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The “Stop the Bleed” campaign advocates for non-medical personnel to be trained in basic hemorrhage control. However, it is not clear what type of education or the duration of instruction needed to meet that requirement. The objective of this study was to determine the impact of a brief hemorrhage control educational curriculum on the willingness of laypersons to respond during a traumatic emergency.
This “Stop the Bleed” education initiative was conducted by the University of Texas Health San Antonio Office of the Medical Director (San Antonio, Texas USA) between September 2016 and March 2017. Individuals with formal medical certification were excluded from this analysis. Trainers used a pre-event questionnaire to assess participants knowledge and attitudes about tourniquets and responding to traumatic emergencies. Each training course included an individual evaluation of tourniquet placement, 20 minutes of didactic instruction on hemorrhage control techniques, and hands-on instruction with tourniquet application on both adult and child mannequins. The primary outcome in this study was the willingness to use a tourniquet in response to a traumatic medical emergency.
Of 236 participants, 218 met the eligibility criteria. When initially asked if they would use a tourniquet in real life, 64.2% (140/218) responded “Yes.” Following training, 95.6% (194/203) of participants responded that they would use a tourniquet in real life. When participants were asked about their comfort level with using a tourniquet in real life, there was a statistically significant improvement between their initial response and their response post training (2.5 versus 4.0, based on 5-point Likert scale; P<.001).
In this hemorrhage control education study, it was found that a short educational intervention can improve laypersons’ self-efficacy and reported willingness to use a tourniquet in an emergency. Identified barriers to act should be addressed when designing future hemorrhage control public health education campaigns. Community education should continue to be a priority of the “Stop the Bleed” campaign.
RossEM, RedmanTT, MappJG, BrownDJ, TanakaK, CooleyCW, KharodCU, WamplerDA. Stop the Bleed: The Effect of Hemorrhage Control Education on Laypersons’ Willingness to Respond During a Traumatic Medical Emergency. Prehosp Disaster Med. 2018;33(2):127–132.
We present a new, more transnational, networked perspective on corruption. It is premised on the importance of professional intermediaries who constitute networks facilitating cross-border illicit finance, the blurring of legal and illegal capital flows, and the globalization of the individual via multiple claims of residence and citizenship. This perspective contrasts with notions of corruption as epitomized by direct, unmediated transfers between bribe-givers and bribe-takers, disproportionately a problem of the developing world, and as bounded within national units. We argue that the professionals in major financial centers serve to lower the transaction costs of transnational corruption by senior foreign officials. Wealthy, politically powerful individuals on the margins of the law are increasingly globalized as they secure financial access, physical residence, and citizenship rights in major OECD countries. These trends are evidenced by an analysis of the main components of the relevant transnational networks: banks, shell companies, foreign real estate, and investor citizenship programs, based on extensive interviews with key informants across multiple sites.
This chapter investigates the complex interplay between music, history, and the sacred, by examining broad historical constructions of religion and music in South Asia. In the most recent past, nationalism and communalism have been the agents that justify particular histories of religious music. These are the same histories that tend to stabilize Hindu practices into Hinduism and that oversimplify or ignore much of the creative ideological borrowing that has taken place between Hinduism, its relatives and South Asian Islamic and Christian practices. The chapter explores the performance of sacred music which also addresses ideas about history in addition to repertories and genres being drawn into histories. It examines the relationship of sacred music in South Asian history, and history in South Asian sacred music and reveals how this relationship has been mobilized by large-scale narratives and how musical performance provides opportunities to revise the narratives.
This article presents thirty ‘auditory snapshots’ from a wide variety of geographical locations and contexts in order to elaborate several points. First, we believe that the study of history cannot be separated from the study of sound, whether in the form of ‘soundscapes’ or pieces of music. Second, we find that considerations of edges, into which we fold such things as provinces, peripheries and frontiers, can be greatly enriched by looking at a broad range of musical phenomena, from the liturgy of Ugandan Jews to reggae-infused Polish mountain songs and from the sounds of Mozart's Black contemporary Saint-Georges to Silent Night on the Southern Seas. Finally, drawing on certain ideas from James C. Scott's The Art of Not Being Governed, we argue that paradoxically, in music, the middle often has unusual properties. In other words, musical structure mimics the ongoing battle between those in positions of authority and those who wish to evade that authority. Beginnings and endings, then, tend to be sites of power and convention, while middles attempt to subvert it. While culturally and geographically we may contrast centres and peripheries, in music the centre is often the edge.
