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Following Faber–Pandharipande, we use the virtual localization formula for the moduli space of stable maps to $\mathbb {P}^{1}$ to compute relations between Hodge integrals. We prove that certain generating series of these integrals are polynomials.
Goodstein’s principle is arguably the first purely number-theoretic statement known to be independent of Peano arithmetic. It involves sequences of natural numbers which at first appear to diverge, but eventually decrease to zero. These sequences are defined relative to a notation system based on exponentiation for the natural numbers. In this article, we provide a self-contained and modern analysis of Goodstein’s principle, obtaining some variations and improvements. We explore notions of optimality for notation systems and apply them to the classical Goodstein process and to a weaker variant based on multiplication rather than exponentiation. In particular, we introduce the notion of base-change maximality, and show how it leads to far-reaching extensions of Goodstein’s result. We moreover show that by varying the initial base of the Goodstein process, one readily obtains independence results for each of the fragments $\mathsf {I}\Sigma _n$ of Peano arithmetic.
This article discusses houses on the periphery of Barcelona and in particular in the El Carmel neighbourhood, which were built by poor country-to-city migrants from southern Spain in the post-World War II period. They were constructed following two typologies: barracas (sheds), one-storey huts on an irregular street plan, and coreas (‘Korea houses’), more formally looking one- to three-storey structures lined up on orderly laid-out streets. Based on archival documents, contemporaneous publications and interviews with former autoconstructores (self-builders), the article analyses both social conditions and physical structures. While these buildings were often unauthorized and constructed by informal means, they were just as often built with the landowner’s consent, involving architects and building professionals, and retroactively legalized. The article concludes that in this respect Barcelona’s ‘informal neighbourhoods’ in fact straddled the realms of the formal and the informal, to the extent that the habitual distinction between formal and informal architecture has to be considered inadequate.
Gust response has consistently been a concern in engineering. Critical theories have been proposed in the past to predict the unsteady lift response of an airfoil experiencing vertical gusts by Atassi, and longitudinal gusts by Greenberg. However, their applicability for an airfoil with non-zero angles of attack still needs clarification. Thus, force measurements are conducted to examine these theories’ validity and quasi-steady corrections are applied to compensate potential disparities between the idealised and real flow conditions. Velocity measurements are performed to scrutinise the effect of gusts on the flow around the airfoil, and subsequently to reveal the underlying mechanism governing the airfoil's response to gust-induced perturbations. In the study, two pitching vanes are arranged upstream to generate periodic vertical and longitudinal gusts, whereas a downstream airfoil with angles of attack of 0–12° is subjected to two gust types. It is found that Greenberg's theory demonstrates superior predictive capability in pre-stall regimes, with the potential for its effectiveness to be expanded to post-stall regimes through theoretical refinements. In contrast, Atassi's theory exhibits significant deviations from experimental outcomes across the measured angles of attack. Nevertheless, a modified version of the theory aligns better with experimental results at small angles of attack, whereas substantial discrepancies persist as the angle of attack increases. In the pre-stall regime, the aerodynamic response of the airfoil to vertical gusts displays a linear correlation with the flow angle near the leading edge. In the post-stall regime, the vertical gust induces dynamic stall of the airfoil. The flow angle has an essential effect on the lift coefficient but it alone is inadequate to dictate the trend of the lift coefficient. The vorticity statistics show that negative vortex circulation strongly correlates with the lift coefficient. Thus, further correction of the theory or a new vortex model can be expected to predict the lift variation.
There is concern that junior doctors are not prepared for their post-graduate attachments in ENT. The aims of this study were to capture the learning priorities of those in the ENT first on-call role and facilitate further educational opportunities to address these needs.
Method
Semi-structured interviews were undertaken to explore the learning needs of junior doctors with seven junior and two senior ENT clinicians.
Results
The thematic analysis generated three themes: the role of the ENT Junior; the perceived, expressed and prescribed learning needs; and attitudes towards future learning. These themes explored the misalignment between undergraduate training and post-graduate expectations, the lack of competence in ENT practical skills and the need for focused ENT training prior to commencing on-call shifts.
