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A theorem of Burgess and Stephenson asserts that in an exchange ring with central idempotents, every maximal left ideal is also a right ideal. The proof uses sheaf-theoretic techniques. In this paper, we give a short elementary proof of this important theorem.
Introduction: Situational awareness (SA) is essential for maintenance of scene safety and effective resource allocation in mass casualty incidents (MCI). Unmanned aerial vehicles (UAV) can potentially enhance SA with real-time visual feedback during chaotic and evolving or inaccessible events. The purpose of this study was to test the ability of paramedics to use UAV video from a simulated MCI to identify scene hazards, initiate patient triage, and designate key operational locations. Methods: A simulated MCI, including fifteen patients of varying acuity (blast type injuries), plus four hazards, was created on a college campus. The scene was surveyed by UAV capturing video of all patients, hazards, surrounding buildings and streets. Attendees of a provincial paramedic meeting were invited to participate. Participants received a lecture on SALT Triage and the principles of MCI scene management. Next, they watched the UAV video footage. Participants were directed to sort patients according to SALT Triage step one, identify injuries, and localize the patients within the campus. Additionally, they were asked to select a start point for SALT Triage step two, identify and locate hazards, and designate locations for an Incident Command Post, Treatment Area, Transport Area and Access/Egress routes. Summary statistics were performed and a linear regression model was used to assess relationships between demographic variables and both patient triage and localization. Results: Ninety-six individuals participated. Mean age was 35 years (SD 11), 46% (44) were female, and 49% (47) were Primary Care Paramedics. Most participants (80 (84%)) correctly sorted at least 12 of 15 patients. Increased age was associated with decreased triage accuracy [-0.04(-0.07,-0.01);p=0.031]. Fifty-two (54%) were able to localize 12 or more of the 15 patients to a 27x 20m grid area. Advanced paramedic certification, and local residency were associated with improved patient localization [2.47(0.23,4.72);p=0.031], [-3.36(-5.61,-1.1);p=0.004]. The majority of participants (78 (81%)) chose an acceptable location to start SALT triage step two and 84% (80) identified at least three of four hazards. Approximately half (53 (55%)) of participants designated four or more of five key operational areas in appropriate locations. Conclusion: This study demonstrates the potential of UAV technology to remotely provide emergency responders with SA in a MCI. Additional research is required to further investigate optimal strategies to deploy UAVs in this context.
By use ot the TAURUS imaging Fabry–Perot interferometer (Taylor & Atherton 1980) we have obtained seeing limited two–dimensional velocity, line width and line flux maps of the ionised gas in two polar ring systems.
An almost inertial celestial reference frame based upon extragalactic sources is in the process of being established. This reference frame is to be global with a minimum density of one source/100 square degrees. The source positions will be based upon radio observations and will allow optical reference frames to be related to this frame at the 0.03 arc second level.
Rapid exposure of a trauma patient is an essential component of the primary survey. No gold standard exists regarding the best technique to remove clothing from a trauma patient. The purpose of this study is to compare two techniques of clothing removal versus usual practice using standard trauma shears.
Advanced Care Paramedic (ACP) students were randomized to either the Cut and Rip (CAR) or Cut Alone (CAL) techniques to remove clothing from a standardized trauma mannequin. Practicing paramedics were recruited to remove clothing from the mannequin using Usual Practice (UP). Total time and time for removal of individual pieces of clothing was recorded.
Twenty-four participants (8 per group) were recruited to participate. The student groups (CAR, CAL) were similar in mean age (29, 27), years of practice (1 student >5 years) and male gender (63, 43%). The UP group was older (mean 34), more experienced (63% practice >5 years), and had a higher level of training (63% ACP) but a similar percentage of males (63%). Removal time was significantly less in the CAR group compared to the CAL group (mean 104 seconds, 95% CI 88–120 vs. mean 136 seconds, 95% CI 119–154, p=0.02). Removal times in the UP group were not significantly different from the other groups (mean 124 seconds, 95% CI 108–140, p>0.05).
The CAR technique is faster than both CAL and UP groups to remove clothing from a standard trauma mannequin.
In 2014, the first two authors proved an extension to modules of a theorem of Camillo and Yu that an exchange ring has stable range 1 if and only if every regular element is unit-regular. Here, we give a Morita context version of a stronger theorem. The definition of regular elements in a module goes back to Zelmanowitz in 1972, but the notion of a unit-regular element in a module is new. In this paper, we study unit-regular elements and give several characterizations of them in terms of “stable” elements and “lifting” elements. Along the way, we give natural extensions to the module case of many results about unit-regular rings. The paper concludes with a discussion of when the endomorphism ring of a unit-regular module is a unit-regular ring.
Observations of speckles in the scattering disk of the Vela pulsar are presented and speckle techniques for studying and circumventing scattering of radio waves by the turbulent interstellar plasma are discussed. The speckle pattern contains, in a hologrammatic fashion, complete information on the structure of the radio source as well as the distribution of the scattering material. Speckle observations of interstellar scattering of radio waves are difficult because of their characteristically short timescales (≈seconds) and narrow bandwidths (≈kHz). Here, we present first observations, taken at 13 cm wavelength with elements of the SHEVE VLBI network, of speckles in interstellar scattering.
