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Safety and security operations at Appalachian State's Belk Library & Information Commons have evolved and improved over the past 15 years with a focused access services oriented team. Improvements have focused on the challenges posed in four primary areas: understanding the customer base and the challenges posed therein; improving the skills and expanding the pool of library personnel capable of handling security incidents; allowing effective outside security operations and personnel to improve over time; and acting on multiple access issues. The authors of this case study provide insight and recommendations on the challenges faced and actions taken. [ABSTRACT FROM AUTHOR]

In Part I of this observational study inquiring into the relative influences of “top down” synoptic atmospheric conditions and “bottom up” land surface mesoscale conditions in deep convection for the humid lowlands of the Midwest U.S. Central Corn Belt (CCB), the composite atmospheric environments for afternoon and evening periods of convection (CV) versus no convection (NC) were determined for two recent summers (1999 and 2000) having contrasting precipitation patterns and amounts. A close spatial correspondence was noted between composite synoptic features representing baroclinity and upward vertical motion with the observed precipitation on CV days when the “background” (i.e., free atmosphere) wind speed exceeded approximately 10 m s-1 at 500 hPa (i.e., “stronger flow”). However, on CV days when wind speeds were <∼10 m s-1 (i.e., “weaker flow”), areas of increased precipitation can be associated with synoptic composites that are not so different from those for corresponding NC days. From these observations, the presence of a land surface mesoscale influence on deep convection and precipitation is inferred that is better expressed on weaker flow days. Climatically, a likely candidate for enhancing low-level moisture convergence to promote deep convection are the quasi-permanent vegetation boundaries (QPVBs) between the two major land use and land cover (LULC) types of crop and forest that characterize much of the CCB. Accordingly, in this paper the role of these boundaries on summer precipitation variations for the CCB is extracted in two complementary ways: 1) for contrasting flow day types in the summers 1999 and 2000, by determining the spatially and temporally aggregated land surface influence on deep convection from composites of thermodynamic variables [e.g., surface lifted index (SLI), level of free convection (LFC), and lifted condensation level (LCL)] that are obtained from mapped data of the 6-h NCEP–NCAR reanalyses (NNR), and 0000 UTC rawinsonde ascents; and 2) for summer seasons 1995–2001, from the statistical associations of satellite-retrieved LULC boundary attributes (i.e., length and width) and precipitation at high spatial resolutions. For the 1999 and 2000 summers (item 1 above), thermodynamic composites determined for V(500) categories having minimal differences in synoptic meteorological fields on CV minus NC (CV - NC) days (i.e., weaker flow), show statistically significant increases in atmospheric moisture (e.g., greater precipitable water; lower LCL and LFC) and static instability [e.g., positive convective available potential energy (CAPE)] compared to NC days. Moreover, CV days for both weaker and stronger background flow have associated subregional-scale thermodynamic patterns indicating free convection at the earth’s surface, supported by a synoptic pattern of at least weakly upward motion of air in the midtroposphere in contrast to NC days. The possibility that aerodynamic contrasts along QPVBs readily permit air to be lofted above the LFC when the lower atmosphere is moist, thereby assisting or enhancing deep convection on CV days, is supported by the multiyear analysis (item 2 above). In early summer when LULC boundaries are most evident, precipitation on weaker flow days is significantly greater within 20 km of boundaries than farther away, but there is no statistical difference on stronger flow days. Statistical relationships between boundary mean attributes and mean precipitation change sign between early summer (positive) and late summer (negative), in accord with shifts in the satellite-retrieved maximum radiances from forest to crop areas. These phenological changes appear related, primarily, to contrasting soil moisture and implied evapotranspiration differences. Incorporating LULC boundary locations and phenological status into reliable forecast fields of lower-to-midtropospheric humidity and wind speed should lead to improved short-term predictions of convective precipitation in the Corn Belt and also, potentially, better climate seasonal forecasts. [ABSTRACT FROM AUTHOR]