Conclusion
All interviewees identified the need for greater experience in practical interventional skills prior to their ENT attachments and expressed interest towards a standardised, bootcamp-style induction with simulated emergency experience.
Non-dissolvable nasal packs (Rapid Rhino and Merocel) are widely used in secondary healthcare centres for the control of epistaxis, with some side effects.
Methods
A prospective, observational cohort study was conducted of adults who required Rapid Rhino or Merocel packing for acute epistaxis management in a large healthcare centre between March 2020 and 2021. A validated modified version of the 22-item Sino-Nasal Outcome Test was used.
Results
A total of 80 adults requiring non-dissolvable packs were recruited. Seventy per cent of patients had Rapid Rhino packs inserted. Embarrassment was greater in patients who used Rapid Rhino than Merocel. Merocel packs had a significantly higher mean pain score on removal compared to Rapid Rhino. There was no correlation between rebleed rate and type of nasal pack used.
Conclusion
Non-dissolvable Rapid Rhino and Merocel nasal packs have similar efficacy in controlling epistaxis. Rapid Rhino packs are more embarrassing for patients in comparison to Merocel packs, but are less painful to remove.
U.S. military veterans are an average 20 years older than non-veterans and have elevated rates of certain health conditions. While negative aging stereotypes have been linked to increased risk for various health conditions, little is known about the prevalence and correlates of these stereotypes in this population. Using data from a nationally representative sample of 4,069 U.S. veterans surveyed between 11/19 and 3/20, we examined (1) the current prevalence of negative aging stereotypes related to physical, mental, and cognitive health and (2) sociodemographic, health, and psychosocial factors associated with these stereotypes. Multivariable regression and relative weight analyses were conducted to identify independent correlates of negative aging stereotypes. Results revealed that 82.3%, 71.1%, and 30.0% of veterans endorsed negative aging stereotypes related to physical, cognitive, and emotional health, respectively. Older age (36.6% relative variance explained), grit (23.6%), and optimism (17.5%) explained the majority of the variance in negative age stereotypes related to physical aging; grit (46.6%), openness to experiences (31.5%), and older age (15.1%) in negative age stereotypes related to cognitive aging; and emotional stability (28.8%), purpose in life (28.8%), and grit (25.3%) in negative age stereotypes related to emotional aging. This study provides an up-to-date characterization of the prevalence and correlates of negative aging stereotypes in U.S. veterans. Results underscore the importance of targeting key correlates of negative aging stereotypes, such as lower grit, as part of efforts to promote health and functioning in this population.
Airport emergencies are rare but potentially catastrophic; therefore, system preparedness is crucial. Airport emergency plans include the organization of emergency drills on a regular basis, including full-scale exercises, to train and test the entire rescue organization.
Objective:
This report describes a full-scale simulation at Bologna International Airport, Italy, in October 2022, involving local EMS resources.
Methods:
A full-scale aeroplane crash was simulated on the airport ground, activating the Airport emergency plan, and requiring the intervention of supplementary resources (ambulances, medical cars, and other emergency vehicles).
Results:
Twenty-seven simulated patients were evaluated by EMS: START triage assessment was correct for 81.48% of patients; 11.11% were over-triaged and 7.41% were under-triaged. All patients were transported to the hospitals of the area. The simulation ended 2 hours and 28 minutes after the initial alarm.
Conclusion:
The response time proved a good response. Triage accuracy was correct in more than 80% of simulated patients. The availability of a trauma centre within 6 kilometres allowed the transportation of a quota of patients directly from the event, without affecting transportation times. Areas for improvement were identified in the communication within the different agencies and in moving ambulances within the airport runway without airport personnel guidance.
