Objective To clinically evaluate a new patented multimodal system (SAFERSleep) designed to reduce errors in the recording and administration of drugs in anaesthesia. Design Prospective randomised open label clinical trial.Setting Five designated operating theatres in a major tertiary referral hospital.Participants Eighty nine consenting anaesthetists managing 1075 cases in which there were 10 764 drug administrations.Intervention Use of the new system (which includes customised drug trays and purpose designed drug trolley drawers to promote a well organised anaesthetic workspace and aseptic technique; pre-filled syringes for commonly used anaesthetic drugs; large legible colour coded drug labels; a barcode reader linked to a computer, speakers, and touch screen to provide automatic auditory and visual verification of selected drugs immediately before each administration; automatic compilation of an anaesthetic record; an on-screen and audible warning if an antibiotic has not been administered within 15 minutes of the start of anaesthesia; and certain procedural rules-notably, scanning the label before each drug administration) versus conventional practice in drug administration with a manually compiled anaesthetic record. Main outcome measuresPrimary: composite of errors in the recording and administration of intravenous drugs detected by direct observation and by detailed reconciliation of the contents of used drug vials against recorded administrations; and lapses in responding to an intermittent visual stimulus (vigilance latency task). Secondary: outcomes in patients; analyses of anaesthetists' tasks and assessments of workload; evaluation of the legibility of anaesthetic records; evaluation of compliance with the procedural rules of the new system; and questionnaire based ratings of the respective systems by participants. ResultsThe overall mean rate of drug errors per 100 administrations was 9.1 (95% confidence interval 6.9 to 11.4) with the new system (one in 11 administrations) and 11.6 (9.3 to 13.9) with conventional methods (one in nine administrations) (P=0.045 for difference). Most were recording errors, and, though fewer drug administration errors occurred with the new system, the comparison with conventional methods did not reach significance. Rates of errors in drug administration were lower when anaesthetists consistently applied two key principles of the new system (scanning the drug barcode before administering each drug and keeping the voice prompt active) than when they did not: mean 6.0 (3.1 to 8.8) errors per 100 administrations v 9.7 (8.4 to 11.1) respectively (P=0.004). Lapses in the vigilance latency task occurred in 12% (58/471) of cases with the new system and 9% (40/473) with conventional methods (P=0.052). The records generated by the new system were more legible, and anaesthetists preferred the new system, particularly

Potts (2005) and many subsequent works have argued that the semantic content of appositive (non-restrictive) relative clauses, e.g., the underlined material in John, who nearly killed a woman with his car, visited her in the hospital, must be in some way separate from the content of the rest of the sentence, i.e., from at-issue content. At the same time, there is mounting evidence from various anaphoric processes that the two kinds of content must be integrated into a single, incrementally evolving semantic representation. The challenge is how to reconcile this informational separation with these pervasive anaphoric connections. We propose a dynamic semantic account that accomplishes this by taking appositive and at-issue content to involve two different kinds of updates to the Context Set (CS). Treating the context set as a distinguished propositional variable, p cs , we argue that appositives directly impose their content on the CS by eliminating possible values assigned to p cs. In contrast, we treat at-issue assertions as introducing a new propositional dref and proposing that p cs be updated with its content, subject to addressee's response. In addition to capturing the behavior of appositives in discourse, we show that the account can be extended to capture the projection of appositive content past various sentential operators.

Studies on the digenean parasites of deep-sea (> 200 m depth) teleosts are reviewed and two case study generic phylogenies are presented based on LSU rDNA and ND1 mtDNA sequences. The phylogeny of the lepocreadiid genus Lepidapedon, the most common deep-sea digenean genus, is not clearly resolved as the two gene trees are not compatible. It can be inferred, however, that the genus has radiated in the deeper waters off the continental shelf, mainly in fishes of the gadiform family Macrouridae. Steringophorus, a fellodistomid genus, is better resolved. In this case a deep-sea radiation is also indicated, but the pattern of host-specificity is not clear, with evidence of much host-switching. Results of studies of the parasites of the macrourid fish Coryphaenoides (Nematonurus) armatus from various depths have reinforced recent views on the lack of zoned depth-related communities in the deep-sea. The diversity of deep-sea digeneans is relatively low with only 18 families (of about 60) reported. Little, or nothing, is known from most deep-sea areas and nothing from trenches and mid-ocean ridge systems.

This paper presents an analysis of a new scope puzzle that arises through the interaction of two lesser-studied constructions, dependent indefinites and verbal pluractionality. The result is a novel account of dependent indefinites that correctly predicts their grammaticality with pluractionals by recognizing two ways of establishing the covariation they require: (i) true distributive quantifiers, and (ii) pluractional operators that structure thematic dependencies. The core insight is that both routes, while compositionally different, lead to similar output structures in Dynamic Plural Logic (DPlL) (van den Berg 1996) or its closely related alternatives (Brasoveanu 2008, Nouwen 2003, which is what dependent indefinites constrain. The analysis not only permits a better understanding of dependent indefinites in Kaqchikel, an endangered and understudied Mayan language of highland Guatemala, but it clarifies their place in a crosslinguistic typology of similar expressions (e.g., Balusu 2006, Choe 1987, Farkas 1997a, 2002, Yanovich 2005. Along the way I produce the first description and analysis of these phenomena in Kaqchikel.

Elk (Cervus elaphus) are increasing in fragmented landscapes that result from exurban human development throughout western North America, which increases human-wildlife conflicts and poses a challenge to wildlife managers. Elk hunting must often be intensively managed to reduce population growth rate, crop depredation, and habituation to humans. However, little was known about the indirect effect hunting has on anti-predator behavior, movement, resource selection, and human-elk conflicts. We outfitted elk with global positioning system (GPS) collars in the wildland-urban interface (WUI) of Missoula, Montana, USA, 2007, to test the indirect effects of hunting on elk. We used data from 9 GPS-collared adult female elk during 3 hunting seasons with increasing hunting pressure (2007)(2008)(2009) to test relationships between movement rates measured by first passage time (FPT) and resource selection. Elk movement rates were lower approximately 750 m from houses and trails, resulting in resource selection for areas approximately 1,200 m from houses and trails; this suggested that habituation to humans contributed to humanwildlife conflict. Movement rates increased with increasing hunting pressure, and were lower in general versus focal hunting seasons and with archery versus rifle hunting. Thus, intensive hunting seasons in the WUI increased elk movement rates and exposure to hunter predation risk, as predicted. These results support the hypothesis that elk modify their behavior in relation to temporal and spatial variation in human predation risk. In the intensively managed WUI, our results demonstrate that even small increases in the area hunted and increases in intensity can indirectly change resource selection and movement rates of elk, potentially reversing recent trends of increasing habituation in WUI elk populations. ß 2012 The Wildlife Society.