The effective reproduction number $ R $ was widely accepted as a key indicator during the early stages of the COVID-19 pandemic. In the UK, the $ R $ value published on the UK Government Dashboard has been generated as a combined value from an ensemble of epidemiological models via a collaborative initiative between academia and government. In this paper, we outline this collaborative modelling approach and illustrate how, by using an established combination method, a combined $ R $ estimate can be generated from an ensemble of epidemiological models. We analyse the $ R $ values calculated for the period between April 2021 and December 2021, to show that this $ R $ is robust to different model weighting methods and ensemble sizes and that using heterogeneous data sources for validation increases its robustness and reduces the biases and limitations associated with a single source of data. We discuss how $ R $ can be generated from different data sources and show that it is a good summary indicator of the current dynamics in an epidemic.

Most medical diagnostic tests are expensive, involve slow turnaround times from centralized laboratories and require highly specialized equipment with seasoned technicians to carry out the assay. To facilitate realization of precision medicine at the point of care, we have developed a mixed-scale nanosensor chip featuring high surface area pillar arrays where solid-phase reactions can be performed to detect and identify nucleic acid targets found in diseased patients. Products formed can be identified and detected using a polymer nanofluidic channel. To guide delivery of this platform, we discuss the operation of various components of the device and simulations (COMSOL) used to guide the design by investigating parameters such as pillar array loading, and hydrodynamic and electrokinetic flows. The fabrication of the nanosensor is discussed, which was performed using a silicon (Si) master patterned with a combination of focused ion beam milling and photolithography with deep reactive ion etching. The mixed-scale patterns were transferred into a thermoplastic via thermal nanoimprint lithography, which facilitated fabrication of the nanosensor chip making it appropriate for in vitro diagnostics. The results from COMSOL were experimentally verified for hydrodynamic flow using Rhodamine B as a fluorescent tracer and electrokinetic flow using single fluorescently labelled oligonucleotides (single-stranded DNAs, ssDNAs).

Distinguished Oral

Background: Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, California (SHIELD OC) was a CDC-funded regional decolonization intervention from April 2017 through July 2019 involving 38 hospitals, nursing homes (NHs), and long-term acute-care hospitals (LTACHs) to reduce MDROs. Decolonization in NH and LTACHs consisted of universal antiseptic bathing with chlorhexidine (CHG) for routine bathing and showering plus nasal iodophor decolonization (Monday through Friday, twice daily every other week). Hospitals used universal CHG in ICUs and provided daily CHG and nasal iodophor to patients in contact precautions. We sought to evaluate whether decolonization reduced hospitalization and associated healthcare costs due to infections among residents of NHs participating in SHIELD compared to nonparticipating NHs. Methods: Medicaid insurer data covering NH residents in Orange County were used to calculate hospitalization rates due to a primary diagnosis of infection (counts per member quarter), hospital bed days/member-quarter, and expenditures/member quarter from the fourth quarter of 2015 to the second quarter of 2019. We used a time-series design and a segmented regression analysis to evaluate changes attributable to the SHIELD OC intervention among participating and nonparticipating NHs. Results: Across the SHIELD OC intervention period, intervention NHs experienced a 44% decrease in hospitalization rates, a 43% decrease in hospital bed days, and a 53% decrease in Medicaid expenditures when comparing the last quarter of the intervention to the baseline period (Fig. 1). These data translated to a significant downward slope, with a reduction of 4% per quarter in hospital admissions due to infection (P < .001), a reduction of 7% per quarter in hospitalization days due to infection (P < .001), and a reduction of 9% per quarter in Medicaid expenditures (P = .019) per NH resident. Conclusions: The universal CHG bathing and nasal decolonization intervention adopted by NHs in the SHIELD OC collaborative resulted in large, meaningful reductions in hospitalization events, hospitalization days, and healthcare expenditures among Medicaid-insured NH residents. The findings led CalOptima, the Medicaid provider in Orange County, California, to launch an NH incentive program that provides dedicated training and covers the cost of CHG and nasal iodophor for OC NHs that enroll.

Funding: None

Disclosures: Gabrielle M. Gussin, University of California, Irvine, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

Anthocyanins and bromelain have gained significant attention due to their antioxidative and anti-inflammatory properties. Both have been shown to improve endothelial function, blood pressure (BP) and oxygen utility capacity in humans; however, the combination of these two and the impacts on endothelial function, BP, total antioxidant capacity (TAC) and oxygen utility capacity have not been previously investigated. The purpose of this study was to investigate the impacts of a combined anthocyanins and bromelain supplement (BE) on endothelial function, BP, TAC, oxygen utility capacity and fatigability in healthy adults. Healthy adults (n 18, age 24 (sd 4) years) received BE or placebo in a randomised crossover design. Brachial artery flow-mediated dilation (FMD), BP, TAC, resting heart rate, oxygen utility capacity and fatigability were measured pre- and post-BE and placebo intake. The BE group showed significantly increased FMD, reduced systolic BP and improved oxygen utility capacity compared with the placebo group (P < 0·05). Tissue saturation and oxygenated Hb significantly increased following BE intake, while deoxygenated Hb significantly decreased (P < 0·05) during exercise. Additionally, TAC was significantly increased following BE intake (P < 0·05). There were no significant differences for resting heart rate, diastolic BP or fatigability index. These results suggest that BE intake is an effective nutritional therapy for improving endothelial function, BP, TAC and oxygen utility capacity, which may be beneficial to support vascular health in humans.

