Background: Carbapenem-resistant Enterobacteriaceae (CRE) are endemic in the Chicago region. We assessed the regional impact of a CRE control intervention targeting high-prevalence facilities; that is, long-term acute-care hospitals (LTACHs) and ventilator-capable skilled nursing facilities (vSNFs). Methods: In July 2017, an academic–public health partnership launched a regional CRE prevention bundle: (1) identifying patient CRE status by querying Illinois’ XDRO registry and periodic point-prevalence surveys reported to public health, (2) cohorting or private rooms with contact precautions for CRE patients, (3) combining hand hygiene adherence, monitoring with general infection control education, and guidance by project coordinators and public health, and (4) daily chlorhexidine gluconate (CHG) bathing. Informed by epidemiology and modeling, we targeted LTACHs and vSNFs in a 13-mile radius from the coordinating center. Illinois mandates CRE reporting to the XDRO registry, which can also be manually queried or generate automated alerts to facilitate interfacility communication. The regional intervention promoted increased automation of alerts to hospitals. The prespecified primary outcome was incident clinical CRE culture reported to the XDRO registry in Cook County by month, analyzed by segmented regression modeling. A secondary outcome was colonization prevalence measured by serial point-prevalence surveys for carbapenemase-producing organism colonization in LTACHs and vSNFs. Results: All eligible LTACHs (n = 6) and vSNFs (n = 9) participated in the intervention. One vSNF declined CHG bathing. vSNFs that implemented CHG bathing typically bathed residents 2–3 times per week instead of daily. Overall, there were significant gaps in infection control practices, especially in vSNFs. Also, 75 Illinois hospitals adopted automated alerts (56 during the intervention period). Mean CRE incidence in Cook County decreased from 59.0 cases per month during baseline to 40.6 cases per month during intervention (P < .001). In a segmented regression model, there was an average reduction of 10.56 cases per month during the 24-month intervention period (P = .02) (Fig. 1), and an estimated 253 incident CRE cases were averted. Mean CRE incidence also decreased among the stratum of vSNF/LTACH intervention facilities (P = .03). However, evidence of ongoing CRE transmission, particularly in vSNFs, persisted, and CRE colonization prevalence remained high at intervention facilities (Table 1). Conclusions: A resource-intensive public health regional CRE intervention was implemented that included enhanced interfacility communication and targeted infection prevention. There was a significant decline in incident CRE clinical cases in Cook County, despite high persistent CRE colonization prevalence in intervention facilities. vSNFs, where understaffing or underresourcing were common and lengths of stay range from months to years, had a major prevalence challenge, underscoring the need for aggressive infection control improvements in these facilities.

Funding: The Centers for Disease Control and Prevention (SHEPheRD Contract No. 200-2011-42037)

Disclosures: M.Y.L. has received research support in the form of contributed product from OpGen and Sage Products (now part of Stryker Corporation), and has received an investigator-initiated grant from CareFusion Foundation (now part of BD).

Residual herbicides are routinely applied to control troublesome weeds in pumpkin production. Fluridone and acetochlor, Groups 12 and 15 herbicides, respectively, provide broad-spectrum PRE weed control. Field research was conducted in Virginia and New Jersey to evaluate pumpkin tolerance and weed control to PRE herbicides. Treatments consisted of fomesafen at two rates, ethalfluralin, clomazone, halosulfuron, fluridone, S-metolachlor, acetochlor emulsifiable concentrate (EC), acetochlor microencapsulated (ME), and no herbicide. At one site, fluridone, acetochlor EC, acetochlor ME, and halosulfuron injured pumpkin 81%, 39%, 34%, and 35%, respectively, at 14 d after planting (DAP); crop injury at the second site was 40%, 8%, 19%, and 33%, respectively. Differences in injury between the two sites may have been due to the amount and timing of rainfall after herbicides were applied. Fluridone provided 91% control of ivyleaf morningglory and 100% control of common ragweed at 28 DAP. Acetochlor EC controlled redroot pigweed 100%. Pumpkin treated with S-metolachlor produced the most yield (10,764 fruits ha–1) despite broadcasting over the planted row; labeling requires a directed application to row-middles. A separate study specifically evaluated fluridone applied PRE at 42, 84, 126, 168, 252, 336, and 672 g ai ha–1. Fluridone resulted in pumpkin injury ≥95% when applied at rates of ≥168 g ai ha–1; significant yield loss was noted when the herbicide was applied at rates >42 g ai ha–1. We concluded that fluridone and acetochlor formulations are unacceptable candidates for pumpkin production.

