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Following limited clinical exposure during the coronavirus disease 2019 pandemic, a simulation-based platform aimed at providing a unique and safe learning tool was established. The aim was to improve the skills, knowledge and confidence of new ENT doctors.
Method
The course was developed through 5 iterations over 28 months, moving from a half-day session to 2 full-day courses with more scenarios. Participant, faculty and local simulation team feedback drove course development. High-fidelity scenarios were provided, ranging from epistaxis to stridor, using technology including SimMan3 G mannequin, mask-Ed™ and nasendoscopy simulators.
Results
Participant feedback consistently demonstrated that the knowledge and skills acquired enhanced preparedness for working in ENT, with impact being sustained in clinical practice.
Conclusion
Preparing healthcare professionals adequately is essential to enhancing patient safety. This simulation course has been effective in supporting new doctors in ENT and has subsequently been rolled out at a national level.
Over the last few years, much of public discourse has been concerned with the rise of populist movements across the world. Hindu nationalism, Brexit, and the rise of Le Pen are just some of the phenomena that have garnered attention and concern. Although, in Rome and America, classicist and political scientist Dean Hammer does not start with this topic, contemporary populism is his destination, specifically in the shape of Donald Trump and the conditions in which his presidency arose. As Hammer investigates several aspects of both the creation and undoing of self-identity and political norms in the United States, he cites templates, points of comparison, and, finally, warnings in both Rome's founding myths and the history of its transition from republic to principate.
The Ancient Commentators of Aristotle series has recently published three important volumes. The first two are the last instalments of Simplicius’ commentary on Aristotle's Physics, the culmination of a monumental endeavour that started in 2001 and now comprises twelve books. One of these two final volumes contains the translation of Simplicius’ On Aristotle Physics 1.1–2, the other is a detailed General Introduction to the whole commentary, both authored by Stephen Menn. In his acknowledgements, Menn explains that the translation began as a joint work with Rachel Barney, who contributed, among other things, by revising early drafts, composing the paragraph summaries, and collaborating on the endnotes. Unfortunately, we are told, she had to withdraw from the project, leaving Menn to finish it and take all responsibility for the final product. The translation is accompanied by an eighteen-page preface by the series editors, Michael Griffin and Richard Sorabji (which, in fact, offers a shorter version of Menn's General Introduction), and a twelve-page note on the text and translation. The translation is, of course, careful and beautifully assembled, supplied with diagrams by Henry Mendell.
This article brings together two well known literary readings: the obscene interpretation of Catullus’ passer, and the interpretation of Ovid, Amores 2.6 as a self-conscious, creative imitation of Catullus 3. It will first offer a further reason to think that Catullus’ contemporary readers understood c.3 as a poem about impotence, and then go on to suggest that Ovid had some fun with this interpretation in his psittacus-poem.
We characterize the ideals of the semicrossed product $C_0(X)\times _\phi {\mathbb Z}_+$, associated with suitable sequences of closed subsets of X, with left (resp. right) approximate unit. As a consequence, we obtain a complete characterization of ideals with left (resp. right) approximate unit under the assumptions that X is metrizable and the dynamical system $(X,\phi )$ contains no periodic points.
This paper looks at a genre of meetings that, while neither purely ‘scientific’ nor ‘diplomatic’, drew on elements from both professional spheres and gained prominence in the interwar decades and during the Second World War. It proposes to make sense of ‘technical conferences’ as a phenomenon that was made by and through scientific experts and politicians championing the organizing power of rationality, science and liberal internationalism. Against the background of swelling ranks of state-employed scientists, this paper documents the emergence of technical conferences as the forums where they got down to work. To make this case the paper traces the influence of a new way of thinking about the function and organization of conferences, originating in the time around the First World War, on one international organization in particular: the United Nations Relief and Rehabilitation Administration (UNRRA), as a new hub of scientists and technicians.