Optimization of laser wakefield acceleration involves understanding and control of the laser evolution in tenuous plasmas, the response of the plasma medium, and its effect on the accelerating particles. We explore these phenomena in the weakly nonlinear regime, in which the laser power is similar to the critical power for self-focusing. Using Particle-In-Cell simulations with the code QuickPIC, we demonstrate that a laser pulse can remain focused in a plasma channel for hundreds of Rayleigh lengths and efficiently accelerate a high-quality electron beam to 100GeV (25GeV) in a single stage with average gradient 3.6GV/m (7.2GV/m).
The stringent weight and space requirements of advanced space and aerospace systems have lead to a need for stronger, lighter, smaller, and more flexible cable and wiring components. Syscom has fabricated a multifunctional metal/polymer hybrid fiber from a rigid-rod type of polymer, such as poly(p-phenylene benzobisoxazole) (PBO) fiber, for signal transfer and electromagnetic interference (EMI) shielding in wiring and cable applications. The test results indicated that the metal/polymer hybrid PBO fiber exhibited ∼67% the electrical conductivity, ∼73% the weight and ∼200% the tensile strength of a comparable size of beryllium-copper CS95 wire. Additional experimental results of electric current carrying capability, cable shielding performance and atomic oxygen erosion protection will also be discussed.
This paper briefly describes the principle of operation and science goals of the AMANDA high energy neutrino telescope located at the South Pole, Antarctica. Results from an earlier phase of the telescope, called AMANDA-BIO, demonstrate both reliable operation and the broad astrophysical reach of this device, which includes searches for a variety of sources of ultrahigh energy neutrinos: generic point sources, Gamma-Ray Bursts and diffuse sources. The predicted sensitivity and angular resolution of the telescope were confirmed by studies of atmospheric muon and neutrino backgrounds. We also report on the status of the analysis from AMANDA-II, a larger version with far greater capabilities. At this stage of analysis, details of the ice properties and other systematic uncertainties of the AMANDA-II telescope are under study, but we have made progress toward critical science objectives. In particular, we present the first preliminary flux limits from AMANDA-II on the search for continuous emission from astrophysical point sources, and report on the search for correlated neutrino emission from Gamma Ray Bursts detected by BATSE before decommissioning in May 2000. During the next two years, we expect to exploit the full potential of AMANDA-II with the installation of a new data acquisition system that records full waveforms from the in-ice optical sensors.
Recent results from inelastic neutron scattering studies on Ce0.9Th0.1 are used to demonstrate the importance of electron-phonon coupling to the physical properties of f-electron bonded metals. In the case of Ce0.9Th0.1, the phonon density of states (DOS) of α-phase shows a significant softening when heated but shows no change across the α-γ transition despite the 11% volume change. This is supported by analysis of the magnetic spectra showing that most of the transition entropy can be accounted for with the crystal field and spin fluctuations. The precursor phonon softening, the lack of any phonon change across the transition, the magnetic spectra, and the volume transition itself can all be explained in terms of the atomic displacement sensitivity of the hybridization of the local f-electrons with conduction electrons. The electron-phonon coupling resulting from these displacement-sensitive electronic states appears to be essential to understanding cerium. Some of the behavior characteristic of these states, a large volume changes and precursor phonon softening, occurs in many other f-electron bonded metals suggesting that the phenomena is not unique to cerium.
The application of both classical and advanced microscopy to the exploration of abnormal, human, fetal development (birth defects) and to other forms of human, fetal disease has generated a wealth of information, often documented by dramatic images. We have studied, at varying levels of inquiry (simple inspection to molecular analysis), some 10,000 normal and abnormal specimens. For presentation purposes, we first demonstrate the use of imaging in explorations of the fetal habitat (the gestational sac). Our studies reveal a variety of fetal surface encounter lesions (skin-to-amnion). Many of these lesions in the past have been erroneously interpreted. These include fetal amputations, strangulations, and also the reimplantation of amputated parts to ectopic sites. We have also explored, by various imaging techniques, developmental abnormalities within a variety of fetal organs.
