Diagnostic stewardship of urine cultures is a recognized tool for CAUTI prevention, yet few diagnostic algorithms have been validated. This study of a novel diagnostic CAUTI algorithm showed a significant and durable improvement in urine culturing, catheter exchange, and CAUTI rate, supporting this algorithm as an effective diagnostic stewardship tool.

Kinship can be difficult to discern in the archaeological record, but the study of ancient DNA offers a useful window into one form of kinship: biological relatedness. Here, the authors explore possible kin connections at the post-Roman site of Worth Matravers in south-west England. They find that, while clusters of genetically related individuals are apparent, the inclusion of unrelated individuals in double or triple burials demonstrates an element of social kinship in burial location. Some individuals also carried genetic signatures of continental ancestry, with one young male revealing recent West African ancestry, highlighting the diverse heritage of early medieval Britain.

Ice shelves affect the stability of ice sheets by supporting the mass balance of ice upstream of the grounding line. Marine ice, formed from supercooled water freezing at the base of ice shelves, contributes to mass gain and affects ice dynamics. Direct measurements of marine ice thickness are rare due to the challenges of borehole drilling. Here we assume hydrostatic equilibrium to estimate marine ice distribution beneath the Amery Ice Shelf (AIS) using meteoric ice-thickness data obtained from radio-echo sounding collected during the Chinese National Antarctic Research Expedition between 2015 and 2019. This is the first mapping of marine ice beneath the AIS in nearly 20 years. Our new estimates of marine ice along two longitudinal bands beneath the northwest AIS are spatially consistent with earlier work but thicker. We also find a marine ice layer exceeding 30 m of thickness in the central ice shelf and patchy refreezing downstream of the grounding line. Thickness differences from prior results may indicate time-variation in basal melting and freezing patterns driven by polynya activity and coastal water intrusions masses under the ice shelf, highlighting that those changes in ice–ocean interaction are impacting ice-shelf stability.

A major subglacial lake, Lake Snow Eagle (LSE), was identified in East Antarctica by airborne geophysical surveys. LSE, contained within a subglacial canyon, likely hosts a valuable sediment record of the geological and glaciological changes of interior East Antarctica. Understanding past lake activity is crucial for interpreting this record. Here, we present the englacial radiostratigraphy in the LSE area mapped by airborne ice-penetrating radar, which reveals a localized high-amplitude variation in ice unit thickness that is estimated to be ∼12 ka old. Using an ice-flow model that simulates englacial stratigraphy, we investigate the origin of this feature and its relationship to changes in ice dynamical boundary conditions. Our results reveal that local snowfall redistribution initiated around the early Holocene is likely the primary cause, resulting from a short-wavelength (∼10 km) high-amplitude (∼20 m) ice surface slope variation caused by basal lubrication over a large subglacial lake. This finding indicates an increase in LSE water volume during the Holocene, illustrating the sensitivity in volume of a major topographically constrained subglacial lake across a single glacial cycle. This study demonstrates how englacial stratigraphy can provide valuable insight into subglacial hydrological changes before modern satellite observations, both for LSE and potentially at other locations.

The Arctic is at the forefront of climate change, undergoing some of the most rapid environmental transformations globally. Here, we examine the impacts of climate change on the livelihoods in the coastal Inuit community of Hopedale, Nunatsiavut, Canada. The study examines recently evolved adaptation strategies employed by Inuit and the challenges to these adaptations. We document changing sea ice patterns, changing weather patterns and the impact of invasive species on food resources and the environment. Utilising knowledge co-production and drawing upon Indigenous knowledge, we monitor the changes and multiple stresses through direct observations, engagement with rights holders and community experiences to characterise climate risks and associated changes affecting livelihoods. We use both decolonising research and participatory methodologies to develop collaboration and partnership, ensuring that monitoring reflects local priorities and realities while also fostering trust and collaboration. We showcase that monitoring environmental trends involves more than data collection; it includes observing and analysing how environmental changes affect community well-being, particularly in terms of food security, cultural practices, economic activities, mental health, sea ice changes and weather patterns. The paper contributes to a nuanced understanding of Inuit resilience and experiences in confronting climate risks and the broader implications for Indigenous communities confronting climate challenges.

An array of information about the Antarctic ice sheet can be extracted from ice-sheet internal architecture imaged by airborne ice-penetrating radar surveys. We identify, trace and date three key internal reflection horizons (IRHs) across multiple radar surveys from South Pole to Dome A, East Antarctica. Ages of ~38 ± 2.2, ~90 ± 3.6 and ~162 ± 6.7 ka are assigned to the three IRHs, with verification of the upper IRH age from the South Pole ice core. The resultant englacial stratigraphy is used to identify the locations of the oldest ice, specifically in the upper Byrd Glacier catchment and the Gamburtsev Subglacial Mountains. The distinct glaciological conditions of the Gamburtsev Mountains, including slower ice flow, low geothermal heat flux and frozen base, make it the more likely to host the oldest ice. We also observe a distinct drawdown of IRH geometry around South Pole, indicative of melting from enhanced geothermal heat flux or the removal of deeper, older ice under a previous faster ice flow regime. Our traced IRHs underpin the wider objective to develop a continental-scale database of IRHs which will constrain and validate future ice-sheet modelling and the history of the Antarctic ice sheet.

