We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure coreplatform@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To assess extent of a healthcare-associated outbreak of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and to evaluate the effectiveness of infection control measures, including universal masking.
Design:
Outbreak investigation including 4 large-scale point-prevalence surveys.
Setting:
Integrated VA healthcare system with 2 facilities and 330 beds.
Participants:
Index patient and 250 exposed patients and staff.
Methods:
We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and an assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth face masks. We conducted 4 point-prevalence surveys of patient and staff subsets using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2.
Results:
Among 250 potentially exposed patients and staff, 14 confirmed cases of coronavirus disease 2019 (COVID-19) were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of COVID-19, without evidence of healthcare-associated transmission.
Conclusions:
Universal masking with medical face masks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.
Digital imaging technologies have enhanced archaeological research and profoundly expanded the scale of the discipline’s potentialities. As illustrators and archaeologists move away from using hand-drawn images (of hand-held, real-life objects) to depict artifacts and other archaeological information, certain capabilities of the traditional illustrative process are lost. One such loss is the ability to present a complete and informed representation of an artifact free of the distortions and visual limitations that single-perspective (i.e., digital or photographic) imagery produces. This is accomplished by the illustrator through the unification of multiple views of the artifact from various perspectives into a single two-dimensional image that communicates to the viewer important attributes of the artifact, free of distortion and remaining true to the measured, analytical conventions of the illustrative process. Liberation from the single-viewpoint perspective was one of the fundamental elements of the Cubist movement. Traditional archaeological illustrators utilize Cubist principles to communicate visually to the viewer a complete, accurate, and undistorted package of information about an artifact. The supplanting of hand-drawn illustrations by digital images in today’s archaeological publications threatens to revert the visual representation of data back to uninformed, surficial “snapshots” of incomplete objects.
Pulmonary aspiration of gastric contents occurs 20 to 30% of the time during cardiopulmonary resuscitation (CPR) of cardiac arrest due to loss of protective airway reflexes, pressure changes generated during CPR, and positive pressure ventilation (PPV). Although the American Heart Association has recommended the laryngeal mask airway (LMA) as an acceptable alternative airway for use by emergency medical service personnel, concerns over the capacity of the device to protect from pulmonary aspiration remain.We sought to determine the occurrence of aspiration after LMA placement, CPR, and PPV.
Methods:
We inserted a size 4 LMA, modified so that a vacuum catheter could be advanced past the LMA diaphragm, into the hypopharynx of 16 consecutive postexperimental mixed-breed domestic swine. Fifteen millilitres of heparinized blood was instilled into the oropharynx. Chest compressions were performed for 60 seconds with asynchronous ventilation via a mechanical ventilator. We then suctioned through the LMA for 1 minute. The catheter was removed and inspected for signs of blood. The LMA cuff was deflated, removed, and inspected for signs of blood.
Results:
None of 16 animals (95% CI 0-17%) had a positive test for the presence of blood in both the vacuum catheter and the intima of the LMA diaphragm.
Conclusions:
In this swine model of regurgitation after LMA placement, there were no cases with evidence of blood beyond the seal created by the LMA cuff. Future studies are needed to determine the frequency of pulmonary aspiration after LMA placement during CPR and PPV in the clinical setting.
A new process route for lateral growth of nearly defect free GaN structures via Pendeo-epitaxy is discussed. Lateral growth of GaN films suspended from {110} side walls of [0001] oriented GaN columns into and over adjacent etched wells has been achieved via MOVPE technique without the use of, or contact with, a supporting mask or substrate. Pendeo-epitaxy is proposed as the descriptive term for this growth technique. Selective growth was achieved using process parameters that promote lateral growth of the {110} planes of GaN and disallow nucleation of this phase on the exposed SiC substrate. Thus, the selectivity is provided by tailoring the shape of the underlying GaN layer itself consisting of a sequence of alternating trenches and columns, instead of selective growth through openings in SiO2 or SiNx mask, as in the conventional lateral epitaxial overgrowth (LEO).
Two modes of initiation of the pendeo-epitaxial GaN growth via MOVPE were observed: Mode A - promoting the lateral growth of the {110} side facets into the wells faster than the vertical growth of the (0001) top facets; and Mode B - enabling the top (0001) faces to grow initially faster followed by the pendeo-epitaxial growth over the wells from the newly formed {110} side facets. Four-to-five order decrease in the dislocation density was observed via transmission electron microscopy (TEM) in the pendeo-epitaxial GaN relative to that in the GaN columns. TEM observations revealed that in pendeo-epitaxial GaN films the dislocations do not propagate laterally from the GaN columns when the structure grows laterally from the sidewalls into and over the trenches. Scanning electron microscopy (SEM) studies revealed that the coalesced regions are either defect-free or sometimes exhibit voids. Above these voids the PEGaN layer is usually defect free.
A new process route for lateral growth of nearly defect free GaN structures via Pendeoepitaxy is discussed. Lateral growth of GaN films suspended from {1120} side walls of [0001] oriented GaN columns into and over adjacent etched wells has been achieved via MOVPE technique without the use of, or contact with, a supporting mask or substrate. Pendeo-epitaxy is proposed as the descriptive term for this growth technique. Selective growth was achieved using process parameters that promote lateral growth of the { 1120) planes of GaN and disallow nucleation of this phase on the exposed SiC substrate. Thus, the selectivity is provided by tailoring the shape of the underlying GaN layer itself consisting of a sequence of alternating trenches and columns, instead of selective growth through openings in SiO2 or SiNx mask, as in the conventional lateral epitaxial overgrowth (LEO).
Two modes of initiation of the pendeo-epitaxial GaN growth via MOVPE were observed: Mode A - promoting the lateral growth of the {1120} side facets into the wells faster than the vertical growth of the (0001) top facets; and Mode B - enabling the top (0001) faces to grow initially faster followed by the pendeo-epitaxial growth over the wells from the newly formed {1120} side facets. Four-to-five order decrease in the dislocation density was observed via transmission electron microscopy (TEM) in the pendeo-epitaxial GaN relative to that in the GaN columns. TEM observations revealed that in pendeo-epitaxial GaN films the dislocations do not propagate laterally from the GaN columns when the structure grows laterally from the sidewalls into and over the trenches. Scanning electron microscopy (SEM) studies revealed that the coalesced regions are either defect-free or sometimes exhibit voids. Above these voids the PEGaN layer is usually defect free.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.