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Edited by
William J. Brady, University of Virginia,Mark R. Sochor, University of Virginia,Paul E. Pepe, Metropolitan EMS Medical Directors Global Alliance, Florida,John C. Maino II, Michigan International Speedway, Brooklyn,K. Sophia Dyer, Boston University Chobanian and Avedisian School of Medicine, Massachusetts
Civil unrest or terrorism at mass gathering events can erupt with significant violence and multiple casualties. These are high-risk situations, not only because of physical casualties, but also because of ethical, political and psychological sequelae. Beyond specialized planning, multi-agency drills and proficient tactical medicine training, medical teams should co-create secured access and egress, alternative medical responses and rapidly-adapting coordination and secure communications with other agencies. Civil protests can escalate, especially when extremist groups infiltrate them. Multi-site violence and assaults can evolve, particularly in terroristic attacks. Key lessons include unrelenting vigilance until all participants have left the mass gathering scene in its entirety. Violence (bombs, shootings, vehicle attacks) will often erupt when mass gatherings are dispersing and considered over. Terrorists can also purposely target medical personnel or incite one event (fire, bomb, shooting) to create crushing stampedes or to herd crowds into more vulnerable areas where they can be further attacked more directly with other modern weapons. Terrorists often attack from elevated perches or generate “protracted suicide” incidents while holding hostages, including many severely-wounded. The resulting frustration, anger and guilt commonly can consume medical rescuers when beholding slaughtered innocents or simply because they were (appropriately) staged during containment of on-going violence.
In May 2016 a Norovirus (NoV) gastroenteritis outbreak involved a high school class visiting a seaside resort near Taormina (Mascali, Sicily). Twenty-four students and a teacher were affected and 17 of them showed symptoms on the second day of the journey, while the others got ill within the following 2 days. Symptoms included vomiting, diarrhoea and fever, and 12 students required hospitalisation. Stool samples tested positive for NoV genome by Real-Time polymerase chain reaction assay in all 25 symptomatic subjects. The GII.P2/GII.2 NoV genotype was linked to the outbreak by ORF1/ORF2 sequence analysis. The epidemiological features of the outbreak were consistent with food/waterborne followed by person-to-person and/or vomit transmission. Food consumed at a shared lunch on the first day of the trip was associated to illness and drinking un-bottled tap water was also considered as a risk factor. The analysis of water samples revealed the presence of bacterial indicators of faecal contamination in the water used in the resort as well as in other areas of the municipal water network, linking the NoV gastroenteritis outbreak to tap water pollution from sewage leakage. From a single water sample, an amplicon whose sequence corresponded to the capsid genotype recovered from patients could be obtained.
Charge Transfer Inefficiency (CTI) is a well known effect of charge-coupled devices (CCD). The charge transfer from one pixel to the next is not perfect and is quantified by the fraction of charge successfully moved (clocked) between adjacent pixels. The amplitude of this effect depends on the signal level inside the pixel. In the context of high-precision radial velocity measurements using cross-dispersed echelle spectrograph, this CTI effect on a CCD recording spectral orders may introduce associated spectral lines shifts. Indeed if the signal level recorded on the spectra is changing, the CTI amplitude will change affecting the associated centroid of all spectral lines. Such effect may introduced radial velocity shifts of several m s-1. We describe here CTI effect which is affecting the SOPHIE spectrograph installed on the 1.93-m telescope of Observatoire de Haute Provence (OHP). We calibrated the effect thanks to the Thorium-Argon lines and we applied a software correction on the spectra in order to assess the charge lost during the readout process on all pixels.
The SOPHIE Consortium started a large program of exoplanets search and characterization in the Northern hemisphere with the new spectrograph SOPHIE at the 1.93-m telescope of Haute-Provence Observatory, France. The objectives of this program are to characterize the zoo of exoplanets and to bring strong constraints on their processes of formation and evolution using the radial velocity technique. We present here new SOPHIE measurements of the transiting planet host star XO-3. This allowed us to observe the Rossiter-McLaughlin effect and to refine the parameters of the planet. The unusual shape of the radial velocity anomaly during the transit provides a hint for a nearly transverse Rossiter-McLaughlin effect. The sky-projected angle between the planetary orbital axis and the stellar rotation axis should be λ = 70° ± 15° to be compatible with our observations. This suggests that some close-in planets might result from gravitational interaction between planets and/or stars rather than migration. This result requires confirmation by additional observations.
Exoplanet search programs need to study how to disentangle radial-velocity (RV) variations due to Doppler motion and the noise induced by stellar activity. We monitored the active K2V HD 189733 with the high-resolution SOPHIE spectrograph (OHP, France). We refined the orbital parameters of HD 189733b and put limitations on the eccentricity and on a long-term velocity gradient. We subtracted the orbital motion of the planet and compared the variability of activity spectroscopic indices (HeI, Hα, Ca II H&K lines) to the evolution of the RV residuals and the shape of spectral lines. All are in agreement with an active stellar surface in rotation. We used such correlations to correct for the RV jitter due to stellar activity. This results in achieving a high precision on the orbital parameters, with a semi-amplitude: K=200.56±0.88m⋅s−1 and a derived planet mass of MP=1.13±0.03 MJup.
The combination of the collecting power of an ELT with an ultra-stable high resolution spectrograph opens up the possibility to measure for the first time directly the dynamical effect of the acceleration of the Universe. CODEX will also provide unique opportunities for advance in many other branches of astrophysics. The CODEX design is based on an array of several identical spectrographs. It is highly modular and can be easily adapted to a large range of sky apertures and telescope diameters. CODEX is designed to work as a seeing limited instrument. The requirements for the telescope are moderate and clearly identified.
To assess the accuracy of paramedic estimates of adult body weights in cardiac arrest cases.
Hypothesis:
Paramedics could accurately estimate the weights of out-of-hospital cardiac arrest patients.
Design:
Retrospective data analysis of a 15-month, multicenter study involving nontraumatic out-of-hospital cardiac arrest patients. Paramedic estimates of body weights were compared to weights measured in the hospital. Patients were included in the analysis only if both a paramedic weight and a measured in-hospital weight were recorded.
Setting:
Six urban emergency medical services systems.
Participants:
The study population included adults with return of spontaneous circulation who subsequently were admitted to the hospital.
Measurements:
Pearson correlation analysis of paramedic-estimated weights and measured weights.
Results:
Among the 133 study patients, the correlation coefficient (R) for paramedic estimates and the actual measured weight was 0.93. Paramedic estimates of weight were within 10% of the measured weights in 74% of the patients, and within 20% of measured weights in 93% of the patients.
Conclusion:
Paramedic weight estimates correlated well with measured weights.
Current-voltage characteristics and dV/dI curves of a YBCO/Nb bulk junction at 4.2 K are reported. The presence of the Josephosn effect is clearly shown. The dV/dI spectrum shows sharp structures which can be related to the Niobium and the YBCO energy gaps Δnb and ΔNb and ΔYBCO. A value ΔYBCO = 26.2 ± 1.0 meV can be estimated, confirming the strong coupling character of such a compound.
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