The cirrus-level “condensation trails” (contrails) produced by jet aircraft are considered to influence surface climate and its recent changes. To reveal the synoptic atmospheric environments typically associated with multiple co-occurrences of contrails occurring in otherwise clear or partly cloudy skies (outbreaks) for the United States, and ultimately to assist in forecasting these events, a composite (i.e., multicase average) “synoptic climatology” at regional scales is developed for the midseason months (January, April, July, October) of 2000–02. The NCEP–NCAR reanalysis data that emphasize upper-troposphere (UT) variables are allied with manually identified outbreaks appearing on satellite Advanced Very High Resolution Radiometer digital data, using a geographic information system. The highest frequencies of outbreaks by far occur in the Midwest (32.6% of all-U.S. total), followed by the Northeast (17.6%) and Southeast (17.2%). In these regions, all of which have a high density of jet air traffic, an additional 2% cirrus cloud coverage from outbreak-related contrails is inferred. Large interannual and interseasonal variations in contrail outbreak frequencies support the role of meteorological variations. For most regions, the outbreak-associated synoptic circulation composite conditions involve UT ridging and a higher and colder tropopause than the climatological average; meridionally enhanced gradients of the UT vertical motion, located between sinking air to the east (in the ridge) and rising air to the west, in advance of a trough; similarly strong gradients of mid–upper-troposphere humidity, comprising dry air located to the east and moist air to the west; and horizontal speed shear ahead of an advancing jet stream. Notwithstanding, there is a geography (i.e., areal differentiation) to contrail outbreak environments: composites for the Northeast suggest an influence of land–sea contrasts on synoptic systems and, therefore, on contrail outbreaks. For the Northwest, there is evident a greater impact of horizontal wind shear contrasted with other regions. The synoptic climatology results are supported by the all-U.S. averages of contrail outbreak UT conditions [climate diagnostics (CDNs)] previously determined for early–mid-September periods of 1995–2001. Moreover, a comparison of these CDNs with those derived for nearby thick natural clouds, including cirrus, helps to clarify their different synoptic associations: the UT conditions typical of thick clouds represent an intensification of those associated with contrail outbreaks and include the greater upward vertical motion, moister air, and stronger westerly winds characteristic of a trough. Given the location of most contrail outbreaks downstream of multilayered cloud systems, contrails may help to extend the “natural” cirrus and cirrostratus spatial coverage. [ABSTRACT FROM AUTHOR]

The article offers information on the effects of jet aircraft flight activity on the condition of earth's atmosphere. Data on jet aircraft flight activity in the United States were obtained to assess its impact to contrail frequency. Increase in jet fuel usage and distance flown has led to increases in jet contrails. Contrails due to jet flights are considered to be one of the main reasons of contrail changes. Contrail frequency change involve cooling of the tropopause for the largest frequency increase which causes a switch in positive and negative phases of the Arctic Oscillation.

The grounding of all commercial aircraft within U.S. airspace for the 3-day period following the 11 September 2001 terrorist attacks provides a unique opportunity to study the potential role of jet aircraft contrails in climate. Contrails are most similar to natural cirrus clouds due to their high altitude and strong ability to efficiently reduce outgoing infrared radiation. However, they typically have a higher albedo than cirrus; thus, they are better at reducing the surface receipt of incoming solar radiation. These contrail characteristics potentially suppress the diurnal temperature range (DTR) when contrail coverage is both widespread and relatively long lasting over a specific region. During the 11–14 September 2001 grounding period natural clouds and contrails were noticeably absent on high-resolution satellite imagery across the regions that typically receive abundant contrail coverage. A previous analysis of temperature data for the grounding period reported an anomalous increase in the U.S.-averaged, 3-day DTR value. Here, the spatial variation of the DTR anomalies as well as the separate contributions from the maximum and minimum temperature departures are analyzed. These analyses are undertaken to better evaluate the role of jet contrail absence and synoptic weather patterns during the grounding period on the DTR anomalies. It is shown that the largest DTR increases occurred in regions where contrail coverage is typically most prevalent during the fall season (from satellite-based contrail observations for the 1977–79 and 2000–01 periods). These DTR increases occurred even in those areas reporting positive departures of tropospheric humidity, which may reduce DTR, during the grounding period. Also, there was an asymmetric departure from the normal maximum and minimum temperatures suggesting that daytime temperatures responded more to contrail absence than did nighttime temperatures, which responded more to synoptic conditions. The application of a statistical model that “retro-predicts” contrail-favored areas (CFAs) on the basis of upper-tropospheric meteorological conditions existing during the grounding period, supports the role of contrail absence in the surface temperature anomalies; especially for the western United States. Along with previous studies comparing surface climate data at stations beneath major flight paths with those farther away, the regionalization of the DTR anomalies during the September 2001 “control” period implies that contrails have been helping to decrease DTR in areas where they are most abundant, at least during the early fall season. [ABSTRACT FROM AUTHOR]

