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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.
Rock debris covers ~30% of glacier ablation areas in the Central Himalaya and modifies the impact of atmospheric conditions on mass balance. The thermal properties of supraglacial debris are diurnally variable but remain poorly constrained for monsoon-influenced glaciers over the timescale of the ablation season. We measured vertical debris profile temperatures at 12 sites on four glaciers in the Everest region with debris thickness ranging from 0.08 to 2.8 m. Typically, the length of the ice ablation season beneath supraglacial debris was 160 days (15 May to 22 October)—a month longer than the monsoon season. Debris temperature gradients were approximately linear (r2 > 0.83), measured as −40°C m–1 where debris was up to 0.1 m thick, −20°C m–1 for debris 0.1–0.5 m thick, and −4°C m–1 for debris greater than 0.5 m thick. Our results demonstrate that the influence of supraglacial debris on the temperature of the underlying ice surface, and therefore melt, is stable at a seasonal timescale and can be estimated from near-surface temperature. These results have the potential to greatly improve the representation of ablation in calculations of debris-covered glacier mass balance and projections of their response to climate change.
OBJECTIVES/GOALS: Introduction: Between 2014 and 2019 the National Institute of Health (NIH) through the National Center for the Advancement of Translational Science (NCATS) has awarded about $2.7 billion to U.S. Academic Medical Centers to build a national network of clinical and translational science program hubs that serve to meet their key goals and initiatives. Today there are about 60 Clinical and Translational Science Award (CTSA) program hubs. Each CTSA program hub has a corresponding website highlighting its clinical and translational science centered programs and activities. These websites are a critical communication gateway to promote NCATS goals and initiatives. Objective: The objective of this research is to evaluate the NIH funded Clinical and Translational Science Award (CTSA) program hub websites for NCATS goals and initiative content alignment, navigability, and interactivity. METHODS/STUDY POPULATION: Methods: Each CTSA program hub website was systematically evaluated for information or tools that align with the five NCATS / CTSA Goals and eight CTSA nationally identified program initiatives. Each NCATS goal and CTSA initiative was subsequently ranked by information diversity level (text, tool, interactivity) and navigation level (click distance from the home page). RESULTS/ANTICIPATED RESULTS: Results: Four of the five NCATS goals are thoroughly and consistently represented among the CTSA Consortium with workforce development, patient and community engagement, and quality and efficiency of research being the top three. Informatics is thoroughly and consistently represented, but not always clearly identified on the home page. The most underrepresented goal is integration of special and underserved populations which was identified on only 60% of CTSA program hub websites. The most common focus of the eight CTSA program initiatives is the Trial Innovation Network in CTSA program hub websites. The Smart IRB comes in a distant second. The remaining six initiatives are severely underrepresented. DISCUSSION/SIGNIFICANCE OF IMPACT: Discussion: The identification of these gaps among the CTSA program hubs presents an understanding of content management and website functionality among the consortium from 3 principal approaches. First it creates an understanding of CTSA program hub content alignment with its funding source goals and initiatives. Such an understanding presents an opportunity to promote ways to create a better aligned consortium with improved collaboration pathways by the funding source through program hub website content standards. Second, it creates an opportunity for program hubs to understand and respond to the messaging their websites are presenting as it relates to the funding source. Third, it provides an opportunity to identify specific program initiatives and goals the CTSA institutions independently chose to highlight which can open a dialog to the better understanding the value of the program initiatives as they relate to the needs of CTSA program hubs. Ultimately, CTSA websites through content alignment should lead to an improved user experience.
To assess the nutritional quality of Australian supermarket own brand chilled convenience foods (SOBCCF), for example, ready meals, pizza, pies and desserts.
Two large supermarkets (Coles and Woolworths) in Perth, Western Australia were audited in February 2017.
Data were extracted from photographic images of 291 SOBCCF, including front-of-pack information (i.e. product name, description and nutrition labels including Health Star Rating (HSR)) and back-of-pack information (i.e. nutrition information panel and ingredients list). SOBCCF were classified as healthy or unhealthy consistent with principles of the Australian Guide to Healthy Eating (AGTHE), NOVA classification of level of food processing and HSR score.
