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 no-reply@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.
Government conservation measures will always depend on public support. While more has been learnt about which species the public values and which conservation measures are socially acceptable, less is known about the criteria that the public thinks government should consider when making conservation investment decisions. This study uses a stated preference best–worst scaling method to gauge the views of a sample of the Australian public on what they think government should consider when allocating funding to threatened species conservation. We found that the three most important factors were the risk that a species might become extinct, the likelihood that a conservation intervention might be effective and the risk of unintended consequences for other species that could potentially arise if the measure was implemented. Costs of conservation measures and the degree to which the society accepts these costs were considered much less important. The latter aspect was consistent with the high level of trust that respondents placed in the judgement of experts and scientists concerning threatened species conservation. We conclude that the Australian Government has a societal mandate to spend more money on threatened species conservation, provided that there is little risk and that it is backed up by science.
The years 2010–2020 that economists often dub ‘the lost decade’ has been among the most volatile in modern British history. They included the Great Recession at the beginning, austerity economics and the convulsions of Brexit in mid-term and COVID-19 at the end. Each of these events were seismic on their own and yet were interwoven, creating a convulsion in the body politic unparalleled in postwar Britain. The resulting shift in public policy was to envisage a more interventionist role for the state and the need for a less confrontational, more relational culture between private and public providers, together harnessed to delivering social value for communities dislocated by recession, austerity and the pandemic.
The widening inequalities gap
The thread that ran through these years and which set the political priorities for the following decade was Britain’s widening socioeconomic inequality. The recession and its devastating impact on the public finances led to austerity and a stagnation in living standards for the lower paid, generating a resentment that found its expression in the vote for Brexit in the 2016 EU referendum. The pandemic then laid bare the socioeconomic inequalities that had been exacerbated by the recession and the negative impact of austerity on public services which the government from 2017 onwards felt compelled to address. One consequence was the reorientation of traditional political allegiances with an ostensibly right-wing Conservative government, elected in 2019 through the support of working-class pro-Brexit voters in England’s industrial North and Midlands, henceforth committed to removing regional economic inequalities and addressing social wicked issues through state intervention and public spending supported by private sector investment.
While therefore austerity through spending cuts in the first half of the decade signalled a downgrading of the state’s role, Brexit and the pandemic signalled the opposite through an unprecedented rise both in public spending and in the high profile role of key state services like the National Health Service (NHS) and local government in tackling COVID-19. The new political landscape marked a step change away from the traditional left– right divide as well as heralding a more pragmatic era in the relationship between public and private providers.
The Galactic TeV ${\gamma}$-ray source ${\mathrm{HESS\,J}1804{-}216}$ is currently an unidentified source. In an attempt to unveil its origin, we present here the most detailed study of interstellar gas using data from the Mopra Southern Galactic Plane CO Survey, 7- and 12-mm wavelength Mopra surveys and Southern Galactic Plane Survey of HI. Several components of atomic and molecular gas are found to overlap ${\mathrm{HESS\,J}1804{-}216}$ at various velocities along the line of sight. The CS(1-0) emission clumps confirm the presence of dense gas. Both correlation and anti-correlation between the gas and TeV ${\gamma}$-ray emission have been identified in various gas tracers, enabling several origin scenarios for the TeV ${\gamma}$-ray emission from ${\mathrm{HESS\,J}1804{-}216}$. For a hadronic scenario, ${\mathrm{SNR\,G}8.7{-}0.1}$ and the progenitor supernova remnant (SNR) of ${\mathrm{PSR\,J}1803{-}2137}$ require cosmic ray (CR) enhancement factors of ${\mathord{\sim} 50}$ times the solar neighbour CR flux value to produce the TeV ${\gamma}$-ray emission. Assuming an isotropic diffusion model, CRs from both these SNRs require a slow diffusion coefficient, as found for other TeV SNRs associated with adjacent ISM gas. The morphology of gas located at 3.8 kpc (the dispersion measure distance to ${\mathrm{PSR\,J}1803{-}2137}$) tends to anti-correlate with features of the TeV emission from ${\mathrm{HESS\,J}1804{-}216}$, making the leptonic scenario possible. Both pure hadronic and pure leptonic scenarios thus remain plausible.
Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.
Objectives:
To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators.
