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Investigate an outbreak of coronavirus disease 2019 (COVID-19) among operating room staff utilizing contact tracing, mass testing for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and environmental sampling.
Operating room staff with positive SARS-CoV-2 molecular testing.
Epidemiologic and environmental investigations were conducted including contact tracing, environmental surveys, and sampling and review of the operating room schedule for staff-to-staff, staff-to-patient, and patient-to-staff SARS-CoV-2 transmission.
In total, 24 healthcare personnel (HCP) tested positive for SARS-CoV-2, including nurses (29%), surgical technologists (25%), and surgical residents (16%). Moreover, 19 HCP (79%) reported having used a communal area, most commonly break rooms (75%). Overall, 20 HCP (83%) reported symptomatic disease. In total, 72 environmental samples were collected from communal areas for SARS-CoV-2 genomic testing; none was positive. Furthermore, 236 surgical cases were reviewed for transmission: 213 (90%) had negative preoperative SARS-CoV-2 testing, 21 (9%) had a positive test on or before the date of surgery, and 2 (<1%) did not have a preoperative test performed. In addition, 40 patients underwent postoperative testing (mean, 13 days to postoperative testing), and 2 returned positive results. Neither of these 2 cases was linked to our outbreak.
Complacency in infection control practices among staff during peak community transmission of SARS-CoV-2 is believed to have driven staff-to-staff transmission. Prompt identification of the outbreak led to rapid interventions, ultimately allowing for uninterrupted surgical service.
Potential effectiveness of harvest weed seed control (HWSC) systems depends upon seed shatter of the target weed species at crop maturity, enabling its collection and processing at crop harvest. However, seed retention likely is influenced by agroecological and environmental factors. In 2016 and 2017, we assessed seed-shatter phenology in 13 economically important broadleaf weed species in soybean [Glycine max (L.) Merr.] from crop physiological maturity to 4 wk after physiological maturity at multiple sites spread across 14 states in the southern, northern, and mid-Atlantic United States. Greater proportions of seeds were retained by weeds in southern latitudes and shatter rate increased at northern latitudes. Amaranthus spp. seed shatter was low (0% to 2%), whereas shatter varied widely in common ragweed (Ambrosia artemisiifolia L.) (2% to 90%) over the weeks following soybean physiological maturity. Overall, the broadleaf species studied shattered less than 10% of their seeds by soybean harvest. Our results suggest that some of the broadleaf species with greater seed retention rates in the weeks following soybean physiological maturity may be good candidates for HWSC.
Seed shatter is an important weediness trait on which the efficacy of harvest weed seed control (HWSC) depends. The level of seed shatter in a species is likely influenced by agroecological and environmental factors. In 2016 and 2017, we assessed seed shatter of eight economically important grass weed species in soybean [Glycine max (L.) Merr.] from crop physiological maturity to 4 wk after maturity at multiple sites spread across 11 states in the southern, northern, and mid-Atlantic United States. From soybean maturity to 4 wk after maturity, cumulative percent seed shatter was lowest in the southern U.S. regions and increased moving north through the states. At soybean maturity, the percent of seed shatter ranged from 1% to 70%. That range had shifted to 5% to 100% (mean: 42%) by 25 d after soybean maturity. There were considerable differences in seed-shatter onset and rate of progression between sites and years in some species that could impact their susceptibility to HWSC. Our results suggest that many summer annual grass species are likely not ideal candidates for HWSC, although HWSC could substantially reduce their seed output during certain years.
Establishment of alfalfa by interseeding it with corn planted for silage can enhance crop productivity but weed management is a challenge to adoption of the practice. Although a simple and effective approach to weed management would be to apply a glyphosate-based herbicide, concerns about herbicide resistance and limitations in available alfalfa varieties exist. Field experiments were conducted to compare the efficacy and selectivity of PRE, POST, and PRE followed by POST herbicide programs to a glyphosate-only strategy when interseeding alfalfa with corn. Experiment 1 compared PRE applications of acetochlor, mesotrione, S-metalochlor, metribuzin, and flumetsulam. Results indicate that acetochlor and metribuzin, and S-metalochlor used at a rate of 1.1 kg ai ha−1 were the most effective and selective PRE herbicides 4 wk after treatment (WAT), but each resulted in greater overall weed cover than glyphosate by 8 WAT. Experiment 2 evaluated applications of bentazon, bromoxynil, 2,4-DB, and mesotrione at early and late POST times. Several herbicides used POST exhibited similar effectiveness and selectivity as glyphosate, including early applications of bromoxynil (0.14 kg ai ha−1) and 2,4-DB (0.84 or 1.68 kg ai ha−1), as well as late applications of bromoxynil (0.42 kg ai ha−1), 2,4-DB (0.84 kg ai ha−1), and mesotrione (0.05 or 0.11 kg ai ha−1). A third experiment compared applications of acetochlor PRE, bromoxynil POST, and a combination of acetochlor PRE with bromoxynil POST. All treatments were effective and safe for use in this interseeded system, although interseeded alfalfa provided 65% to 70% weed suppression in corn planted for silage without any herbicide. Herbicide treatments had no observable impacts on corn and alfalfa yields, so weed management was likely of limited economic importance. However, weed competitiveness can vary based on several different factors including weed species, density, and site-specific factors, and so further investigations under different environments and conditions are needed.
