Food production, distribution and processing in Cornwall and the Isles of Scilly

Cornwall Taste of the West; Cornwall Agricultural Counci

Helicopter emergency medical services for adults with major trauma.

BACKGROUND: Although helicopters are presently an integral part of trauma systems in most developed nations, previous reviews and studies to date have raised questions about which groups of traumatically injured people derive the greatest benefit. OBJECTIVES: To determine if helicopter emergency medical services (HEMS) transport, compared with ground emergency medical services (GEMS) transport, is associated with improved morbidity and mortality for adults with major trauma. SEARCH METHODS: We ran the most recent search on 29 April 2015. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library (Cochrane Central Register of Controlled Trials; CENTRAL), MEDLINE (OvidSP), EMBASE Classic + EMBASE (OvidSP), CINAHL Plus (EBSCOhost), four other sources, and clinical trials registers. We screened reference lists. SELECTION CRITERIA: Eligible trials included randomized controlled trials (RCTs) and nonrandomized intervention studies. We also evaluated nonrandomized studies (NRS), including controlled trials and cohort studies. Each study was required to have a GEMS comparison group. An Injury Severity Score (ISS) of at least 15 or an equivalent marker for injury severity was required. We included adults age 16 years or older. DATA COLLECTION AND ANALYSIS: Three review authors independently extracted data and assessed the risk of bias of included studies. We applied the Downs and Black quality assessment tool for NRS. We analyzed the results in a narrative review, and with studies grouped by methodology and injury type. We constructed 'Summary of findings' tables in accordance with the GRADE Working Group criteria. MAIN RESULTS: This review includes 38 studies, of which 34 studies examined survival following transportation by HEMS compared with GEMS for adults with major trauma. Four studies were of inter-facility transfer to a higher level trauma center by HEMS compared with GEMS. All studies were NRS; we found no RCTs. The primary outcome was survival at hospital discharge. We calculated unadjusted mortality using data from 282,258 people from 28 of the 38 studies included in the primary analysis. Overall, there was considerable heterogeneity and we could not determine an accurate estimate of overall effect.Based on the unadjusted mortality data from six trials that focused on traumatic brain injury, there was no decreased risk of death with HEMS. Twenty-one studies used multivariate regression to adjust for confounding. Results varied, some studies found a benefit of HEMS while others did not. Trauma-Related Injury Severity Score (TRISS)-based analysis methods were used in 14 studies; studies showed survival benefits in both the HEMS and GEMS groups as compared with MTOS. We found no studies evaluating the secondary outcome, morbidity, as assessed by quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs). Four studies suggested a small to moderate benefit when HEMS was used to transfer people to higher level trauma centers. Road traffic and helicopter crashes are adverse effects which can occur with either method of transport. Data regarding safety were not available in any of the included studies. Overall, the quality of the included studies was very low as assessed by the GRADE Working Group criteria. AUTHORS' CONCLUSIONS: Due to the methodological weakness of the available literature, and the considerable heterogeneity of effects and study methodologies, we could not determine an accurate composite estimate of the benefit of HEMS. Although some of the 19 multivariate regression studies indicated improved survival associated with HEMS, others did not. This was also the case for the TRISS-based studies. All were subject to a low quality of evidence as assessed by the GRADE Working Group criteria due to their nonrandomized design. The question of which elements of HEMS may be beneficial has not been fully answered. The results from this review provide motivation for future work in this area. This includes an ongoing need for diligent reporting of research methods, which is imperative for transparency and to maximize the potential utility of results. Large, multicenter studies are warranted as these will help produce more robust estimates of treatment effects. Future work in this area should also examine the costs and safety of HEMS, since multiple contextual determinants must be considered when evaluating the effects of HEMS for adults with major trauma

Constraints on the Formation of the Galactic Bulge from Na, Al, and Heavy Element Abundances in Plaut's Field

We report chemical abundances of Na, Al, Zr, La, Nd, and Eu for 39 red giant branch (RGB) stars and 23 potential inner disk red clump stars located in Plaut-s low extinction window. We also measure lithium for a super Li-rich RGB star. The abundances were determined by spectrum synthesis of high resolution (R~25,000), high signal-to-noise (S/N~50-100 pixel-1) spectra obtained with the Blanco 4m telescope and Hydra multifiber spectrograph. For the bulge RGB stars, we find a general increase in the [Na/Fe] and [Na/Al] ratios with increasing metallicity, and a similar decrease in [La/Fe] and [Nd/Fe]. Additionally, the [Al/Fe] and [Eu/Fe] abundance trends almost identically follow those of the {\alpha}-elements, and the [Zr/Fe] ratios exhibit relatively little change with [Fe/H]. The consistently low [La/Eu] ratios of the RGB stars indicate that at least a majority of bulge stars formed rapidly (<1 Gyr) and before the main s-process could become a significant pollution source. In contrast, we find that the potential inner disk clump stars exhibit abundance patterns more similar to those of the thin and thick disks. Comparisons between the abundance trends at different bulge locations suggest that the inner and outer bulge formed on similar timescales. However, we find evidence of some abundance differences between the most metal-poor and metal-rich stars in various bulge fields. The data also indicate that the halo may have had a more significant impact on the outer bulge initial composition than the inner bulge composition. The [Na/Fe] and to a lesser extent [La/Fe] abundances further indicate that the metal-poor bulge, at least at ~1 kpc from the Galactic center, and thick disk may not share an identical chemistry.Comment: Accepted for publication in ApJ; 66 pages, 17 figures, 3 tables; prior to publication, data tables in electronic form will be made available upon reques