Data sources:
We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews.
Methods:
Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized.
Results:
In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.
Conclusions:
Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
Posttraumatic stress disorder (PTSD) is often complicated by the after-effects of mild traumatic brain injury (mTBI). The mixture of brain conditions results in abnormal affective and cognitive functioning, as well as maladaptive behavior. To better understand how brain activity explains cognitive and emotional processes in these conditions, we used an emotional N-back task and functional magnetic resonance imaging (fMRI) to study neural responses in US military veterans after deployments to Iraq and Afghanistan. Additionally, we sought to examine whether hierarchical dimensional models of maladaptive personality could account for the relationship between combat-related brain conditions and fMRI responses under cognitive and affective challenge. FMRI data, measures of PTSD symptomatology (PTSS), blast-induced mTBI (bmTBI) severity, and maladaptive personality (MMPI-2-RF) were gathered from 93 veterans. Brain regions central to emotion regulation were selected for analysis, and consisted of bilateral amygdala, bilateral dorsolateral prefrontal (dlPFC), and ventromedial prefrontal/subgenual anterior cingulate (vmPFC-sgACC). Cognitive load increased activity in dlPFC and reduced activity in emotional responding brain regions. However, individuals with greater PTSS showed blunted deactivations in bilateral amygdala and vmPFC-sgACC, and weaker responses in right dlPFC. Additionally, we found that elevated emotional/internalizing dysfunction (EID), specifically low positive emotionality (RC2), accounted for PTSS-related changes in bilateral amygdala under increased cognitive load. Findings suggest that PTSS might result in amygdala and vmPFC-sgACC activity resistant to moderation by cognitive demands, reflecting emotion dysregulation despite a need to marshal cognitive resources. Anhedonia may be an important target for interventions that improve the affective and cognitive functioning of individuals with PTSD.
Effective patient engagement is central to patient-centered outcomes research. A well-designed infrastructure supports and facilitates patient engagement, enabling study development and implementation. We sought to understand infrastructure needs from recipients of Patient-Centered Outcomes Research Institute (PCORI) pilot grant awards.
Methods
We surveyed recipients of PCORI pilot project awards on self-perceived strengths in engagement infrastructure through PCORI’s Ways of Engaging-Engagement Activity Tool survey, and interviewed leaders of 8 projects who volunteered as exemplars. Descriptive statistics summarized the survey findings. We conducted a thematic analysis of the interview transcripts.
Results
Of the 50 surveyed pilots, 22 answered the engagement infrastructure questions (44% response rate). Survey and interview findings emphasized the importance of committed institutional leadership, ongoing relationships with stakeholder organizations, and infrastructure funding through Clinical and Translational Science Awards, PCORI, and institutional discretionary funds.
Conclusions
These findings highlight the importance of and how to improve upon existing institutional infrastructure.
In recent years there has been an increasing interest in the history of the numerous houses of monks, canons and nuns which existed in the medieval British Isles, considering them in their wider socio-cultural-economic context; historians are now questioning some of the older assumptions about monastic life in the later Middle Ages, and setting new approaches and new agenda. The present volume reflects these new trends. Its fifteen chapters assess diverse aspects of monastic history, focusing on the wide range of contacts which existed between religious communities and the laity in the later medieval British Isles, covering a range of different religious orders and houses. This period has often been considered to represent a general decline of the regular life; but on the contrary, the essays here demonstrate that there remained a rich monastic culture which, although different from that of earlier centuries, remained vibrant.
