Introduction: Patients with advanced malignant and non-malignant disease (advanced disease—AD) who do not want or benefit from aggressive resuscitation may unfortunately receive such treatments if unable to communicate in an emergency. Timely access to patients’ resuscitation wishes is imperative for treating physicians and for medical information systems. Our aim was to determine what proportion of emergency department (ED) patients with AD have accurate, readily accessible resuscitation status documentation. Methods: This cross-sectional, prospective study was conducted at a tertiary care ED during purposefully sampled random accrual times in summer 2016. We enrolled all patients with: 1) palliative care consultation, 2) metastatic malignancy, 3) COPD or CHF on home oxygen, 4) hemodialysis, or 5) advanced neurodegenerative disease/dementia. The primary outcome was the retrieval of any existing resuscitation status documents. Documentation was obtained from a standardized review of forms accompanying the patient (“arrival documents”) and electronic medical record (“EMR”). We measured the time to retrieve this documentation, and interviewed consenting patients to corroborate documentation with their current wishes. Results: Of 85 enrolled patients, only 33 (39%) had any documentation of resuscitation status: 28 (33%) had goals of care retrieved from the hospital EMR, and 11 (15%) from arrival documents (some had both). Patients from long-term care facilities were more likely to have documentation available (odds ratio 13 [95% CI 2.5-65] vs community-living). Of 32 patients who were able to be interviewed, 20 (63%) expressed “do not resuscitate” wishes. Ten of these 20 lacked any documents to support their expressed resuscitation wishes. Previously expressed resuscitation wishes took more than 5 minutes to be retrieved in 3 cases when not filed “one click deep” in our EMR. Conclusion: The majority of patients with AD, including half of those who would not wish resuscitation from cardiorespiratory arrest, did not have goals of care documents readily available upon arrival to the ED. Patients living in the community with AD appear to be at high risk for unwanted resuscitative treatments should they present to hospital in extremis. Having documentation of their goals of care that is easily retrievable from the EMR shows promise, though issues of retrieval, accuracy, and validity remain important considerations.

The ClOVER instrument (described elsewhere in this volume) isbeing built to measure the B-mode polarisation of the Cosmic MicrowaveBackground. Each of the 256 pixels is made up a pseudo-correlationreceiver that can be realised using either waveguide or microstriptechnology. In this work we present a design study for a possiblewaveguide-based solution. Each of the individual components has beenoptimised using electromagnetic finite-element modelling software(HFSS).

We present a new, fully-funded ground-based instrument designed to measurethe B-mode polarization of the Cosmic Microwave Background (CMB). The conceptis based on three independent sub-systems operating at 90, 150 and 220 GHz,each comprising a telescope and a focal plane of horn-coupled background-limited bolometers. This highly-sensitive experiment, planned to be based at Dome C station in Antarctica, is optimised to produce very low systematiceffects. It will allow the detection of the CMB polarization over angular multipoles 20<l<1000accurately enough to measure the B-mode signature from gravitationalwaves to a lensing-confusion-limited tensor-to-scalar ratio r ~ 0.005.

Raman scattering (RS) spectroscopy is employed to characterize the effect of nitrogen on structural properties of GaNxP1-x alloy with nitrogen composition up to 3 %. Two-mode behavior of the alloy is clearly shown. The frequency of the GaP-like LO phonons is found to decrease with N composition as –1.13 cm-1x. This dependence is proposed to be largely due to the biaxial strain in the GaNP epilayers, as a result of lattice mismatch to the GaP substrate. The frequency of the GaN-like phonons is found to be more sensitive to nitrogen content, increasing with the rate of +2.6 cm-1x. The addition of nitrogen is also found to cause a dramatic quenching of the two-phonon Raman scattering and an appearance of the zone edge GaP-like vibrations. These effects are suggested to reflect local distortion in the GaNP lattice induced by nitrogen, as well as possible clustering of N atoms.