Background: Surgical site infections (SSIs) among cardiothoracic (CT) patients are associated with high rates of morbidity and mortality. Data are limited regarding SSI incidence among pediatric patients undergoing primary reparative procedures for congenital cardiac disease. Published evidence on targeted interventions to prevent pediatric CT-surgery SSI is lacking. We aimed to establish standard metrics for measuring CT-surgery SSI incidence and to implement bundled interventions for SSI prevention. Methods: A dedicated CT-surgery SSI prevention workgroup was established, consisting of hospital leadership, CT surgeons, cardiac critical care unit staff, anesthesia, perfusion, environmental services, instrument sterile processing, risk management, infection prevention and antibiotic stewardship. We created a standard definition for CT-surgery SSI and calculated retrospective SSI rates over a 24-month period (2017–2019). The outcome measured was incidence of CT-surgery SSI per 100 primary cardiac procedures with delayed ( 3 days after primary surgery) or non-delayed chest closure. The difference in proportion of SSI was reported separately for delayed closure and non-delayed closure; statistical significance was tested using a Fisher’s Exact test. We identified many potential improvement opportunities, including gaps in SSI surveillance, poor compliance with daily bathing, inconsistent perioperative antimicrobial prophylaxis, lack of controlled environment for bedside chest closures, and lapses in environmental cleaning. These issues informed the enhanced SSI prevention bundle, which included education on sterility with the operating room (OR) staff. Protocols for care of cardiac patients with delayed chest closures focused on universal daily and preoperative chlorhexidine baths. In addition, the bundle incorporated stringent environmental cleaning interventions including scheduled decluttering of patient rooms and clinical spaces, terminal cleaning of patient rooms prior to returning from the OR, and use of adjunctive ultraviolet light for the daily cleaning of operating rooms and patient rooms at discharge. Results: Surveillance definition of microbiological growth from a clinical sample obtained within 30 days of primary cardiac procedure sufficiently captured all CT-surgery SSIs. Of 551 CT-surgery procedures prior to intervention, 91 (17%) had delayed final operative closures. Prior to the intervention, 16 SSIs were identified from July 2017 – May 2019 for a rate of 2.90 per /100 procedures, and was higher among patients with delayed chest closure 6.59 per /100 procedures (6 SSIs/91 procedures) versus those with primary chest closure 2.17 per /100 procedures (10 SSIs/460 procedures; P = 0.034). Gram-positive organisms, including coagulase coagulase-negative Staphylococci, were most frequently identified as the causative organisms for SSIs. Compliance with bundled intervention, rolled out over a 2-month period, was associated with an immediate decrease in the number of SSIs for primary and delayed chest closures 6SSIs /185 procedures in the initial quarters (August – December 2019) of the post-intervention period. However, this decrease was not reflected in the overall rate (3.24 per /100 procedures) due to fewer procedures performed. Data collection to measure sustainability is ongoing. Conclusions: Bundled interventions targeting skin antisepsis and environmental cleaning may be associated with a decrease in SSIs among pediatric CT-surgery patients. Ongoing surveillance is required to determine sustainability of these interventions.

Funding: None

Disclosures: None

This paper describes a collaborative approach to professional learning that has provided an opportunity for refreshed practices and growth in capacity in schools supporting students with various learning needs in several schools that are part of the Association of Independent Schools in the Australian Capital Territory. An action research approach to professional learning for school staff was facilitated with the participating schools in 2018/2019, centred on the Nationally Consistent Collection of Data on School Students with Disability.

Research using single-word paradigms has established that forced language switching incurs processing costs for some bilinguals, yet, less research has addressed this phenomenon at the utterance level or considered real-world applications. The current study examined the impacts of forced language switching on spoken output and stress using a simulated virtual meeting. Twenty Spanish–English heritage bilinguals responded to general work-oriented questions in monolingual English (control) or language-switching (experimental) conditions. Responses were analyzed for mean length of utterance (MLU) and type-token-ratio (TTR). Multilevel modeling revealed an interaction effect of Condition (control vs. experimental) and question order on MLU, such that participants in the experimental condition produced significantly shorter utterances by the end of the task. Participants also had significantly lower lexical variation (TTR) overall in the experimental than the control condition. A 2 × 2 ANOVA revealed a significant effect of Condition and an interaction of Task (pre- vs. posttask) and Condition, such that participants in the control condition reported significantly lower stress after the activity. Results demonstrated the impact of a forced switching condition on production at the utterance level. Findings have implications for theory and scenarios in which heritage bilinguals are asked to use multiple languages in the workplace.

