Tate Objects in Exact Categories

We study elementary Tate objects in an exact category. We characterize the category of elementary Tate objects as the smallest subcategory of admissible Ind-Pro objects which contains the categories of admissible Ind-objects and admissible Pro-objects, and which is closed under extensions. We compare Beilinson’s approach to Tate modules to Drinfeld’s. We establish several properties of the Sato Grassmannian of an elementary Tate object in an idempotent complete exact category (e.g., it is a directed poset). We conclude with a brief treatment of n-Tate modules and n-dimensional adèles. An appendix due to J. Šťovíček and J. Trlifaj identifies the category of flat Mittag-Leffler modules with the idempotent completion of the category of admissible Ind-objects in the category of finitely generated projective modules

Naloxone Administration Route in Opioid Overdose: A Review of Vermont EMS Data

Objective: Emergency Medical System (EMS) personnel administer the direct opioid antagonist naloxone in cases of opioid overdose via intramuscular (IM), intravenous (IV), subcutaneous (SQ), intraosseous (IO), or intranasal (IN) routes. Some early studies suggest that the intranasal route of administration is of similar effectiveness to injectable routes. The main objective of our study was to compare the efficacy of intravenous and intraosseous (IV/IO) routes of naloxone administration to the intranasal (IN) route in suspected opioid overdoses in Vermont. Methods: We reviewed retrospective data from Vermont EMS Statewide Incident Reporting Network (SIREN) between April 2014 and August 2016. We included all patients that were entered into SIREN and administered naloxone during the study period. Predictor variables were route of administration, medication dosage, crew member level, and cardiac arrest (yes or no). We conducted a binary logistic regression in SPSS to predict improvement in patient condition. Results: Our sample consisted of 1139 cases of first-dose naloxone administration. 1076 cases contained sufficient data to be analyzed. Patients who experienced a cardiac arrest were less likely to respond to naloxone (OR 10.8, 95% CI (5.908-19.694)). Route of administration, crew member level, and dosage (in the normal therapeutic range of 0.1-2mg) did not have a statistically significant effect on patient response to naloxone. Conclusions: Our findings, in conjunction with other recent research, suggest that intranasal administration is a safe and effective route when compared with intravenous and intraosseous routes. Intranasal administration has several distinct advantages over injectable routes, including the potential to reduce the risk of needle-stick injuries and blood-borne pathogen transmissions and to be handled by individuals with less medical training. In cases of cardiac arrest, we recommend that providers focus on treatments with proven benefit, including CPR and proper ventilation and oxygenation

The dynamics of measles in sub-Saharan Africa.

Although vaccination has almost eliminated measles in parts of the world, the disease remains a major killer in some high birth rate countries of the Sahel. On the basis of measles dynamics for industrialized countries, high birth rate regions should experience regular annual epidemics. Here, however, we show that measles epidemics in Niger are highly episodic, particularly in the capital Niamey. Models demonstrate that this variability arises from powerful seasonality in transmission-generating high amplitude epidemics-within the chaotic domain of deterministic dynamics. In practice, this leads to frequent stochastic fadeouts, interspersed with irregular, large epidemics. A metapopulation model illustrates how increased vaccine coverage, but still below the local elimination threshold, could lead to increasingly variable major outbreaks in highly seasonally forced contexts. Such erratic dynamics emphasize the importance both of control strategies that address build-up of susceptible individuals and efforts to mitigate the impact of large outbreaks when they occur

A Quadtree-Based Dynamic Attribute Indexing Method

Dynamic attributes are attributes that change continuously over time making it impractical to issue explicit updates for every change. In this paper, we adapt a variant of the quadtree structure to solve the problem of indexing dynamic attributes. The approach is based on the key idea of using a linear function of time for each dynamic attribute that allows us to predict its value in the future. We contribute an algorithm for regenerating the quadtree-based index periodically that minimizes CPU and disk access cost. We also provide an experimental study of performance focusing on query processing and index update overheads

Renal Foreign Bodies

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67109/2/10.1177_000992286900800511.pd

Becoming Breastfeeding Friendly Scotland: report

Background: Breastfeeding and the provision of human milk is the most accessible and cost-effective activity available to public health, which is known to prevent a range of infectious and non-communicable diseases (NCDs), specifically gastro-enteritis, childhood obesity, diabetes type 2 and maternal breast cancer[1],[2]. However, global efforts to further improve exclusive breastfeeding rates have had limited success, in part because effective scaling‐up frameworks and roadmaps have not been developed[3]. Breastfeeding rates in Scotland have improved in recent years, with an increase from 44% (2001/2002) to 51% (2017/2018) of babies reportedly receiving 'any breastfeeding' at first health visitor visit at 10-14 days, and the proportion of babies being breastfed at 6-8 weeks rising from 36% of babies (born in 2001/02) to 42% of babies (born in 2017/18)[4] However, the figures remain relatively low and drop off rates high when compared to other countries and recommended targets, with breastfeeding rates lower among women in areas of higher deprivation, exacerbating health inequalities. BBF: The Becoming Breastfeeding Friendly (BBF) toolkit was developed through highly structured technical and academic collaboration, led by Yale University and has been piloted in Mexico and Ghana. In the short term, it provides an evidence-based tool to guide countries in assessing their breastfeeding status and their readiness to scale up. In the long term, it supports countries to identify the concrete measures they can take to sustainably increase breastfeeding rates, based on data-driven recommendations. The BBF Gear Model is made up of eight simultaneous conditions which sustain breastfeeding: the gears. This conceptual model illustrates how each gear must be sufficiently mobilised to turn the next, whilst the central Coordination gear gathers and delivers timely feedback. Using the BBF framework, the BBF Scotland committee has prioritised a set of eight recommendation themes to take forward in order to scale up the protection, promotion and support of breastfeeding in Scotland

