Mass vaccination campaigns have been used effectively to limit the impact of communicable disease on public health. However, the scale of the coronavirus disease (COVID-19) vaccination campaign is unprecedented. Mass vaccination sites consolidate resources and experience into a single entity and are essential to achieving community (“herd”) immunity rapidly, efficiently, and equitably. Health care systems, local and regional public health entities, emergency medical services, and private organizations can rapidly come together to solve problems and achieve success. As medical directors at several mass vaccination sites across the United States, we describe key mass vaccination site concepts, including site selection, operational models, patient flow, inventory management, staffing, technology, reporting, medical oversight, communication, and equity. Lessons learned from experience operating a diverse group of mass vaccination sites will help inform not only sites operating during the current pandemic, but also may serve as a blueprint for future outbreaks of highly infectious communicable disease.

This study provides a morphological and phylogenetic characterization of two novel species of the order Haplosporida (Haplosporidium carcini n. sp., and H. cranc n. sp.) infecting the common shore crab Carcinus maenas collected at one location in Swansea Bay, South Wales, UK. Both parasites were observed in the haemolymph, gills and hepatopancreas. The prevalence of clinical infections (i.e. parasites seen directly in fresh haemolymph preparations) was low, at ~1%, whereas subclinical levels, detected by polymerase chain reaction, were slightly higher at ~2%. Although no spores were found in any of the infected crabs examined histologically (n = 334), the morphology of monokaryotic and dikaryotic unicellular stages of the parasites enabled differentiation between the two new species. Phylogenetic analyses of the new species based on the small subunit (SSU) rDNA gene placed H. cranc in a clade of otherwise uncharacterized environmental sequences from marine samples, and H. carcini in a clade with other crustacean-associated lineages.

Bandelier National Monument (BNM) was created to protect an extraordinary inventory of archaeological resources carved in the Tshirege Member of the Bandelier Tuff. These include more than one thousand excavated chambers, called cavates, used for dwelling, storage, and textile production. The glass-rich tuffs at the base of the Tshirege Member are poorly consolidated and susceptible to erosion by wind, rain, and mechanical abrasion, with resultant loss of cultural material. However, rock surfaces develop protective weathering rinds that are resistant to erosion. Using optical microscopy, SEM-EDS, XRD, and electron microprobe analysis, we determined that this rind consists of clay and silt sediments colonized by lichens and other surface biota, accompanied by the precipitation of secondary minerals in the near-surface pore space. Scoping experiments focused on glass-organic acid interactions indicate that oxalic acid excreted by microbial crust constituents catalyzes biogeochemical reactions that lead to the preferential dissolution of Si, Al, and Fe components of the volcanic glass; these cations become available for precipitation of opal, and smectite and sepiolite clays. Enzyme assays that quantify biological activity at outcrop surfaces indicate that microbial populations initially thrive as they derive nutrients from the dissolution reactions of the glass, but activity starts to decline as precipitation of secondary minerals limits access to new sources of nutrients, so that alteration processes are self-limiting. As case hardening progresses, imbibition rates at the surface decrease, and the erosion resistance of the altered surfaces is substantially improved. This article presents summary results of research conducted over a period of five years to characterize the roles of lichens and other microflora in rind formation, and the resulting contributions to tuff stability. The interaction of lichens and other microflora with rock surfaces in archaeological sites and monuments is usually explored in terms of biodeterioration and consequent damage. However, this study shows that, under some circumstances, lichens and microflora provide a level of erosion protection to relatively porous and unconsolidated rock strata that outweighs their biodeteriorative effects.

Objective: The Advisory Council of the American Red Cross Disaster Services requested that an independent study determine whether first-aid providers without professional mental health training, when confronted with people who have experienced a traumatic event, offer a “safe, effective and feasible intervention.”

Methods: Standard databases were searched by an expert panel from 1990 to September 2010 using the keyword phrase “psychological first aid.” Documents were included if the process was referred to as care provided to victims, first responders, or volunteers and excluded if it was not associated with a disaster or mass casualty event, or was used after individual nondisaster traumas such as rape and murder. This search yielded 58 citations.

Results: It was determined that adequate scientific evidence for psychological first aid is lacking but widely supported by expert opinion and rational conjecture. No controlled studies were found. There is insufficient evidence supporting a treatment standard or a treatment guideline.

Conclusion: Sufficient evidence for psychological first aid is widely supported by available objective observations and expert opinion and best fits the category of “evidence informed” but without proof of effectiveness. An intervention provided by volunteers without professional mental health training for people who have experienced a traumatic event offers an acceptable option. Further outcome research is recommended.

(Disaster Med Public Health Preparedness. 2012;6:247–252)

Children of parents with a range of psychiatric disorders are at increased risk of developing psychological disturbance themselves. There is growing evidence that this includes children who have parents with a chronic somatoform disorder. The health beliefs of children with a parent with a somatoform disorder were compared with those of children with a parent with an organic physical disorder. Children of parents with somatoform disorder scored higher on bodily preoccupation and disease phobia scales and their health beliefs showed similarities to the beliefs of their parents.