This paper applies a model of colour vision to achieve optimal use of colour in a software system that visualizes the results of experiments in high energy physics. It shows how the elements of the visualization were designed and provides details of why particular colours were chosen. By grounding these findings in psychological research, it is able to show how other computer systems that use colour may profitably apply this methodology. [ABSTRACT FROM AUTHOR]

Addresses the hypothesis that pulmonary blood vessels contain sufficient cholinesterase activity to regulate the action of acetylcholine (ACh) in lung tissues. Enzyme kinetics; Characterization of cholinesterase; Neostigmine effects on activity; Effects on vasodilation and vasoconstriction.

Presents an empirical model to predict widespread occurrences of condensation trails (contrails), which was developed from a combination of rawinsonde temperature and Geostationary Operational Environment Satellite (GOES) water vapor information. How the model performance was evaluated; What comparisons of the predictions to satellite observations of the existing conditions demonstrate; Benefit of the model to climate researchers.

Reports on the result of a three-day grounding of all commercial aircraft in the U.S in the aftermath of the terrorist attacks on September 11, 2002 which showed an increase in diurnal temperature range (DTR) caused by condensation trails from jet aircraft. Increase in diurnal temperature range during the period; Effect of day-to-day changes in synoptic atmospheric conditions on regional DTR.

In the Midwest U.S. Corn Belt, the 1999 and 2000 summer seasons (15 June–15 September) expressed contrasting spatial patterns and magnitudes of precipitation (1999: dry; 2000: normal to moist). Distinct from the numerical modeling approach often used in studies of land surface–climate interactions, a “synoptic climatological” (i.e., stratified composite) approach is applied to observation data (e.g., precipitation, radar, and atmospheric reanalyses) to determine the relative influences of “top-down” synoptic atmospheric circulation (Part I, this paper) and “bottom-up” land surface mesoscale conditions (Part II) on the predominantly convective precipitation variations. Because mesoscale modeling suggests that the free-atmosphere wind speed (“background wind”) regulates the land surface–atmosphere mesoscale interaction, each day’s spatial range of wind speed at 500 hPa [V(500)] over the Central Corn Belt (CCB) is classified into one of five categories ranging from “weak flow” to “jet maximum.” Deep convective activity (i.e., presence/absence and morphological signature type) is determined for each afternoon and early evening period from the Next Generation Weather Radar (NEXRAD) imagery. Frequencies of the resulting background wind–convection joint occurrence types for the 1999 and 2000 summer seasons are examined in the context of the statistics determined for summers in the longer period of 1996–2001, and also compose categories for which NCEP–NCAR reanalysis (NNR) fields are averaged to yield synoptic composite environments for the two study seasons. The latter composites are compared visually with high-resolution (spatial) composites of precipitation to help identify the influence of top-down climate controls. The analysis confirms that reduced (increased) organization of radar-indicated deep convection tends to occur with weaker (stronger) background flow. The summers of 1999 and 2000 differ from one another in terms of background flow and convective activity, but more so with respect to the six-summer averages, indicating that a fuller explanation of the precipitation differences in the two summers must be sought in the analysis of additional synoptic meteorological variables. The composite synoptic conditions on convection (CV) days (no convection (NC) days) in 1999 and 2000 are generalized as follows: low pressure incoming from the west (high pressure or ridging), southerly (northerly) lower-tropospheric winds, positive (negative) anomalies of moisture in the lower troposphere, rising (sinking) air in the midtroposphere, and a location south of the upper-tropospheric jet maximum (absence of an upper-tropospheric jet or one located just south of the area). Features resembling the “northerly low-level jets” identified in previous studies for the Great Plains are present on some NC-day composites. On CV days the spatial synchronization of synoptic features implying baroclinity increases with increasing background wind speed. The CV and NC composites differ least on days of weaker flow, and there are small areas within the CCB having no obvious association between precipitation elevated amounts and synoptic circulation features favoring the upward motion of air. These spatial incongruities imply a contributory influence of “stationary” (i.e., climatic) land surface mesoscale processes in convective activity, which are examined in Part II. [ABSTRACT FROM AUTHOR]

