Introduction: In-hospital cardiac arrest (IHCA) most commonly occurs in non-monitored areas, where we observed a 10min delay before defibrillation (Phase I). Nurses (RNs) and respiratory therapists (RTs) cannot legally use Automated External Defibrillators (AEDs) during IHCA without a medical directive. We sought to evaluate IHCA outcomes following usual implementation (Phase II) vs. a Theory-Based educational program (Phase III) allowing RNs and RTs to use AEDs during IHCA. Methods: We completed a pragmatic before-after study of consecutive IHCA. We used ICD-10 codes to identify potentially eligible cases and included IHCA cases for which resuscitation was attempted. We obtained consensus on all data definitions before initiation of standardized-piloted data extraction by trained investigators. Phase I (Jan.2012-Aug.2013) consisted of baseline data. We implemented the AED medical directive in Phase II (Sept.2013-Aug.2016) using usual implementation strategies. In Phase III (Sept.2016-Dec.2017) we added an educational video informed by key constructs from a Theory of Planned Behavior survey. We report univariate comparisons of Utstein IHCA outcomes using 95% confidence intervals (CI). Results: There were 753 IHCA for which resuscitation was attempted with the following similar characteristics (Phase I n = 195; II n = 372; III n = 186): median age 68, 60.0% male, 79.3% witnessed, 29.7% non-monitored medical ward, 23.9% cardiac cause, 47.9% initial rhythm of pulseless electrical activity and 27.2% ventricular fibrillation/tachycardia (VF/VT). Comparing Phases I, II and III: an AED was used 0 times (0.0%), 21 times (5.6%), 15 times (8.1%); time to 1st rhythm analysis was 6min, 3min, 1min; and time to 1st shock was 10min, 10min and 7min. Comparing Phases I and III: time to 1st shock decreased by 3min (95%CI -7; 1), sustained ROSC increased from 29.7% to 33.3% (AD3.6%; 95%CI -10.8; 17.8), and survival to discharge increased from 24.6% to 25.8% (AD1.2%; 95%CI -7.5; 9.9). In the VF/VT subgroup, time to first shock decreased from 9 to 3 min (AD-6min; 95%CI -12; 0) and survival increased from 23.1% to 38.7% (AD15.6%; 95%CI -4.3; 35.4). Conclusion: The implementation of a medical directive allowing for AED use by RNs and RRTs successfully improved key outcomes for IHCA victims, particularly following the Theory-Based education video. The expansion of this project to other hospitals and health care professionals could significantly impact survival for VF/VT patients.

High-resolution measurements of the molybdenum L heavy-ion-induced X-ray satellite emission (HIXSE) spectra of a series of Mo alloys and compounds have been obtained with a new, high-efficiency, high-resolution Bragg crystal spectrometer in the von Hamos geometry. The improved resolution (5 eV at 2.3 keV) is sufficient to reveal the LnMm configuration lines in the Lα and Lβ hypersatellite bands. Both sets of lines exhibit the same trend in the variation of the relative yield distribution with the chemical environment as was observed for KLn lines of lower Z targets. Difference spectra, using elemental molybdenum as a subtrahend, enhance the systematic variation. These results confirm the analysis and conclusions of lower resolution studies. They also indicate a potential for even greater sensitivity to the chemical environment.

Satellite observations of microwave emission are a key resource for estimating surface temperatures in Antarctica. Use of these data to examine climate variability, however, relies on the assumption of constancy through time in the relationship between surface temperatures and the proxy brightness temperatures. Thus we are motivated to study the physical relationship between surface and brightness temperature time series, and to seek indicators of possible temporal variability in that relationship. Here we report an initial study using near-surface temperatures from the Byrd Station automated weather station in West Antarctica and 37 GHz, vertically polarized brightness temperatures from the Scanning Multichannel Microwave Radiometer. We begin with the simplest model of the relevant thermal and microwave physics and derive a convolution expression that relates surface and brightness temperatures. The convolution kernel depends on firn thermal diffusivity and the microwave extinction coefficient in a particularly simple way: solely through a single characteristic time-scale. For the Byrd data, we find that the (fractional variation in) observed brightness temperatures can be reproduced by our model in considerable detail, on scales from interannual down to a few days. The time-scale is tightly constrained by minimization of the discrepancy between observed and simulated time series, and the optimized value agrees closely with that derived from independent estimates of firn thermal and microwave parameters. We find no evidence thus far of temporal variability in the relation between surface and brightness temperatures, though investigation across a wider domain in space and time is needed before such variability can be ruled out.

