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The COVID-19 pandemic has created a high demand on personal protective equipment, including disposable N95 masks. Given the need for mask reuse, we tested the feasibility of vaporized hydrogen peroxide (VHP), ultraviolet light (UV), and ethanol decontamination strategies on N95 mask integrity and the ability to remove the infectious potential of SARS-CoV-2.
Disposable N95 masks, including medical grade (1860, 1870+) and industrial grade (8511) masks, were treated by VHP, UV, and ethanol decontamination. Mask degradation was tested using a quantitative respirator fit testing. Pooled clinical samples of SARS-CoV-2 were applied to mask samples, treated, and then either sent immediately for real-time reverse transcriptase–polymerase chain reaction (RT-PCR) or incubated with Vero E6 cells to assess for virucidal effect.
Both ethanol and UV decontamination showed functional degradation to different degrees while VHP treatment showed no significant change after two treatments. We also report a single SARS-CoV-2 virucidal experiment using Vero E6 cell infection in which only ethanol treatment eliminated detectable SARS-CoV-2 RNA.
We hope our data will guide further research for evidenced-based decisions for disposable N95 mask reuse and help protect caregivers from SARS-CoV-2 and other pathogens.
Psychotic experiences (PE) are highly prevalent in childhood and are known to be associated with co-morbid mental health disorders and functional difficulties in adolescence. However, little is known about the long-term outcomes of young people who report PE.
As part of the Adolescent Brain Development Study, 211 young people were recruited in childhood (mean age 11.7 years) and underwent detailed clinical interviews, with 25% reporting PE. A 10 year follow-up study was completed and 103 participants returned (mean age 20.9 years). Structured clinical interviews for DSM-5 (SCID-5) and interviewer-rated assessments of functioning were conducted. A detailed neuropsychological battery was also administered. Analyses investigated group differences between those who had ever reported PE and controls in early adulthood.
The PE group was at a significantly higher risk of meeting DSM-5 criteria for a current (OR 4.08, CI 1.16–14.29, p = 0.03) and lifetime psychiatric disorder (OR 3.27, CI 1.43–7.47, p = 0.005). They were also at a significantly higher risk of multi-morbid lifetime psychiatric disorders. Significantly lower scores on current social and global functioning measures were observed for the PE group. Overall, there were no differences in neuropsychological performance between groups apart from significantly lower scores on the Stroop Word task and the Purdue Pegboard task for the PE group.
Our findings suggest that reports of PE are associated with poorer mental health and functional outcomes in early adulthood, with some persisting cognitive and motor deficits. Young people who report such symptoms could be considered a target group for interventions to aid functional outcomes.
Nut consumers have lower body weight and are at lower cardiovascular disease risk than non-consumers. Interestingly, minority adults, who have the highest prevalence of obesity and are at disproportionate risk of cardiovascular disease, have low nut intakes. The goal of this study was to test whether consumption of almonds, compared to low-fat/high-carbohydrate cereal bars (LF-HC), as a supplement for 24 wk, would improve appetite regulation and body composition in Blacks and Hispanics. Twenty-nine adults, BMI > 25 kg/m2, age 30–65 y, were recruited and randomized to consume either almonds or LF-HC providing 17.5% of their estimated energy requirements as part of their regular diet. A total of 17 adults completed the study, 9 men and 8 women; 7 of whom were randomized to almond consumption (4 men, 3 women), and 10 to LF-HC consumption (5 men, 5 women). Outcome variables included appetite-regulating hormones and inflammatory markers, which were measured from fasting blood samples taken at baseline, week 12, and endpoint. Body composition was measured by magnetic resonance imaging at baseline and endpoint. Data were analyzed using linear mixed model with treatment, time, and their interaction as predictor variables; age, race, sex, and baseline BMI as covariates; and participant ID as a random effect variable. Peptide YY concentrations were higher in the almond group compared to LF-HC (time x treatment interaction at 12 wk, P < 0.001; 24 wk, P = 0.13). Glucagon-like peptide 1 concentrations were higher in the almond group compared to LF-HC (time x treatment interaction at 12 wk, P = 0.10; 24 wk, P = 0.015). Ghrelin levels decreased in LF-HC compared to the almond group at 12 wk but not 24 wk (time x treatment interaction at 12 wk, P = 0.017; 24 wk, P = 0.23). There was a slight trend for a time x treatment interaction on body weight (P = 0.14; change in almond = 0.6 ± 1.8 kg; LF-HC = 1.9 ± 2.7 kg). There was a time x treatment interaction on intermuscular adipose tissue (P = 0.013; change in almond = -0.10 ± 0.14 cm3; LF-HC = 0.04 ± 0.07 cm3). None of the measured inflammatory markers (C reactive protein, interleukin-6, and tumor necrosis factor) were affected by the dietary interventions. Despite the lack of profound body composition changes, daily almond intake for 24 wk, within the usual diet, ameliorated satiety and ectopic fat deposition, suggesting a potential role of nut consumption in the context of a weight reduction program in minority adults. Our data support further exploration of the health effects of nut consumption in this population.