Fifty-four percentage of SOBCCF were classified as unhealthy according to AGTHE principles, 94 % were ultra-processed foods using NOVA and 81 % scored a HSR of ≥2·5, implying that they were a healthy choice. Some convenience food groups comprised more healthy choices overall including prepared vegetables, salad kits and bowls, soups and vegetarian food. A significantly larger proportion of SOBCCF from Coles were classified as unhealthy compared with Woolworths (70 v. 44 %, P < 0·05) using the AGTHE.
The findings suggest there is potential for Australian supermarkets to improve the nutritional quality of their SOBCCF and highlights the differences between supermarkets in applying their corporate social responsibility policies. Policies to assist consumers to select healthier foods should address difficulties in identifying healthy convenience foods. The findings reveal misclassification of unhealthy SOBCCF as healthy by the HSR suggesting that its algorithm should be reformed to align with recommendations of the AGTHE.
A person’s egonet, the set of others with whom that person is connected, is a personal sample of society which especially influences that person’s experience and perceptions of society. We show that egonets systematically misrepresent the general population because each person is included in as many egonets as that person has “friends.” Previous research has recognized that this unequal weighting in egonets leads many people to find that their friends have more friends than they themselves have. This paper builds upon that research to show that people’s egonets provide them with systematically biased samples of the population more generally. We discuss how this ubiquitous egonet bias may have far reaching implications for people’s experiences and perceptions of frequencies of other people’s ties and traits in ways that may influence their own feelings and behaviors. In particular, these egonet biases may help explain people’s tendencies to disproportionately experience and overestimate the prevalence of certain types of deviance and other social behaviors and consequently be influenced toward them. We illustrate egonet bias with analyses of all friends among 63,731 Facebook users. We call for further empirical investigation of egonet biases and their consequences for individuals and society.
Identifying early risk factors for the development of social anxiety symptoms has important translational implications. Accurately identifying which children are at the highest risk is of critical importance, especially if we can identify risk early in development. We examined continued risk for social anxiety symptoms at the transition to adolescence in a community sample of children (n = 112) that had been observed for high fearfulness at age 2 and tracked for social anxiety symptoms from preschool through age 6. In our previous studies, we found that a pattern of dysregulated fear (DF), characterized by high fear in low threat contexts, predicted social anxiety symptoms at ages 3, 4, 5, and 6 years across two samples. In the current study, we re-evaluated these children at 11–13 years of age by using parent and child reports of social anxiety symptoms, parental monitoring, and peer relationship quality. The scores for DF uniquely predicted adolescents’ social anxiety symptoms beyond the prediction that was made by more proximal measures of behavioral (e.g., kindergarten social withdrawal) and concurrent environmental risk factors (e.g., parental monitoring, peer relationships). Implications for early detection, prevention, and intervention are discussed.
Psychiatric disorders, including eating disorders (EDs), have clinical outcomes that range widely in severity and chronicity. The ability to predict such outcomes is extremely limited. Machine-learning (ML) approaches that model complexity may optimize the prediction of multifaceted psychiatric behaviors. However, the investigations of many psychiatric concerns have not capitalized on ML to improve prognosis. This study conducted the first comparison of an ML approach (elastic net regularized logistic regression) to traditional regression to longitudinally predict ED outcomes.
Females with heterogeneous ED diagnoses completed demographic and psychiatric assessments at baseline (n = 415) and Year 1 (n = 320) and 2 (n = 277) follow-ups. Elastic net and traditional logistic regression models comprising the same baseline variables were compared in ability to longitudinally predict ED diagnosis, binge eating, compensatory behavior, and underweight BMI at Years 1 and 2.
Elastic net models had higher accuracy for all outcomes at Years 1 and 2 [average Area Under the Receiving Operating Characteristics Curve (AUC) = 0.78] compared to logistic regression (average AUC = 0.67). Model performance did not deteriorate when the most important predictor was removed or an alternative ML algorithm (random forests) was applied. Baseline ED (e.g. diagnosis), psychiatric (e.g. hospitalization), and demographic (e.g. ethnicity) characteristics emerged as important predictors in exploratory predictor importance analyses.