Because individuals develop dementia as a manifestation of neurodegenerative or neurovascular disorder, there is a need to develop reliable approaches to their identification. We are undertaking an observational study (Ontario Neurodegenerative Disease Research Initiative [ONDRI]) that includes genomics, neuroimaging, and assessments of cognition as well as language, speech, gait, retinal imaging, and eye tracking. Disorders studied include Alzheimer’s disease, amyotrophic lateral sclerosis, frontotemporal dementia, Parkinson’s disease, and vascular cognitive impairment. Data from ONDRI will be collected into the Brain-CODE database to facilitate correlative analysis. ONDRI will provide a repertoire of endophenotyped individuals that will be a unique, publicly available resource.

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. It is the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention(CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Streams draining the Cypress Hills support unique and understudied macroinvertebrate communities in Saskatchewan, Canada. Here, we report the discovery of a species of caddisfly new to the Cypress Hills and Saskatchewan, Neophylax splendens Denning (Trichoptera: Thremmatidae). Larvae were collected early in May 2012, and are found to enter pre-pupal diapause in mid-June until mid-September. Larvae were identified as N. splendens by morphological characters and verified with genetic analysis. Its occurrence strengthens the biogeographical link between the montane regions in British Columbia, Canada and Utah, United States of America with the southwest corner of Saskatchewan. This study highlights the importance of seasonal sampling, resolute species level identifications in biological surveys and the use of genetic analyses to obtain this level of identification.

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Infect Control Hosp Epidemiol 2014;35(8):967–977

Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. It is the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

Field bindweed is extremely susceptible to aminocyclopyrachlor compared to other weed species. Laboratory studies were conducted to determine if absorption, translocation, and metabolism of aminocyclopyrachlor in field bindweed differs from other, less susceptible species. Field bindweed plants were treated with 3.3 kBq 14C-aminocyclopyrachlor by spotting a single leaf mid-way up the stem with 10 µl of herbicide solution. Plants were then harvested at set intervals over 192 h after treatment (HAT). Aminocyclopyrachlor absorption reached a maximum of 48.3% of the applied radioactivity by 48 HAT. A translocation pattern of herbicide movement from the treated leaf into other plant tissues emerged, revealing a nearly equal aminocyclopyrachlor distribution between the treated leaf, aboveground tissue, and belowground tissue of 13, 14, and 14% of the applied radioactivity by 192 HAT. Over the time-course, no soluble aminocyclopyrachlor metabolites were observed, but there was an increase in radioactivity recovered bound in the nonsoluble fraction. These results suggest that aminocyclopyrachlor has greater translocation to belowground plant tissue in field bindweed compared with results from other studies with other herbicides and other weed species, which could explain the increased level of control observed in the field. The lack of soluble metabolites also suggests that very little metabolism occurred over the 192 h time course.

Star-formation is one of the main processes that shape galaxies, and together with black-hole accretion activity the two agents of energy production in galaxies. It is important on a range of scales from star clusters/OB associations to galaxy-wide and even group/cluster scales. Recently, studies of star-formation in sub-galactic and galaxy-wide scales have met significant advances owing to: (a) developments in the theory of stellar evolution, stellar atmospheres, and radiative transfer in the interstellar medium; (b) the availability of more sensitive and higher resolution data; and (c) observations in previously poorly charted wavebands (e.g. Ultraviolet, Infrared, and X-rays). These data allow us to study more galaxies at ever-increasing distances and nearby galaxies in greater detail, and different modes of star formation activity such as massive star formation and low level continuous star formation in a variety of environments. In this contribution we summarize recent results in the fields of multi-wavelength calibrations of star-formation rate indicators, the Stellar Initial Mass function, and radiative transfer and modeling of the Spectrale Energy Disrtributions of galaxies.

The complex microstructure of hardened cement paste is produced by hydration reactions between cement particles and the water in which they are suspended. In recent years, algorithms like the diffusion-limited aggregation (DLA) and Eden models have demonstrated that simple growth rules can result in complex aggregated structures. The model described in this paper simulates, via simplified growth rules, the microstructural development ofhydrating cement paste. This model has similarities to DLA, but with the additional novel features of dissolution of solid particles, and a free-space nucleation probability. The percolation aspects and transport properties of the model's pore space are computed and discussed.