Emergency Medical Services (EMS) systems have developed protocols for prehospital activation of the cardiac catheterization laboratory for patients with suspected ST-elevation myocardial infarction (STEMI) to decrease first-medical-contact-to-balloon time (FMC2B). The rate of “false positive” prehospital activations is high. In order to decrease this rate and expedite care for patients with true STEMI, the American Heart Association (AHA; Dallas, Texas USA) developed the Mission Lifeline PreAct STEMI algorithm, which was implemented in Los Angeles County (LAC; California USA) in 2015. The hypothesis of this study was that implementation of the PreAct algorithm would increase the positive predictive value (PPV) of prehospital activation.
This is an observational pre-/post-study of the effect of the implementation of the PreAct algorithm for patients with suspected STEMI transported to one of five STEMI Receiving Centers (SRCs) within the LAC Regional System. The primary outcome was the PPV of cardiac catheterization laboratory activation for percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). The secondary outcome was FMC2B.
A total of 1,877 patients were analyzed for the primary outcome in the pre-intervention period and 405 patients in the post-intervention period. There was an overall decrease in cardiac catheterization laboratory activations, from 67% in the pre-intervention period to 49% in the post-intervention period (95% CI for the difference, -14% to -22%). The overall rate of cardiac catheterization declined in post-intervention period as compared the pre-intervention period, from 34% to 30% (95% CI, for the difference -7.6% to 0.4%), but actually increased for subjects who had activation (48% versus 58%; 95% CI, 4.6%-15.0%). Implementation of the PreAct algorithm was associated with an increase in the PPV of activation for PCI or CABG from 37.9% to 48.6%. The overall odds ratio (OR) associated with the intervention was 1.4 (95% CI, 1.1-1.8). The effect of the intervention was to decrease variability between medical centers. There was no associated change in average FMC2B.
The implementation of the PreAct algorithm in the LAC EMS system was associated with an overall increase in the PPV of cardiac catheterization laboratory activation.
Addition of fats to the diets of ruminants has long been known to result in a reduction in enteric methane emissions. Tannins have also been used to reduce methane emissions but with mixed success. However, the effect of feeding fat in combination with tannin is unknown. Eight ruminally cannulated Holstein-Friesian cows were fed four diets in a double Latin-square, full crossover sequence. The treatments were 800 ml/day of water (CON), 800 g/day of cottonseed oil, 400 g/day of tannin, and 800 g/day of cottonseed oil and 400 g/day of tannin in combination (fat- and tannin-supplemented diet). Methane emissions were measured using open-circuit respiration chambers. Intake of basal diets was not different between treatments. Cows fed cottonseed oil had greater milk yield (34.9 kg/day) than those fed CON (32.3 kg/day), but the reduced concentration of milk fat meant there was no difference in energy-corrected milk between treatments. Methane yield was reduced when either cottonseed oil (14%) or tannin (11%) was added directly to the rumen, and their effect was additive when given in combination (20% reduction). The mechanism of the anti-methanogenic effect remains unclear but both fat and tannin appear to cause a reduction in fermentation in general rather than cause a change in the type of fermentation.
Methadone, a long-acting opioid agonist commonly used in the treatment of opiate dependence, has been reported to cause QTc interval prolongation, increasing the risk of a fatal cardiac arrhythmia – Torsades-de-Pointes (TdP). This effect seems to be attributable to methadone's inhibitory effect on the cardiac “hERG”-K+ ion channel and is dose-dependent. There is a lack of consensus regarding when to perform an ECG for patients on methadone.
Identifying other TdPPRFs in a cohort of patients receiving ≥ 85 mg (high dose) methadone daily to inform local clinical safety guidelines.
Our outpatient caseload was filtered to select opiate-dependent patients receiving more than 85 mg methadone daily. Primary care summaries and laboratory results databases were analysed for the presence of other TdPPRFs: female sex a documented history of ECG abnormalities, electrolyte imbalance, liver or renal failure, and concomitant use of other QT prolonging medication or stimulants.
