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Chemical, biological, radiological, and nuclear (CBRN) events with multiple casualties are rare events, but preparedness is crucial for hospitals to respond properly. This study evaluated the preparedness and disaster planning of German hospitals for CBRN incidents.
Methods
In a cross-sectional study, German hospitals with level III (highest level) emergency departments were surveyed using an online questionnaire focusing on risk assessment, infrastructure, hospital disaster planning, and preparedness for CBRN events.
Results
Between June and July 2023, 50 hospitals were surveyed. 62.5% of the hospitals had a section on chemical incidents in their disaster plan. A decontamination facility was available in 29.8% of the hospitals and chemical protective suits in 46.8%. The minority of the hospitals trained the correct handling of personal protective equipment (PPE) (39.1%) regularly or had frequent CBRN drills (21.3%). Most hospitals had the infrastructure for medical isolation (93.6%).
Conclusions
The level of CBRN preparedness is heterogeneous for German hospitals. Most were well prepared for infectious patients, but only half of all hospitals had sufficient PPE for chemical incidents and only 30% had a decontamination facility available. Overall, the level of CBRN preparedness is still insufficient and needs further improvement.
Alongside the well-known jurisprudential ideas associated with legal realism, some scholars have highlighted the realists’ political-economic ideas. Best known among them has been Morton Horwitz, who has argued that the realists launched an “attack on the legitimacy of the market.” Other scholars challenged this view and argued that there was no significant connection between legal realism and political economic ideas. I offer a corrective to both views. I first consider the work of five legal realists (Karl Llewellyn, Adolf Berle, William O. Douglas, Jerome Frank, and Thurman Arnold) and show that all held views that were well within the political-economic mainstream of their era, which did not challenge the legitimacy of market capitalism but wanted to see markets better regulated. I also show that for many of these realists, there were important connections between their jurisprudential and political-economic ideas. I then turn to some neglected writings of Felix Cohen to show that he too saw a direct link between his legal and economic ideas. However, unlike the other legal realists discussed here, he was a radical critic of market capitalism. I use his political-economic writings for a reconsideration of his better-known jurisprudential works.
The crystal structure of perfluorononanoic acid (PFNA) was solved via parallel tempering using synchrotron powder diffraction data obtained from the Brockhouse X-ray Diffraction and Scattering (BXDS) Wiggler Lower Energy (WLE) beamline at the Canadian Light Source. PFNA crystallizes in monoclinic space group P21/c (#14) with lattice parameters a = 26.172(1) Å, b = 5.6345(2) Å, c = 10.9501(4) Å, and β = 98.752(2)°. The crystal structure is composed of dimers, with pairs of PFNA molecules connected by hydrogen bonds via the carboxylic acid functional groups. The Rietveld-refined structure was compared to a density functional theory-optimized structure, and the root-mean-square Cartesian difference was larger than normally observed for correct powder structures. The powder data likely exhibited evidence of disorder which was not successfully modeled.
As a kind of lower-limb motor assistance device, the intelligent walking aid robot plays an essential role in helping people with lower-limb diseases to carry out rehabilitation walking training. In order to enhance the safety performance of the lower-limb walking aid robot, this study proposes a deep vision-based abnormal lower-limb gait prediction model construction method for the problem of abnormal gait prediction of patients’ lower limbs. The point cloud depth vision technique is used to acquire lower-limb motion data, and a multi-posture angular prediction model is trained using long and short-term memory networks to build a model of the user’s lower-limb posture characteristics during normal walking as well as a real-time lower-limb motion prediction model. The experimental results indicate that the proposed lower-limb abnormal behavior prediction model is able to achieve a 97.4% prediction rate of abnormal lower-limb movements within 150 ms. Additionally, the model demonstrates strong generalization ability in practical applications. This paper proposes further ideas to enhance the safety performance of lower-limb rehabilitation robot use for patients with lower-limb disabilities.