Efforts to increase efficiency of energy conversion devices have required their operation at ever higher temperatures. This will force the substitution of highertemperature structural ceramics for lower temperature materials, largely metals. Yet, many of these ceramics will require protection from high temperature corrosion caused by combustion gases, atmospheric contaminants, or the operating medium. This paper discusses examples of the initial development of such coatings and materials for potential application in combustion, aluminum smelting, and other harsh environments.
As historical background helpful to understanding current concepts and practices of apple pest management, we review the origin and rise of key pests of apple in North America and the evolution of approaches to their management, culminating with the concept of integrated pest management (IPM). We propose four levels of integration of orchard pest management practices. First-level IPM integrates chemically based and biologically based management tactics for a single class of pests, such as arthropods, diseases, weeds or vertebrates. Second-level IPM, the focus of our effort here, integrates multiple management tactics across all classes of pests. We describe components of second-level IPM for Massachusetts apple orchards, which are threatened each year by an exceptionally broad range of injurious pests. We illustrate the tentative advantages and shortcomings of second-level IPM using 1993 data from six commercial orchard test blocks. Our predominant approach was to use chemically based tactics for controlling arthropods, diseases and weeds early in the growing season, and afterwards to rely exclusively (for insects) or largely (for other pests) on biologically based tactics, such as cultural, behavioral, and biological controls. Compared with nearby first-level IPM blocks, insecticide use in 1993 was reduced substantially (about 30%), with only slightly more insect injury to fruit and little difference in populations of foliar insect pests. The results for mite pests and diseases were less encouraging although summer pruning significantly reduced disease injury caused by flyspeck. We discuss how second-level IPM poses special biological or operational challenges to apple pest management practitioners. The concept has merit, but refinements are necessary before it can be recommended broadly to commercial apple growers in Massachusetts as an economical and reliable alternative to first-level IPM.
Published studies have shown inconsistent effects of proteinaceous bait sprays against apple maggot flies, Rhagoletis pomonella (Walsh). Explanations of inconsistency could involve the presence of natural food such as bird droppings competing with bait sprays for attraction of flies. Under field, semi-field, or laboratory conditions, we found that: (1) aqueous solutions of 10% proteinaceous bait (Nulure) were significantly more attractive than water to protein-denied but not to protein-provided apple maggot flies; (2) addition of 2% toxicant (malathion 50 EC) did not affect attractiveness of Nulure droplets but did significantly deter feeding by arriving protein-provided flies (though not protein-denied flies); (3) droppings collected from barn swallows, chickens, and unidentified birds on apple trees were significantly more attractive than solutions or droplets of Nulure to protein-denied flies; (4) droppings that were freshly deposited or fresh from cold storage were significantly less attractive than droppings held under ambient conditions for 1 or 2 days; (5) droppings allowed to dry for 1 day at 25 °C, 60% RH were no less attractive than droppings that received water to simulate dew or rainfall; and (6) droppings treated with antibiotics were significantly less attractive than droppings not treated with antibiotics, indicating that bacteria may be involved in generating attractive volatiles. Together, these findings suggest that in situations where natural sources of protein such as bird droppings or insect honeydew are abundant, apple maggot flies may be relatively unaffected by addition of proteinaceous bait to insecticide sprays.
Glyceraldehyde-3-phosphate dehydrogenase (G3PD) was viewed by darkfield microscopy in the STEM using several specimen preparations including the use of negative stain, positive stains and no stain. Some of the resultant images have been subsequently compared with projections of the molecule computed from atomic coordinates (coordinates provided by M. G. Rossmann, Purdue University). G3PD is a glycolytic enzyme of molecular weight approximately 140,000, exists as a tetramer and is approximately 75 Å in diameter.
Fig. 1 shows a negatively stained protein on the left compared to a computed, projected view of the protein on the right. The stain used was methyl amine tungstate. 5-10 Å detail is visible in micrographs taken with this type of preparation. 10 Å detail seems to reproducibly correspond to the known structure. A 5 Å strand, presumably part of the polypeptide from the unfixed protein, is visible in Fig. 2.