CONTRIBUTORS: KAREN STOBER, JULIE KERR, EMILIA JAMROZIAK, MARTIN HEALE, COLMAN O CLABAIGH, ANDREW ABRAM, MICHAEL HICKS, JANET BURTON, KIMM PERKINS-CURRAN, JAMES CLARK, GLYN COPPACK, JENS ROHRKASTEN, SHEILA SWEETINBURGH, NICHOLAS ORME, CLAIRE CROSS
The low-nitrogen status of highly weathered soils may offer a potential alternative for weed suppression in agricultural systems with N2-fixing crops. In this study, we used sicklepod as a model to evaluate weed response that might occur with managed reductions in nitrogen-soil fertility. A field study was conducted with the parental generation supplied 0, 112, 224, or 448 kg N ha−1. Decreased nitrogen fertility led to reduced shoot biomass, seed number, and total seed mass. Individual seed mass was lower, but seed % nitrogen was not affected. Analysis of seed-mass distribution confirmed that low parental fertility was associated with more small seeds as a proportion of total seeds produced. Additional experiments in hydroponics culture revealed slower growth rates of seedlings produced from small seeds when grown under low-nitrogen conditions. Competitiveness of plants from small (low nitrogen) and large (high nitrogen) seed classes was determined in a replacement-series experiment conducted in sand culture in a controlled environment at two densities and two levels of nitrogen nutrition. Plants produced from smaller seeds were less competitive in low-nitrogen fertility conditions, but plants from small and large seeds competed similarly when grown under high-nitrogen fertility. The results support the hypothesis that comprehensive management strategies to reduce nitrogen availability for weed growth in low-fertility conditions could decrease weed interference by decreasing growth and seed production of parental plants and through maternal effects that lower competitiveness of offspring.
Doveweed is becoming more common in agronomic crops in North Carolina. Laboratory and greenhouse experiments were conducted to determine the effect of temperature and seed burial depth on doveweed germination and emergence. Germination of lightly scarified seed at constant temperature was well described by a Gaussian model, which estimated peak germination at 28 C. Similar maximum percentage of germination was observed for optimal treatments under both constant and alternating temperatures. Among alternating temperatures, a 35/25 C regime gave greatest germination (77%). In spite of similar average daily temperatures, germination was greater with alternating temperature regimes of 40/30 and 40/35 C (65 and 30%, respectively) than constant temperatures of 36 and 38 C (4 and 0%, respectively). No germination was observed at 38 C constant temperature or for alternating temperature regimes of 20/10 and 25/15 C. Light did not enhance germination. Greatest emergence occurred from 0 to 1 cm, with a reduction in emergence as depth increased to 4 cm. No emergence occurred from 6 cm or greater depth. This information on seedbank dynamics may aid in developing tools and strategies for management.
Knowledge of the influence of environmental factors on weed populations is important in developing sustainable turfgrass management practices. Studies were conducted to evaluate the relationship of green and false-green kyllinga population densities with elevation and edaphic factors in turfgrass systems. Studies were conducted on five different golf courses in North Carolina, three affected by green kyllinga, and two affected by false-green kyllinga. According to Spearman correlation coefficients, both green and false-green kyllinga were correlated with increasing soil volumetric water content, whereas correlation of other edaphic variables varied among sites and species. Stepwise logistic regression confirmed the correlation of volumetric water with green kyllinga presence, but model components varied among sites for false-green kyllinga. Increasing green kyllinga populations correlated with increasing soil sodium; however, sodium did not reach a level believed to be detrimental to turfgrass growth. No other variables correlated with green or false-green kyllinga across all sites. We hypothesized that the lack of significant correlations was due to the overall influence of relative elevation on edaphic variables. According to principal components analysis (PCA), relative elevation had a profound impact on the measured edaphic variables at all sites. However, results of PCA at one site differed sharply from other sites. Results from that site demonstrate the potentially strong effects of management practices to alter edaphic trends normally observed with topography.
Bushkiller was evaluated under inter- and intraspecific competition. Inexperiment 1, bushkiller, trumpetcreeper, and wild grape weregreenhouse-grown alone and in two or three species mixtures in pots. Of thethree species, bushkiller grew the tallest and had the greatest finalbiomass when grown alone. When all three species were grown together,bushkiller grew over twice the height of trumpetcreeper, over three timesthe height of wild grape, and over four times the biomass of eithercompeting species. Plots of height over time showed that competition did notaffect bushkiller or wild grape growth rate, but trumpetcreeper growth wasreduced when grown with bushkiller. In experiment 2, bushkiller was grown incultures of one, two, and three plants per pot to determine intraspecificcompetition effects on growth. Final height of bushkiller was not affectedby intraspecific competition; however, bushkiller biomass decreased withincreasing competition.