Archaeological fieldwork at Eversley Quarry, Fleet Hill Farm, Finchampstead, Berkshire documented evidence of Mesolithic activity, associated with paleoenvironmental deposits, on the Blackwater River floodplain, a river for which activity of this period was previously unknown. The discovery evolved from initial recognition of worked flint artefacts across a well weathered, stripped subsoil surface in part of the site. Additional material was collected subsequently from the summit of an adjacent low knoll. The findings were of sufficient extent and importance to warrant supplementary archaeological fieldwork using a gridded test pit strategy to evaluate the Mesolithic potential in remaining parts of the site. This resulted in the identification of additional clusters of worked flints, which were preserved in situ.
The clusters were predominantly of Mesolithic date but also included Neolithic and Bronze Age artefacts, indicating prolonged use of the landscape. Concentrations were consistently located on slightly elevated sand bars flanking palaeochannels of a formerly braided river system. The contemporaneity of the palaeodrainage and Mesolithic activity has been confirmed by radiocarbon dates from peat that formed during the Holocene. The collective results mark a significant contribution to knowledge of the Blackwater River valley, a major communications artery in the Mesolithic period linking the west end of the Wealden Greensand to the Rivers Thames and Kennet. These findings also highlight the importance that river valleys can make to locations that have been less well studied but nevertheless enjoyed prolonged use.
Data reconstruction of rotating turbulent snapshots is investigated utilizing data-driven tools. This problem is crucial for numerous geophysical applications and fundamental aspects, given the concurrent effects of direct and inverse energy cascades. Additionally, benchmarking of various reconstruction techniques is essential to assess the trade-off between quantitative supremacy, implementation complexity and explicability. In this study, we use linear and nonlinear tools based on the proper orthogonal decomposition (POD) and generative adversarial network (GAN) for reconstructing rotating turbulence snapshots with spatial damages (inpainting). We focus on accurately reproducing both statistical properties and instantaneous velocity fields. Different gap sizes and gap geometries are investigated in order to assess the importance of coherency and multi-scale properties of the missing information. Surprisingly enough, concerning point-wise reconstruction, the nonlinear GAN does not outperform one of the linear POD techniques. On the other hand, the supremacy of the GAN approach is shown when the statistical multi-scale properties are compared. Similarly, extreme events in the gap region are better predicted when using GAN. The balance between point-wise error and statistical properties is controlled by the adversarial ratio, which determines the relative importance of the generator and the discriminator in the GAN training.
We investigated the compositions of a suite of 361 chrome-bearing spinels from spinel peridotites, ophiolitic mantle chromitites and from layered igneous intrusions in which the Fe2+/Fe3+ ratio has been determined by Mössbauer spectroscopy. We explore the crystal-chemical controls on the distribution of Fe3+ and on mineral stoichiometry with regard to electron-probe correction procedures for estimating Fe3+ in spinel. We find that chrome-bearing spinels can be subdivided into three groups: a Cr–Al-rich group; a high-Fe group; and a highly oxidised group. Spinels of the Cr–Al group are found in spinel peridotites and ophiolitic mantle chromitites. They are normal spinels with a low Fe3+ content and compositions that are close to stoichiometric. Spinels in the high-Fe group are found in layered igneous intrusions. They are also normal spinels which have higher concentrations of Fe3+ on the octahedrally coordinated site than is found for the Cr–Al group. Stoichiometric calculations tend to overestimate the Fe3+ content and their compositions do not conform to the MgO–cr# correlation found in the Cr–Al group. Spinels in the highly oxidised group are found in layered intrusions and ophiolitic mantle chromitites. They have (Fe3+/ΣFe)Möss > 0.4 and high Cr (cr# > 0.5), but relatively low Fe2+ (fe# 0.24–0.56). Stoichiometric calculations tend to underestimate the Fe3+ content. They represent normal spinels in which tetrahedrally coordinated Fe2+ has been oxidised to Fe3+.
Our data show that spinels with greater Cr and Fe are sufficiently different in their crystal chemistry from the aluminous spinels to indicate that the EPMA correction procedures developed for Fe3+ in aluminous spinels on the basis of the Cr/Al ratio, and used in oxy-thermobarometry, are inappropriate for Cr-rich and Fe-rich compositions.