The Cape Sable seaside sparrow is a Federally listed endangered species endemic to south Florida's Everglades. It nests near the ground in seasonally dry prairies. Consequently, the timing and depth of seasonal water flows determine its fate. With water management plans the central focus of Everglades' restoration schemes, the demography of this bird becomes central to hydrologic planning. In order to understand how its demography influences restoration options, we calculated survivorship, fecundity and dispersal within three of the sparrow's six populations. Nearly 40% of adult sparrows die from year to year. Sparrows can produce up to four broods per breeding season, and typically produce two (March to August). Females lay an average of three eggs per nest, two of which usually hatch. The success of these nests varies among populations such that nests in population E are more than four times as likely to fledge young as nests within population A. Nest success within population B is 26% early in the breeding season, but drops to 9% after the onset of summer rains in early June. Nests are built 16 to 21 cm from the soil surface making them vulnerable to water depths that exceed these values. Based on observations of marked individuals, sparrows generally remain within a 1 km area centred on their breeding grounds. We have never observed immigration between populations. A simple demographic model demonstrates that breeding success and duration appear to constrain sparrow population growth more than other demographic parameters. Maintaining suitable breeding conditions restricts water management options to those that will restore hydrological conditions to their original patterns.

The category ‘somatoform disorders' was introduced comparatively recently in DSM–III and thereafter in ICD–10: it is the umbrella term currently favoured to cover a heterogeneous group of interrelated and overlapping syndromes, which have been given many names over the years. All these syndromes have in common the process of somatisation: that is, the presence of physical symptoms unexplained by physical disease, with variable degrees of distress and loss of function, about which the patient consults doctors.

Introduction: Prior studies have documented less than 3% survival for out-of-hospital cardiac arrest (CA) in D.C. EMS intubation has failed to improve extremely poor survival rates for out of hospital CA. This study will investigate whether the addition of automatic external defibrillator (AED) use will improve the negligible survival rate experienced in a system that transports 80,000 pts/yr; Thus replicating success with AED for CA in other centers.

Methods: Retrospective review of all CA data from D.C. EMS system from 1-12/91 (no AED) vs. 1-12/93 (AED in use). Supporting data from run sheets and hospital records was compared for years with and without the AED using student's t test, chi-square with p <0.05.

Results: In 1991 there were 414 out of hospital CAs arrests with an overall survival rate of 2.3% with a mean EMS arrival time of 10 minutes. There were no significant differences with respect to CA patients’ age, bystander CPR or BLS/ALS response times between two years (1991 and 1993) p = NS. In VF patients who comprised 26% and 24% of presenting rhythms for ’91 and ’93 respectively, the use of AEDs improved survival 3.8% vs. 29% with AEDs in ’93 (p <0.05). There was no difference in percentage of non-VF presenting rhythms or patient outcomes between the two groups.

High-resolution transmission electron microscopy has been used to investigate the structure and growth behavior of three separate multilayer systems composed of spin-glass alloys(AuFe.03,CuMn.15, and AgMn.09) alternating with amorphous silicon. Each of the three systems was fabricated with two different sample configurations. The first consisted of bilayers with 3 nm spinglass alloy and 7 nm amorphous siliconlayers. The second consisted of 7 nm spin-glass alloy and 7 nm amorphous silicon layers. HRTEM images of ion-milled cross-sectioned samples revealed variations in the degree of crystallinity of the spin-glass material. Variations in the amount and symmetry of interlayer formation were also observed. Systematic studies of such variations should help to explain differences in their measured spin-glass properties.

Increasing circuit densities produce higher metal wiring aspect ratios, and more difficult feature fill for damascene processing. One method of extending the use of sputter deposition to challenging aspect ratios is to collimate the sputtered flux using a collimator plate, and to avoid randomizing the collimated flux by using low process pressures corresponding to long sputtered atom mean free paths. In this paper, we discuss our fabrication of damascene AI-0.5Cu-2Si and AI-2Mg wiring using both collimated and uncollimated sputtering, and our observations of collimation-induced changes in Al alloy electromigration and microstructure. Our experiments show that collimation has only a small effect on AlCuSi, but a large effect on AIMg. Specifically, the median time to electromigration failure for collimated AIMg was ∼10X the value for uncollimated AlMg and ∼6X the values for collimated and uncollimated AlCuSi. Transmission electron microscope and x-ray diffraction analyses of these films show that the collimation-induced improvement in AIMg t50 is associated with the formation of smaller, lower strain grains which are clustered in very well-oriented (111) domains. We propose that the advantageous AlMg microstructure results from enhanced texture produced by aspects of the collimated deposition active in the absence of incoherent precipitates.

“In a prospective, randomised, controlled trial to determine whether comprehensive lifestyle changes affect coronary atherosclerosis after 1 year, 28 patients were assigned to an experimental group (low-fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care control group. 195 coronary artery lesions were analysed by quantitative coronary angiography. The average percentage diameter stenosis regressed from 40.0 (SD 16.9)% to 37.8 (16.5)% in the experimental group yet progressed from 42.7 (15.5)% to 46.1 (18.5)% in the control group. When only lesions greater than 50% stenosed were analysed, the average percentage diameter stenosis regressed from 61.1 (8.8)% to 55.8 (11.0)% in the experimental group and progressed from 61.7 (9.5)% to 64.4 (16.3)% in the control group. Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year, without use of lipid-lowering drugs.”