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Cometography is a multi-volume catalog of every comet observed from ancient times up to the 1990s, when the internet took off as a medium of scientific record. It uses the most reliable orbits known to determine the distances from the Earth and Sun at the time of discovery and last observation, as well as the largest and smallest angular distance to the Sun, most northerly and southerly declination, closest distance to the Earth, and other details, to enable the reader to understand each comet's physical appearance. Volume 6, the final volume in the catalog, covers the observations and pertinent calculations for every comet seen between 1983 and 1993. The comets are listed in chronological order, with complete references to publications relating to each comet and physical descriptions of each comet's development throughout its apparition. Cometography is the definitive reference on comets through the ages, for astronomers and historians of science.
The government publishes 3 different public report surgical site infection (SSI) metrics, all called standardized infection ratios (SIRs), that impact perceived hospital quality. We conducted a non-random cross-sectional observational pilot study of 20 California hospitals that voluntarily submitted colon surgery and SSI data. Discordant SIR values, leading to contradictory conclusions, occurred in 35% of these hospitals.
To assess the impact of an emergency intensive care unit (EICU) established concomitantly with a freestanding emergency department (ED) during the aftermath of Hurricane Sandy.
We retrospectively reviewed records of all patients in Bellevue’s EICU from freestanding ED opening (December 10, 2012) until hospital inpatient reopening (February 7, 2013). Temporal and clinical data, and disposition upon EICU arrival, and ultimate disposition were evaluated.
Two hundred twenty-seven patients utilized the EICU, representing approximately 1.8% of freestanding ED patients. Ambulance arrival occurred in 31.6% of all EICU patients. Median length of stay was 11.55 hours; this was significantly longer for patients requiring airborne isolation (25.60 versus 11.37 hours, P<0.0001 by Wilcoxon rank sum test). After stabilization and treatment, 39% of EICU patients had an improvement in their disposition status (P<0.0001 by Wilcoxon signed rank test); upon interhospital transfer, the absolute proportion of patients requiring ICU and SDU resources decreased from 37.8% to 27.1% and from 22.2% to 2.7%, respectively.
An EICU attached to a freestanding ED achieved significant reductions in resource-intensive medical care. Flexible, adaptable care systems should be explored for implementation in disaster response. (Disaster Med Public Health Preparedness. 2016;10:496–502)
RF-plasma MBE was used to epitaxially grow 4 – 100-nm-thick metallic
β-Nb2N thin films on hexagonal SiC substrates. When the
N/Nb flux ratios are greater than one, the most critical parameter for
high-quality β-Nb2N is the substrate temperature. The X-ray
diffraction (XRD) of films grown between 775 °C and 850 °C
demonstrates pure β-Nb2N phase formation which was also
confirmed by X-ray photoelectron spectroscopy and transmission electron
microscopy measurements. Using the (0002) and (21
1) XRD peaks of a β-Nb2N film grown at 850
°C reveals a 0.68% lattice mismatch to the 6H-SiC substrate. This
suggests that β-Nb2N can be used for high-quality
metal/semiconductor heterostructures that cannot be fabricated at present.
Several studies demonstrating that central line–associated bloodstream infections (CLABSIs) are preventable prompted a national initiative to reduce the incidence of these infections.
We conducted a collaborative cohort study to evaluate the impact of the national “On the CUSP: Stop BSI” program on CLABSI rates among participating adult intensive care units (ICUs). The program goal was to achieve a unit-level mean CLABSI rate of less than 1 case per 1,000 catheter-days using standardized definitions from the National Healthcare Safety Network. Multilevel Poisson regression modeling compared infection rates before, during, and up to 18 months after the intervention was implemented.
A total of 1,071 ICUs from 44 states, the District of Columbia, and Puerto Rico, reporting 27,153 ICU-months and 4,454,324 catheter-days of data, were included in the analysis. The overall mean CLABSI rate significantly decreased from 1.96 cases per 1,000 catheter-days at baseline to 1.15 at 16–18 months after implementation. CLABSI rates decreased during all observation periods compared with baseline, with adjusted incidence rate ratios steadily decreasing to 0.57 (95% confidence intervals, 0.50–0.65) at 16–18 months after implementation.
Coincident with the implementation of the national “On the CUSP: Stop BSI” program was a significant and sustained decrease in CLABSIs among a large and diverse cohort of ICUs, demonstrating an overall 43% decrease and suggesting the majority of ICUs in the United States can achieve additional reductions in CLABSI rates.