Data were extracted from the case records of UK patients admitted with laboratory-confirmed influenza A(H1N1)pdm09. White and non-White patients were characterized by age, sex, socioeconomic status, pandemic wave and indicators of pre-morbid health status. Logistic regression examined differences by ethnicity in patient characteristics, care pathway and clinical outcomes; multivariable models controlled for potential confounders. Whites (n = 630) and non-Whites (n = 510) differed by age, socioeconomic status, pandemic wave of admission, pregnancy, recorded obesity, previous and current smoking, and presence of chronic obstructive pulmonary disease. After adjustment for a priori confounders non-Whites were less likely to have received pre-admission antibiotics [adjusted odds ratio (aOR) 0·43, 95% confidence interval (CI) 0·28–0·68, P < 0·001) but more likely to receive antiviral drugs as in-patients (aOR 1·53, 95% CI 1·08–2·18, P = 0·018). However, there were no significant differences by ethnicity in delayed admission, severity at presentation for admission, or likelihood of severe outcome.
Understanding the nutritional demands on serving military personnel is critical to inform training schedules and dietary provision. Troops deployed to Afghanistan face austere living and working environments. Observations from the military and those reported in the British and US media indicated possible physical degradation of personnel deployed to Afghanistan. Therefore, the present study aimed to investigate the changes in body composition and nutritional status of military personnel deployed to Afghanistan and how these were related to physical fitness. In a cohort of British Royal Marines (n 249) deployed to Afghanistan for 6 months, body size and body composition were estimated from body mass, height, girth and skinfold measurements. Energy intake (EI) was estimated from food diaries and energy expenditure measured using the doubly labelled water method in a representative subgroup. Strength and aerobic fitness were assessed. The mean body mass of volunteers decreased over the first half of the deployment ( − 4·6 (sd 3·7) %), predominately reflecting fat loss. Body mass partially recovered (mean +2·2 (sd 2·9) %) between the mid- and post-deployment periods (P< 0·05). Daily EI (mean 10 590 (sd 3339) kJ) was significantly lower than the estimated daily energy expenditure (mean 15 167 (sd 1883) kJ) measured in a subgroup of volunteers. However, despite the body mass loss, aerobic fitness and strength were well maintained. Nutritional provision for British military personnel in Afghanistan appeared sufficient to maintain physical capability and micronutrient status, but providing appropriate nutrition in harsh operational environments must remain a priority.
The article presents a newly created precipitation data set for the African continent and describes the methodology used in its creation. It is based on a combination of proxy data and rain gauge records. The data set is semi-quantitative, with a “wetness” index of − 3 to + 3 to describe the quality of the rainy season. It covers the period AD 1801 to 1900 and includes data for 90 geographical regions of the continent. The results underscore a multi-decadal period of aridity early in the nineteenth century.
The effects of LH-RH agonists in advanced breast cancer patients are reviewed and compared to the efficacy of surgical ablation of the ovaries and X-ray induced menopause in the treatment of this disease. In both pre- and postmenopausal women, LH-RH agonists produce pituitary gland desensitisation and a fall in concentrations of LH and FSH. In premenopausal patients plasma progesterone and oestradiol levels fall to the castrate or postmenopausal range within three to four weeks. Tumour remissions have been observed in approximately 30% of premenopausal women (50% ER-positive) and approximately 10% of postmenopausal patients. The mechanism of action of LH-RH agonists is discussed and their current application to combined endocrine therapy, early breast cancer and mastalgia briefly outlined.
Air photo interpretation and geochemistry have been used to supplement sparse field data in compiling a reconnaissance geological map of the area around the Lecht. Upper Appin and lower Argyll Group rocks are exposed, the best marker horizons being correlatives of the Appin and Jura Quartzites. Scatter plots, Q mode factor analysis and Pearson correlation coefficients of geochemical data were successfully used in the correlation of the pelite and limestone outcrops. The presence of major recumbent folds is inferred. The area is cut by numerous minor faults which are thought to be related to a major transcurrent fault, the probable north-eastern continuation of the Loch Tay fault, which was active in Lower Old Red Sandstone times.
The Lecht manganiferous ironstone is a seepage-bog ore type deposit derived by weathering of the local Dalradian sequence. Despite intensive leaching, this sequence still shows anomalously high levels of several elements, particularly Mn, Ba and Zn. In addition, stratiform sphalerite and manganiferous garnet are present in Blair Atholl Subgroup limestone and pelite horizons, respectively. Mineralogical and geochemical evidence suggests the presence of Zn–Pb–(Ag)–(?Au) exhalative mineralisation within the upper Appin Group Dalradian of the region, of which the Lecht represents the distal manganiferous expression.
