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We present continuous estimates of snow and firn density, layer depth and accumulation from a multi-channel, multi-offset, ground-penetrating radar traverse. Our method uses the electromagnetic velocity, estimated from waveform travel-times measured at common-midpoints between sources and receivers. Previously, common-midpoint radar experiments on ice sheets have been limited to point observations. We completed radar velocity analysis in the upper ~2 m to estimate the surface and average snow density of the Greenland Ice Sheet. We parameterized the Herron and Langway (1980) firn density and age model using the radar-derived snow density, radar-derived surface mass balance (2015–2017) and reanalysis-derived temperature data. We applied structure-oriented filtering to the radar image along constant age horizons and increased the depth at which horizons could be reliably interpreted. We reconstructed the historical instantaneous surface mass balance, which we averaged into annual and multidecadal products along a 78 km traverse for the period 1984–2017. We found good agreement between our physically constrained parameterization and a firn core collected from the dry snow accumulation zone, and gained insights into the spatial correlation of surface snow density.
To evaluate whether incorporating mandatory prior authorization for Clostridioides difficile testing into antimicrobial stewardship pharmacist workflow could reduce testing in patients with alternative etiologies for diarrhea.
Single center, quasi-experimental before-and-after study.
Tertiary-care, academic medical center in Ann Arbor, Michigan.
Adult and pediatric patients admitted between September 11, 2019 and December 10, 2019 were included if they had an order placed for 1 of the following: (1) C. difficile enzyme immunoassay (EIA) in patients hospitalized >72 hours and received laxatives, oral contrast, or initiated tube feeds within the prior 48 hours, (2) repeat molecular multiplex gastrointestinal pathogen panel (GIPAN) testing, or (3) GIPAN testing in patients hospitalized >72 hours.
A best-practice alert prompting prior authorization by the antimicrobial stewardship program (ASP) for EIA or GIPAN testing was implemented. Approval required the provider to page the ASP pharmacist and discuss rationale for testing. The provider could not proceed with the order if ASP approval was not obtained.
An average of 2.5 requests per day were received over the 3-month intervention period. The weekly rate of EIA and GIPAN orders per 1,000 patient days decreased significantly from 6.05 ± 0.94 to 4.87 ± 0.78 (IRR, 0.72; 95% CI, 0.56–0.93; P = .010) and from 1.72 ± 0.37 to 0.89 ± 0.29 (IRR, 0.53; 95% CI, 0.37–0.77; P = .001), respectively.
We identified an efficient, effective C. difficile and GIPAN diagnostic stewardship approval model.
Monolayer (ML) molybdenum disulfide (MoS₂) is a novel 2-dimensional (2D) semiconductor whose properties have many applications in devices. Despite its potential, ML MoS₂ is limited in its use due to its degradation under exposure to ambient air. Therefore, studies of possible degradation prevention methods are important. It is well established that air humidity plays a major role in the degradation. In this paper, we investigate the effects of substrate hydrophobicity on the degradation of chemical vapor deposition (CVD) grown ML MoS2. We use optical microscopy, atomic force microscopy (AFM), and Raman mapping to investigate the degradation of ML MoS2 grown on SiO2 and Si3N4 that are hydrophilic and hydrophobic substrates, respectively. Our results show that the degradation of ML MoS₂ on Si3N4 is significantly less than the degradation on SiO2. These results show that using hydrophobic substrates to grow 2D transition metal dichalcogenide ML materials may diminish ambient degradation and enable improved protocols for device manufacturing.
Tim Harris, BA, MA and PhD from Cambridge University,
Justin Champion, completing undergraduate and postgraduate degrees at Churchill College.,
John Marshall, Leonard and Helen R. Stulman Professor of History at the Johns Hopkins University in Baltimore.,
John Coffey, Professor of Early Modern History at the University of Leicester.
This volume is a tribute to Mark Adrian Goldie, from friends and former students, to mark his retirement from the Cambridge History Faculty in September 2019. It is intended to honour both his own scholarly contribution to the field and his role as a teacher and a mentor. Mark's interests have been broad and have grown broader over the course of his career. He is at once an historian of ideas, political historian and historian of religion, while some of his publications have branched into social and cultural history. Although Mark's geographical and chronological focus has been on England under the later Stuarts – the period from the restoration of the monarchy in 1660 to the Hanoverian succession of 1714 – he has also written about Scotland and Ireland, continental Europe and colonial North America, and published pieces that go back to the sixteenth century or push forward into the late eighteenth. On his Cambridge University website, Mark describes his research interests broadly as ‘British intellectual, political, and religious history, c. 1650–c. 1800’, a claim vindicated not only by his own publication record but also by the wide variety of topics his graduate students have pursued. Mark has supervised thirty PhD theses to date. Limitations of space meant that we were unable to ask all Mark's former students to contribute to this volume. We endeavoured, however, to solicit contributions that would reflect the breadth of Mark's scholarly endeavours and also the various generational cohorts he has inspired. Contributors were asked to write pieces that in some way engaged with Mark's work and publications. We hope that what is offered here does justice to the man, his scholarship and his mentorship.
Given the range of Mark's interests, we puzzled over how best to write the introduction to this volume. We could highlight some of Mark's landmark articles, essays, edited volumes and books, but which ones? The four editors all have quite discrete interests and scholarly foci, albeit overlapping to some degree, and we each have our own lists of favourites – and they are long! We decided, instead, that each editor should write his own reflection, albeit with briefs to focus on particular areas so as to lend the introduction overall coverage and coherence.
Clinical Enterobacteriacae isolates with a colistin minimum inhibitory concentration (MIC) ≥4 mg/L from a United States hospital were screened for the mcr-1 gene using real-time polymerase chain reaction (RT-PCR) and confirmed by whole-genome sequencing. Four colistin-resistant Escherichia coli isolates contained mcr-1. Two isolates belonged to the same sequence type (ST-632). All subjects had prior international travel and antimicrobial exposure.
Using existing data from clinical registries to support clinical trials and other prospective studies has the potential to improve research efficiency. However, little has been reported about staff experiences and lessons learned from implementation of this method in pediatric cardiology.
We describe the process of using existing registry data in the Pediatric Heart Network Residual Lesion Score Study, report stakeholders’ perspectives, and provide recommendations to guide future studies using this methodology.
The Residual Lesion Score Study, a 17-site prospective, observational study, piloted the use of existing local surgical registry data (collected for submission to the Society of Thoracic Surgeons-Congenital Heart Surgery Database) to supplement manual data collection. A survey regarding processes and perceptions was administered to study site and data coordinating center staff.
Survey response rate was 98% (54/55). Overall, 57% perceived that using registry data saved research staff time in the current study, and 74% perceived that it would save time in future studies; 55% noted significant upfront time in developing a methodology for extracting registry data. Survey recommendations included simplifying data extraction processes and tailoring to the needs of the study, understanding registry characteristics to maximise data quality and security, and involving all stakeholders in design and implementation processes.
Use of existing registry data was perceived to save time and promote efficiency. Consideration must be given to the upfront investment of time and resources needed. Ongoing efforts focussed on automating and centralising data management may aid in further optimising this methodology for future studies.