Background Mild therapeutic hypothermia is argued being beneficial for outcome after cardiac arrest. Materials and methods Retrospective analysis of Circulation Improving Resuscitation Care ( CIRC) trial data to assess if therapeutic cooling to 33 ± 1 °C core temperature had an association with survival. Of 4231 adult, out-of-hospital cardiac arrests of presumed cardiac origin initially enrolled, eligibility criteria for therapeutic hypothermia were met by 1812. Logistic regression was undertaken in a stepwise fashion to account for the impact on outcome of each significant difference and for the variable of interest between the groups. Results Out-of- and in-hospital cooled were 263 (15%), only after admission cooled were 230 (13%) and not cooled were 357 (20%) patients. The group cooled out of- and in hospital had 98 (37%) survivors as compared to the groups cooled in hospital only [80 (35%)] and of those not cooled [68 (19%)]. After adjusting for known covariates (sex, age, witnessed cardiac arrest, no- and low-flow time, shockable initial rhythm, random allocation, bystander cardiopulmonary resuscitation and percutaneous coronary intervention), the odds ratio for survival comparing no cooling to out-of- plus in-hospital cooling was 0·53 [95% confidence interval ( CI): 0·46-0·61, P < 0·001], and comparing to in-hospital cooling only was 0·67 (95% CI: 0·50-0·89, P = 0·006). Conclusion Mild therapeutic hypothermia initiated out of hospital and/or in hospital was associated with improved survival within this secondary analysis of the CIRC cohort compared to no therapeutic hypothermia. [ABSTRACT FROM AUTHOR]

Introduction: An 80% chest compression fraction (CCF) during resuscitation is recommended. However, heterogeneous results in CCF studies were found during the 2015 Consensus on Science (CoS), which may be because chest compressions are stopped for a wide variety of reasons including providing lifesaving care, provider distraction, fatigue, confusion, and inability to perform lifesaving skills efficiently.Objective: The effect of confounding variables on CCF to predict cardiac arrest survival.Methods: A secondary analysis of emergency medical services (EMS) treated out-of-hospital cardiac arrest (OHCA) patients who received manual compressions. CCF (percent of time patients received compressions) was determined from electronic defibrillator files. Two Sample Wilcoxon Rank Sum or regression determined a statistical association between CCF and age, gender, bystander CPR, public location, witnessed arrest, shockable rhythm, resuscitation duration, study site, and number of shocks. Univariate and multivariate logistic regressions were used to determine CCF effect on survival.Results: Of 2132 patients with manual compressions 1997 had complete data. Shockable rhythm (p<0.001), public location (p<0.004), treatment duration (p<0.001), and number of shocks (p<0.001) were associated with lower CCF. Univariate logistic regression found that CCF was inversely associated with survival (OR 0.07; 95% CI 0.01-0.36). Multivariate regression controlling for factors associated with survival and/or CCF found that increasing CCF was associated with survival (OR 6.34; 95% CI 1.02-39.5).Conclusion: CCF cannot be looked at in isolation as a predictor of survival, but in the context of other resuscitation activities. When controlling for the effects of other resuscitation activities, a higher CCF is predictive of survival. This may explain the heterogeneity of findings during the CoS review. [ABSTRACT FROM AUTHOR]