The coronavirus disease 2019 (COVID-19) pandemic highlighted the lack of agreement regarding the definition of aerosol-generating procedures and potential risk to healthcare personnel. We convened a group of Massachusetts healthcare epidemiologists to develop consensus through expert opinion in an area where broader guidance was lacking at the time.

The Ediacaran rangeomorph Fractofusus misrai is the most common and best-preserved of the E Surface fossil assemblage in the Mistaken Point Ecological Reserve of southeastern Newfoundland, Canada. Fractofusus has been interpreted as a fusiform epifaunal soft-sediment recliner, and like other rangeomorphs it has a self-similar, fractal-like branching morphology. The rangeomorph branching of Fractofusus has been considered to be identical on the upper and lower surfaces; however, study of specimens with complex biostratinomic histories suggests clear differences between the upper and lower surfaces. The first-order branches grew downwards into the sediment from a high point near the midline but grew above the sediment–water interface at their lateral and distal margins. Our new three-dimensional appreciation of rangeomorph branching in Fractofusus explains many of the taphomorphs of Fractofusus including straight, curved, kinked and tousled forms. The three-dimensional morphology, mode of life, taphonomy and palaeoenvironmental interactions of F. misrai are discussed along with a new three-dimensional reconstruction.

Artifacts, including ceramics, ground stone, and soil samples, as well as dental calculus, recovered from sites in the eastern North American central Plains were submitted to multiple laboratories for analysis of microbotanical remains. Direct accelerator mass spectrometer (AMS) dates of 361–197 cal BC provide evidence for the earliest use of maize (Zea mays ssp. mays) in this region. Squash (Cucurbita sp.), wild rice (cf. Zizania spp.), and palm (Arecaceae sp.) microremains were also found. This research adds to the growing evidence of the importance of microbotanical analysis in documenting plant use and in the identification of early maize. The combined data on early maize from the eastern Plains adds to our understanding of the timing and dispersal of this crop out of the American Southwest. Alternative explanations for the adoption and early use of maize by eastern central Plains communities include its value as a secondary resource, as an addition to an existing farming strategy, or as a component of Middle Woodland rituals.

Subglacial hydrology modulates basal motion but remains poorly constrained, particularly for soft-bedded Greenlandic outlet glaciers. Here, we report detailed measurements of the response of subglacial water pressure to the connection and drainage of adjacent water-filled boreholes drilled through kilometre-thick ice on Sermeq Kujalleq (Store Glacier). These measurements provide evidence for gap opening at the ice-sediment interface, Darcian flow through the sediment layer, and the forcing of water pressure in hydraulically-isolated cavities by stress transfer. We observed a small pressure drop followed by a large pressure rise in response to the connection of an adjacent borehole, consistent with the propagation of a flexural wave within the ice and underlying deformable sediment. We interpret the delayed pressure rise as evidence of no pre-existing conduit and the progressive decrease in hydraulic transmissivity as the closure of a narrow (< 1.5 mm) gap opened at the ice-sediment interface, and a reversion to Darcian flow through the sediment layer with a hydraulic conductivity of ≤ 10−6 m s−1. We suggest that gap opening at the ice-sediment interface deserves further attention as it will occur naturally in response to the rapid pressurisation of water at the bed.

In an attempt to respond to recent calls for better understanding the coexistence of multiple business models, we develop the concept of ‘multidexterity’ – the ability to develop, nurture, and execute several distinctive BM strategies simultaneously across different levels and functions of the MNC and its host markets. To illustrate this approach, we describe a European healthcare firm entering the rapidly transforming economy of China and facing regulatory constraints and ambiguities in the application of industry standards. This situation is a generic challenge for MNCs entering rapidly transforming economies, which they help in turn to substantially alter and develop. We argue multidextrous business models are effective entry strategies for MNCs. They also help resolve two conceptual limitations in the BMI literature: (1) the problem of environmental contingencies and (2) the interrelatedness of factors at the macro, meso, and micro levels. We address these problems from a practice approach. We provide some implications for the concept of multidexterity and business models and address managerial challenges and prospects in developing multidextrous organizations.