As the startup ecosystem emerges, Cambodia requires a distinct set of legal frameworks to promote many regulatory aspects to boost national innovation and strengthen the connection of key players in the ecosystem. One of them is financial support for startups, ‘Venture Capital Law’. Therefore, this paper studies the current existing legal framework of Venture Capital (VC) in Cambodia, key bottlenecks that VC encountered, comparative analysis with other countries such as the United States, Japan, and China, and then propose new regulatory frameworks which solve the key bottlenecks and aim to optimise the growth of a startup ecosystem. The finding is that different stages of VC present different bottlenecks such as fundraising (funding source), startup investment (investment readiness of the startup, and deal structure), and exit (immature the capital market for startup's IPO and lack of regulations for Merger and Acquisition (M&A)). The new regulatory frameworks should endorse the use of pension funds as a source of VC funds in the future, encourage private corporations to invest in startup causes, include regulations to promote the readiness of founders, encourage the use of convertible notes, and fasten the regulation governing M&A with the balance of antitrust law.
In 1958, A.J.P. Taylor's essay The Troublemakers explored the tradition of dissent against power politics in the United Kingdom. Gaetano Salvemini, who had always shown a consistent interest in British political and cultural debates, shared many of the positions put forward by these ‘troublemakers’, such as free trade, the fight against military expenditure, and suspicions regarding standing armies. At the outbreak of the First World War, Salvemini used these arguments to support Italy's involvement in the war against autocratic and militarist central powers. Salvemini's journal L'Unità reported the stances expressed by a ‘troublemaker network’ called the Union of Democratic Control, despite their criticism of the United Kingdom's line of action during the war. In the course of the conflict, Salvemini kept in close contact with a specific group of ‘troublemakers’ around Robert Seton-Watson's journal The New Europe. Salvemini championed The New Europe's fight for subject nationalities in the Habsburg Empire, though he criticised their support of Yugoslavian claims to Istria, Trieste and Venezia Giulia. This essay will focus on the complex relationship between Salvemini and these British ‘troublemakers’ through the former's writings and correspondence.
Despite early imperial portenta being largely ignored in secondary literature, the reports of such incidents demand increased scholarly attention. This paper contends that decoding reports of portents from the early empire can give us fundamental insights into key moments of identity negotiation in this period. This paper will primarily focus on two such reports, signs of divine displeasure reported in Athens and in Camulodunum. This paper contends that within such reports we can glimpse complex and contested issues of identity creation and redefinition at intra-local, trans-local, and global levels.
Before the Omicron variant ran amok inside China in November 2022, the Chinese central government’s dynamic zero-COVID policy effectively contained the spread of the coronavirus and its variants during multiple waves of outbreaks. However, it was not without cost. This study examines the impacts of stringent lockdown interventions on urban residents’ mental health during the initial outbreak of the Omicron variant in the spring of 2022. Using survey data from 522 respondents within the same neighbourhood and a spatial quasi-experimental design, the results show that strict lockdown interventions are significantly related to higher levels of psychological distress after controlling for observed confounders and that lockdown interventions have further spillover effects on mental health for residents in adjacent residential compounds who are otherwise free. Moreover, the results show that the lack of material supplies and medical care plays a more salient role in explaining lockdown effects on psychological distress than residents’ social interaction and trust levels of COVID-19 policy. Policy and intervention implications are also discussed.
Existing literature shows the importance of maternity leave as a strategy for women to balance work and family responsibilities. However, only a few studies focused on the long-run impact of maternity leave length on maternal health. Therefore, how exactly they are related remains unclear. We examine women’s selection into different lengths of maternity leave as a potential explanation for the inconclusive findings in the literature on the association between maternity leave and maternal health. This study aims to unravel the association between maternity leave length and mothers’ long-term health in Germany. Drawing on detailed data from the German Statutory Pension Fund (DRV), we estimated the association between maternity leave length and sick leave from 3 years following their child’s birth for 4,243 women living in Germany in 2015 by applying discrete-time logistic regression. Our results show a negative relationship between maternity-leave length and long-term maternal health, likely driven by negative health selection. Long maternity leaves of more than 24 months were associated with worse maternal health in the long run, while a positive association emerged for vulnerable women with pre-existing health problems.