ML algorithms can enhance the prediction of ED symptoms for 2 years and may identify important risk markers. The superior accuracy of ML for predicting complex outcomes suggests that these approaches may ultimately aid in advancing precision medicine for serious psychiatric disorders.
Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.
From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.
All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.
No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.
Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.
Resistant dextrins are glucose polymers with atypical linkages making them non-digestible in the upper part of the gastrointestinal tract. NUTRIOSE® is slightly digested in the small intestine and then, progressively fermented in the colon. The objective of this study is to investigate the beneficial effects resulting from the colonic fermentation of NUTRIOSE® and the underlying mechanism of action in rats.
Materials & Methods:
This experiment was conducted according to the French Regulations for Animal Experimentation and authorized under the project Number 00619.01. After acclimatisation on maintaining diet, 20 Sprague-Dawley rats were blocked by body weight and randomly split into 2 groups. The control group was given a fibre-free diet where corn starch was used to replace fibre and the experimental group was supplemented with 10% NUTRIOSE®. Feces were collected for enzymatic activities measurement. Caecal contents were collected so as caecal cell walls and colon biopsies for gene expression analysis.
The significant increases in caecal content weight (p < 0.001) fecal activity of saccharolytic enzymes (p < 0.05) and the decrease in caecal pH (p < 0.001) after the supplementation of NUTRIOSE® suggested its fermentation in the colon and caecum. It is also known from literature that NUTRIOSE® fermentation leads to higher levels of short chain fatty acids including higher levels of propionate and butyrate. This enhanced fermentation induced several positive impacts in the colon such as an increased caecal wall weight (p < 0.001) demonstrating beneficial effect on colon epithelial cells, an up-regulation of genes involved in membrane integrity (occludin (p = 0.01), ZO-1(p = 0.01)), and a positive impact on genes involved in inflammation (Tnf-α (p = 0.03), FOXP3 (p = 0.01)). The present study demonstrated the positive effects of NUTRIOSE® supplementation on glucose metabolism through the up-regulation of PEPCK in the colon (p < 0.001). This effect may also be mediated by the up-regulation of the GPR41 receptor in the colon (p < 0.001) and probably activated by butyrate.
All together, these results confirmed that NUTRIOSE® is well fermented in the colon and that these fermentations may be associated with beneficial impacts on colonic epithelial integrity, inflammation and neoglucogenesis. Here we demonstrate a putative mechanism of action of NUTRIOSE® to improve the colonic health which is through the production of butyrate and the resulting activation of GPR41 receptor. Thus, this study helps us to understand the physiological impact of NUTRIOSE® fermentation in colon to produce several health benefits as observed in clinical studies.
Frascati international research criteria for HIV-associated neurocognitive disorders (HAND) are controversial; some investigators have argued that Frascati criteria are too liberal, resulting in a high false positive rate. Meyer et al. recommended more conservative revisions to HAND criteria, including exploring other commonly used methodologies for neurocognitive impairment (NCI) in HIV including the global deficit score (GDS). This study compares NCI classifications by Frascati, Meyer, and GDS methods, in relation to neuroimaging markers of brain integrity in HIV.
Two hundred forty-one people living with HIV (PLWH) without current substance use disorder or severe (confounding) comorbid conditions underwent comprehensive neurocognitive testing and brain structural magnetic resonance imaging and magnetic resonance spectroscopy. Participants were classified using Frascati criteria versus Meyer criteria: concordant unimpaired [Frascati(Un)/Meyer(Un)], concordant impaired [Frascati(Imp)/Meyer(Imp)], or discordant [Frascati(Imp)/Meyer(Un)] which were impaired via Frascati criteria but unimpaired via Meyer criteria. To investigate the GDS versus Meyer criteria, the same groupings were utilized using GDS criteria instead of Frascati criteria.
