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The Ediacaran/Cambrian transition (ECT; ~575–500 Ma) captures the early diversification of animals, including the oldest crown-group taxa of most major animal phyla alive today. Key to understanding the drivers underneath the ECT macroevolutionary patterns are the interactions of animals with one another and their environment, and how these interactions scale up to global diversity patterns. Understanding the ecology of ECT organisms is enabled by the abundance of Lagerstätten over this time period, with a relatively large proportion of soft-bodied organisms preserved, often within the communities in which they lived. Here, we review our understanding of organismal, community, and macroecology of the ECT, and how these different scales of ecological analyses relate to the macroevolutionary diversification patterns we see over this 75 Myr time period. Across all ecological scales, we find clear trends, starting with stochastic ecosystem dynamics dominated by generalist taxa in the first Ediacaran communities, to more structured, niche-driven specialist dynamics by Cambrian Epoch 2. These trends are reflected in organism functional morphology, the complexity and strength of organisms’ interactions within their communities, and large-scale metacommunity, biogeographic, and biodiversity patterns. Yet there is often a time delay between the origination of a new type of ecological interaction and when it is observed to impact the ecosystem as a whole. As such, while many modern ecological innovations were in place by the end of the Cambrian, the knock-on effects and complexity of these interactions continued to build up throughout the Phanerozoic, leading to the complex biosphere we have today.
Chaotic environments are producing unique and unprecedented challenges for multinational companies, challenges that raise important questions about whether and how multinationals will survive or wither away. This Element explores both the macro political, economic, technological, and social forces impacting international business and the strategic management adaptations that leading companies have deployed to respond to these challenges. We observe that a new organizational form – the Global Multi-Business – has evolved that may be especially adapted to respond to and challenge a world in which change is ubiquitous, with the direction of change unpredictable and the pace of change accelerating. It accomplishes this through the strategic assembly of the organization and the animation of its many parts.
Evaluation of adult antibiotic order sets (AOSs) on antibiotic stewardship metrics has been limited. The primary outcome was to evaluate the standardized antimicrobial administration ratio (SAAR). Secondary outcomes included antibiotic days of therapy (DOT) per 1,000 patient days (PD); selected antibiotic use; AOS utilization; Clostridioides difficile infection (CDI) cases; and clinicians’ perceptions of the AOS via a survey following the final study phase.
Design:
This 5-year, single-center, quasi-experimental study comprised 5 phases from 2017 to 2022 over 10-month periods between August 1 and May 31.
Setting:
The study was conducted in a 752-bed tertiary care, academic medical center.
Intervention:
Our institution implemented AOSs in the electronic medical record (EMR) for common infections among hospitalized adults.
Results:
For the primary outcome, a statistically significant decreases in SAAR were detected from phase 1 to phase 5 (1.0 vs 0.90; P < .001). A statistically significant decreases were detected in DOT per 1,000 PD (4,884 vs 3,939; P = .001), fluoroquinolone orders (407 vs 175; P < .001), carbapenem orders (147 vs 106; P = .024), and clindamycin orders (113 vs 73; P = .01). No statistically significant change in mean vancomycin orders was detected (991 vs 902; P = .221). A statistically significant decrease in CDI cases was also detected (7.8, vs 2.4; P = .002) but may have been attributable to changes in CDI case diagnosis. Clinicians indicated that the AOSs were easy to use overall and that they helped them select the appropriate antibiotics.
Conclusions:
Implementing AOS into the EMR was associated with a statistically significant reduction in SAAR, antibiotic DOT per 1,000 PD, selected antibiotic orders, and CDI cases.
Load balancing of constrained healthcare resources has become a critical aspect of assuring access to care during periods of pandemic related surge. These impacts include patient surges, staffing shortages, and limited access to specialty resources. This research focuses on the creation and work of a novel statewide coordination center, the Washington Medical Coordination Center (WMCC), whose primary goal is the load balancing of patients across the healthcare continuum of Washington State.
Methods:
This article discusses the origins, development, and operations of the WMCC including key partners, cooperative agreements, and structure necessary to create a patient load balancing system on a statewide level.
Results:
As of April 21, 2022, the WMCC received 3821 requests from Washington State hospitals. Nearly 90% were received during the pandemic surge. Nearly 75% originated from rural hospitals that are most often limited in their ability to transfer patients when referral centers are also overwhelmed.
Conclusions:
The WMCC served as an effective tool to carry out patient load balancing activities during the COVID-19 pandemic surge in Washington State. It (the WMCC) has been shown to be an equity enhancing, cost effective means of managing healthcare surge events across a broad geographic region.
