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Moderate rotation and moderate horizontal confinement similarly enhance the heat transport in Rayleigh–Bénard convection (RBC). Here, we systematically investigate how these two types of flow stabilization together affect the heat transport. We conduct direct numerical simulations of confined-rotating RBC in a cylindrical set-up at Prandtl number $\textit {Pr}=4.38$, and various Rayleigh numbers $2\times 10^{8}\leqslant {\textit {Ra}}\leqslant 7\times 10^{9}$. Within the parameter space of rotation (given as inverse Rossby number $0\leqslant {\textit {Ro}}^{-1}\leqslant 40$) and confinement (given as height-to-diameter aspect ratio $2\leqslant \varGamma ^{-1}\leqslant 32$), we observe three heat transport maxima. At lower $ {\textit {Ra}}$, the combination of rotation and confinement can achieve larger heat transport than either rotation or confinement individually, whereas at higher $ {\textit {Ra}}$, confinement alone is most effective in enhancing the heat transport. Further, we identify two effects enhancing the heat transport: (i) the ratio of kinetic and thermal boundary layer thicknesses controlling the efficiency of Ekman pumping, and (ii) the formation of a stable domain-spanning flow for an efficient vertical transport of the heat through the bulk. Their interfering efficiencies generate the multiple heat transport maxima.
‘When you go to India and to the interior of Africa you will hear Il Trovatore’, Giuseppe Verdi playfully boasted in May 1862 (quoted in Budden 1978: 112). Would the maestro then be disappointed to learn that ‘to a child reared […] in western Nigeria in the 1930's and 40’s, the name Verdi or Puccini probably meant no more than some exotic candy or a new brand of tinned pilchards in the local expatriate shops’? Wole Soyinka (1999), to whom we owe this mischievous recollection of the genre's ‘Otherness’, does not hesitate however to describe ‘the European operatic form’ as the ‘most accessible vehicle even for the most distinctive African themes from antiquity and mythology’:
Nothing is more ‘natural’ than the expression of the adventures of the deities in a medium of music, elliptical dialogue, movement and spectacle, elements central to the Western opera. This alliance of presentation idioms has always been present in traditional African theater, and the contemporary artist merely takes them along the path of stylistic refinements, in some cases borrowing boldly from the artistic idioms of a totally different culture. (Soyinka 1999)
In spite of opera's recent discovery as ‘an unlikely space for voicing black experiences’, as Naomi André proposes in her study on Black Opera (2018: 28), this newly found enthusiasm is hardly reflected in the available research literature. Other than in the settler colony of South Africa, there has never been a considerable institutional representation of European opera on the west coast of the continent; and, unlike the eagerly embraced novel or drama, the genre held little attraction for a new generation of musicians. The staging of Gilbert and Sullivan operettas in Victorian Lagos or at the elite boarding schools of Umuahia, Ibadan or Achimota probably formed the closest point of contact, while the cultural policy of the missions and the colonial school system kept the achievements of extended tonality at bay.
In 2017, dicamba-resistant (DR) soybean was commercially available to farmers in the United States. In August and September of 2017, a survey of 312 farmers from 60 Nebraska soybean-producing counties was conducted during extension field days or online. The objective of this survey was to understand farmers’ adoption and perceptions regarding DR soybean technology in Nebraska. The survey contained 16 questions and was divided in three parts: (1) demographics, (2) dicamba application in DR soybean, and (3) dicamba off-target injury to sensitive soybean cultivars. According to the results, 20% of soybean hectares represented by the survey were planted to DR soybean in 2017, and this number would probably double in 2018. Sixty-five percent of survey respondents own a sprayer and apply their own herbicide programs. More than 90% of respondents who adopted DR soybean technology reported significant improvement in weed control. Nearly 60% of respondents used dicamba alone or glyphosate plus dicamba for POST weed control in DR soybean; the remaining 40% added an additional herbicide with an alternative site of action (SOA) to the POST application. All survey respondents used one of the approved dicamba formulations for application in DR soybean. Survey results indicated that late POST dicamba applications (after late June) were more likely to result in injury to non-DR soybean compared to early POST applications (e.g., May and early June) in 2017. According to respondents, off-target dicamba movement resulted both from applications in DR soybean and dicamba-based herbicides applied in corn. Although 51% of respondents noted dicamba injury on non-DR soybean, 7% of those who noted injury filed an official complaint with the Nebraska Department of Agriculture. Although DR soybean technology allowed farmers to achieve better weed control during 2017 than previous growing seasons, it is apparent that off-target movement and resistance management must be addressed to maintain the viability and effectiveness of the technology in the future.