When examining Frascati versus Meyer criteria, discordant Frascati(Imp)/Meyer(Un) individuals had less cortical gray matter, greater sulcal cerebrospinal fluid volume, and greater evidence of neuroinflammation (i.e., choline) than concordant Frascati(Un)/Meyer(Un) individuals. GDS versus Meyer comparisons indicated that discordant GDS(Imp)/Meyer(Un) individuals had less cortical gray matter and lower levels of energy metabolism (i.e., creatine) than concordant GDS(Un)/Meyer(Un) individuals. In both sets of analyses, the discordant group did not differ from the concordant impaired group on any neuroimaging measure.
The Meyer criteria failed to capture a substantial portion of PLWH with brain abnormalities. These findings support continued use of Frascati or GDS criteria to detect HIV-associated CNS dysfunction.
This interdisciplinary collection of essays, containing chapters from specialists in history, art history, medical history, and literature, examines how the intimately familiar language of the body served as a convenient medium through which to imagine and describe transformations of the larger world, both for the better and also for the worse. Its individual contributors demonstrate the myriad ways in which rethinking the human body was one way to approach rethinking the social, political, and religious realities of the world from the Middle Ages until the early modern period.
FLUID BODIES AND Bodily Fluids in Premodern Europe: Bodies, Blood, and Tears in Literature, Theology, and Art is an interdisciplinary collection, containing chapters from specialists in history, art history, and literature, dealing with material from the early Middle Ages to the early modern period. The essays focus on discussions regarding the body and how its fluids both signify and explain change. For medieval and early modern thinkers, the apparent solidity of the body only came about through the dynamic interplay of a host of fluidities in constant flux. The intimately familiar language of the body served as a convenient medium through which to imagine and describe transformations of the larger world, both for the better and also for the worse. Rethinking the human body was one way to approach redefining the social, political, and religious realities of the world.
Fluid Bodies situates itself in the context of a rich and ongoing conversation regarding conceptions of the human body and its significations in the medieval and early modern Western world. There is no shortage of scholarship on the subject of corporeality in these periods. Past work has interrogated the range of meanings assigned to the category of body. This work has stressed the multiplicity of these meanings, destabilizing monolithic categories of universal personhood or universal body by approaching their subjects through the lenses of gender, teleology, narrative, sexuality, and developing notions of the role played by bodily fluids in human physiology, particularly the humoral body and its reciprocal relations with its environment.
Materiality itself has also served as a frequent focus for recent research, particularly into the way the sacred and the material can interact and sometimes cohere. This work, especially as it has been developed by scholars such as Caroline Walker Bynum, has stressed the recurrent anxieties that result from the investment of the divine in the material. Most pertinently for this volume, it also explores the ultimate fruitfulness of these anxieties as drives for cultural expression and creative thought, particularly in the signifying power of blood. Bynum's work has illustrated that speculation regarding bodily change often prompts focused reflections on personal identity
Few independent studies have examined the psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults, despite growing interest in its use for clinical purposes. In this paper we report the test–retest reliability and construct validity of the NIHTB-CB, as well as its agreement or concordance with traditional neuropsychological tests of the same construct to determine whether tests could be used interchangeably.
Sixty-one cognitively healthy adults ages 60–80 completed “gold standard” (GS) neuropsychological tests, NIHTB-CB, and brain MRI. Test–retest reliability, convergent/discriminant validity, and agreement statistics were calculated using Pearson’s correlations, concordance correlation coefficients (CCC), and root mean square deviations.
Test–retest reliability was acceptable (CCC = .73 Fluid; CCC = .85 Crystallized). The NIHTB-CB Fluid Composite correlated significantly with cerebral volumes (r’s = |.35−.41|), and both composites correlated highly with their respective GS composites (r’s = .58−.84), although this was more variable for individual tests. Absolute agreement was generally lower (CCC = .55 Fluid; CCC = .70 Crystallized) due to lower precision in fluid scores and systematic overestimation of crystallized composite scores on the NIHTB-CB.
These results support the reliability and validity of the NIHTB-CB in healthy older adults and suggest that the fluid composite tests are at least as sensitive as standard neuropsychological tests to medial temporal atrophy and ventricular expansion. However, the NIHTB-CB may generate different estimates of performance and should not be treated as interchangeable with established neuropsychological tests.