Multiple studies have elucidated the antioxidant properties of Se, which are now well known among the nutrition and biomedical science communities. Recently, considerable interest has been focused on the possible association between Se exposure and risk of metabolic disease, such as lipid dysregulation; however, there is limited epidemiological data on this topic. The present study aimed to investigate associations between toenail Se levels and dyslipidaemia or individual lipid levels, and to examine the effect of dietary supplement use on these associations. We analysed baseline data from a cohort in the Yeungnam area, including 232 men and 269 women. Information on demographic, dietary and lifestyle characteristics was obtained through a self-reported questionnaire. Se levels in toenail specimens were measured using neutron activation analysis. Fasting blood lipid levels were measured during medical examinations. After adjusting for multiple confounding variables, we observed no association between toenail Se levels and dyslipidaemia or individual lipid profiles. However, the association was modified by dietary supplement use. Among the supplement users, higher toenail Se levels were associated with a higher prevalence of lipid dysregulation, whereas non-users exhibited a lower prevalence of lipid dysregulation. Associations between toenail Se levels, lipid levels and dyslipidaemia may be influenced by taking dietary supplements. Future large-scale, prospective cohort studies should be conducted to further evaluate the association between Se levels in the body and metabolic health effects in light of increasing rates of dietary supplement use.

Sulfur cinquefoil is an exotic, perennial forb that invades a wide range of ecosystems in western North America. It forms dense populations and often threatens native plant species and communities. In this study, we address the following questions: (1) what herbicides, rates, and application times are most effective at reducing sulfur cinquefoil abundance while having the least impact on native plants; and (2) does postherbicide seeding with native grass species increase native plant abundance? In 2002, we experimentally examined the effects of five herbicides (dicamba + 2,4-D; metsulfuron-methyl; triclopyr; glyphosate; and picloram) at two rates of application (low and high), three application times (early summer, fall, and a combined early summer–fall treatment), and two postherbicide seed addition treatments (seeded or not seeded) on sulfur cinquefoil abundance, plant community composition, and species richness. Experimental plots were monitored through 2005. Picloram was the most effective herbicide at reducing sulfur cinquefoil density, the proportion of remaining adult plants, and seed production. The effects of picloram continued to be evident after 3 yr, with 80% reduction of sulfur cinquefoil in 2005. In addition, seeding of native grass seeds alone (no herbicide application) reduced the proportion of sulfur cinquefoil plants that were reproductively active. Despite reductions in sulfur cinquefoil abundance, all treatments remained dominated by exotic species because treated areas transitioned from exotic forb- to exotic grass-dominated communities. However, a one-time herbicide application controlled sulfur cinquefoil for at least 3 yr, and therefore might provide a foundation to begin ecological restoration. Herbicide applications alone likely are to be insufficient for long-term sulfur cinquefoil control without further modification of sites through native grass or forb seeding. Integrating herbicides with native plant seeding to promote the development of plant communities that are resistant to sulfur cinquefoil invasion is a promising management approach to ecological restoration.

Herbicides are the primary method used to control exotic, invasive plants. This study evaluated restoration efforts applied to grasslands dominated by an invasive plant, sulfur cinquefoil, 6 yr after treatments. Of the five herbicides we evaluated, picloram continued to provide the best control of sulfur cinquefoil over 6 yr. We found the timing of picloram applications to be important to the native forb community. Plots with picloram applied in the fall had greater native forb cover. However, without the addition of native perennial grass seeds, the sites became dominated by exotic grasses. Seeding resulted in a 20% decrease in exotic grass cover. Successful establishment of native perennial grasses was not apparent until 6 yr after seeding. Our study found integrating herbicide application and the addition of native grass seed to be an effective grassland restoration strategy, at least in the case where livestock are excluded.

We examine excess emission at high positive and negative velocities toward known Galactic supernova remnants (SNRs) in the “Inner-Galaxy Arecibo L-band Feed Array (I-GALFA)” Hi 21-cm survey data. The I-GALFA survey covers ℓ = 32° to 77°, and has a velocity range of ±700 km s−1 with high angular and velocity resolutions (4′ and 0.18 km s−1, respectively) and good sensitivity (0.2 K). The excess emission which is thought to be part of a fast-expanding Hi shell of a SNR is detected from four among 39 SNRs in the I-GALFA area: W44, G54.4–0.3, W51C, and CTB 80. Although the Hi shells of the four SNRs were already reported in low-resolution studies, the first detection of both sides of an expanding Hi shell associated with W44 is very inspiring. We discuss physical properties of these four SNRs and their statistical nature.

We show evidence of electrical and thermal conductivity percolation in polymer based carbon nanotube (CNT) composites, which follow power law variations with respect to the CNT concentrations in the matrix. The experimentally obtained percolation thresholds, i.e., ~ 0.074 vol % for single walled CNTs and ~ 2.0 vol % for multi-walled CNTs, were found to be aspect ratio dependent and in accordance with those determined theoretically from excluded volume percolation theory. A much greater enhancement, over 10 orders of magnitude, was obtained in the electrical conductivity at the percolation threshold, while a smaller increase of ~ 100 % was obtained in the thermal conductivity values. Such a difference is qualitatively explained on the basis of the respective conductivity contrast between the CNT filler and the polymer matrix.