Decreasing Blood Culture Contamination Rates in the Emergency Department

Introduction: Blood cultures (BCs) are a vital diagnostic tool for sepsis in patients with a suspected infection. Emergency departments are the primary place where BCs are drawn, but the BC contamination rates in emergency departments are the highest and most varied in healthcare. This project’s goal was to decrease the BC contamination rate below 3% (the national benchmark for BC contamination) in an ED in the Southeastern region through the implementation of a blood culture collection toolkit. Methods: The best practices for reducing the BC contamination rate in the emergency department was determined through a thorough literature review. A cost-effective, evidence-based plan was formed to utilize emergency department resources more effectively to decrease the BC contamination rate. The BC toolkit consisted of nursing education on proper BC collection, monthly aggregate level feedback in the ED, and packaged BC collection kit. Results: The monthly contamination rates were 3.6%, 1,7%, and 2.1% respectively during the 3-month implementation of the project. This emergency department had not had two consecutive months with contamination rates less than 3% in 3 years prior to this project. When compared to the corresponding 3 months from the previous year, there was a statistically significant decrease in the BC contamination rates during implementation. There was a clinically significant decrease in the BC contamination rates when compared to the 3 months immediately before implementation. Discussion: As evidenced by the results of this project, emergency departments can decrease BC contamination rates to meet the national benchmark of 3% through a well-structured strategy. Further, this can be accomplished at no additional cost to the emergency department. The cost-effective nature of this project combined with a strong sense of teamwork will lead to sustainable change in emergency departments to consistently improve the quality of care given to patients

Electric-field driven insulating to conducting transition in a mesoscopic quantum dot lattice

We investigate electron transport through a finite two dimensional mesoscopic periodic potential, consisting of an array of lateral quantum dots with electron density controlled by a global top gate. We observe a transition from an insulating state at low bias voltages to a conducting state at high bias voltages. The insulating state shows simply activated temperature dependence, with strongly gate voltage dependent activation energy. At low temperatures the transition between the insulating and conducting states becomes very abrupt and shows strong hysteresis. The high-bias behavior suggests underdamped transport through a periodic washboard potential resulting from collective motion.Comment: 4 pages, 4 figure

Towards the Avoidance of Counterfeit Memory: Identifying the DRAM Origin

Due to the globalization in the semiconductor supply chain, counterfeit dynamic random-access memory (DRAM) chips/modules have been spreading worldwide at an alarming rate. Deploying counterfeit DRAM modules into an electronic system can have severe consequences on security and reliability domains because of their sub-standard quality, poor performance, and shorter life span. Besides, studies suggest that a counterfeit DRAM can be more vulnerable to sophisticated attacks. However, detecting counterfeit DRAMs is very challenging because of their nature and ability to pass the initial testing. In this paper, we propose a technique to identify the DRAM origin (i.e., the origin of the manufacturer and the specification of individual DRAM) to detect and prevent counterfeit DRAM modules. A silicon evaluation shows that the proposed method reliably identifies off-the-shelf DRAM modules from three major manufacturers

Evolutionary Signatures in the Formation of Low-Mass Protostars. II. Towards Reconciling Models and Observations

A long-standing problem in low-mass star formation is the "luminosity problem," whereby protostars are underluminous compared to the accretion luminosity expected both from theoretical collapse calculations and arguments based on the minimum accretion rate necessary to form a star within the embedded phase duration. Motivated by this luminosity problem, we present a set of evolutionary models describing the collapse of low-mass, dense cores into protostars, using the Young & Evans (2005) model as our starting point. We calculate the radiative transfer of the collapsing cores throughout the full duration of the collapse in two dimensions. From the resulting spectral energy distributions, we calculate standard observational signatures to directly compare to observations. We incorporate several modifications and additions to the original Young & Evans model in an effort to better match observations with model predictions. We find that scattering, 2-D geometry, mass-loss, and outflow cavities all affect the model predictions, as expected, but none resolve the luminosity problem. A cycle of episodic mass accretion, however, can resolve this problem and bring the model predictions into better agreement with observations. Standard assumptions about the interplay between mass accretion and mass loss in our model give star formation efficiencies consistent with recent observations that compare the core mass function (CMF) and stellar initial mass function (IMF). The combination of outflow cavities and episodic mass accretion reduce the connection between observational Class and physical Stage to the point where neither of the two common observational signatures (bolometric temperature and ratio of bolometric to submillimeter luminosity) can be considered reliable indicators of physical Stage.Comment: 27 pages. Accepted for publication in Ap

The Spatial Distribution of Star Formation in the Solar Neighbourhood: Do all stars form in clusters?

We present a global study of low mass, young stellar object (YSO) surface densities in nearby (< 500 pc) star forming regions based on a comprehensive collection of Spitzer Space Telescope surveys. We show that the distribution of YSO surface densities in the solar neighbourhood is a smooth distribution, being adequately described by a lognormal function from a few to 10^3 YSOs per pc^2, with a peak at 22 stars/pc^2 and a dispersion of 0.85. We do not find evidence for multiple discrete modes of star-formation (e.g. clustered and distributed). Comparing the observed surface density distribution to previously reported surface density threshold definitions of clusters, we find that the fraction of stars in clusters is crucially dependent on the adopted definitions, ranging from 40 to 90%. However, we find that only a low fraction (< 26%) of stars are formed in dense environments where their formation/evolution (along with their circumstellar disks and/or planets) may be affected by the close proximity of their low-mass neighbours.Comment: 6 pages, 2 figures, MNRAS letters, accepte

Ecology of Feral Pigeons: Population Monitoring, Resource Selection, and Management Practices

Feral pigeons (Columba livia) are typically ignored by ornithologists but can be found roosting in the thousands within cities across the world. Pigeons have been known to spread zoonoses, through ectoparasites and excrement they produce. Along with disease, feral pigeons have an economic impact due to the cost of cleanup and maintenance of human infrastructure. Many organizations have tried to decrease pigeon abundances through euthanasia or use of chemicals that decrease reproductive output. However, killing pigeons has been unsuccessful in decreasing abundance, and chemical inhibition can be expensive and must be used throughout the year. A case study at Texas Tech University has found that populations fluctuate throughout the year, making it difficult to manage numbers. To successfully decrease populations, it is important to have a multifaceted approach that includes removing necessary resources (i. e. nest sites and roosting areas) and decreasing the number of offspring through humane techniques

TEF, Vol. 1 No. 1

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