High saturated fat intake is an established risk factor for several chronic diseases. The objective of the present study is to report dietary intakes and main food sources of fat and fatty acids (FA) from the first year of the National Diet and Nutrition Survey (NDNS) rolling programme in the UK. Dietary data were collected using 4 d estimated food diaries (n 896) and compared with dietary reference values (DRV) and previous NDNS results. Total fat provided 34–36 % food energy (FE) across all age groups, which was similar to previous surveys for adults. Men (19–64 years) and older girls (11–18 years) had mean intakes just above the DRV, while all other groups had mean total fat intakes of < 35 % FE. SFA intakes were lower compared with previous surveys, ranging from 13 to 15 % FE, but still above the DRV. Mean MUFA intakes were 12·5 % FE for adults and children aged 4–18 years and all were below the DRV. Mean n-3 PUFA intake represented 0·7–1·1 % FE. Compared with previous survey data, the direction of change for n-3 PUFA was upwards for all age groups, although the differences in absolute terms were very small. Trans-FA intakes were lower than in previous NDNS and were less than 2 g/d for all age groups, representing 0·8 % FE and lower than the DRV in all age groups. In conclusion, dietary intake of fat and FA is moving towards recommended levels for the UK population. However, there remains room for considerable further improvement.
Several characterizations are given of (Zelmanowitz) regular modules among the torsionless modules, the locally projective modules, the nonsingular modules, and modules where certain submodules are pure. Along the way, a version of the unimodular row lemma for torsionless modules is given, and it is shown that a regular ring is left self-injective if and only if every nonsingular left module is regular.
The National Diet and Nutrition Survey (NDNS) is a cross-sectional survey designed to gather data representative of the UK population on food consumption, nutrient intakes and nutritional status. The objectives of the present paper were to identify and describe food consumption and nutrient intakes in the UK from the first year of the NDNS rolling programme (2008–09) and compare these with the 2000–01 NDNS of adults aged 19–64 years and the 1997 NDNS of young people aged 4–18 years. Differences in median daily food consumption and nutrient intakes between the surveys were compared by sex and age group (4–10 years, 11–18 years and 19–64 years). There were no changes in energy, total fat or carbohydrate intakes between the surveys. Children aged 4–10 years had significantly lower consumption of soft drinks (not low calorie), crisps and savoury snacks and chocolate confectionery in 2008–09 than in 1997 (all P < 0·0001). The percentage contribution of non-milk extrinsic sugars to food energy was also significantly lower than in 1997 in children aged 4–10 years (P < 0·0001), contributing 13·7–14·6 % in 2008–09 compared with 16·8 % in 1997. These changes were not as marked in older children and there were no changes in these foods and nutrients in adults. There was still a substantial proportion (46 %) of girls aged 11–18 years and women aged 19–64 years (21 %) with mean daily Fe intakes below the lower reference nutrient intake. Since previous surveys there have been some positive changes in intakes especially in younger children. However, further attention is required in other groups, in particular adolescent girls.
Geopolymers are made by adding aluminosilicates to concentrated alkali solutions for dissolution and subsequent polymerization to form a solid. They are amorphous to semicrystalline three dimensional aluminosilicate networks. Although they have been used in several applications their widespread use is restricted due to lack of long term durability studies and detailed scientific understanding. Three important tools for the study of geopolymers are transmission electron microscopy (TEM), solid state magic angle spinning nuclear magnetic resonance (MAS NMR) and infra red (IR) spectroscopy.
Cs and Sr are two of the most difficult radionuclides to immobilize and are therefore suitable elements to study in assessing geopolymers as matrices for immobilization of radioactive wastes. In this study Cs or Sr was added to geopolymer samples prepared using fly ash precursors. A commercial metakaolinite geopolymer was studied for comparison.
The geopolymers were mainly amorphous as shown by TEM, whether they were made from fly ash or metakaolinite. In the fly ash geopolymer, Cs preferentially inhabited the amorphous phase over the minor crystalline phases, whereas Sr was shared in both. The MAS NMR showed that Cs is held mostly in the geopolymer structure for both fly ash and metakaolinite geopolymers. The IR spectra showed a slight shift in antisymmetric Si-O-Al stretch band to a lower wavenumber for the fly ash geopolymer, which implies that more Al is incorporated in this geopolymer structure than in the metakaolinite geopolymer.
Although pneumonia is a leading cause of death from infectious disease worldwide, comprehensive information about its causes and incidence in low- and middle-income countries is lacking. Active surveillance of hospitalized patients with pneumonia is ongoing in Thailand. Consenting patients are tested for seven bacterial and 14 viral respiratory pathogens by PCR and viral culture on nasopharyngeal swab specimens, serology on acute/convalescent sera, sputum smears and antigen detection tests on urine. Between September 2003 and December 2005, there were 1730 episodes of radiographically confirmed pneumonia (34·6% in children aged <5 years); 66 patients (3·8%) died. A recognized pathogen was identified in 42·5% of episodes. Respiratory syncytial virus (RSV) infection was associated with 16·7% of all pneumonias, 41·2% in children. The viral pathogen with the highest incidence in children aged <5 years was RSV (417·1/100 000 per year) and in persons aged ⩾50 years, influenza virus A (38·8/100 000 per year). These data can help guide health policy towards effective prevention strategies.