A detailed analysis of steady coating flow of a thin film of a viscous fluid on the outside of a uniformly rotating horizontal circular cylinder in the absence of surface-tension effects but in the presence of a non-uniform pressure distribution due to an irrotational airflow with circulation shows that the presence of the airflow can result in qualitatively different behaviour of the fluid film from that in classical coating flow. Full-film solutions corresponding to a continuous film of fluid covering the entire cylinder are possible only when the flux and mass of fluid do not exceed critical values, which are determined in terms of the non-dimensional parameters $F$ and $K$ representing the speed of the far-field airflow and the circulation of the airflow, respectively. The qualitative changes in the behaviour of the film thickness as $F$ and $K$ are varied are described. In particular, the film thickness can have as many as four stationary points and, in general, has neither top-to-bottom nor right-to-left symmetry. In addition, when the circulation of the airflow is in the same direction as the rotation of the cylinder the maximum mass of fluid that can be supported on the cylinder is always less than that in classical coating flow, whereas when the circulation is in the opposite direction the maximum mass of fluid can be greater than that in classical coating flow.
Target-date funds in corporate retirement plans grew from $5 billion in 2000 to $734 billion in 2018, partly because federal regulation sanctioned these as default investments in automatic enrollment plans. We show that adopters delegated pension investment decisions to fund managers selected by plan sponsors. Inclusion of these funds in retirement saving menus raised equity shares, boosted bond exposures, curtailed cash/company stock holdings, and reduced idiosyncratic risk. The adoption of low-cost target-date funds may enhance retirement wealth by as much as 50% over a 30-year horizon.
Conflicts between people with different worldviews, values and perspectives over nature and its conservation can be damaging for both people and nature. Managing such conflicts is therefore a priority and key to effective conservation. In this chapter we outline some of the current approaches to managing conflicts in conservation. We focus on the aim of bringing about fundamental shifts in the ways in which the people involved in the conflict reflect on the real point of conflict and the paradigms and approaches used to mitigate it, leading to the transformation of the institutions and discourses, as well as in the relationships within and between the conflicted parties. We conclude with the need to focus on worldviews, as they can and do shape evidence, institutional arrangements and approaches to conservation, including the way in which conflicts are managed.
The Döşeme Boğazı (‘Pass with the Pavement’) is one of the ancient routes through the Taurus Mountains that connected the Anatolian interior with the southern coastal regions (fig. 1). From an early date it was an important component of the Roman road-system in Asia Minor (fig. 2). The pass lay near the S end of the Republican route from the Dardanelles to Side which was created by Manius Aquillius, first proconsul of Asia between 129 and 126 B.C. The S part of this road was incorporated into the via Sebaste, built in 6/5 B.C., which linked several of the Roman colonies founded by Augustus in south-central Anatolia to the Mediterranean coast. By good fortune, the ancient settlements and the Roman and post-Roman road in this defile have survived largely untouched by modern development. The course of the road between the Roman colony of Comama (Pisidia) and Perge (Pamphylia), as well as branch roads leading to other settlements, can be traced precisely. Well-preserved remains of two settlements, both occupied between the 2nd and 6th c., are identifiable at the upper and lower ends of the defile: in them are houses having from 2 to 10 rooms, the larger ones arranged around courtyards and some having cisterns and towers (Turmgehöfte), a bath-house and public cisterns, roadside shops, sarcophagi and small heroa in prominent positions by the road, and numerous churches. The lower site includes a large walled structure probably of the 6th c., that was almost certainly designed as an animal enclosure to control transhumant flocks. Most remarkable of all the surviving structures in the pass, however, are the remains of a mansio or way-station, which survives up to roof level and is the best-preserved building of this type in the entire empire.
The current study examined the pattern of neurocognitive impairments in a community-recruited sample of clinical high-risk (CHR) participants and established relationships with psychosocial functioning.
Methods
CHR-participants (n = 108), participants who did not fulfil CHR-criteria (CHR-negatives) (n = 42) as well as a group of healthy controls (HCs) (n = 55) were recruited. CHR-status was assessed using the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Schizophrenia Proneness Instrument, Adult Version (SPI-A). The Brief Assessment of Cognition in Schizophrenia Battery (BACS) as well as tests for emotion recognition, working memory and attention were administered. In addition, role and social functioning as well as premorbid adjustment were assessed.
Results
CHR-participants were significantly impaired on the Symbol-Coding and Token-Motor task and showed a reduction in total BACS-scores. Moreover, CHR-participants were characterised by prolonged response times (RTs) in emotion recognition as well as by reductions in both social and role functioning, GAF and premorbid adjustments compared with HCs. Neurocognitive impairments in emotion recognition accuracy, emotion recognition RT, processing speed and motor speed were associated with several aspects of functioning explaining between 4% and 12% of the variance.
Conclusion
The current data obtained from a community sample of CHR-participants highlight the importance of dysfunctions in motor and processing speed and emotion recognition RT. Moreover, these deficits were found to be related to global, social and role functioning, suggesting that neurocognitive impairments are an important aspect of sub-threshold psychotic experiences and a possible target for therapeutic interventions.