Malthus was severely critical of the old poor law, especially when the payments paid to recipients were made in conformity to the principles adopted by the local magistrates in Speenhamland in 1795. He considered that it encouraged early and improvident marriage with unfortunate consequences. There have been a number of attempts to determine whether Malthus was justified in supposing that the old poor law had this effect, some concluding that he was correct in his assumption, others that he was mistaken. The information contained in the first four English censuses did not include a breakdown of the population by age, sex, and marital status, and therefore did not provide a basis for a definitive test of Malthus's assertion before the repeal of the old poor law in 1834. The 1851 census, however, did provide this breakdown for five-year age groups which makes it possible to compare marriage patterns in counties in which a large proportion of the male workforce were ‘peasants’ (Malthus's term for agricultural labourers), and the Speenhamland provisions were widely adopted, with other counties. The results show that Malthus was mistaken.

Cleland and Chyba published a classic piece in 2002 that began a movement I call definitional pessimism, where it is argued that there is no point in attempting anything like a general definition of life. This paper offers a critical response to the pessimist position in general and the influential arguments offered by Cleland and her collaborators in particular. One such argument is that all definitions of life fall short of an ideal in which necessary and sufficient conditions produce unambiguous categorizations that dispose of all counterexamples. But this concept of definition is controversial within philosophy; a fact that greatly diminishes the force of the admonition that biologists should conform to such an ideal. Moreover, biology may well be fundamentally different from logic and the physical sciences from which this ideal is drawn, to the point where definitional conformity misrepresents biological reality. Another idea often pushed is that the prospects for definitional success concerning life are on a par with medieval alchemy's attempts to define matter – that is, doomed to fail for lack of a unifying scientific theory. But this comparison to alchemy is both historically inaccurate and unfair. Planetary science before the discovery of the first exoplanets offers a much better analogy, with much more optimistic conclusions. The pessimists also make much of the desirability of using microbes as models for any universal concept of life, from which they conclude that certain types of ‘Darwinian’ evolutionary definitions are inadequate. But this argument posits an unrealistic ideal, as no account of life can both be universal and do justice to the sorts of precise causal mechanisms microbes exemplify. The character of biology and the demand for universality in definitions of life thus probably accords better with functional rather than structural categories. The bottom line is that there is simply no viable alternative, either pragmatically or theoretically, to the pursuit of definitions. If nothing else, the empirical data the pessimists demand will be a very long time coming and scientists will of necessity continue to employ definitions of life in the interim. Chastising them for this will only drive their ideas underground where they can escape critical analysis, making the problems caused by problematic conceptions of life worse.

In western Canada, more money is spent on wild oat herbicides than on any other weed species, and wild oat resistance to herbicides is the most widespread resistance issue. A direct-seeded field experiment was conducted from 2010 to 2014 at eight Canadian sites to determine crop life cycle, crop species, crop seeding rate, crop usage, and herbicide rate combination effects on wild oat management and canola yield. Combining 2× seeding rates of early-cut barley silage with 2× seeding rates of winter cereals and excluding wild oat herbicides for 3 of 5 yr (2011 to 2013) often led to similar wild oat density, aboveground wild oat biomass, wild oat seed density in the soil, and canola yield as a repeated canola–wheat rotation under a full wild oat herbicide rate regime. Wild oat was similarly well managed after 3 yr of perennial alfalfa without wild oat herbicides. Forgoing wild oat herbicides in only 2 of 5 yr from exclusively summer annual crop rotations resulted in higher wild oat density, biomass, and seed banks. Management systems that effectively combine diverse and optimal cultural practices against weeds, and limit herbicide use, reduce selection pressure for weed resistance to herbicides and prolong the utility of threatened herbicide tools.

