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Background Wound classification scores are used to categorize the risk of postoperative infections. It was noted at our academic institution that wound classifications were often inaccurately recorded in the electronic health record. We thus instituted a quality improvement program, hypothesizing that this would improve charting accuracy. Methods On June 1, 2019, we posted the wound classifications in each pediatric operating room (OR), provided OR nurses with teaching, and began including the classification in the postoperative surgeon debriefing. We performed a retrospective chart review of all general pediatric operations from June 19 to December 19 to compare classifications recorded in the electronic health record to the "correct" classification determined by manual review of operating reports. These data were compared with a similar chart review from 2018. To compare the efficacy of nursing versus physician focused changes, we compared our appendectomy data with a nearby community institution where the same group of surgeons practice. Pearson's Chi-squared test was used to report the significance of the differences observed in the concordance proportion, with 95% confidence intervals calculated using the Clopper-Pearson procedure. Results Overall, 444 pre- and 179 postpractice change charts were reviewed. There were no significant differences pre or postpractice change. At the community institution, we noted a significant improvement in charting accuracy for appendectomies from 3.33% to 44.83%. Discussion Despite implementing nursing and physician focused quality improvement practices, there was not a significant improvement in charting accuracy at the academic institution. However, we did note an improvement at the community facility where our pediatric surgeons also practice. We thus suspect that our nursing focused changes may have been inadequate. Future efforts will focus on providing intensive and sustained OR nurse training to help improve the wound classification charting accuracy.

This paper examines how real-time force monitoring keeps operations on path by decreasing operational failures (such as stuck or parted pipe), reducing non-productive time (NPT), and increasing drillout efficiency (hour/plug). Utilizing interactive tubing force analysis (TFA) models with real-time data overlays provides coiled tubing operators with the data needed to reduce stuck pipe events, increase drillout efficiencies, and decrease mechanical failures (both on the surface and downhole). The key to optimizing efficiencies is maintaining consistent data that can be analyzed with the TFA. One current challenge is that analyzed data can only affect future operations if engineering controls are executed in the field. By using the interactive TFA and real-time operational data synchronously, users can positively impact their current and future operations by using data-driven decisions instead of predetermined processes. By implementing a cloud-based application in conjunction with software that acquires and stores field data, one field-based end user recognized real-time divergence from the modeled parameters. This is a key indicator of potential failures. The application allows for on-the-fly procedural corrections (such as stop and circulate) to alleviate operational risk for stuck pipe instances. In one case, the application indicated forewarned risk while running in hole that would have saved the service company and Exploration and Production (E&P) company more than 48 hours in NPT. Having cloud-connected software with pre-defined warnings provides the field, management, and engineering staff with real-time access to the same data, allowing quick and inclusive decisions to be made prior to potential failures. Without this implementation, only post-job analysis would have revealed the divergence of the field data from the predictive data. The live feed of operational data provided by the application prevented stuck pipe scenarios when well conditions changed. Personnel could not have made this prediction if the coiled tubing (CT) operator was relying solely on the pre-defined job scope and pre-job planning procedures. This paper expands on previous documentation where the TFA and real-time data were manually overlaid to significantly reduce an E&P's risk. This novel refinement of technology coalesces essential information to create a holistic view of operations thereby preventing issues rather than analyzing them after the fact.

In modern ooid-forming environments in the Caribbean, aerobic respiration of organic matter below the sediment–water interface drives an increase in pCO2 and a corresponding decrease in carbonate saturation state (Ω) that creates shallow sediment porewater that is neutral or slightly caustic to carbonate. The locus of ooid growth, therefore, is presumed to be in the water column during suspension, where supersaturation with respect to calcium carbonate is the norm. In the past, however, during conditions of low aqueous O2, high Ω, or low organic-matter input, the shallow sub-sediment marine burial environment was conducive to carbonate precipitation. Here we present petrographic and electron probe microanalyzer (EPMA) data from exquisitely preserved oolites through time that suggests that some ancient ooids may have grown within the sediment pile. We propose that each increment of ooid cortical growth originated as incipient isopachous marine cement formed during shallow burial within migrating ooid dunes. After a period of burial (∼ weeks to months), ooids were remobilized and rounded during bedload transport. This “bedform model” for ooid growth explains: 1) why ancient ooids are not limited by the precipitation–abrasion balance that appears to prohibit modern tangential Caribbean ooids from achieving grain sizes larger than coarse sand, 2) the radial crystal fabric that defines the internal structure of many ancient ooids, and 3) the first-order correlation of the abundance of large and giant ooids in the rock record to periods with predicted high porewater Ω. This model implies that photosynthetic microbes were unimportant for growth of large and giant ooid but it remains agnostic to the effect of other microbes. The physical and chemical milieu of modern marine ooid-forming environments is perhaps not the best analogue for ancient ooid-forming environments; this should be considered when using ancient ooids to reconstruct secular trends in ocean chemistry.