The most resonant intersection of travel and religion is pilgrimage, from the Latin peregrinatio, a word capacious enough after centuries of allegorical and metaphoric expansion to take on even the most attenuated ‘spiritual’ motives or responses. In Europe and the Americas, and in most writing in European languages, latter-day pilgrimages of secular people constitute allusions to a form of both travelling and writing that emerged in the Mediterranean littoral in the first centuries of Christian Holy Land travel, though pagan Greeks and Romans had visited shrines and oracles. The Hindu practice of pilgrimage to legendary places in the Indian subcontinent has ancient roots, but like pagan Greek shrine-going did not generate a written corpus (except the genealogies maintained by the Pandits of the pilgrimage city of Haridwar). Modern Jews make aliyah to Israel, the ‘Jewish homeland’, and before the destruction of the Second Temple individual men made pilgrimages from other cities to Jerusalem's Temple (though see Friedman 1996). Expansionist Islam would generate its own spectacular pilgrimage, the mandatory hajj to Mecca's scene of revelation, but again, produce no distinct literary genre. The Chinese Buddhist Xuanzang's solo pilgrimage to the India of Buddha's revelation – also a journey to a sacred spot outside one's native land – did produce a major work of travel writing, which inspired the classic novel, Journey to the West (1592). But the English word ‘pilgrim’ mispronounces Old French pèlerin (Latin peregrinus, stranger), which arose during the crusades, and pèlerinage (the ‘general passage’ that generated chronicles like Jean de Joinville's Vie de Saint-Louis) is first attested in reference to crusade rather than individual journeys. In Europe, pilgrimage was a ritualized, collective, sometimes military Christian activity directed to the foreign landscape of a sacred past – though Gerhard Ladner (1967) (in ‘Homo Viator’) describes the first Christian wanderers as hatless loners, sans destination, homeless and unaccompanied by choice on the peregrinatio of earthly life.
This Latin peregrinatio initially referred to travelling or living abroad. Literally: per-(before, around, through) -agri (fields, ‘acres’). There is a hint in Indo-European etymologies that per-looks back rather than out and beyond, as if a peregrinatio heads towards a lost homeland.
Wonder is a word for an important ‘cognitive emotion’. It has been much studied and theorized over the past 20 years as academic interest in affect increased, but started, at least in the Euro-American philosophical tradition, with Aristotle, for whom wonder itself is the starting point of philosophy.
In fact, Aristotle can be found at the roots of both the epistemological and what we might call the ‘spectacular’ discourses of wonder. These are fused in the preprofessional history of ethnography, which overlaps significantly with the corpus of travel writing. The popularity of this branch of knowledge was for millennia based in the frisson of wonder invoked by descriptions and illustrations of foreign bodies, climates and customs. In the Poetics Aristotle explains the importance of spectacle for drama, which by his account is emotional instruction in the form of a rollercoaster of cognitive-emotional experience, resolved at last by the rational or objective spectacle, however pitiable, of justice. The pleasurable or satisfying stupefactions of wonder (meanings of the useful Arabic móha include ‘delusion,’ ‘stupefaction’) remain a powerful force of social control – now bent towards market growth rather than subjection to Aristotelian tragedy's ‘Law of the Fathers’.
In the Metaphysics, Aristotle makes a different pedagogical claim for the usefulness of wonder: ‘it is owing to wonder that men both now begin and at first began to philosophize. They wondered originally at the obvious difficulties, then advanced little by little and stated difficulties about the phenomenon of the moon and those of the sun and stars, and about the genesis of the universe’ (Metaphysics 1.2, 982b10-1). In the right contexts, then, the cognitive emotion of wonder can lead to what we now call curiosity, and investigation of causes. TED talks, science magazines and introductory lecture courses rely as heavily as Aristotle on the chain reaction he outlined in one of the first texts of natural philosophy in the Mediterranean world.
The English verb ‘wonder’, a Germanic word with no Indo-European root (whose spelling is suggestively similar to Old Frisian wondrian, to wander), introduces predications meaning ‘to ask oneself’, as in the French se demander, or be curious (‘I wonder if she's from Samarkand?’); it can also refer to being astonished or entranced by something.
Candida auris (CA) is an emerging multidrug-resistant pathogen associated with increased mortality. The environment may play a role, but transmission dynamics remain poorly understood. We sought to limit environmental and patient CA contamination following a sustained unsuspected exposure.
A 528-bed teaching hospital.
The index case patient and 17 collocated ward mates.
