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In May 2024, German EMTs ASB, Cadus, Humedica and Johanniter conducted a joint disaster response field exercise including a Cholera outbreak scenario. The RRML CIBU (Cellule d’Intervention Biologique d’Urgence) from Institut Pasteur, France, embedded in an EMT, supported the exercise. Amateur actors presented injuries and cases of acute watery diarrhea with different levels of severity. Dummy samples were collected and transported to the RRML for analysis. An external IPC-Team from the German Robert Koch Institute conducted facility assessments to provide Cholera-specific IPC advice and training.
Objectives:
To assess
1. the implementation of Cholera-specific IPC measures.
2. the need for and benefit of external IPC support.
3. the interoperability between EMTs and RRML.
Method/Description:
Qualitative evaluation through observation and interviews.
Results/Outcomes:
All EMTs (n=4) had access to IPC guidelines and personal protective equipment (PPE) and implemented active screening for signs of infection (n=4). 75% (n=3) of the EMTs actively isolated suspected cholera cases. EMTs underlined the benefit of external IPC support (n=3) and training provided (n=4). 48 EMT staff were trained in donning/doffing of PPE and management of spill events. The RRML provided transport material and training on packaging of samples. Occasional contamination of the outer packaging and incorrectly filled-in lab forms were reported. Sample transport was aligned to lab schedule.
Conclusion:
The EMTs adapted competently to the Cholera scenario. Interoperability with the RRML was satisfying. The IPC team was seen as important support. Lessons learned included the need for improved isolation precautions, packaging of samples and completion of lab forms.
Mobile-based trading apps have made investing easier than ever before, but this includes enabling access to risky investments that many investors may not be able to trade safely. The UK financial regulator thereby requires Contract for Difference (CFD) trading apps to make disclosures such as, ‘89% of retail investor accounts lose money when trading CFDs with this provider’. However, these disclosures might be counteracted by either their suboptimal implementation, or by other aspects of these apps’ deceptive choice architecture. Therefore, the present study audited choice architecture characteristics of demo-modes of the 14 most-popular CFD trading apps in the UK. A content analysis found for example that 31.6% of risk warnings did not comply with the regulator’s standards, and that only 35.7%% of apps contained risk warnings within the app’s main tabs. A thematic analysis suggested that apps’ educational resources could instil users with the hope of winning, by emphasising practice, strategies and psychological mindset – instead of acknowledging luck as the predominant factor underlying CFD trading profitability. Overall, this study added to previous research highlighting the similarities between certain high-risk investments and gambling, and added to the behavioural public policy literature on deceptive choice architecture.
We report on Lagrangian statistics of turbulent Rayleigh–Bénard convection under very different conditions. For this, we conducted particle tracking experiments in a $H=1.1$-m-high cylinder of aspect ratio $\varGamma =1$ filled with air (Pr = 0.7), as well as in two rectangular cells of heights $H=0.02$ m ($\varGamma =16$) and $H=0.04$ m ($\varGamma =8$) filled with water (Pr = 7.0), covering Rayleigh numbers in the range $10^6\le {\textit {Ra}}\le 1.6\times 10^9$. Using the Shake-The-Box algorithm, we have tracked up to 500 000 neutrally buoyant particles over several hundred free-fall times for each set of control parameters. We find the Reynolds number to scale at small Ra (large Pr) as $ {\textit{Re}} \propto {\textit{Ra}}^{0.6}$. Further, the averaged horizontal particle displacement is found to be universal and exhibits a ballistic regime at small times and a diffusive regime at larger times, for sufficiently large $\varGamma$. The diffusive regime occurs for time lags larger than $\tau _{co}$, which is the time scale related to the decay of the velocity autocorrelation. Compensated as $\tau _{co} {\textit {Pr}}^{-0.3}$, this time scale is universal and rather independent of $ {\textit {Ra}}$ and $\varGamma$. We have also investigated the Lagrangian velocity structure function $S^2_i(\tau )$, which is dominated by viscous effects for times smaller than the Kolmogorov time $\tau _\eta$ and hence $S^2_i\propto \tau ^2$. For larger times we find a novel scaling for the different components with exponents smaller than what is expected in the inertial range of homogeneous isotropic turbulence without buoyancy. Studying particle-pair dispersion, we find a Batchelor scaling (${\propto }\,t^2$) on small time scales, diffusive scaling (${\propto }\,t$) on large time scales and Richardson-like scaling (${\propto }\,t^3$) for intermediate time scales.
Post-procedural antimicrobial prophylaxis is not recommended by professional guidelines but is commonly prescribed. We sought to reduce use of post-procedural antimicrobials after common endoscopic urologic procedures.
Design:
A before-after, quasi-experimental trial with a baseline (July 2020–June 2022), an implementation (July 2022), and an intervention period (August 2022–July 2023).
Setting:
Three participating medical centers.
Intervention:
We assessed the effect of a bundled intervention on excess post-procedural antimicrobial use (ie, antimicrobial use on post-procedural day 1) after three types of endoscopic urologic procedures: ureteroscopy and transurethral resection of bladder tumor or prostate. The intervention consisted of education, local champion(s), and audit-and-feedback of data on the frequency of post-procedural antimicrobial-prescribing.
Results:
1,272 procedures were performed across all 3 sites at baseline compared to 525 during the intervention period; 644 (50.6%) patients received excess post-procedural antimicrobials during the baseline period compared to 216 (41.1%) during the intervention period. There was no change in the use of post-procedural antimicrobials at sites 1 and 2 between the baseline and intervention periods. At site 3, the odds of prescribing a post-procedural antimicrobial significantly decreased during the intervention period relative to the baseline time trend (0.09; 95% CI 0.02–0.45). There was no significant increase in post-procedural unplanned visits at any of the sites.