Aging is associated with performance reductions in executive function and episodic memory, although there is substantial individual variability in cognition among older adults. One factor that may be positively associated with cognition in aging is physical activity. To date, few studies have objectively assessed physical activity in young and older adults, and examined whether physical activity is differentially associated with cognition in aging. Young (n=29, age 18–31 years) and older adults (n=31, ages 55–82 years) completed standardized neuropsychological testing to assess executive function and episodic memory capacities. An experimental face-name relational memory task was administered to augment assessment of episodic memory. Physical activity (total step count and step rate) was objectively assessed using an accelerometer, and hierarchical regressions were used to evaluate relationships between cognition and physical activity. Older adults performed more poorly on tasks of executive function and episodic memory. Physical activity was positively associated with a composite measure of visual episodic memory and face-name memory accuracy in older adults. Physical activity associations with cognition were independent of sedentary behavior, which was negatively correlated with memory performance. Physical activity was not associated with cognitive performance in younger adults. Physical activity is positively associated with episodic memory performance in aging. The relationship appears to be strongest for face-name relational memory and visual episodic memory, likely attributable to the fact that these tasks make strong demands on the hippocampus. The results suggest that physical activity relates to cognition in older, but not younger adults. (JINS, 2015, 21, 780–790)

The multicomponent Dry Creek site, located in the Nenana Valley, central Alaska, is arguably one of the most important archaeological sites in Beringia. Original work in the 1970s identified two separate cultural layers, called Components 1 and 2, thought to date to the terminal Pleistocene and suggesting that the site was visited by Upper Paleolithic huntergatherers between about 13,000 and 12,000 calendar years before present (cal B.P.). The oldest of these became the typeassemblage for the Nenana complex. Recently, some have questioned the geoarchaeological integrity of the site's early deposits, suggesting that the separated cultural layers resulted from natural postdepositional disturbances. In 2011, we revisited Dry Creek to independently assess the site's age and formation. Here we present our findings and reaffirm original interpretations of clear separation of two terminal Pleistocene cultural occupations. For the first time, we report direct radiocarbon dates on cultural features associated with both occupation zones, one dating to 13,485-13,305 and the other to 11,060-10,590 cal B.P.

In 1969, Robert E. Gregg collected five species of ants (Hymenoptera: Formicidae) in three Subarctic localities near the town of Churchill, Manitoba, Canada, which he documented in a 1972 publication in The Canadian Entomologist. To determine whether there have been any additions to the local fauna – as might be predicted to occur in response to a warming climate and increased traffic to the Port of Churchill in the intervening 40 years – we re-collected ants from the same localities in 2012. We identified the ants we collected from Gregg’s sampling sites using both traditional morphological preparations and DNA barcoding. In addition, we examined specimens from Gregg’s initial collection that are accessioned at the Field Museum of Natural History (Chicago, Illinois, United States of America). Using this integrative approach we report seven species present at the same sites Gregg sampled 40 years earlier. We conclude that the apparent increase is likely not due to any arrivals from more southerly distributed ants, but to the increased resolution provided by DNA barcodes to resident species complexes with a complicated history. We provide a brief synopsis of these results and their taxonomic context.

Background: Extreme appraisals of internal states correlate with and prospectively predict mood symptoms in adults, and discriminate individuals with bipolar disorder from individuals with unipolar depression and non-clinical controls. Aims: These findings required replication in adolescents. This study sought to investigate the relationships between appraisals of internal states, mood symptoms and risk for bipolar disorder in an adolescent sample. Method: A non-clinical sample (n = 98) of adolescents completed measures of mood symptoms, appraisals, and mania risk, alongside covariates. Results: Appraisals of internal states were associated with analogue bipolar symptoms, independently of impulsivity and responses to positive affect. Positive appraisals of activated mood states were uniquely associated with hypomania, whilst negative appraisals were uniquely associated with depression and irritability symptoms. Individuals who appraised activated states as both extremely positive and extremely negative were more likely to score at high or moderate risk for future mania. Conclusions: This study is the first to demonstrate associations between appraisals of internal states, analogue mood symptoms and mania risk in adolescents. Clinical implications are discussed.

This study investigates the linguistic characteristics of Swedish clinical text in radiology reports and doctor's daily notes from electronic health records (EHRs) in comparison to general Swedish and biomedical journal text. We quantify linguistic features through a comparative register analysis to determine how the free text of EHRs differ from general and biomedical Swedish text in terms of lexical complexity, word and sentence composition, and common sentence structures. The linguistic features are extracted using state-of-the-art computational tools: a tokenizer, a part-of-speech tagger, and scripts for statistical analysis. Results show that technical terms and abbreviations are more frequent in clinical text, and lexical variance is low. Moreover, clinical text frequently omit subjects, verbs, and function words resulting in shorter sentences. Clinical text not only differs from general Swedish, but also internally, across its sub-domains, e.g. sentences lacking verbs are significantly more frequent in radiology reports. These results provide a foundation for future development of automatic methods for EHR simplification or clarification.