Immediately after confirmation of CA in the bloodstream and urine of a patient admitted 6 days previously, active surveillance, enhanced transmission-based precautions, environmental cleaning with peracetic acid-hydrogen peroxide and ultraviolet light, and patient relocation were undertaken. Pre-existing agreements and foundational relationships among internal multidisciplinary teams and external partners were leveraged to bolster detection and mitigation efforts and to provide genomic epidemiology.
Candida auris was isolated from 3 of 132 surface samples on days 8, 9, and 15 of ward occupancy, and from no patient samples (0 of 48). Environmental and patient isolates were genetically identical (4–8 single-nucleotide polymorphisms [SNPs]) and most closely related to the 2013 India CA-6684 strain (~200 SNPs), supporting the epidemiological hypothesis that the source of environmental contamination was the index case patient, who probably acquired the South Asian strain from another New York hospital. All isolates contained a mutation associated with azole resistance (K163R) found in the India 2105 VPCI strain but not in CA-6684. The index patient remained colonized until death. No surfaces were CA-positive 1 month later.
Compared to previous descriptions, CA dissemination was minimal. Immediate access to rapid CA diagnostics facilitates early containment strategies and outbreak investigations.
Excavations at Tell Khaiber in southern Iraq by the Ur Region Archaeological Project have revealed a substantial building (hereafter the Public Building) dating to the mid-second millennium b.c. The results are significant for the light they shed on Babylonian provincial administration, particularly of food production, for revealing a previously unknown type of fortified monumental building, and for producing a dated archive, in context, of the little-understood Sealand Dynasty. The project also represents a return of British field archaeology to long-neglected Babylonia, in collaboration with Iraq's State Board for Antiquities and Heritage. Comments on the historical background and physical location of Tell Khaiber are followed by discussion of the form and function of the Public Building. Preliminary analysis of the associated archive provides insights into the social milieu of the time. Aspects of the material culture, including pottery, are also discussed.
The purpose was to examine the associations among body weight status, blood pressure and daily Na intake among grade 7 students from south-western Ontario, Canada.
Cross-sectional. Data were collected using the Food Behaviour Questionnaire, including a 24 h diet recall. Measured height and weight were used to determine BMI. Blood pressure was taken manually using mercury sphygmomanometers.
Twenty-six schools in south-western Ontario, Canada.
Grade 7 students (n 1068).
Body weight status indicated 1 % were underweight, 56 % normal weight, 23 % overweight and 20 % were obese. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 108·3 (sd 10·3) mmHg and 66·0 (sd 7·5) mmHg, respectively, and mean Na intake was 2799 (sd 1539) mg/d. Bivariate analyses suggested that SBP (P < 0·001) and DBP (P < 0·001) were significantly different by body weight status, yet no associations were observed for Na. Adjusted for gender, ethnicity and under-reporting, participants were more likely to be overweight/obese if they had higher SBP (v. lower: OR = 1·06, 95 % CI 1·05, 1·08, P < 0·001), higher DBP (v. lower: OR = 1·02, 95 % CI 1·00, 1·04, P = 0·043) and higher intakes of Na (3rd v. 1st quartile: OR = 1·72, 95 % CI 1·14, 2·59, P = 0·009; 4th v. 1st quartile: OR = 2·88, 95 % CI, 1·76, 4·73, P < 0·001).
High intakes of Na, coupled with high SBP and DBP, were associated with overweight and obesity status among the grade 7 sample from south-western Ontario, Canada.
This literature review focuses on what matters to young adults when they access primary care services in the United Kingdom.
Patients’ access to and experience of primary care services differs across age groups. Existing research has largely focused on the needs and experiences of children, adolescents, and adults. There is some evidence to suggest the views of young adults (aged 18–25 years) that may differ from the views of other age groups, and research has not previously reported specifically on the views of this group of the population.
The literature was reviewed to identify the views and priorities of young UK adults regarding primary healthcare provision, and furthermore, to identify those related topics that would benefit from further research. Relevant academic publications and grey literature published from 2000 onwards was reviewed and synthesised. We identified and reported emerging themes that were of importance to young adults in respect of the UK primary care provision. A total of 19 papers met our inclusion criteria.
Young adults access primary care services less frequently than other age groups; this may be because of their experience of primary care throughout childhood and adolescence. Five aspects of primary care provision emerged as being of importance to young adults – the accessibility and availability of services, the confidentiality of health-related information, issues relating to communication with healthcare professionals, continuity of care, and behaviours and attitudes expressed towards young adults by healthcare professionals.
There is a lack of focus of current research on the expectations, needs, and primary healthcare experiences of young adults. Young adults may hold views that are distinct from other age groups. Further research is needed to better understand the needs of a young adult population as their needs may impact the future use of services.