Fourteen opiate-dependent patients (10.29% of patients on methadone) were maintained on ≥ 85 mg methadone daily. Gender distribution was F:M = 1:1.8; 64% misused illicit stimulants; 57% were prescribed other QTc prolonging medication and 29% had a documented history of liver/renal failure or electrolyte imbalance. Only 14% had previous ECGs documented in primary care summaries. Of patients on high dose methadone, 85.7% had at least one TdPPRFs present and 64.3% had at least two.
These results demonstrate an increased rate of TdPPRFs in this patient group and highlight the importance of ECG monitoring which ideally should be offered to patients receiving even lower doses of methadone.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We present a machine learning methodology to separate quasars from galaxies and stars using data from S-PLUS in the Stripe-82 region. In terms of quasar classification, we achieved 95.49% for precision and 95.26% for recall using a Random Forest algorithm. For photometric redshift estimation, we obtained a precision of 6% using k-Nearest Neighbour.
We have analyzed Chandra/High Energy Transmission Grating spectra of the X-ray emission line gas in the Seyfert galaxy NGC 4151. The zeroth-order spectral images show extended H- and He-like O and Ne, up to a distance r ˜ 200 pc from the nucleus. Using the 1st-order spectra, we measure an average line velocity ˜230 km s–1, suggesting significant outflow of X-ray gas. We generated Cloudy photoionization models to fit the 1st-order spectra; the fit required three distinct emission-line components. To estimate the total mass of ionized gas (M) and the mass outflow rates, we applied the model parameters to fit the zeroth-order emission-line profiles of Ne IX and Ne X. We determined an M ≍ 5.4 × 105Mʘ. Assuming the same kinematic profile as that for the [O III] gas, derived from our analysis of Hubble Space Telescope/Space Telescope Imaging Spectrograph spectra, the peak X-ray mass outflow rate is approximately 1.8 Mʘ yr–1, at r ˜ 150 pc. The total mass and mass outflow rates are similar to those determined using [O III], implying that the X-ray gas is a major outflow component. However, unlike the optical outflows, the X-ray emitting mass outflow rate does not drop off at r > 100pc, which suggests that it may have a greater impact on the host galaxy.
We used Space Telescope Imaging Spectrograph (STIS) long slit medium-resolution G430M and G750M spectra to analyze the extended [O III] λ5007 emission in a sample of twelve QSO2s from Reyes et al. (2008). The purpose of the study was to determine the properties of the mass outflows and their role in AGN feedback. We measured fluxes and velocities as functions of deprojected radial distances. Using photoionization models and ionizing luminosities derived from [O III], we were able to estimate the densities for the emission-line gas. From these results, we derived masses, mass outflow rates, kinetic energies and kinetic luminosity rates as a function of radial distance for each of the targets. Masses are several times 103 - 107 solar masses, which are comparable to values determined from a recent photoionization study of Mrk 34 (Revalski). Additionally, we are studying the possible role of X-ray winds in these QSO2s.
Observations at high redshift reveal that a population of massive, quiescent galaxies (called red nuggets) already existed 10 Gyr ago. These objects undergo a significant size evolution over time, likely due to minor mergers. In this work we present an analysis of local massive compact galaxies to assess if their properties are consistent with what is expected for unevolved red nuggets (relic galaxies). Using integral field spectroscopy (IFS) data from the MaNGA survey from the Sloan Digital Sky Survey (SDSS), we characterized the kinematics and properties of stellar populations of massive compact galaxies, and find that these objects exhibit, on average, a higher rotational support than a control sample of average sized early-type galaxies. This is in agreement with a scenario in which these objects have a quiet accretion history, rendering them candidates for relic galaxies.
Optically luminous early type galaxies host X-ray luminous, hot atmospheres. These hot atmospheres, which we refer to as coronae, undergo the same cooling and feedback processes as are commonly found in their more massive cousins, the gas rich atmospheres of galaxy groups and galaxy clusters. In particular, the hot coronae around galaxies radiatively cool and show cavities in X-ray images that are filled with relativistic plasma originating from jets powered by supermassive black holes (SMBH) at the galaxy centers. We discuss the SMBH feedback using an X-ray survey of early type galaxies carried out using Chandra X-ray Observatory observations. Early type galaxies with coronae very commonly have weak X-ray active nuclei and have associated radio sources. Based on the enthalpy of observed cavities in the coronae, there is sufficient energy to “balance” the observed radiative cooling. There are a very few remarkable examples of optically faint galaxies that are 1) unusually X-ray luminous, 2) have large dark matter halo masses, and 3) have large SMBHs (e.g., NGC4342 and NGC4291). These properties suggest that, in some galaxies, star formation may have been truncated at early times, breaking the simple scaling relations.