Introduction: Animal studies indicate higher termination of VF/VT (TOF) rates after shocks delivered during the decompression phase of the compression cycle for manual and mechanical CPR. We investigated TOF for shocks delivered in different compression cycle phases during load distributing band (LDB) mechanical CPR in the CIRC trial.Methods: Shocks were retrospectively categorized as delivered during the compression, decompression, or relaxation phase of LDB compressions using transthoracic impedance data. Shocks delivered when the LDB device was paused, were used as controls. The first shock and the first up-to-three shocks (first shocks plus shocks two and three if given) from patients with initial VF/VT and LDB CPR prior to shock were grouped according to compression cycle phase. TOF rates for these groups versus the control group were analyzed using logistic regression for first shocks and the general estimating equations (GEE) model for the up-to-three shocks. Adjustments were made for bystander CPR, witnessed arrest, defibrillator shock energy and transthoracic impedance.Results: Among 244 first shocks and 685 up-to-three shocks TOF success rates were lower (p<0.05 and p<0.02) for shocks given during the compression phase (72% and 71% respectively) than for control shocks given during compression pauses (86% and 82% respectively). Decompression and relaxation phase shocks had TOF rates not different from the controls.Conclusion: Shocks delivered in the compression phase of LDB chest compressions had lower TOF rates than shocks delivered while pausing the LDB device. More research is needed to see how defibrillation during chest compressions affect ROSC and survival. [ABSTRACT FROM AUTHOR]

Contrail statistical prediction methods are often location specific. To take advantage of the fact that the upper-tropospheric (UT) meteorological conditions that favor 'clear-sky outbreaks' of persisting contrails, or contrail favored areas (CFAs), tend to be synoptic in scale, a visual UT-map technique to hindcast CFAs has been developed and tested for subregions of the contiguous United States (CONUS) that have high outbreak frequencies in midseason months (January, April, July, and October) of 2000-02. The method compares daily maps with the composite fields for outbreak days (CON) versus nonoutbreak days (NON), and those assessments are evaluated using standard skill measures. Binary logistic regression determines which UT variables are significant predictors, individually and in combination. The reproducibility of the outbreak hindcast results is tested on the same subregions for the corresponding months of 2008-09. The results confirm the importance of UT relative humidity and vertical-motion (omega) map patterns in regional clear-sky outbreaks. Although the hindcast skill is modest, sensitivity tests suggest that the method will be substantially improved when a longer-term climatological dataset of outbreaks becomes available (to increase sample sizes) and with explicit consideration of the synoptic types on CON days. The latter is demonstrated specifically for the southern CONUS in January, where to improve hindcast success one should also consider the vertical wind shear in the upper troposphere, given the importance of the subtropical jet stream in contrail outbreaks there. Further development of the method to improve its skill ultimately should permit its use in combination with existing objective (statistical and physical models) methods of contrail prediction. [ABSTRACT FROM AUTHOR]