Trematodes and their snail hosts have developed intimate parasite-host associations, with snails supporting a diverse and often species-specific trematode fauna. In the faucet snail, Bithynia tentaculata (Caenogastropoda, Littorinimorpha), a unique trematode fauna has been recorded recently. However, knowledge of the exact species identity, phylogenetic relationships, and geographical distribution remains limited as many of the species belong to groups with unclear or controversial taxonomical assignment. To contribute to our knowledge of the trematodes, we investigated the trematode fauna of B. tentaculata by examining a total of 556 snails from lakes in County Galway, Ireland. Using an integrative taxonomic approach including DNA sequence data analyses (28S rRNA gene, ITS1-5.8S-ITS2, ITS2, cox1, nad1) and morphological tools (taxonomical drawings and measurements), we identified nine trematode species of seven families, with seven species occurring as cercariae (Cyathocotyle prussica, Lecithodendrium linstowi, Lecithodendrium sp., Asymphylodora progenetica, Sphaerostoma bramae, Metorchis xanthosomus, and Notocotylus sp.) and three species occurring as metacercariae (A. progenetica, Parasymphylodora parasquamosa, and Sphaeridiotrema sp.). Except for S. bramae, all are new species records for Ireland and provide the most western distribution of these trematodes in Europe. The trematode species recorded are known to use a wide range of definitive hosts and have a wide geographical distribution; among them are species members of genera that are zoonotic (Metorchis) and pathogenic to wildlife (Cyathocotyle, Sphaeridiotrema, and Notocotylus). There remains an ongoing need for precise identification of the trematode species to ensure that wider ecological contexts are correctly understood and biodiversity and disease threats can be accurately evaluated.
Scholars of Jin history have noted a flourishing literati culture after the mid-Jin period, but excavated tombs suggest a more complicated picture. The shi, referring to literati without official titles, constituted a prominent group in Northern Song tombs, as evidenced by their epitaphs, but this group appears to have nearly vanished from the Jin tombs. To search for traces of the shi, this article comprehensively examines the social elites’ tombs with burial inscriptions and ink writings, where the shi would most likely be laid to rest. It shows that the text and paratext of epitaphs, as well as the tombs that yielded them, contain direct information about the shi and their interactions with other officials and non-official elites. Analysis of ink writings suggests that the shi played a role in the advanced literary expression in the tombs of some non-literati local elites. Examining these traces of the shi in tombs allows us to reintegrate them into broader society, investigate their interactions with other elites, and attain a more holistic understanding of Jin elite society and culture.
The present work aims to extend the capabilities of DUST, a mid-fidelity aerodynamic solver developed at Politecnico di Milano, for the aerodynamic simulation of rotorcraft applications. With this aim, a numerical element was implemented in the solver obtained by a coupling between the potential unsteady vortex lattice method and viscous aerodynamic data of aerofoil sections available from two-dimensional high-fidelity computational fluid dynamics (CFD) simulations or experimental wind-tunnel tests. The paper describes the mathematical formulation of the method as well as a validation of the implementation performed by comparison with both high-fidelity CFD simulation results and experimental data obtained over aerodynamics and aeroelastic fixed-wing benchmarks. Then, the method was used for the evaluation of the aerodynamic performance of two rotorcraft test cases, i.e. the full-scale proprotor of the XV-15 tiltrotor operating in different flight conditions and two propellers in tandem with overlapping disks. Simulation results comparison with high-fidelity CFD and data from wind tunnel tests highlighted the potentialities and advantages of the implemented approach to be used for the design and investigation of rotorcraft configurations characterised by consistent viscosity effects.
Agimund's Homiliary is extant in two eighth-century manuscripts in BAV, Vat. lat. 3835 and 3836 and is one of the very few Roman texts actually written in Roman script surviving from the early Middle Ages. This article argues that the Homiliary is a crucial piece of evidence for early medieval Roman liturgical and cultural life and the patristic resources of Rome. Agimund's Homiliary, and the late eighth-century additions which are actually part of another, hitherto unidentified Roman Homiliary, together constitute evidence of the degree to which patristic theology and exegesis were embedded in Roman culture, of the interchange between the Latin- and Greek-speaking communities in Rome and the Lateran in the early Middle Ages, and of the intellectual productivity and cultural versatility of early medieval Rome.
Based on self-determination theory, this research relied on person-centered analyses to show how the distinct components of psychological need states combine to produce distinct profiles. We also explored contemporarily antecedents (perceptions of the organization’s environmental corporate social responsibility and negative moral emotions related to the organization’s environmental (ir)responsibility) and organizational outcomes (affective organizational commitment, turnover intentions, and cyberslacking). Questionnaire surveys were completed by 525 French employees. Four profiles characterized by configurations of psychological need states were identified and showed well-differentiated patterns. Negative moral emotions predicted membership in the most detrimental need states profiles while corporate social responsibility perceptions did not. As expected, we found opposite patterns of associations between profile membership and affective organizational commitment and turnover intentions, while the highest levels of cyberslacking were found in the most positive need states profiles. The results add to person-centered research and emphasize the importance of psychological experiences in the workplace and organizational outcomes.