Conclusions:
Implementation of a bundled intervention was associated with reduced post-procedural antimicrobial use at one of three sites, with no increase in complications. These findings demonstrate both the safety and challenge of guideline implementation for optimal perioperative antimicrobial prophylaxis.
This trial was registered on clinicaltrials.gov, NCT04196777.
X-ray diffraction (XRD) characterization of natural and intercalated smectites is usually limited to the apparent d-value estimated from the peak maxima in the raw data. This can lead to the misinterpretation of the measured data. In the case of XRD, the interference function is modulated by instrumental factors (Lorentz-polarization factor, diffraction geometry) and physical factors (structure factor, surface roughness effect). These effects lead to diffraction profile distortions, depending on the diffraction angle and peak full width at half maximum (FWHM). As a result, the diffraction profiles for structures with large line broadening (FWHM > 1°) exhibit a significant peak shift (Δd ∼ 1.5 Å), especially at low angles (2θ ≤ 10°). The present work deals with the detailed analysis of all these effects, their corrections and their consequences for the interpretation of diffraction patterns (including possible errors in determining lattice parameters or the structure model). The investigated materials were montmorillonites (MMT) intercalated with hydroxy-Al polymers. Diffraction profile analysis revealed the corrected d-values and showed that the intercalated sample is not a mixed-layered structure. As a result a structural model of the interlayer is presented.
Languages vary in the mapping of relational terms onto events. For instance, English motion descriptions favor manner (how something moves) verbs over path (where something move) verbs, whereas those of other languages, like Spanish, show the opposite pattern. While these lexicalization biases are malleable, adopting a novel lexicalization pattern can be slow for second language learners. One potential mechanism for learning non-native verb mappings is cross-situational statistical learning (CSSL). However, the application of CSSL to verbs is limited and does not explicitly examine how lexicalization biases may complicate adults’ ability to resolve the referential uncertainty of multiple referents. We ask English-speaking monolingual adults to learn the mappings of ten verbs via CSSL. Verbs mapped onto either manner or path of motion, with the other event component held constant. Adults in both conditions demonstrated successful learning of novel verbs, with adults learning the manner verbs showing more consistent performance across accepting correct referents and rejecting incorrect ones. Our results are the first to demonstrate adults’ use of CSSL to acquire verb meanings that both align with and cut against native lexicalization biases and suggest a limited influence of lexicalization biases on adults’ learning in idealized CSSL conditions.
We evaluated a digital learning programme for non-specialists to develop knowledge-based competencies in a problem-solving intervention for adolescents to examine the overall impact of training on knowledge-based competencies among learners; and to compare the effects of two training conditions (self-guided digital training with or without coaching) in a nested parallel, two-arm, individually randomised controlled trial. Eligible participants were 18 or older; fluent in Hindi or English; able to access digital training; and had no prior experience of delivering structured psychotherapies. 277 participants were enrolled from 31 March 2022 to 19 June 2022 of which 230 (83%) completed the study. There was a significant increase in competency score from pre-training (Mean = 7.01, SD = 3.29) to post-training (Mean = 8.88, SD = 3.80), 6 weeks after the pre-training assessment. Knowledge competency scores showed larger increase among participants randomised to the coaching arm (AMD = 1.09, 95% CI 0.26–1.92, p = 0.01) with an effect size (d) of 0.33 (95% CI 0.08–0.58). More participants completed training in the coaching arm (n = 96, 69.6%) compared to the self-guided training arm (n = 56, 40.3%). In conclusion, a coach-supported remote digital training intervention is associated with enhanced participation by learners and increased psychotherapeutic knowledge competencies.
Chapter 4 examines Franz Rosenzweig’s relationship to classical rabbinic Judaism and his response to Hegel regarding the individual, the state, and sacrifice in warfare. It argues that Rosenzweig’s presentation of Jewish life and community is connected to his critique of the dominant tradition of Western philosophy, that Hegel’s account of Judaism has important parallels to rabbinic understandings, and that Christianity’s connection to power-politics leaves it intertwined with ‘paganism’ for Rosenzweig.
Chapter 5 shows that Walter Benjamin’s ‘Critique of Violence’ stands in close relation to classical rabbinic understandings of law and power. It shows that the rabbinic texts have a surprisingly antinomian character when illuminated by Benjamin’s writings, and that Benjamin’s critique of mythic violence has an underlying connection to biblical and rabbinic ideas, including criticism of idolatry and understanding of God as the sole authorizer of violence.
Chapter 2 looks at Mendelssohn’s understanding of permitted or forbidden areas of Jewish participation in modern society. It highlights how key areas of life in the modern state, such as military service and carrying out capital punishment, become highly problematic in Mendelssohn’s theopolitical framework and understanding of divine sovereignty, and explores the profound implications of this for Mendelssohn’s political philosophy as a whole and for his account of the relation between Judaism and Christianity.
This concluding chapter assesses similarities and differences among Moses Mendelssohn, Hermann Cohen, Franz Rosenzweig, and Walter Benjamin regarding politics, power, God, and violence, as well as exploring further connections between these authors and rabbinic ideas about idolatry and the value of individual life. In light of the consistent pattern of thought and reasoning found in all four thinkers and classical rabbinic literature, the chapter argues for a fundamental rethinking of typical understandings of Judaism and politics, the history of Jewish thought, and the ethical and political dynamics of the broader Western philosophical tradition.
Chapter 1 examines Moses Mendelssohn’s claim that Jewish legal violence has been suspended following the destruction of the Temple in Jerusalem and is no longer legitimate. While other scholars have viewed this claim as a departure from previous Jewish thought, this chapter shows that Mendelssohn’s assertions stand in close connection to classical rabbinic understandings of the relation between violence and the Temple.