Introduction College students often struggle to adjust to the demanding nature of college life, which can translate to decreased overall health and poor sleep. Healthy sleep practices are important for obtaining good sleep quality and quantity, leading to optimal cognitive performance. Interventions, including educational approaches to improve sleep in college students, may lead to better concentration, memory retention, and subsequent academic performance. The focus of the current study was to examine habitual sleep habits in college students, provide a brief educational intervention, and investigate potential changes in sleep and cognition. Methods Participants included 14 undergraduate students (6 men, average age M=20.64 years, SD=2.13) who wore wrist actigraphs to measure their typical sleep habits. After one week, participants completed questionnaires about sleep (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Epworth Sleepiness Scale, ESS), and fatigue (Multidimensional Assessment of Fatigue Scale, MAF). Participants also completed cognitive tests (Stroop, Digit Span, and Simple Reaction Time). Subjects participated in a short lecture about healthy sleep hygiene habits and the importance of sleep and then repeated the one-week observational study. Results Paired sample t-tests revealed a significant increase from baseline average sleep duration (M=5.83 hours) to post-intervention sleep duration (6.64 hours; t(13)=-2.532, p=.013). Sleep efficiency (actigraphy) and quality (PSQI) did not improve significantly. ESS scores decreased significantly (t(13)=3.76, p=.002 (pre M=9.29; post M=5.43) and MAF scores decreased significantly (t(13)=2.19, p=.047 (pre M=20.48; post M=15.60). A difference in reaction times for Stroop incongruent prompts approached significance (p=.083, pre M=979.46; post M=884.70), but no differences were found for errors, Digit Span, or Simple Reaction Times. Conclusion The results of this study suggest that one educational lecture about sleep hygiene may be a start to improving sleep in college students. Even a 48-minute increase resulted in decreased sleepiness and fatigue. However, no improvements were found in sleep quality or efficiency. Although a slight improvement was found in reaction time, no other cognitive benefits were noted. More research should be conducted on how to improve sleep habits in college students beyond an educational approach. Support (If Any) None.

Introduction Typically, college students practice unhealthy sleep hygiene behaviors, obtain too little sleep, and experience poor sleep quality. Sleep hygiene includes the routines or practices that prepare a person for the best possible night of sleep. Good sleep hygiene habits, like creating a sleep-friendly environment and making time for sleep, promote healthy duration and quality of sleep. Stress is also an important factor to consider during the college experience. Sleep and mental health are tightly connected, and stress can negatively impact the sleep and mental health of individuals. The focus of the current study was to examine habitual sleep habits in college students, in association with sleep quality and psychological health. Methods Participants included 51 undergraduate students (18 men, average age M=20.25 years, SD=1.78) who wore wrist actigraphs to measure their typical sleep habits for one week. After one week, participants completed questionnaires about sleep quality (Pittsburgh Sleep Quality Index, PSQI) and sleep hygiene practices (Sleep Hygiene Index, SHI). Higher scores on PSQI represent poorer quality; higher scores on SHI represent unhealthy sleep hygiene behaviors. Mental health symptoms were measured by the Depression, Anxiety, and Stress Scale (DASS-21). Results Overall sleep duration was 6.59 hours and sleep efficiency was 82.55% as measured by actigraphy. PSQI scores (M=6.86) demonstrated poor sleep quality and SHI scores (M= 24.80) indicated overall poor sleep hygiene practices. SHI scores predicted higher PSQI scores (F(1, 50) = 18.05, p Conclusion As expected, college students’ sleep was short in duration, poor in efficiency, and poor in quality. Additionally, poor sleep hygiene practices predicted poorer sleep quality. Interestingly, scores that indicated worse depression, anxiety, and stress predicted poorer sleep hygiene practices, suggesting that mental health may contribute to healthy sleep practices. More research is needed to understand the complex relationship between mental health, sleep, and healthy sleep practices Support (If Any) None.