The noxious weed Benghal dayflower has become a severely troublesome agricultural weed in Georgia in the southeastern Unite States, and there are indications that it is moving northward. Benghal dayflower is glyphosate tolerant and possesses a high degree of reproductive elasticity, making it a formidable threat in many crop systems. The purpose of these experiments was to develop the first temperature response profiles for Benghal dayflower, and use them to evaluate whether temperature might limit its northward invasion into North Carolina and adjacent states on the U.S. east coast. Experiments focused on vegetative and early reproductive growth, stages considered crucial for establishment and competitiveness. Exposure to a range of aerial temperatures revealed that Benghal dayflower growth and production of aerial and subterranean reproductive structures were maximized at 30 C, with sharp declines occurring at cooler temperatures. When exposed to differing root temperatures in hydroponics, with a constant aerial temperature, Benghal dayflower growth did not show the same cool temperature sensitivity, but reproductive performance declined when temperatures decreased below about 29 C. The root temperature responses of several other weed species known to thrive in the climate of this geographic area also were determined. Growth of sicklepod, hemp sesbania, and jimsonweed was more sensitive than Benghal dayflower to cool temperatures, whereas the growth response of velvetleaf was similar. Based on the comparison of the Benghal dayflower temperature responses in controlled environments to (1) seasonal air and soil temperatures in the field, and (2) the temperature responses of agronomic weeds known to thrive in the region, it is concluded that cool temperatures will not restrain the northward spread of Benghal dayflower into North Carolina.
Because soil characteristics and weed densities vary within agricultural landscapes, determining which subfield areas are most favorable to weed species may aid in their management. Field and greenhouse studies were conducted to determine whether subfield environments characterized by higher soil organic carbon (SOC), or ridge vs. furrow microsites, affect common sunflower seed germination after winter burial, seedling emergence, or the control afforded by a preemergence herbicide in a ridge-tillage corn production system. Among seeds buried in situ during winter months and germinated in the laboratory, no differences in common sunflower seed germination or mortality were detected between high-SOC (1.8% mean) and low-SOC (1.1% mean) locations. However, seeds buried at 5-cm depth had about 40% laboratory germination compared with about 10% for seeds stratified on the soil surface or under crop residues. In field emergence and survival experiments, the SOC main-plot effect indicated 25% greater seedling survival in high- than in low-SOC locations. In the absence of herbicide, both emergence and survival were ≥ 35% greater in the ridge than in the furrow microsite, and seedling survival was 48% greater in high- vs. low-SOC furrow environments. However, common sunflower seedling survival was similar between herbicide-treated high- and low-SOC ridges. Greenhouse studies indicated a 13 to 24% increase in common sunflower seedling biomass per 1% increase in SOC under three atrazine doses. Altered or additional weed management tactics should be considered for common sunflower in high-SOC environments to offset the greater potential for seedling survival and growth.
Tropical spiderwort (more appropriately called Benghal dayflower) poses a serious threat to crop production in the southern United States. Although tropical spiderwort has been present in the United States for more than seven decades, only recently has it become a pest in agricultural fields. Identified as an isolated weed problem in 1999, tropical spiderwort became the most troublesome weed in Georgia cotton by 2003. Contributing to the significance of tropical spiderwort as a troublesome weed is the lack of control afforded by most commonly used herbicides, especially glyphosate. Vegetative growth and flower production of tropical spiderwort were optimized between 30 and 35 C, but growth was sustained over a range of 20 to 40 C. These temperatures are common throughout much of the United States during summer months. At the very least, it appears that tropical spiderwort may be able to co-occur with cotton throughout the southeastern United States. The environmental limits of tropical spiderwort have not yet been determined. However, the rapid spread through Georgia and naturalization in North Carolina, coupled with its tolerance to current management strategies and aggressive growth habit, make tropical spiderwort a significant threat to agroecosystems in the southern United States.