To compare 6 airway-management devices in 3 isolation scenarios regarding their effect on airway management: portable isolation unit (PIU), personal protective equipment (PPE), and standard protection measures
METHODS
In total, 30 anesthesiologists working in emergency medical services performed airway management on mannequins in 3 isolation settings using 6 different airway management devices (in random order): (1) standard Macintosh laryngoscope; (2) Airtraq SP-video-laryngoscope; (3) i-gel; (4) LMA-Fastrach; (5) Ambu fiberoptic-aScope; and (6) Melker cricothyrotomy-set. Each was assessed regarding time-to-ventilate (primary outcome) and rating of difficulty handling the device.
RESULTS
In 86% (standard protection) and 85% (PPE) of attempts, airway management was achieved in <60 seconds, irrespective of the device used. In the PIU setting, only 69% of attempts succeeded within this time frame (P<.05). Median time-to-ventilate was shorter for standard protection (23 seconds) and PPE (25 seconds) compared to the PIU (38 seconds; P<.001). In the PIU setting, the fiberscope took the longest (median, 170 seconds), while i-gel was the quickest (median, 13 seconds). The rating of difficulty (visual analogue scale [VAS], 0–100) differed significantly between the isolation scenarios: Airway management was most difficult with PIU (VAS, 76), followed by PPE (VAS, 35), and standard protection (VAS, 9) (P<.01).
CONCLUSION
Wearing PPE produced similar times-to-ventilate as standard protection among anesthesiologists, but it was subjectively rated more difficult. The portable isolation unit permitted acceptable times-to-ventilate when excluding fiberscope and cricothyrotomy. Supraglottic airway devices allowed the fastest airway management in all isolation scenarios, thus being highly recommendable if a portable isolation unit is used and emergency airway management becomes necessary.
We sought to conduct a major objective of the CAEP Academic Section, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools.
Methods
We developed an 84-question questionnaire, which was distributed to academic heads. The responses were validated by phone by the lead author to ensure that the questions were answered completely and consistently. Details of pediatric emergency medicine units were excluded from the scan.
Results
At eight of 17 universities, emergency medicine has full departmental status and at two it has no official academic status. Canadian academic emergency medicine is practiced at 46 major teaching hospitals and 13 specialized pediatric hospitals. Another 69 Canadian hospital EDs regularly take clinical clerks and emergency medicine residents. There are 31 full professors of emergency medicine in Canada. Teaching programs are strong with clerkships offered at 16/17 universities, CCFP(EM) programs at 17/17, and RCPSC residency programs at 14/17. Fourteen sites have at least one physician with a Master’s degree in education. There are 55 clinical researchers with salary support at 13 universities. Sixteen sites have published peer-reviewed papers in the past five years, ranging from four to 235 per site. Annual budgets range from $200,000 to $5,900,000.
Conclusion
This comprehensive review of academic activities in emergency medicine across Canada identifies areas of strengths as well as opportunities for improvement. CAEP and the Academic Section hope we can ultimately improve ED patient care by sharing best academic practices and becoming better teachers, educators, and researchers.
In response to the increasing demand for 14C analysis of samples containing less than 25 μg C, ultra-small graphitization reactors with an internal volume of ∼0.8 mL were developed at NOSAMS. For samples containing 6 to 25 μg C, these reactors convert CO2 to graphitic carbon in approximately 30 min. Although we continue to refine reaction conditions to improve yield, the reactors produce graphite targets that are successfully measured by AMS. Graphite targets produced with the ultra-small reactors are measured by using the Cs sputter source on the CFAMS instrument at NOSAMS where beam current was proportional to sample mass. We investigated the contribution of blank carbon from the ultra-small reactors and estimate it to be 0.3 ± 0.1 μg C with an Fm value of 0.43 ± 0.3. We also describe equations for blank correction and propagation of error associated with this correction. With a few exceptions for samples in the range of 6 to 7 μg C, we show that corrected Fm values agree with expected Fm values within uncertainty for samples containing 6–100 μg C.
