Nursing Compliance with VAP Bundle

It has been proposed that by initiating the highest percentages of nursing compliance, overall patient outcomes will improve along with a decrease in the number of ventilator-associated events (VAEs). The aim of the study is to appraise the association between nursing compliance with a ventilator bundle and a successful decline in the number of events of ventilator-associated pneumonia (VAP) in the intensive care unit (ICU). The study also provides evidence-based direction on the best nursing practices essential to reducing the rates of VAP. Objectives include expanding the awareness of critical care staff on prevention and compliance and to improve teamwork and collaborative efforts among the healthcare team. This creates conditions promising to patients beginning with the delivery of safe and effective nursing care

Identification of a resilient mouse facial motoneuron population following target disconnection by injury or disease

Background: When nerve transection is performed on adult rodents, a substantial population of neurons survives short-term disconnection from target, and the immune system supports this neuronal survival, however long-term survival remains unknown. Understanding the effects of permanent axotomy on cell body survival is important as target disconnection is the first pathological occurrence in fatal motoneuron diseases such as amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA). Objective: The goal of this study was to determine if facial motoneurons (FMN) could survive permanent target disconnection up to 26 weeks post-operation (wpo) after facial nerve axotomy (FNA). In addition, the potentially additive effects of immunodeficiency and motoneuron disease on post-axotomy FMN survival were examined. Methods: This study included three wild type (WT) mouse strains (C57BL/6J, B6SJL, and FVB/NJ) and three experimental models (RAG-2-/-: immunodeficiency; mSOD1: ALS; Smn-/-/SMN2+/+: SMA). All animals received a unilateral FNA, and FMN survival was quantified at early and extended post-operative timepoints. Results: In the C57BL/6J WT group, FMN survival significantly decreased at 10 wpo (55 ± 6%), and then remained stable out to 26 wpo (47 ± 6%). In the RAG-2-/- and mSOD1 groups, FMN death occurred much earlier at 4 wpo, and survival plateaued at approximately 50% at 10 wpo. The SMA model and other WT strains also exhibited approximately 50% FMN survival after FNA. Conclusion: These results indicate that immunodeficiency and motoneuron disease accelerate axotomy-induced neuron death, but do not increase total neuron death in the context of permanent target disconnection. This consistent finding of a target disconnection-resilient motoneuron population is prevalent in other peripheral nerve injury models and in neurodegenerative disease models as well. Characterization of the distinct populations of vulnerable and resilient motoneurons may reveal new therapeutic approaches for injury and disease

The 5-year Spam: Tracking a Persistent Chinese Influence Operation

This report analyzes the behavior of a single, coordinated inauthentic information operator working within China and in the interests of the Chinese government. This operator has been called by different names by different analysts, including “Spamouflage Dragon“ (by the network analysis firm Graphika) and “Dragonbridge” (by the Google owned cybersecurity firm Mandiant) and has been operating continuously since, at least, April 2017. In this report we will refer to this actor as Dragonbridge. Section II of this report gives an update on several campaign this actor has engaged in recent months. Section III presents a synthetic overview of some of Dragonbridge’s past and ongoing tactics and targets. Section IV draws some more general lessons about how this actor operates

A Comparison of Water Vapor Line Parameters for Modeling the Venus Deep Atmosphere

The discovery of the near infrared windows into the Venus deep atmosphere has enabled the use of remote sensing techniques to study the composition of the Venus atmosphere below the clouds. In particular, water vapor absorption lines can be observed in a number of the near-infrared windows allowing measurement of the H2O abundance at several different levels in the lower atmosphere. Accurate determination of the abundance requires a good database of spectral line parameters for the H2O absorption lines at the high temperatures (up to ~700 K) encountered in the Venus deep atmosphere. This paper presents a comparison of a number of H2O line lists that have been, or that could potentially be used, to analyze Venus deep atmosphere water abundances and shows that there are substantial discrepancies between them. For example, the early high-temperature list used by Meadows and Crisp (1996) had large systematic errors in line intensities. When these are corrected for using the more recent high-temperature BT2 list of Barber et al. (2006) their value of 45+/-10 ppm for the water vapor mixing ratio reduces to 27+/-6 ppm. The HITRAN and GEISA lists used for most other studies of Venus are deficient in "hot" lines that become important in the Venus deep atmosphere and also show evidence of systematic errors in line intensities, particularly for the 8000 to 9500 cm-1 region that includes the 1.18 um window. Water vapor mixing ratios derived from these lists may also be somewhat overestimated. The BT2 line list is recommended as being the most complete and accurate current representation of the H2O spectrum at Venus temperatures.Comment: 42 pages, 11 figures, Accepted by Icaru

Where do we go from here? - Opportunities and barriers to the career development of trial managers: a survey of UK-based trial management professionals

BackgroundClinical trials commonly have a dedicated trial manager and effective trial management is essential to the successful delivery of high-quality trials. Trial managers have diverse experience and currently there is no standardised structured career pathway. The UK Trial Managers’ Network (UKTMN) surveyed its members to understand what is important to them with respect to career development since this would be important in the development of any initiative intended to develop a skilled workforce.MethodsWe conducted an online survey of UKTMN members, who are trial management professionals, working on academic-led trials in the UK. Members were asked what they perceive as opportunities and barriers to career development. Two reminders were sent to facilitate completion of the survey, and responders were offered the opportunity to enter a prize draw for waived fees at the UKTMN annual meeting. Data were analysed descriptively by using Stata (version 15.1), and free-text responses were reviewed for themes.ResultsThe survey was sent to 819 UKTMN members; 433 responses were received, although 13 were from non-UKTMN members; thus 420 respondents' data were included in analyses. Respondents were representative of UKTMN membership; however, more responses were received by trial managers based in registered clinical trials units (CTUs). The top three opportunities for career development were (i) training, (ii) helping design trials and (iii) undertaking relevant qualifications. The top three barriers were (i) funding, (ii) few opportunities to get involved in development activities aside from managing a trial and (iii) unclear organisational career pathway. Almost all respondents (401/420, 95.4%) considered career development either very or quite important. Although all respondents had a day-to-day role in managing trials, there was huge disparity between job titles.ConclusionCareer development is important to trial managers yet there is a lack of a structured pathway. The enablers and disablers to career development for trial managers should be clearly considered by the clinical trial community and, in particular, employers, sponsors and funders in order to develop a highly skilled workforce of trial managers, who are key to the delivery of trials

The incidence of scarring on the dorsum of the hand

When undertaking image comparison of the hand between accused and perpetrator, it is not unusual for scars to be identified on the back of the hand. To investigate the occurrence of scarring in a discreet sample, a database of 238 individuals was examined, and the dorsum of the right and left hands was gridded for each individual. The position, size and type of scar were recorded within each grid. It was found that, in general, males exhibited a higher incidence of scarring than females. However, males were more likely to show scarring on their left hand whereas females were more likely to exhibit scarring on their right hand. Contrary to the literature, scarring was not most prevalent along the borders of the hand but occurred more frequently in association with the index and middle finger corridor regions. Surgical scars were rare as were large scars whereas linear scars smaller than 6 mm were the most frequently identified. Close to half of the sample did not exhibit scarring on one hand. The importance of understanding the pattern of scarring on the back of the hand is discussed in the light of forensic image comparison analysis