Introduction College students tend to struggle with managing healthy sleep habits; these unhealthy behaviors can lead to poor sleep and impact their overall mental and physical health. More specifically, sleep is intimately connected to psychological and physiological factors such as anxiety, depression, and blood pressure. The focus of the current study was to examine habitual sleep habits in college students, provide a brief educational intervention, and investigate potential changes in psychological and physiological health. Methods Participants included 14 undergraduate students (6 men, average age M=20.64 years, SD=2.13) who wore wrist actigraphs to measure their typical sleep habits. After one week, participants completed questionnaires about sleep (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Epworth Sleepiness Scale, ESS), fatigue (Multidimensional Assessment of Fatigue Scale, MAF), and psychological symptoms (i.e., depression, anxiety, and stress; Depression Anxiety Stress Scales, DASS-21). Blood pressure and heart rate were measured using a wrist device. Subjects participated in a short lecture about healthy sleep hygiene habits and the importance of sleep and then repeated the one-week observational study. Results Paired sample t-tests revealed a significant increase from baseline average sleep duration (M=5.83 hours) to post-intervention sleep duration (6.64 hours; t(13)=-2.532, p=.013). Sleep efficiency (actigraphy) and quality (PSQI) did not improve significantly. ESS scores decreased significantly (t(13)=3.76, p=.002 (pre M=9.29; post M=5.43) and MAF scores decreased significantly (t(13)=2.19, p=.047 (pre M=20.48; post M=15.60). No significant differences were found in depressive, anxiety, or stress symptoms when comparing DASS-21 scores pre- vs post-intervention. Baseline systolic blood pressure (M=114.88) significantly decreased compared to post-intervention recordings (M=108.21). Diastolic blood pressure and heart rate did not differ significantly. Conclusion The results of this study suggest that one educational lecture about sleep hygiene may be a start to improving sleep in college students. Even a 48-minute increase resulted in decreased sleepiness and fatigue. However, no improvements were found in sleep quality or efficiency. Although a slight improvement was found in systolic blood pressure, no other physiological or psychological benefits were noted. More research should be conducted on how to improve sleep habits in college students beyond an educational approach. Support (If Any) None.

Increased use and improved methodology of carbonate clumped isotope thermometry has greatly enhanced our ability to interrogate a suite of Earth‐system processes. However, interlaboratory discrepancies in quantifying carbonate clumped isotope (Δ47) measurements persist, and their specific sources remain unclear. To address interlaboratory differences, we first provide consensus values from the clumped isotope community for four carbonate standards relative to heated and equilibrated gases with 1,819 individual analyses from 10 laboratories. Then we analyzed the four carbonate standards along with three additional standards, spanning a broad range of δ47 and Δ47 values, for a total of 5,329 analyses on 25 individual mass spectrometers from 22 different laboratories. Treating three of the materials as known standards and the other four as unknowns, we find that the use of carbonate reference materials is a robust method for standardization that yields interlaboratory discrepancies entirely consistent with intralaboratory analytical uncertainties. Carbonate reference materials, along with measurement and data processing practices described herein, provide the carbonate clumped isotope community with a robust approach to achieve interlaboratory agreement as we continue to use and improve this powerful geochemical tool. We propose that carbonate clumped isotope data normalized to the carbonate reference materials described in this publication should be reported as Δ47 (I‐CDES) values for Intercarb‐Carbon Dioxide Equilibrium Scale., Key Points The exclusive use of carbonate reference materials is a robust method for the standardization of clumped isotope measurementsMeasurements using different acid temperatures, designs of preparation lines, and mass spectrometers are statistically indistinguishableWe propose new consensus values for a set of seven carbonate reference materials and updated guidelines to report clumped isotope measurements

International audience; The potential for carbonate clumped isotope thermometry to independently constrain both the formation temperature of carbonate minerals and fluid oxygen isotope composition allows insight into long-standing questions in the Earth sciences, but remaining discrepancies between calibration schemes hamper interpretation of temperature measurements. To address discrepancies between calibrations, we designed and analyzed a sample suite (41 total samples) with broad applicability across the geosciences, with an exceptionally wide range of formation temperatures, precipitation methods, and mineralogies. We see no statistically significant offset between sample types, although the comparison of calcite and dolomite remains inconclusive. When data are reduced identically, the regression defined by this study is nearly identical to that defined by four previous calibration studies that used carbonate-based standardization; we combine these data to present a composite carbonate-standardized regression equation. Agreement across a wide range of temperature and sample types demonstrates a unified, broadly applicable clumped isotope thermometer calibration.