalists, or serious charges, such as sedition, filed against them (RSF 2016).
Breast-feeding is thought to facilitate young children’s acceptance of new foods, including vegetables, but the evidence for this relationship appears inconsistent across studies. Increasing children’s vegetable intake remains challenging; therefore the present study aimed to investigate whether breast-feeding duration predicts vegetable intake in 2–6-year-old children.
Actual vegetable intake was measured in studies across three European countries. General linear model analyses with breast-feeding duration, sex and age of the child and maternal education as variables were used to predict children’s vegetable intake per country. Additionally, the relationships between child eating behaviour characteristics (asked through the Child Eating Behaviour Questionnaire) and vegetable intake were investigated via Pearson correlations.
Daycare centres, schools and home settings in Denmark, Greece and the Netherlands.
Children aged 2–6 years (n 750).
Breast-feeding duration was positively associated with children’s vegetable intake at 2–6 years old in Denmark (P<0·01) and the Netherlands (P<0·05), but not in Greece (P=0·17). Age of the child, maternal education and sex of the child did not predict vegetable intake in our sample. All countries showed an inverse relationship between food neophobia and children’s vegetable intake and a positive relationship between vegetable liking and intake.
The present study found that breast-feeding duration is a predictor of later vegetable intake, but that current child eating behaviour characteristics, such as vegetable liking, food neophobia and enjoyment of food, also influence vegetable intake. Besides encouragement of breast-feeding duration, strategies that support vegetable liking and food enjoyment and decrease food neophobia are needed to support young children’s vegetable intake.
The U.S. Supreme Court's decision in Kiobel v. Royal Dutch Petroleum Co. limits the potential of the Alien Tort Statute (ATS) as a means of legal redress for victims of human rights abuses caused by transnational companies. Interestingly enough, almost simultaneously with the Kiobel decision by the U.S. Supreme Court, a Dutch court issued its rulings in five cases concerning Nigerian individuals, supported by a Dutch environmental nongovernmental organization (NGO), in their claims against Royal Dutch Shell (RDS), headquartered in the Netherlands, and its Nigerian subsidiary, Shell Petroleum Development Company of Nigeria, Ltd. (SPDC). These cases relate to oil spills for which the plaintiffs believed Shell should be held liable.
The presence of salt in dilatant normal faults may have a strong influence on fault mechanics in the Groningen field and on the related induced seismicity. At present, little is known of the structure of these fault zones. This study starts with the geological evolution of the Groningen area, where, during tectonic faulting, rock salt may have migrated downwards into dilatant faults. These fault zones therefore may contain inclusions of rock salt. Because of its rate-dependent mechanical properties, the presence of salt in a fault may introduce a loading-rate dependency into fault movement and affect the distribution of magnitudes of seismic events. We present a first-look study showing how these processes can be investigated using a combination of analogue and numerical modelling. Full scaling of the models and quantification of implications for induced seismicity in Groningen require further, more detailed studies: an understanding of fault zone structure in the Groningen field is required for improved predictions of induced seismicity. The analogue experiments are based on a simplified stratigraphy of the Groningen area, where it is generally thought that most of the Rotliegend faulting has taken place in the Jurassic, after deposition of the Zechstein. This suggests that, at the time of faulting, the sulphates were already transformed into brittle anhydrite. If these layers were sufficiently brittle to fault in a dilatant fashion, rock salt was able to flow downwards into the dilatant fractures. To test this hypothesis, we use sandbox experiments where we combine cohesive powder as analogue for brittle anhydrites and carbonates with viscous salt analogues to explore the developing fault geometry and the resulting distribution of salt in the faults. Using the observations from analogue models as input, numerical models investigate the stick-slip behaviour of fault zones containing ductile material qualitatively with the discrete element method (DEM). Results show that the DEM approach is suitable for modelling the seismicity of faults containing salt. The stick-slip motion of the fault becomes dependent on shear loading rate with a modification of the frequency–magnitude distribution of the generated seismic events.
After more than half a century of production and with some 350 wells, the Groningen gas field must be one of the best-studied gas fields in the world. Initially, it was considered to be relatively simple and behaving like one big tank. Now that it is entering a phase of declining production it has become clear that many subtleties are not fully understood yet. Prediction and management of subsidence and induced earth tremors require a detailed understanding of the field geology. In addition, an optimum gas recovery is only possible if details of, for example, reservoir quality distribution and faulting, that did not appear relevant before, are well understood.