Large herbivores can act as keystone species that strongly influence their communities. During the Pliocene and Pleistocene, Australia was dominated by a number of large to gigantic marsupial herbivore taxa. Many of these have been understudied quantitatively with regard to their ecology; and identifying the diet of these species will improve our understanding of not only their ecologies, but also of past environments. Recent research has found that cranial morphology among kangaroos and wallabies corresponds with foraging behaviors and mechanical properties of preferred plant tissues. Here we apply shape analysis and computational biomechanics to test the hypothesis: that feeding ecology is associated with craniofacial morphology across a taxonomically broad sample of diprotodont herbivores. Based on our results we predict the diet of an extinct short-faced kangaroo, Simosthenurus occidentalis. We find that biting behaviors are reflected in craniofacial morphology, but that these are more a reflection of the hardest bites required for their lifestyle, rather than diet composition alone. A combination of a very short face, robust musculoskeletal features, and dental arrangements predict that S. occidentalis was a browser, capable of consuming particularly resistant, bulky plant matter. These features were largely conserved among other short-faced kangaroos and may have offset the unpredictable availability of quality forage during the climatically variable Pleistocene epoch, contributing to their prolific diversification during this time.
Ion microprobe analysis ofperovskite from kimberlites and alnöites permits the accurate determination of La, Ce, Pr, Nd, Sm, Eu, Gd, Dy, Er and Yb at the part per million level. Other rare earth elements (REE) are subject to interferences in the mass spectrum caused by matrix-derived molecular ions and cannot easily be determined with comparable precision. Chondrite-normalized plots of the ion probe REE data are smooth curves, confirming the superiority of this technique over electron microprobe methods at the levels of REE abundance found in these perovskites. The perovskites analysed contain between 2.8 and 7.1 wt. % REE oxides and are highly enriched in the light REE, having La/Yb ratios of 577–3229. These La/Yb ratios are not representative of the parental magmas but result from REE fractionation during crystallization of the perovskite. Parental magma La/Yb ratios are estimated to be of the order of 120–650. The lower La/Yb ratios (80–200) found for whole-rock kimberlites are considered to result from contamination by relatively heavy REE-enriched crustal material.
Palliative care for nursing home residents with advanced dementia is often sub-optimal due to poor communication and limited care planning. In a cluster randomized controlled trial, registered nurses (RNs) from 10 nursing homes were trained and funded to work as Palliative Care Planning Coordinators (PCPCs) to organize family case conferences and mentor staff. This qualitative sub-study aimed to explore PCPC and health professional perceptions of the benefits of facilitated case conferencing and identify factors influencing implementation.
Method:
Semi-structured interviews were conducted with the RNs in the PCPC role, other members of nursing home staff, and physicians who participated in case conferences. Analysis was conducted by two researchers using a thematic framework approach.
Results:
Interviews were conducted with 11 PCPCs, 18 other nurses, eight allied health workers, and three physicians. Perceived benefits of facilitated case conferencing included better communication between staff and families, greater multi-disciplinary involvement in case conferences and care planning, and improved staff attitudes and capabilities for dementia palliative care. Key factors influencing implementation included: staffing levels and time; support from management, staff and physicians; and positive family feedback.
Conclusion:
The facilitated approach explored in this study addressed known barriers to case conferencing. However, current business models in the sector make it difficult for case conferencing to receive the required levels of nursing qualification, training, and time. A collaborative nursing home culture and ongoing relationships with health professionals are also prerequisites for success. Further studies should document resident and family perceptions to harness consumer advocacy.
In North America, terrestrial records of biodiversity and climate change that span Marine Oxygen Isotope Stage (MIS) 5 are rare. Where found, they provide insight into how the coupling of the ocean–atmosphere system is manifested in biotic and environmental records and how the biosphere responds to climate change. In 2010–2011, construction at Ziegler Reservoir near Snowmass Village, Colorado (USA) revealed a nearly continuous, lacustrine/wetland sedimentary sequence that preserved evidence of past plant communities between ~140 and 55 ka, including all of MIS 5. At an elevation of 2705 m, the Ziegler Reservoir fossil site also contained thousands of well-preserved bones of late Pleistocene megafauna, including mastodons, mammoths, ground sloths, horses, camels, deer, bison, black bear, coyotes, and bighorn sheep. In addition, the site contained more than 26,000 bones from at least 30 species of small animals including salamanders, otters, muskrats, minks, rabbits, beavers, frogs, lizards, snakes, fish, and birds. The combination of macro- and micro-vertebrates, invertebrates, terrestrial and aquatic plant macrofossils, a detailed pollen record, and a robust, directly dated stratigraphic framework shows that high-elevation ecosystems in the Rocky Mountains of Colorado are climatically sensitive and varied dramatically throughout MIS 5.