We investigate the processes of active galactic nuclei (AGN) feeding and feedback in the narrow line regions (NLRs) and host galaxies of nearby AGN through spatially resolved spectroscopy with the Gemini Near-Infrared Integral Field Spectrograph (NIFS) and the Hubble Space Telescope’s Space Telescope Imaging Spectrograph (STIS). We examine the connection between nuclear and galactic inflows and outflows by adding long-slit spectra of the host galaxies from Apache Point Observatory. We demonstrate that nearby AGN can be fueled by a variety of mechanisms. We find that the NLR kinematics can often be explained by in situ ionization and radiative acceleration of ambient gas, often in the form of dusty molecular spirals that may be the fueling flow to the AGN.
NGC 7469 is a well-known type 1 AGN with a cirumnuclear star formation ring. It has previous detections of X-rays warm absorbers and an infrared biconical outflow. We analysed archival MUSE/VLT observations of this galaxy in order to look for an optical counterpart of these outflows. We report spatially resolved winds in the [O III] λ5007 emission line in two regimes: a high velocity regime possibly associated with the AGN and a slower one associated with the massive star formation of the ring. This slower regime is also detected with Hβ.
The Murchison Widefield Array (MWA) is an open access telescope dedicated to studying the low-frequency (80–300 MHz) southern sky. Since beginning operations in mid-2013, the MWA has opened a new observational window in the southern hemisphere enabling many science areas. The driving science objectives of the original design were to observe 21 cm radiation from the Epoch of Reionisation (EoR), explore the radio time domain, perform Galactic and extragalactic surveys, and monitor solar, heliospheric, and ionospheric phenomena. All together
programs recorded 20 000 h producing 146 papers to date. In 2016, the telescope underwent a major upgrade resulting in alternating compact and extended configurations. Other upgrades, including digital back-ends and a rapid-response triggering system, have been developed since the original array was commissioned. In this paper, we review the major results from the prior operation of the MWA and then discuss the new science paths enabled by the improved capabilities. We group these science opportunities by the four original science themes but also include ideas for directions outside these categories.
Multispectral imaging – the acquisition of spatially contiguous imaging data in a modest number (~3–16) of spectral bandpasses – has proven to be a powerful technique for augmenting panchromatic imaging observations on Mars focused on geologic and/or atmospheric context. Specifically, multispectral imaging using modern digital CCD photodetectors and narrowband filters in the 400–1100 nm wavelength region on the Mars Pathfinder, Mars Exploration Rover, Phoenix, and Mars Science Laboratory missions has provided new information on the composition and mineralogy of fine-grained regolith components (dust, soils, sand, spherules, coatings), rocky surface regions (cobbles, pebbles, boulders, outcrops, and fracture-filling veins), meteorites, and airborne dust and other aerosols. Here we review recent scientific results from Mars surface-based multispectral imaging investigations, including the ways that these observations have been used in concert with other kinds of measurements to enhance the overall scientific return from Mars surface missions.
The Murchison Widefield Array (MWA) is an electronically steered low-frequency (<300 MHz) radio interferometer, with a ‘slew’ time less than 8 s. Low-frequency (∼100 MHz) radio telescopes are ideally suited for rapid response follow-up of transients due to their large field of view, the inverted spectrum of coherent emission, and the fact that the dispersion delay between a 1 GHz and 100 MHz pulse is on the order of 1–10 min for dispersion measures of 100–2000 pc/cm3. The MWA has previously been used to provide fast follow-up for transient events including gamma-ray bursts (GRBs), fast radio bursts (FRBs), and gravitational waves, using systems that respond to gamma-ray coordinates network packet-based notifications. We describe a system for automatically triggering MWA observations of such events, based on Virtual Observatory Event standard triggers, which is more flexible, capable, and accurate than previous systems. The system can respond to external multi-messenger triggers, which makes it well-suited to searching for prompt coherent radio emission from GRBs, the study of FRBs and gravitational waves, single pulse studies of pulsars, and rapid follow-up of high-energy superflares from flare stars. The new triggering system has the capability to trigger observations in both the regular correlator mode (limited to ≥0.5 s integrations) and using the Voltage Capture System (VCS, 0.1 ms integration) of the MWA and represents a new mode of operation for the MWA. The upgraded standard correlator triggering capability has been in use since MWA observing semester 2018B (July–Dec 2018), and the VCS and buffered mode triggers will become available for observing in a future semester.