The large Groningen field comprises a structurally high block during much of its history, probably already from Devonian times onwards. The desert sandstones of the Rotliegend reservoir exhibit a strong south-to-north proximal–distal relationship. Whilst diagenesis has in many fields led to deterioration of reservoir properties, this effect is small in the Groningen field. The field is dipping to the north, and bounded by a series of normal faults in the west, south and east. Almost all faults are normal extensional faults, but locally inverse reactivation has led to small pop-up structures. Reactivation of older faults must have resulted in oblique movements along most faults.
The challenges for future development of the Groningen field are immense. Managing the risks associated with induced seismicity and recovery of the remaining gas will continue to require an increasingly detailed knowledge and understanding of its geology.
T91 ferritic/martensitic (F/M) steel is an expected structural material candidate for Gen IV liquid lead-bismuth cooled nuclear reactors. However, molten lead-bismuth eutectic alloy (mLBE) often causes liquid-metal embrittlement (LME) of F/M steels. Although prior austenite grain boundaries and martensite block boundaries were reported to be preferential sites for LME, the mechanism of LME in a T91/LBE couple is yet to be comprehensively understood. In this paper, the effect of mLBE on T91 steel was investigated using micropillar compression tests. mLBE corrosion was found to cause a significant decrease in yield stress. The micropillar made from mLBE-corroded specimen was significantly sheared along high angle boundaries. In addition, EDS analysis demonstrated the presence of Pb/Bi at these high angle boundaries.
Strongyloidiasis is a neglected tropical disease caused by the roundworm Strongyloides stercoralis affecting 30–100 million people worldwide. Many Southeast-Asian countries report a high prevalence of S. stercoralis infection, but there are little data from Vietnam. Here, we evaluated the seroprevalence of S. stercoralis related to geography, sex and age in Vietnam through serological testing of anonymized sera. Sera (n = 1710, 1340 adults and 270 children) from an anonymized age-stratified serum bank from four regions in Vietnam between 2012 and 2013 were tested using a commercial Strongyloides ratti immunoglobulin G ELISA. Seroreactivity was found in 29·1% (390/1340) of adults and 5·5% (15/270) of children. Male adults were more frequently seroreactive than females (33·3% vs. 24·9%, P = 0·001). The rural central highlands had the highest seroprevalence (42·4% of adults). Seroreactivity in the other regions was 29·9% (Hue) and 26·0% and 18·2% in the large urban centres of Hanoi and Ho Chi Minh City, respectively. We conclude that seroprevalence of S. stercoralis was high in the Vietnamese adult population, especially in rural areas.
I discuss the role of religious experience in Richard Swinburne's probabilistic case for theism. Swinburne draws on his principle of credulity to argue that, if in addition to other evidence we consider that many people have theistic religious experiences, theism comes out as more probable than not. However, on many plausible probability assignments for the relevant non-experiential evidence, the conditional probability of theism already converges towards 1. Moreover, an argument analogous to a general Bayesian argument against phenomenal conservatism suggests that, after we take account of evidence from religious experience, the probability of theism cannot be greater than the prior probability that the best rival hypothesis is false. I conclude that these observations are compatible with what Swinburne would call ‘weak rational belief’ in theism and that such weak belief can be strong enough for rational faith.
From the existing literature data have been collected on the stellar rate of mass loss for 189 stars with known or derived values of the effective temperature Teff and luminosity L. It appears that Ṁ depends only on Teff and L for the O- through M-type stars brighter that about 3 × 103 L⊙. This is shown in Figure 1, where we have plotted for each star the value of - log(-Ṁ) with Ṁ expressed in solar masses per year. An interpolation formula has been derived for the Ṁ(Teff, L) dependence. If we define X = log Teff-4, and Y = log(L/L⊙-5, then
The luminous O-type star BD +60°2522 is embedded in the extended H II region S 162. Part of S 162 is NGC 7635, the striking spherically symmetric bubble nebula surrounding BD +60°2522. This star itself is unique in that it is the only known O star apparently associated with warm dust.