Improved catalytic activity of ruthenium–arene complexes in the reduction of NAD+

A series of neutral Ru-II half-sandwich complexes of the type [(eta(6)-arene)Ru(N,N')Cl] where the arene is para-cymene (p-cym), hexamethylbenzene (hmb), biphenyl (bip), or benzene (bn) and N,N' is N-(2-aminoethyl) -4-(trifluoromethyl)benzenesulfonamide (TfEn), N-(2-aminoethyl)-4-toluenesulfonamide (TsEn), or N-(2-aminoethyl)-methylenesulfonamide (MsEn) were synthesized and characterized. X-ray crystal structures of [(p-cym)Ru(MsEn)Cl] (1), [(hmb)Ru(TsEn)Cl] (5), [(hmb)Ru(TfEn)Cl] (6), [(bip)Ru(MsEn)Cl] (7), and [(bip)Ru(TsEn)Cl] (8) have been determined. The complexes can regioselectively catalyze the transfer hydrogenation of NAD(+) to give 1,4-NADH in the presence of formate. The turnover frequencies (TOF) when the arene is varied decrease in the order bn > bip > p-cym > hmb for complexes with the same N,N' chelating ligand. The TOF decreased with variation in the N,N' chelating ligand in the order TfEn > TsEn > MsEn for a given arene. [(bn)Ru(TfEn)Cl] (12) was the most active, with a TOP of 10.4 h(-1). The effects of NAD(+) and formate concentration on the reaction rates were determined for [(p-cym)Ru(TsEn)Cl] (2). Isotope studies implicated the formation of [(arene)Ru(N,N')(H)] as the rate-limiting step. The coordination of formate and subsequent CO2 elimination to generate the hydride were modeled computationally by density functional theory (DFT). CO2 elimination occurs via a two-step process with the coordinated formate first twisting to present its hydrogen toward the metal center. The computed barriers for CO2 release for arene = benzene follow the order MsEn > TsEn > TfEn, and for the Ms En system the barrier followed bn < hmb, both consistent with the observed rates. The effect of methanol on transfer hydrogenation rates in aqueous solution was investigated. A study of pH dependence of the reaction in D2O gave the optimum pH* as 7.2 with a TOF of 1.58 h(-1) for 2. The series of compounds reported here show an improvement in the catalytic activity by an order of magnitude compared to the ethylenediamine analogues

Research-Based Web Design & Usability Guidelines [2006 edition]

The new edition of the U.S. Department of Health and Human Services’ (HHS) Research-Based Web Design and Usability Guidelines. These guidelines reflect HHS’ commitment to identifying innovative, research-based approaches that result in highly responsive and easy-to-use Web sites for the public. These guidelines help move us in that direction by providing practical, yet authoritative, guidance on a broad range of Web design and communication issues. Having access to the best available research helps to ensure we make the right decisions the first time around and reduces the possibility of errors and costly mistakes

Meningococcal carriage within households in the African meningitis belt: A longitudinal pilot study.

OBJECTIVES: Carriers of Neisseria meningitidis are a key source of transmission. In the African meningitis belt, where risk of meningococcal disease is highest, a greater understanding of meningococcal carriage dynamics is needed. METHODS: We randomly selected an age-stratified sample of 400 residents from 116 households in Bamako, Mali, and collected pharyngeal swabs in May 2010. A month later, we enrolled all 202 residents of 20 of these households (6 with known carriers) and collected swabs monthly for 6 months prior to MenAfriVac vaccine introduction and returned 10 months later to collect swabs monthly for 3 months. We used standard bacteriological methods to identify N. meningitidis carriers and fit hidden Markov models to assess acquisition and clearance overall and by sex and age. RESULTS: During the cross-sectional study 5.0% of individuals (20/400) were carriers. During the longitudinal study, 73 carriage events were identified from 1422 swabs analyzed, and 16.3% of individuals (33/202) were identified as carriers at least once. The majority of isolates were non-groupable; no serogroup A carriers were identified. CONCLUSIONS: Our results suggest that the duration of carriage with any N. meningitidis averages 2.9 months and that males and children acquire and lose carriage more frequently in an urban setting in Mali. Our study informed the design of a larger study implemented in seven countries of the African meningitis belt