Inappropriate distribution of casualties in mass-casualty incidents (MCIs) may overwhelm hospitals. This study aimed to review the consequences of evacuating casualties from a bus accident to a single peripheral hospital and lessons learned regarding policy of casualty evacuation.
Methods
Medical records of all casualties relating to evacuation times, injury severity, diagnoses, treatments, resources utilized and outcomes were independently reviewed by two senior trauma surgeons. In addition, four senior trauma surgeons reviewed impact of treatment provided on patient outcomes. They reviewed the times for the primary and secondary evacuation, injury severity, diagnoses, surgical treatments, resources utilized, and the final outcomes of the patients at the point of discharge from the tertiary care hospital.
Results
Thirty-one survivors were transferred to the closest local hospital; four died en route to hospital or within 30 minutes of arrival. Twenty-seven casualties were evacuated by air from the local hospital within 2.5 to 6.15 hours to Level I and II hospitals. Undertriage of 15% and overtriage of seven percent were noted. Four casualties did not receive treatment that might have improved their condition at the local hospital.
Conclusions
In MCIs occurring in remote areas, policy makers should consider revising the current evacuation plan so that only immediate unstable casualties should be transferred to the closest primary hospital. On site Advanced Life Support (ALS) should be administered to non-severe casualties until they can be evacuated directly to tertiary care hospitals. First responders must be trained to provide ALS to non-severe casualties until evacuation resources are available.
AdiniB, CohenR, GlassbergE, AzariaB, SimonD, SteinM, KleinY, PelegK. Reconsidering Policy of Casualty Evacuation in a Remote Mass-Casualty Incident. Prehosp Disaster Med. 2013;28(6):1-5.
This research project seeks to contribute to the literature on management by presenting and testing a model of leadership linking leadership styles directly to culture type and indirectly to firm effectiveness. The authors selected a four-factor theory of leadership and examined how it directly impacted organizational culture, and indirectly impacted organizational effectiveness (via an organization's culture). Using surveys designed to measure attitudinal and behavioral indicators of organizational culture, leadership, and effectiveness, we collected data from 2,662 individuals in 311 organizations. The results generally support the hypotheses that organizational effectiveness is related to type of culture and that cultural norms are related to type of leadership styles. The results have implications for management and organizational development practices and processes. The results indicate that the leadership skills of managers and supervisors are critical factors in the creation and reinforcement of cultural norms. Furthermore, cultural norms seem to positively impact organizational effectiveness.
The CAMCOG, ADAS-cog, and MMSE, designed to grade global cognitive ability in dementia have inadequate precision and accuracy in distinguishing mild dementia from normal ageing. Adding neuropsychological tests to their scale might improve precision and accuracy in mild dementia. We, therefore, pooled neuropsychological test-batteries from two memory clinics (ns = 135 and 186) with CAMCOG data from a population study and 2 memory clinics (n = 829) and ADAS-cog data from 3 randomized controlled trials (n = 713) to estimate a common dimension of global cognitive ability using Rasch analysis. Item difficulties and individuals’ global cognitive ability levels were estimated. Difficulties of 57 items (of 64) could be validly estimated. Neuropsychological tests were more difficult than the CAMCOG, ADAS-cog, and MMSE items. Most neuropsychological tests had difficulties in the ability range of normal ageing to mild dementia. Higher than average ability levels were more precisely measured when neuropsychological tests were added to the MMSE than when these were measured with the MMSE alone. Diagnostic accuracy in mild dementia was consistently better after adding neuropsychological tests to the MMSE. We conclude that extending dementia specific instruments with neuropsychological tests improves measurement precision and accuracy of cognitive impairment in mild dementia. (JINS, 2012, 18, 314–322)