Background Shorter manual chest compression pauses prior to defibrillation attempts is reported to improve the defibrillation success rate. Mechanical load-distributing band (LDB-) CPR enables shocks without compression pause. We studied pre-shock pause and termination of ventricular fibrillation/pulseless ventricular tachycardia 5 s post-shock (TOF) and return of organized rhythm (ROOR) with LDB and manual (M-) CPR. Methods In a secondary analysis from the Circulation Improving Resuscitation Care trial, patients with initial shockable rhythm and interpretable post-shock rhythms were included. Pre-shock rhythm, pause duration (if any), and post-shock rhythm were obtained for each shock. Associations between TOF/ROOR and pre-shock pause duration, including no pause shocks with LDB-CPR, were analyzed with Chi-square test. A p -value <0.05 was considered statistically significant. Results For TOF and ROOR analyses we included 417 LDB-CPR patients with 1476 and 1438 shocks, and 495 M-CPR patients with 1839 and 1796 shocks, respectively. For first shocks with LDB-CPR, pre-shock pause was associated with TOF ( p = 0.049) with lowest TOF (77%) for shocks given without pre-shock compression pause. This association was not significant when all shocks were included ( p = 0.07) and not for ROOR. With M-CPR there were no significant associations between shock-related chest compression pause duration and TOF or ROOR. Conclusion For first shocks with LDB-CPR, termination of fibrillation was associated with pre-shock pause duration. There was no association for the rate of return of organized rhythm. For M-CPR, where no shocks were given during continuous chest compressions, there were no associations between pre-shock pause duration and TOF or ROOR. [ABSTRACT FROM AUTHOR]

Background Guidelines recommend 2 min of CPR after defibrillation attempts followed by ECG analysis during chest compression pause. This pause may reduce the likelihood of return of spontaneous circulation (ROSC) and survival. We have evaluated the possibility of analysing the rhythm earlier in the CPR cycle in an attempt to replace immediate pre-shock rhythm analysis. Methods and results The randomized Circulation Improving Resuscitation Care (CIRC) trial included patients with out of hospital cardiac arrest of presumed cardiac aetiology. Defibrillator data were used to categorize ECG rhythms as shockable or non-shockable 1 min post-shock and immediately before next shock. ROSC was determined from end-tidal CO 2 , transthoracic impedance (TTI), and patient records. TTI was used to identify chest compressions. Artefact free ECGs were categorized during periods without chest compressions. Episodes without ECG or TTI data or with undeterminable ECG rhythm were excluded. Data were analyzed using descriptive statistics. Of 1657 patients who received 3409 analysable shocks, the rhythm was shockable in 1529 (44.9%) cases 1 min post-shock, 13 (0.9%) of which were no longer shockable immediately prior to next possible shock. Of these, three had converted to asystole, seven to PEA and three to ROSC. Conclusion While a shockable rhythm 1 min post-shock was present also immediately before next possible defibrillation attempt in most cases, three patients had ROSC. Studies are needed to document if moving the pre-shock rhythm analysis will increase shocks delivered to organized rhythms, and if it will increase shock success and survival. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To compare integrated automated load distributing band CPR (iA-CPR) with high-quality manual CPR (M-CPR) to determine equivalence, superiority, or inferiority in survival to hospital discharge. Methods: Between March 5, 2009 and January 11, 2011 a randomized, unblinded, controlled group sequential trial of adult out-of-hospital cardiac arrests of presumed cardiac origin was conducted at three US and two European sites. After EMS providers initiated manual compressions patients were randomized to receive either iA-CPR or M-CPR. Patient follow-up was until all patients were discharged alive or died. The primary outcome, survival to hospital discharge, was analyzed adjusting for covariates, (age, witnessed arrest, initial cardiac rhythm, enrollment site) and interim analyses. CPR quality and protocol adherence were monitored (CPR fraction) electronically throughout the trial. Results: Of 4753 randomized patients, 522 (11.0%) met post enrollment exclusion criteria. Therefore, 2099 (49.6%) received iA-CPR and 2132 (50.4%) M-CPR. Sustained ROSC (emergency department admittance), 24h survival and hospital discharge (unknown for 12 cases) for iA-CPR compared to M-CPR were 600 (28.6%) vs. 689 (32.3%), 456 (21.8%) vs. 532 (25.0%), 196 (9.4%) vs. 233 (11.0%) patients, respectively. The adjusted odds ratio of survival to hospital discharge for iA-CPR compared to M-CPR, was 1.06 (95% CI 0.83–1.37), meeting the criteria for equivalence. The 20min CPR fraction was 80.4% for iA-CPR and 80.2% for M-CPR. Conclusion: Compared to high-quality M-CPR, iA-CPR resulted in statistically equivalent survival to hospital discharge. [Copyright &y& Elsevier]