Transient numerical simulations were conducted to investigate the influence of large amplitude and fast impact backpressure on a shock train. The fundamental problem consists of a shock train within a constant-area channel with a Ma=1.61 inflow and a pulse backpressure applied to the outlet. The pressure disturbance in the isolator has an intense forcing-response lag. From the moment of the backpressure peak appearance, it takes 36 times the backpressure duration for the pressure disturbance to reach the upstream end. It moves upstream with time in the form of a normal shock wave. As time progresses, the normal shock degenerates into a $\lambda $ shock and a compression wave behind due to the action of viscous dissipation in the boundary layer. Eventually, a multi-stage shock train is formed. The maximum backpropagation distance is a quadratic function of both the pulse backpressure peak and duration, and the relationship between these variables was determined by fitting. When the integral value of backpressure to time is fixed, reducing the backpressure peak while increasing the duration will reduce the backpressure pulsation at the isolator outlet, which will be more conducive to shortening the maximum backpropagation distance than reducing the duration and increasing the backpressure peak. The values of backpressure peak and duration are obtained from the detonation combustion case, which ensures the authenticity of backpressure characteristics. The relevant research conclusions can provide a reference for the design of the isolator of pulse detonation ramjet.
Otoscopic skills are essential for ENT doctors. Early-stage doctors develop skills whilst treating patients, with minimal teaching, potentially increasing risk to patients. Simulation allows skill development without patient risk; however, simulation often requires subjective expert review of technique. This study compared enhanced low-fidelity simulation with performance feedback against standard simulation using a basic otoscopy skills simulator.
Methods
Two low-fidelity ear simulators were created: a basic model without feedback and an enhanced model which alarms when the aural instrument tip touches the canal wall. Participants were evaluated in a randomised crossover pilot study, using both models to assess whether objective feedback reduced tip touches.
Results
The enhanced simulator reduced tip touches more than the control model, suggesting better and more sustained skill uptake. Participants reported that the enhanced model improved learning.
Conclusion
Enhanced low-fidelity models provide a low-cost opportunity to improve otoscopy skills without patient risk or the need for subjective expert feedback.
To examine and compare rates and methods of probable suicide in a Western region of Ireland during a 24 month period since the onset of the COVID-19 pandemic compared with a similar period immediately prior to the pandemic onset.
Methods:
Post-mortem reports between March 1st 2018 and February 29th 2020 were reviewed and compared with data from March 1st 2020 to February 28th 2022. Relevant demographic data, rates and methods of probable suicide and lifetime engagement with mental health services were compared across the two time points.
Results:
Identical rates of probable suicide (85 individuals at both time points) were demonstrated with no difference evident in the utilisation of violent compared to non-violent methods.
Conclusions:
This study demonstrates that despite previous reports of increased rates of self-harm and some evidence of increased mental distress since the onset of the COVID-19 pandemic, no change in rates of or methods employed by individuals who died by probable suicide were evident in this geographical region.
We offer an account of the metaphysics of persons rooted in Latter-day Saint scripture that vindicates the essentiality of origins. We then give theological support for the claim that prospects for the success of God's soul making project are bound up in God creating particular persons. We observe that these persons would not have existed were it not for the occurrence of a variety of evils (of even the worst kinds), and we conclude that Latter-day saint theology has the resources to endorse a strong soul-making non-identity theodicy. We then introduce two complications for this account rooted in the problem of horrendous evils. First, horrendous evils threaten to undermine our confidence that God is good to each created person within the context of their life. And second, horrendous evils raise concerns about the value of persons whose existence depends on the occurrence of those evils. We may wonder whether those whose existence depends on the occurrence of horrendous evils are valuable enough to motivate God's allowance of those evils. We show that by attending to important structural features of a post-mortem, pre-eschatological state called the spirit world, Latter-day Saints can ameliorate these concerns about horrendous evils.
