8,610 research outputs found
When norms clash: international norms, domestic practices, and Japan's internalisation of the GATT/WTO
Recommended from our members
Attempting to validate the over/under triage matrix at a level I trauma center.
The Optimal Resources Document (ORD) mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the over/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different and Matrix does not discriminate the needs or outcomes of these different groups of patients.Trauma registry data, from 1/2013-12/2015, at a Level I trauma center were reviewed. Over and undertriage rates were calculated by Matrix. Patients with ISS ≥16 were classified by activation level (full, limited, consultation), and triage category by Matrix. Patients in the limited activation and consultation groups were compared to patients with full activation by demographics, injuries, initial vital signs, procedures, delays to procedure, ICU admission, length of stay, and mortality.7031 patients met activation criteria. Compliance with ACS tiered activation criteria was 99%. The Matrix overtriage rate was 45% and undertriage was 24%. Of 2282 patients with an ISS ≥16, 1026 were appropriately triaged (full activation), and 1256 were under triaged. Undertriaged patients had better GCS, blood pressure, and BD than patients with full activation. ICU admission, hospital stays, and mortality were lower in the undertriaged group. The under triaged group required fewer operative interventions with fewer delays to procedure.Despite having an ISS ≥ 16, patients with limited activations were dissimilar to patients with full activation. Level of activation and triage are not equivalent. The ACS-COT full and tiered activation criteria are a robust means to have the appropriate personnel present based on available pre-hospital information. Evaluation of the process of care, regardless of level of activation should be used to evaluate trauma center performance.Level III Therapeutic and Care managementThis is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal
Type Ia supernova diversity: Standardizing the candles
Future use of type Ia supernovae for cosmology aims not only to determine the
equation of state of dark energy, but also to constrain possible variations in
its value. To achieve this goal, supernovae need to become better calibrated
standard candles - not only to improve the precision of the measurement, but
more importantly to gain better control over systematic uncertainties in order
to ensure the accuracy of the result.
Here we report on a project to quantify the diversity in type Ia supernovae,
and to look for trends and/or sub-types that can be used to improve their
calibration as standard candles. We implement a version of principal component
analysis on type Ia supernova spectra. Although the quantity of data is not
sufficient to draw any firm conclusions we show that this method holds promise
for, at the very least, effectively separating peculiar supernovae. Whether it
can be further used to improve the calibration of normal type Ia's remains a
project for future study.Comment: Conference Proceedings. Cefalu 2006, The multicoloured landscape of
compact objects and their explosive origins. Six pages, three figure
Tax Writeoffs and the Value of Sports Teams
Because of IRS treatment of player contracts, purchase of a professional sports team offers a special tax shelter to investors. The effect of the tax shelter on valuation of a team is summarized, together with an analysis of current rates of return that can be earned from investing in “average” teams in baseball, football, and basketball. This paper addresses the problems posed in evaluating a professional sports team as a potential vehicle for investment. These problems arise because of the special tax sheltering advantages of team ownership
THE ECONOMIC THRESHOLD FOR GRASSHOPPER CONTROL ON PUBLIC RANGELANDS
The U.S. Department of Agriculture's Animal and Plant Health Inspection Service (APHIS) is responsible for controlling grasshopper populations on public rangelands. Under current guidelines, control of grasshoppers on rangeland should occur if grasshopper densities are at least eight per square yard. This article evaluates the concept of an economic threshold relative to the value of forage saved from destruction during a grasshopper outbreak. It is shown that financial justification for treating grasshopper outbreaks depends upon grasshopper density, rangeland productivity, climate factors, livestock cost and return relationships, and the efficacy of treatment options.Resource /Energy Economics and Policy, Land Economics/Use,
Modifying monolayer behaviour by incorporating subphase additives and improving Langmuir–Blodgett thin film deposition on optical fibres
Experiments showing the possibility of modifying the behaviour of calix[4]resorcinarene monolayers at the air–water interface and optimising the deposition of multilayer coatings onto optical fibres are presented. The nature of the subphase is fundamental to the behaviour of monolayers and their utility in coating and sensing applications. Here we show initial studies exploring the modification of the calix[4]resorcinarene monolayer–water interaction through the introduction of dipole altering alcohol additives to the aqueous subphase. We explored the effect of this modification for three small alcohols. The resulting isotherms of the materials showed a reduction in the surface pressure and area per molecule required in order for the monolayer to reach its point of collapse. Incorporation of alcohols shifted the point of collapse, leading to the application of ethanol being successful in improving the transfer of material via Langmuir–Blodgett coating onto optical fibres at lower pressures. This method may prove useful in allowing greater control over future sensor surface coatings
- …