Traction of the head-neck is important in the treatment of patients suffering from neck pain due to degeneration of the intervertebral discs. Conventional neck traction is provided manually by experienced physical therapists who maintain a desired orientation of the head-neck relative to the trunk while applying the traction. It is postulated that innovative designs of neck exoskeletons can provide the same function both flexibly and accurately. This article presents a novel architecture of a parallel mechanism whose base sits on the human shoulders with 4 parallel chains, each chain having a revolute-revolute-universal-revolute (RRUR) structure, while the end-effector is connected rigidly to the human head. Each chain has five degrees-of-freedom (DOF) and applies a constraint on the motion of the end-effector. As a result, this parallel mechanism allows two DOFs to the end-effector. These are (i) forward flexion or lateral bending of the head and (ii) vertical translation. An important motivation for the current design with RRUR structure is to characterize the range of forward flexion/lateral bending of the head-neck with this structure and the vertical translation to the end-effector. A physical prototype was constructed and tested to evaluate the performance of this mechanism in hardware for the proposed application.
Hybridization of parasitic species is an emerging health problem in the evolutionary profile of infectious disease, particularly within trematodes of the genus Schistosoma. Because the consequences of this hybridization are still relatively unknown, further studies are needed to clarify the epidemiology of the disease and the biology of hybrid schistosomes. In this article, we provide a detailed review of published results on schistosome hybrids of the haematobium group. Using a mapping approach, this review describes studies that have investigated hybridization in human (S. haematobium, S. guineensis, and S. intercalatum) and animal (S. bovis and S. curassoni) schistosome species in West Africa (Niger, Mali, Senegal, Côte d’Ivoire, Benin, Nigeria) and in Central Africa (Cameroon, Gabon, Democratic Republic of Congo), as well as their limitations linked to the underestimation of their distribution in Africa. This review provides information on studies that have highlighted hybrid species of the haematobium group and the regions where they have been found, notably in West and Central Africa.
This study introduces a hybrid model that utilizes a model-based optimization method to generate training data and an artificial neural network (ANN)-based learning method to offer real-time exoskeleton support in lifting activities. For the model-based optimization method, the torque of the knee exoskeleton and the optimal lifting motion are predicted utilizing a two-dimensional (2D) human–exoskeleton model. The control points for exoskeleton motor current profiles and human joint angle profiles from cubic B-spline interpolation represent the design variables. Minimizing the square of the normalized human joint torque is considered as the cost function. Subsequently, the lifting optimization problem is tackled using a sequential quadratic programming (SQP) algorithm in sparse nonlinear optimizer (SNOPT). For the learning-based approach, the learning-based control model is trained using the general regression neural network (GRNN). The anthropometric parameters of the human subjects and lifting boundary postures are used as input parameters, while the control points for exoskeleton torque are treated as output parameters. Once trained, the learning-based control model can provide exoskeleton assistive torque in real time for lifting tasks. Two test subjects’ joint angles and ground reaction forces (GRFs) comparisons are presented between the experimental and simulation results. Furthermore, the utilization of exoskeletons significantly reduces activations of the four knee extensor and flexor muscles compared to lifting without the exoskeletons for both subjects. Overall, the learning-based control method can generate assistive torque profiles in real time and faster than the model-based optimal control approach.
In sediments, clay minerals are mainly detrital. Formed by continental weathering, they are carried by surface transport predominantly by rivers, glaciers and, to a lesser extent, winds to the adjacent sedimentary basins and then are redistributed by oceanic currents. In a sedimentary core, the variability in the clay mineral assemblages reflects either variable physical and chemical weathering conditions in the watershed, typically with a significant link to climatic conditions, or changes in the mineral source, the latter being associated with various transport agents. When different sources are involved, a combination of mineralogical and geochemical proxies allows us to trace the detrital provenance, but they also indirectly provide valuable information on transport pathways and palaeocurrents. This manuscript reviews several examples from the literature and ongoing research on clay mineral variability in marine or lacustrine sedimentary records and interprets them in terms of: (1) climate control at different timescales, from the Neogene to the Quaternary; and (2) transport paths. Examples are selected to review the various clay-derived proxies in existence.