The failure of glyphosate to control all weeds throughout the entire growing season has sometimes prompted growers to use herbicides other than glyphosate on glyphosate-resistant soybean. Field studies were conducted in 1999 and 2000 to investigate potential crop injury by several herbicides in glyphosate-resistant soybean and to determine the relationships between soybean maturity group, planting date, and herbicide treatment on soybean injury, leaf area index (LAI), and yield. Glyphosate-resistant soybean generally recovered from early-season herbicide injury and LAI reductions; however, some treatments reduced yield. Yield reductions were more common in double-crop soybean than in full-season soybean. In full-season soybean, most yield reductions occurred in the early-maturing ‘RT-386’ cultivar. These yield reductions may be attributed to reduced developmental periods associated with early-maturing cultivars and double-crop soybean that often lead to reduced vegetative growth and limited LAI. Reductions in LAI by some herbicide treatments were not necessarily indicative of yield loss. Further yield reductions associated with herbicide applications occurred, although soybean sometimes produced leaf area exceeding the critical LAI level of 3.5 to 4.0, which is the minimum LAI needed for soybean to achieve maximum yield. Therefore, LAI response to herbicide treatments does not always accurately indicate the response of glyphosate-resistant soybean yield to herbicides.

The simulation of the northern and southern polar climates for 1979–88 by 14 global climate models (GCMs), using the observed monthly averaged sea-surface temperatures and sea-ice extents as boundary conditions, is part of an international effort to determine the systematic errors of atmospheric models under realistic conditions, the so-called Atmospheric Model Intercomparison Project (AMIP), In this study, intercomparison of the models’ simulation of polar climate is discussed in terms of selected surface and vertically integrated monthly averaged quantities, such as sea-level pressure, cloudiness, precipitable water, precipitation and evaporation/sublimation. The results suggest that the accuracy of model-simulated climate features in high latitudes primarily depends on the horizontal resolution and the treatment of physical processes in the GCMs. AMIP offers an unprecedented opportunity for the comprehensive evaluation and validation of current atmospheric models and provides valuable information for model improvement.

The performance of an explicit cloud physics parameterization is examined with simulations of high southern latitude winter climate using a version of the Pennsylvania State University/National Center for Atmospheric Research Mesoscale Model, version 4. The results reveal that there are three moist physics regimes in the vertical over the elevated interior of Antarctica: the very cold upper troposphere, the relatively warm middle troposphere and the cold boundary layer. Deficiencies for these layers include excessive cloud ice in the upper troposphere, excessive cloud ice in the inversion layer near the ice surface, overly warm temperatures in the lower troposphere, overly cold temperatures in the upper troposphere and excessive downward longwave radiation at the Earth’s surface. Three sensitivity experiments were performed to investigate possible improvements in the cloud parameterization. The results indicate that a reduction of the numerous cloud condensation nuclei, while reducing some errors, appears to be insufficient to improve the simulation. A reduction in the excessive cloud ice in the upper troposphere significantly improves the simulation of upper-tropospheric temperature.