Although older people who live alone might be in a vulnerable situation, they have often managed their everyday life for a long time, frequently with health challenges. In this article, we explore how nine older persons who live alone, who receive home care and are identified by home care professionals as being frail, manage their everyday lives by inquiring into their stories about living alone and receiving home care. We conducted three qualitative interviews with each of the nine participants over a period of eight months and analysed the data using thematic analysis and a narrative positioning analysis. Using the concept of resilience as our analytic lens, we identified three thematic threads: continuity, adaptation and resistance. In the narrative positioning analysis of three participants' stories, we identified that the participants used the processes of continuity, adaptation and resistance strategically and interchangeably. The study thus provides insight into how older people who live alone and use home care services narrate their balancing of strengths and vulnerabilities, and engage in the construction and maintenance of a sense of self through positioning in relation to master narratives. Older people's narrations are nuanced and complex, and this study indicates that encouraging storytelling and engaging with older people's narrations might support how older people enact resilience and thus their management of everyday life when living alone and ageing in place.
Filaments are ubiquitous within the microscopic world, occurring in biological and industrial environments and displaying a varied dynamics. Their wide range of applications has spurred the development of a branch of asymptotics focused on the behaviour of filaments, called slender-body theory (SBT). Slender-body theories are computationally efficient and focus on the mechanics of an isolated fibre that is slender and not too curved. However, SBTs that work beyond these limits are needed to explore complex systems. Recently, we developed tubular-body theory (TBT), an approach like SBT that allows the hydrodynamic traction on any isolated fibre in a viscous fluid to be determined exactly. This paper extends TBT to model fibres near plane interfaces by performing a similar expansion on the single-layer boundary integrals (BIs) for bodies by a plane interface. This provides a well-behaved SBT inspired approach for fibres by interfaces with a similar versatility to the BIs but without the singular kernels. The derivation of the new theory, called tubular-body theory for interfaces (TBTi), also establishes a criterion for the convergence of the TBTi series representation. The TBTi equations are solved numerically using a approach similar to boundary element methods (BEMs), called TBTi-BEM, to investigate the properties of TBTi empirically. The TBTi-BEM is found to compare favourably with an existing BEM and the lubrication singularity on a sphere, suggesting TBTi is valid for all separations. Finally, we simulate the hydrodynamics of helices beneath a free interface and a plane wall to demonstrate the applicability of the technique.
Flow between axially rotating concentric cylinders is well known to exhibit rich dynamics. Hence, Taylor instabilities have been studied, both experimentally and theoretically, for many years. Although usually studied in the abstract, such geometries arise in a range of practical situations including drilling, when a drilling fluid flow enters a well via a pipe that is the centre body and returns via the annulus between the pipe and the borehole wall. In drilling, the centre body rotates and the annular flow contains rock cuttings. Here, we report the development of an Eulerian-Eulerian solver, based on OpenFOAM, that solves for this cuttings transport problem in the presence of both gravity and Taylor vortices. To check the reliability of the solver, we conduct a set of experiments spanning a wide range of complex flow regimes. We show that the model successfully predicts, in all regimes, the observed complex redistribution of particulates. However, for suspension flows under viscously dominated conditions, high particle concentrations and in rectilinear flow, particle pressure and normal stress differences are sufficient to capture particle migration. Results show that in more complex flows exemplified by the Taylor–Couette flow studied here, more realistic predictions of non-Brownian particle migration require inclusion of forces arising through the relative velocity of the two phases including lift forces originating both from inertia and particle rotation.
Developing skills in rigid endoscopy poses challenges to the surgical trainee. This study investigates whether a modified manikin can improve the technical skill of junior operators by providing direct quantitative feedback.
Methods
A force-sensing pad was incorporated into the oral cavity of a life support manikin. Junior trainees and senior otolaryngologists were invited to perform rigid endoscopy and received real-time feedback from the force sensor during the procedure.
Results
There was a significant inverse correlation between operator seniority and the weight applied to the oral cavity (p < 0.0001). All junior trainee operators applied less weight after five attempts (346 ± 90.95 g) compared to their first attempt (464 ± 85.79 g). This gave a statistically significant decrease of 118 g (standard deviation = 107.27 g, p = 0.007) when quantitative feedback was provided to learning operators.
Conclusion
This low-cost, simple model allows trainees to rehearse a high-risk procedure in a safe environment and adjust their operative technique.