Seal Coat Productivity

The Indiana Department of Transportation (INDOT) conducts chip seal operations on state highways to prolong the life of the road. The chip seal operation is labor, equipment and material intensive. A typical chip seal operation may involve 35 or more INDOT employees including truck drivers, flagmen, and equipment operators (brooms, rollers, aggregate spreader, and distributors). This project was launched to better understand and document variations in how each of the six INDOT districts, approach the planning and execution of their respective chip seal operations. The goal was to identify areas in the operation where there were differences between districts and to determine best practices that could be shared among the districts. Two observers joined the chip seal operations in all six districts. The observers spent a total of 10 days with the chip seal crews (2 days each with the crews from Fort Wayne, La Porte, Greenfield, and Seymour and 1 day each with the crews from Vincennes and Crawfordsville). One additional day was spent in Crawfordsville observing the Fog Seal operation that takes place a few days following chip seal. During the initial phases of this project, many differences were observed regarding various aspects of the operation including the stone and equipment used, truck loading procedures, traffic control, and covering raised pavement markers (RPNs). These observations were shared with key stakeholders on November 4, 2013 and with a second group of stakeholders on January 22, 2014. With the help of stakeholders, best practices were identified from the observations and a list of 14 recommendations was created to be shared across all districts. A series of meetings were then scheduled to share the recommendations with each district and to determine which recommendations they were interested in piloting. The three ideas found during this project that provide the greatest opportunities for improving the overall operational efficiency of the chip seal operation are (1) the importance of closing roads during chip seal whenever possible, (2) the importance of choosing the best locations for stone stockpiles and oil tanker deliveries, and (3) the importance of fully loading dump trucks to their maximum safe and legal limit

Trypanosoma brucei gambiense group 1 is distinguished by a unique amino acid substitution in the HpHb receptor implicated in human serum resistance

Trypanosoma brucei rhodesiense (Tbr) and T. b. gambiense (Tbg), causative agents of Human African Trypanosomiasis (sleeping sickness) in Africa, have evolved alternative mechanisms of resisting the activity of trypanosome lytic factors (TLFs), components of innate immunity in human serum that protect against infection by other African trypanosomes. In Tbr, lytic activity is suppressed by the Tbr-specific serum-resistance associated (SRA) protein. The mechanism in Tbg is less well understood but has been hypothesized to involve altered activity and expression of haptoglobin haemoglobin receptor (HpHbR). HpHbR has been shown to facilitate internalization of TLF-1 in T.b. brucei (Tbb), a member of the T. brucei species complex that is susceptible to human serum. By evaluating the genetic variability of HpHbR in a comprehensive geographical and taxonomic context, we show that a single substitution that replaces leucine with serine at position 210 is conserved in the most widespread form of Tbg (Tbg group 1) and not found in related taxa, which are either human serum susceptible (Tbb) or known to resist lysis via an alternative mechanism (Tbr and Tbg group 2). We hypothesize that this single substitution contributes to reduced uptake of TLF and thus may play a key role in conferring serum resistance to Tbg group 1. In contrast, similarity in HpHbR sequence among isolates of Tbg group 2 and Tbb/Tbr provides further evidence that human serum resistance in Tbg group 2 is likely independent of HpHbR functio

3D-Stereoscopic Immersive Analytics Projects at Monash University and University of Konstanz

Immersive Analytics investigates how novel interaction and display technologies may support analytical reasoning and decision making. The Immersive Analytics initiative of Monash University started early 2014. Over the last few years, a number of projects have been developed or extended in this context to meet the requirements of semi- or full-immersive stereoscopic environments. Different technologies are used for this purpose: CAVE2™ (a 330 degree large-scale visualization environment which can be used for educative and scientific group presentations, analyses and discussions), stereoscopic Powerwalls (miniCAVEs, representing a segment of the CAVE2 and used for development and communication), Fishtanks, and/or HMDs (such as Oculus, VIVE, and mobile HMD approaches). Apart from CAVE2™ all systems are or will be employed on both the Monash University and the University of Konstanz side, especially to investigate collaborative Immersive Analytics. In addition, sensiLab extends most of the previous approaches by involving all senses, 3D visualization is combined with multi-sensory feedback, 3D printing, robotics in a scientific-artistic-creative environment