The experimental sulfonylurea herbicide ASC-67040 was evaluated preemergence (PRE) and postemergence (POST) at 25 to 100 g ai/ha and PRE at 50 g/ha followed by ASC-67040 POST at 50 g/ha for broadleaf weed control in potato and tomato. In Virginia, ASC-67040 POST at 50 and 100 g/ha gave 70 to 98% control of common lambsquarters, common ragweed, and jimsonweed with slight (0 to 6%) ‘Superior’ potato and moderate (0 to 23%) ‘Agriset’ tomato injury. This crop injury was present primarily as chlorosis in terminal growth and disappeared by 3 wk after treatment (WAT). Potato tuber and tomato fruit yields were high in ASC-67040-treated plots. In North Carolina, ASC-67040 PRE and POST at 50 and 100 g/ha controlled 10 species of annual broadleaf weeds and grasses, and at 25 g/ha ASC-67040 gave greater than 90% control of most species. ASC-67040 injured ‘Fontenot’ potato more than Superior and caused 10 to 13% injury to ‘Mountain Spring’ tomato but did not injure ‘Mountain Pride’ tomato. Mountain Spring tomato recovered rapidly and produced high yields. In the greenhouse, yellow nutsedge control by ASC-67040 POST at 25 to 100 g/ha was 59 to 86% 3 WAT and yellow nutsedge height, dry weight, and regrowth dry weight were reduced by all rates. Lower rates of ASC-67040 might control weeds and cause less injury to potato and tomato.

To evaluate the greatest impact that sea-ice anomalies around Antarctica could have on the global atmosphere, 15 year seasonal cycle simulations are conducted with the U.S. National Center for Atmospheric Research Community Climate Model version 2.1. Sensitivity simulations are performed with the following conditions: (1) all sea ice in the Southern Hemisphere is replaced by year-round open water, but the permanent ice shelves are retained (NSIS); and (2) all sea ice in the Southern Hemisphere and the major ice shelves are removed and replaced by open water (NISH). The results are compared to a standard run (CNT) with boundary conditions set for the present climate. The comparison shows that trains of positive and negative anomalies in zonal-mean fields extend into the tropical latitudes of the Northern Hemisphere. Anomalies are largest during April-October. The additional removal of the ice shelves in NISH enhances the response, as zonally averaged anomalies are similar in pattern to those in NSIS but are roughly twice as large poleward of 50° S, and only slightly larger farther north. Anomalies in the eddy fields are found in both hemispheres. in NISH, and to a lesser degree in NSIS. these anomalies appear to be related to a delayed northern advance over China during June of the rain front associated with the summer monsoon. Consequently, precipitation is enhanced in middle and southern China and decreased in northern China. Observational analyses have also found links between Antarctic sea-ice variations and modulations of the East Asian monsoon.

We evaluated the effectiveness of daily chlorhexidine gluconate (CHG) bathing in decreasing skin carriage of Klebsiella pneumoniae carbapenemase–producing Enterobacteriaceae (KPC) among long-term acute care hospital patients. CHG bathing reduced KPC skin colonization, particularly when CHG skin concentrations greater than or equal to 128 μg/mL were achieved.

By reprocessing the NICMOS coronagraphic archive using improved PSF subtraction methods, we have obtained new images of 5 debris disks, all previously unseen using classical PSF subtractions. Three of the disks are edge on and two appear to be ring like, one of which is extremely asymmetric.

Their stellar hosts are nearby, young F and G type stars (40-90 pc, 12–30 Myr), including one that is a close analog to the young sun at roughly the age at which terrestrial planets were assembling. This is a 25% increase in the sample of debris disks seen in scattered light. Analysis and modeling of the disk geometries is in process. Given these systems' youth, proximity, and brightness (V = 7.2 to 8.5), these will be superb targets for investigating planet formation, and are perfect targets for studies with GPI, SPHERE and JWST.

The Archival Legacy Investigation of Circumstellar Environments (ALICE) project (AR-12652) is currently conducting a comprehensive and consistent reprocessing of HST-NICMOS coronagraphic survey data to search for point sources and disks using advanced PSF subtraction. The KLIP algorithm (Karhunen-Loève Image Projection) was developed for this project, and has proven very effective at processing the hundreds of selected archival images. This project has already been very successful with numerous detections of previously unseen point sources and several resolved debris disks that we are currently following up by multiple avenues. We give an overview of the project including preliminary scientific results with companion candidates and improved images of known disks