The coronavirus disease (COVID-19) pandemic produced swift, extensive changes in daily life, including for first-episode psychosis (FEP) clients. This study examined pandemic-related psychosocial impacts to clients while engaged in Coordinated Specialty Care (CSC). We also examined FEP client vaccination rates, as vaccinations can reduce hospitalizations/deaths, and related worries.
Methods:
Thirty-one clients (45% female; ages 13-39; 26% black, 61% white) from Pennsylvania (PA) CSC outpatient programs completed an online survey evaluating exposure to COVID-19, associated worries, coping, and safety strategies. Descriptive statistics characterized responses and demographic group differences. Additional program evaluation data informed vaccination rates for PA FEP clients.
Results:
Participants reported substantial pandemic-related impacts to daily life. Many clients reported improved safety measures to protect themselves/others from COVID-19. Clients largely denied substantial worries about infection for themselves, reporting greater concern for loved ones. Multiple coping strategies were endorsed, which, with few exceptions, did not differ among demographic groups. FEP clients had a low reported rate of vaccination (28.6%) as of September 2021.
Conclusions:
Observed prolonged pandemic effects may alter FEP client progress in CSC. Stakeholders should be prepared to adjust FEP treatment accordingly in the event of a similar disaster. Concentrated vaccination efforts may be necessary for this population.
The idea that the sea is a dangerous and alien element in which one is at the mercy of higher powers, is deeply imbedded in Mediterranean culture, and has many parallels in Greek and Roman literature. From an Epicurean point of view, however, such higher powers belong to the realm of irrational beliefs which could threaten one's ἀταραξία (‘peace of mind’). What counts in Epicureanism is the rational calculus of all factors in order to minimize the influence of τύχη (‘chance’) on one's endeavours. This article explores how the Epicureans thought about the sea and its many dangers. It tries to establish under which circumstances the sage will travel by sea and gives special attention to Diogenes of Oenoanda's letter (fr. 71 + NF 214 + fr. 72 + fr. 70) about the shipwreck of Niceratus and his friends’ failure to minimize the agency of chance.
We report textural and compositional data for the titanosilicate narsarsukite [Na2(Ti,Fe3+)Si4(O,F)11] in peralkaline granites from the Papanduva Pluton in Graciosa Province, south-southeastern Brazil. Two distinct narsarsukite generations, one late magmatic and the other post-magmatic, were identified on the basis of textural and compositional features. The magmatic generation consists of larger, euhedral to subhedral variably zoned crystals and late poikilitic intergrowths between narsarsukite and albite laths, representing the crystallisation of the latest melt pockets. The post-magmatic generation forms smaller, typically fibrous crystals and irregular aggregates that occur interstitially or replace the primary mafic minerals, particularly arfvedsonite. Compositions of narsarsukite from the Papanduva Pluton cover most of the compositional range described in known occurrences. The magmatic generation is enriched in Zr and depleted in Al. The Fe3+ and Al contents show a positive correlation for the magmatic crystals, but a negative correlation for the post-magmatic narsarsukite. The Al/Fe3+ ratios are higher in the post-magmatic crystals and can be used to discriminate between the two generations. The compositional variations are controlled mainly by the heterovalent substitution (Ti, Zr)4+ + O2– = (Al, Fe)3+ + F1–, and are compatible with (OH)1– ions in the O site. Narsarsukite has significantly higher concentrations of mid REE+Y and HFSE and very low to absent contents of LREE and LILE relative to the host-rocks. The average REE pattern of the magmatic crystals is highly fractionated, consistent with the expected strong preference for the smaller HREE. The post-magmatic crystals that replace arfvedsonite have flatter patterns, with higher concentrations of LREE and MREE. Their compositions suggest a fluid phase relatively rich in HFSE, REE, Y, Pb, Th and U. Narsarsukite is a common phase in strongly peralkaline granites such as the Papanduva Pluton and the well-known Strange Lake Complex, and should be considered a diagnostic mineral of highly peralkaline SiO2-oversaturated rocks containing rare Ti and Zr mineral assemblages.