Dallisgrass response to various MSMA and foramsulfuron herbicide combinations was evaluated from 2004 through 2006 in North Carolina. Dallisgrass control declined with herbicide rates; therefore, only the highest rates (foramsulfuron, 0.15 kg ai/ha; MSMA, 2.5 kg ai/ha) are discussed. Foramsulfuron followed by (fb) foramsulfuron 1 wk after initial treatment (WAIT) provided 60% control of dallisgrass 1 mo after initial treatment (MAIT), but control declined to 40% 3 MAIT. MSMA (2.5 kg ai/ha) applied three times provided 89% dallisgrass control 1 MAIT, but control declined to 71% 3 MAIT. Among 22 MSMA and foramsulfuron sequential application programs, MSMA fb foramsulfuron 2 WAIT fb MSMA 3 WAIT provided the highest control (94%) of dallisgrass 1 MAIT, and control levels remained high (93%) 3 MAIT. This herbicide program provided 85% control 1 yr after initial treatment (YAIT), whereas no other treatment provided greater than 37% control 1 YAIT. Timing of foramsulfuron application following the initial MSMA application affected the control of dallisgrass. Waiting 2 WAIT, rather than 1 WAIT, before applying foramsulfuron increased control of dallisgrass by 20% 1 MAIT and 19% 3 MAIT. However, the increase in control 1 YAIT was only 5% regardless of herbicide rate. The addition of a second application of MSMA following the application of foramsulfuron 2 WAIT of MSMA further increased control by 10% 1 MAIT, 37% 3 MAIT, and 48% 1 YAIT. Results from this study suggest dallisgrass may be controlled with applications of MSMA fb foramsulfuron 2 WAIT fb MSMA 3 WAIT applied during early to midsummer. The use of MSMA was required to achieve dallisgrass control, however, the relatively high level of control achieved 1 YAIT with a program including sequential applications of MSMA and foramsulfuron may help reduce the total amount of arsenical herbicides used to control dallisgrass infestations over time.
Benghal dayflower is an exotic weed species in the United States that is a challenge to manage in agricultural fields. Research was conducted in North Carolina, Georgia, and Florida to evaluate the longevity of buried Benghal dayflower seeds. Seeds were buried in the field for 2 to 60 mo at a depth of 20 cm in mesh bags containing soil native to each area. In North Carolina, decline of Benghal dayflower seed viability was described by a sigmoidal regression model, with seed size having no effect on viability. Seed viability at the initiation of the study was 81%. After burial, viability declined to 51% after 24 mo, 27% after 36 mo, and < 1% after 42 mo. In Georgia, initial seed viability averaged 86% and declined to 63 and 33% at 12 and 24 mo, respectively. Burial of 36 mo or longer reduced seed viability to < 2%. The relationship between Benghal dayflower seed viability and burial time was described by a sigmoidal regression model. In Florida, there was greater variability in Benghal dayflower seed viability than there was at the other locations. Seed viability at the first sampling date after 2 mo of burial was 63%. Although there were fluctuations during the first 24 mo, the regression model indicated approximately 60% of seed remained viable. After 34 mo of burial, seed viability was reduced to 46% and then rapidly fell to 7% at 39 mo, which was consistent with the decrease in seed viability at the other locations. Although there is a physical dormancy imposed by the seed coat of Benghal dayflower, which has been detected in previous studies, it appears that a decline in buried seed viability to minimal levels occurs within 39 to 48 mo in the southeastern United States, suggesting that management programs must prevent seed production for at least four growing seasons to severely reduce the Benghal dayflower soil seedbank.
The effect of mowing regime on lateral spread and rhizome growth of dallisgrass and bahiagrass was determined in field studies conducted in 2003 and 2004 in North Carolina over 5 mo. Treatments were selected to simulate mowing regimes common to intensively managed common bermudagrass turfgrass and include 1.3-, 5.2-, and 7.6-cm heights at frequencies of three, two, and two times per week, respectively. A nonmowed check was included for comparison. Lateral spread of dallisgrass was reduced 38 to 47% regardless of mowing regime when compared with the nonmowed check. Rhizome fresh weight of dallisgrass was reduced 49% in 2003 and 30% in 2004 when mowed at the 7.6-cm regime after 5 mo, whereas the 5.2-cm mowing regime caused a reduction of 31%. Rhizome fresh weight of dallisgrass was most negatively affected by the 1.3-cm regime, which caused reductions of 57% in 2003 and 37% in 2004. Lateral spread of bahiagrass was more strongly affected by mowing height and frequency than dallisgrass, with reductions of 21 to 27%, 40%, and 44 to 62% when mowed at 7.6, 5.2, and 1.3-cm regimes, respectively. Rhizome fresh weight of bahiagrass was reduced 24 to 33%, 55%, and 70 to 73% when mowed at 7.6, 5.2, and 1.3 cm, respectively. Based upon these results, areas mowed at a golf course rough height (≥ 5.2 cm) may be more conducive to bahiagrass spread, whereas dallisgrass may tolerate areas mowed at a fairway height (1.3 cm). Mowing at the shorter heights examined in this study clearly reduced the potential of Paspalum spp. vegetative spread and may help to explain observed distributions of Paspalum spp. infestations in bermudagrass turfgrass.