Beothukis mistakensis from the Ediacaran System of Newfoundland, Canada demonstrates complex fractal-like morphology through the development of primary-, secondary- and tertiary-order Rangea-like units. The primary-order rangeomorph units observed in B. mistakensis are tightly juxtaposed, show no evidence of being independent of one another and are made up of chamber-like secondary-order – probably mesoglea-filled – units. The growth of these rangeomorph units demonstrates that the frond developed from the tip towards the basal region through ontogeny. The tertiary-order units of Beothukis are considered to represent surface morphology on the secondary-order units. This is in contrast to palaeobiological reconstructions of Beothukis that invoke three-dimensional fractal-like branches with independent units, which has been used to infer an osmotrophic mode of life. It is considered here that the fractal-like morphology of the lower surface of B. mistakensis was an adaptation to increase surface area to volume ratio. The quilted morphology of Beothukis proposed here is consistent with a sessile, reclining, phagocytotic and/or chemosymbiotic mode of life similar to that invoked for the reclining rangeomorph Fractofusus.

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.

Several aspects of mother–child relationships are associated with children's internalizing problems. We examined longitudinal associations between mother–child conflict and children's internalizing problems in middle childhood. Specifically, we examined whether conflict and children's internalizing problems predict each other longitudinally in a sample of children from 3rd through 6th grade (N = 1,364) and their mothers using a cross-lagged panel model with random intercepts. In line with expectations, we found stable between-family differences in both mother–child conflict and children's internalizing problems. Contrary to expectations, we did not find that mother–child conflict and children's internalizing problems showed significant cross-lagged associations. However, mother–child conflict and children's internalizing problems had correlated errors at each wave, indicating that these two constructs covary with each other concurrently at multiple times across development, independent of stable between-family associations (i.e., as one increases, so does the other, and vice versa). The results of this study point to the importance of using statistical approaches that can disentangle between-family differences from within-family processes. In future studies, shorter time scales (e.g., weeks or months) may better capture dynamic associations between parent–child conflict and internalizing problems.

Whether monozygotic (MZ) and dizygotic (DZ) twins differ from each other in a variety of phenotypes is important for genetic twin modeling and for inferences made from twin studies in general. We analyzed whether there were differences in individual, maternal and paternal education between MZ and DZ twins in a large pooled dataset. Information was gathered on individual education for 218,362 adult twins from 27 twin cohorts (53% females; 39% MZ twins), and on maternal and paternal education for 147,315 and 143,056 twins respectively, from 28 twin cohorts (52% females; 38% MZ twins). Together, we had information on individual or parental education from 42 twin cohorts representing 19 countries. The original education classifications were transformed to education years and analyzed using linear regression models. Overall, MZ males had 0.26 (95% CI [0.21, 0.31]) years and MZ females 0.17 (95% CI [0.12, 0.21]) years longer education than DZ twins. The zygosity difference became smaller in more recent birth cohorts for both males and females. Parental education was somewhat longer for fathers of DZ twins in cohorts born in 1990–1999 (0.16 years, 95% CI [0.08, 0.25]) and 2000 or later (0.11 years, 95% CI [0.00, 0.22]), compared with fathers of MZ twins. The results show that the years of both individual and parental education are largely similar in MZ and DZ twins. We suggest that the socio-economic differences between MZ and DZ twins are so small that inferences based upon genetic modeling of twin data are not affected.

On an 11 m firn/ice core from Kongsvegen, Svalbard, we have used dielectric profiling (DEP) to measure electrical properties, and digital photography to measure a core optical stratigraphy (COS) profile. We also used a neutron-scattering probe (NP) to measure a density profile in the borehole from which the core was extracted. The NP- and DEP-derived density profiles were similar, showing large-scale (>30 cm) variation in the gravimetric densities of each core section. Fine-scale features (<10 cm) are well characterized by the COS record and are seen at a slightly lower resolution in both the DEP and NP records, which show increasing smoothing. A combination of the density accuracy of NP and the spatial resolution of COS provides a useful method of evaluating the shallow-density profile of a glacier, improving paleoclimate interpretation, mass-balance measurement and interpretation of radar returns.

Satellite altimetric time series allow high-precision monitoring of ice-sheet mass balance. Understanding elevation changes in these regions is important because outlet glaciers along ice-sheet margins are critical in controlling flow of inland ice. Here we discuss a new airborne altimetry dataset collected as part of the ICECAP (International Collaborative Exploration of the Cryosphere by Airborne Profiling) project over East Antarctica. Using the ALAMO (Airborne Laser Altimeter with Mapping Optics) system of a scanning photon-counting lidar combined with a laser altimeter, we extend the 2003–09 surface elevation record of NASA’s ICESat satellite, by determining cross-track slope and thus independently correcting for ICESat’s cross-track pointing errors. In areas of high slope, cross-track errors result in measured elevation change that combines surface slope and the actual Δz/Δt signal. Slope corrections are particularly important in coastal ice streams, which often exhibit both rapidly changing elevations and high surface slopes. As a test case (assuming that surface slopes do not change significantly) we observe a lack of ice dynamic change at Cook Ice Shelf, while significant thinning occurred at Totten and Denman Glaciers during 2003–09.