We performed a literature review to describe the risk of surgical-site infection (SSI) in minimally invasive surgery (MIS) compared to standard open surgery. Most studies reported decreased SSI rates among patients undergoing MIS compared to open procedures. However, many were observational studies and may have been affected by selection bias. MIS is associated with reduced risk of surgical-site infection compared to standard open surgery and should be considered when feasible.

Testing of asymptomatic patients for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) (ie, “asymptomatic screening) to attempt to reduce the risk of nosocomial transmission has been extensive and resource intensive, and such testing is of unclear benefit when added to other layers of infection prevention mitigation controls. In addition, the logistic challenges and costs related to screening program implementation, data noting the lack of substantial aerosol generation with elective controlled intubation, extubation, and other procedures, and the adverse patient and facility consequences of asymptomatic screening call into question the utility of this infection prevention intervention. Consequently, the Society for Healthcare Epidemiology of America (SHEA) recommends against routine universal use of asymptomatic screening for SARS-CoV-2 in healthcare facilities. Specifically, preprocedure asymptomatic screening is unlikely to provide incremental benefit in preventing SARS-CoV-2 transmission in the procedural and perioperative environment when other infection prevention strategies are in place, and it should not be considered a requirement for all patients. Admission screening may be beneficial during times of increased virus transmission in some settings where other layers of controls are limited (eg, behavioral health, congregate care, or shared patient rooms), but widespread routine use of admission asymptomatic screening is not recommended over strengthening other infection prevention controls. In this commentary, we outline the challenges surrounding the use of asymptomatic screening, including logistics and costs of implementing a screening program, and adverse patient and facility consequences. We review data pertaining to the lack of substantial aerosol generation during elective controlled intubation, extubation, and other procedures, and we provide guidance for when asymptomatic screening for SARS-CoV-2 may be considered in a limited scope.

This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.

SHEA endorses adhering to the recommendations by the CDC and ACIP for immunizations of all children and adults. All persons providing clinical care should be familiar with these recommendations and should routinely assess immunization compliance of their patients and strongly recommend all routine immunizations to patients. All healthcare personnel (HCP) should be immunized against vaccine-preventable diseases as recommended by the CDC/ACIP (unless immunity is demonstrated by another recommended method). SHEA endorses the policy that immunization should be a condition of employment or functioning (students, contract workers, volunteers, etc) at a healthcare facility. Only recognized medical contraindications should be accepted for not receiving recommended immunizations.

The Canyon Creek vertebrate-fossil locality is an extensive road cut near Fairbanks that exposes sediments that range in age from early Wisconsin to late Holocene. Tanana River gravel at the base of the section evidently formed during the Delta Glaciation of the north-central Alaska Range. Younger layers and lenses of fluvial sand are interbedded with arkosic gravel from Canyon Creek that contains tephra as well as fossil bones of an interstadial fauna about 40,000 years old. Solifluction deposits containing ventifacts, wedge casts, and rodent burrows formed during a subsequent period of periglacial activity that took place during the maximum phase of Donnelly Glaciation about 25,000–17,000 years ago. Overlying sheets of eolian sand are separated by a 9500-year-old paleosol that may correlate with a phase of early Holocene spruce expansion through central Alaska. The Pleistocene fauna from Canyon Creek consists of rodents (indicated by burrows), Mammuthus primigenius (woolly mammoth), Equus lambei (Yukon wild ass), Camelops hesternus (western camel), Bison sp. cf. B. crassicornis (large-horned bison), Ovis sp. cf.O. dalli (mountain sheep), Canis sp. cf. C. lupus (wolf), Lepus sp. cf. L. othus or L. arcticus (tundra hare), and Rangifer sp. (caribou). This assemblage suggests an open landscape in which trees and tall shrubs were either absent or confined to sheltered and moist sites. Camelops evidently was present in eastern Beringia during the middle Wisconsin interstadial interval but may have disappeared during the following glacial episode. The stratigraphic section at Canyon Creek appears to demonstrate that the Delta Glaciation of the north-central Alaska Range is at least in part of early Wisconsin age and was separated from the succeeding Donnelly Glaciation by an interstadial rather than interglacial episode.

Herbicide soil/solution distribution coefficients (Kd) are used in mathematical models to predict the movement of herbicides in soil and groundwater. Herbicides bind to various soil constituents to differing degrees. The universal soil colloid that binds most herbicides is organic matter (OM), however clay minerals (CM) and metallic hydrous oxides are more retentive for cationic, phosphoric, and arsenic acid compounds. Weakly basic herbicides bind to both organic and inorganic soil colloids. The soil organic carbon (OC) affinity coefficient (Koc) has become a common parameter for comparing herbicide binding in soil; however, because OM and OC determinations vary greatly between methods and laboratories, Koc values may vary greatly. This proposal discusses this issue and offers suggestions for obtaining the most accurate Kd, Freundlich constant (Kf), and Koc values for herbicides listed in the WSSA Herbicide Handbook and Supplement.

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. This document updates “Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals,” published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.

The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:

1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.

2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.

The Richtmyer–Meshkov instability (RMI) is experimentally investigated in a vertical shock tube using a broadband initial condition imposed on an interface between a helium–acetone mixture and argon ($A\approx 0.7$). The interface is created without the use of a membrane by first setting up a flat, gravitationally stable stagnation plane, where the gases are injected from the ends of the shock tube and exit through horizontal slots at the interface location. Following this, the interface is perturbed by injecting gas within the plane of the interface. Perturbations form in the lower portion of this layer due to the shear between this injected stream and the surrounding gas. This shear layer serves as a statistically repeatable broadband initial condition to the RMI. The interface is accelerated by either a $M= 1.6 $ or $M= 2.2 $ planar shock wave, and the development of the ensuing mixing layer is investigated using planar laser-induced fluorescence (PLIF). The PLIF images are processed to reveal the light-gas mole fraction by accounting for laser absorption and laser-steering effects. The images suggest a transition to turbulent mixing occurring during the experiment. An analysis of the mole-fraction distribution confirms this transition, showing the gases begin to homogenize at later times. The scalar variance energy spectra exhibits a near $k^{-5/3}$ inertial range, providing further evidence for turbulent mixing. Measurements of the Batchelor and Taylor microscales are made from the mole-fraction images, giving ${\sim }150\ \mu \mathrm{m}$ and 4 mm, respectively, by the latest times. The ratio of these scales implies an outer-scale Reynolds number of $6\text {--}7\times 10^4$.

The successful development of quantum computers is dependent on identifying quantum systems to function as qubits. Paramagnetic states of point defects in semiconductors or insulators have been shown to provide an effective implementation, with the nitrogen-vacancy center in diamond being a prominent example. The spin-1 ground state of this center can be initialized, manipulated, and read out at room temperature. Identifying defects with similar properties in other materials would add flexibility in device design and possibly lead to superior performance or greater functionality. A systematic search for defect-based qubits has been initiated, starting from a list of physical criteria that such centers and their hosts should satisfy. First-principles calculations of atomic and electronic structure are essential in supporting this quest: They provide a deeper understanding of defects that are already being exploited and allow efficient exploration of new materials systems and “defects by design.”