Demand for organic food products has consistently increased for more than 20 yr. The largest obstacle to organic soybean production in the southeastern United States is weed management. Current organic soybean production relies on mechanical weed control, including multiple postplant rotary hoe uses. Although postplant rotary hoe use is effective at the weed germination stage, its efficacy is severely compromised by delays due to weather. Preplant rotary hoeing is also a practice that has been utilized for weed control but the effectiveness of this practice to reduce the need for multiple postplant rotary hoeing for organic soybean production in the southeastern United States has not been investigated. Preplant rotary hoe treatments included a weekly rotary hoeing 4 wk before planting, 2 wk before planting, and none. Postplant rotary hoe treatments consisted of zero, one, two, three, and four postplant rotary hoe uses. Weed control was increased with preplant rotary hoeing at Plymouth in 2006 and 2007 but this effect disappeared with the first postplant rotary hoeing. Multiple postplant rotary hoe uses decreased soybean plant populations, decreased soybean canopy height, lowered soybean pod position, and decreased soybean yield. Plant mapping revealed that the percentage of total nodes and pods below 30 cm was increased by increased frequency of postplant rotary hoe use.
Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children.
DESIGN
Retrospective cohort
SETTING
Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals
PATIENTS
Patients ≤18 years old ventilated for ≥1 day
METHODS
We identified patients with pediatric VAC based on previously proposed criteria. We applied adult temperature, white blood cell count, antibiotic, and culture criteria for IVAC and PVAP to these patients. We matched pediatric VAC patients with controls and evaluated associations with adverse outcomes using Cox proportional hazards models.
RESULTS
In total, 233 pediatric VACs (12,167 ventilation episodes) were identified. In the cardiac ICU (CICU), 62.5% of VACs met adult IVAC criteria; in the pediatric ICU (PICU), 54.2% of VACs met adult IVAC criteria; and in the neonatal ICU (NICU), 20.2% of VACs met adult IVAC criteria. Most patients had abnormal white blood cell counts and temperatures; we therefore recommend simplifying surveillance by focusing on “pediatric VAC with antimicrobial use” (pediatric AVAC). Pediatric AVAC with a positive respiratory diagnostic test (“pediatric PVAP”) occurred in 8.9% of VACs in the CICU, 13.3% of VACs in the PICU, and 4.3% of VACs in the NICU. Hospital mortality was increased, and hospital and ICU length of stay and duration of ventilation were prolonged among all pediatric VAE subsets compared with controls.
CONCLUSIONS
We propose pediatric AVAC for surveillance related to antimicrobial use, with pediatric PVAP as a subset of AVAC. Studies on generalizability and responsiveness of these metrics to quality improvement initiatives are needed, as are studies to determine whether lower pediatric VAE rates are associated with improvements in other outcomes.
The high Antarctic plateau provides exceptional conditions for infrared observations on account of the cold, dry and stable atmosphere above the ice surface. This paper describes the scientific goals behind the first program to examine the time-varying universe in the infrared from Antarctica — the Kunlun Infrared Sky Survey (KISS). This will employ a 50cm telescope to monitor the southern skies in the 2.4μmKdark window from China's Kunlun station at Dome A, on the summit of the Antarctic plateau, through the uninterrupted 4-month period of winter darkness. An earlier paper discussed optimisation of the Kdark filter for sensitivity (Li et al. 2016). This paper examines the scientific program for KISS. We calculate the sensitivity of the camera for the extrema of observing conditions that will be encountered. We present the parameters for sample surveys that could then be carried out for a range of cadences and sensitivities. We then discuss several science programs that could be conducted with these capabilities, involving star formation, brown dwarfs and hot Jupiters, exoplanets around M dwarfs, the terminal phases of stellar evolution, fast transients, embedded supernova searches, reverberation mapping of AGN, gamma ray bursts and the detection of the cosmic infrared background.