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Substance use disorders are highly prevalent, affecting millions of Americans directly (social, occupational, and health problems) and indirectly (billions of dollars in health care costs and lost revenues due to disability). This section briefly introduces the chemical classification and neurobehavioral properties of the most commonly misused substances.
On-site surveys of weed populations provide information on the relative occurrence and density of weeds that can be useful to growers in that region. Data generated by weed surveys can aid in the management of weed issues by monitoring the movement of problem weeds and forecasting areas susceptible to infestations. Currently, on-site surveys are often performed on a small scale, within single fields or counties. Questionnaire surveys are helpful for assessing relative abundance but do not always provide detailed information on weed distribution in time or space. A survey was conducted annually in Ohio from 2013 through 2017 in 49 counties with soybean [Glycine max (L.) Merr.] production to assess the late-season occurrence of horseweed [Conyza canadensis (L.) Cronquist]. The objectives of this research were to: (1) determine the frequency, level of infestation, and distribution of C. canadensis in soybean fields in the primary soybean-producing Ohio counties over 5 yr; and (2) identify significant spatial clusters or movement trends over time. Conyza canadensis was encountered in each county from 2013 through 2017. Spatial cores of interest, or counties identified as having significant levels of C. canadensis infestations or a lack thereof relative to surrounding counties, were identified in all years except 2017. The lowest frequency of C. canadensis encountered at all rating levels occurred in 2017, which coincided with second-highest frequency of infestations (highest density level) among years. There was no distinct distribution or pattern of C. canadensis movement within the state from year to year, but there was an increase in counties with infestations over time compared with the early years of the survey when many counties had few to no infestations. These results suggest that C. canadensis persists as a common and troublesome threat to Ohio soybean producers and that growers should continue making C. canadensis management a priority when developing weed control programs.
To determine the utility of the Sofia® SARS rapid antigen fluorescent immunoassay (FIA) to guide hospital bed placement of patients being admitted through the emergency department (ED).
Cross-sectional analysis of a clinical quality improvement study.
Two community hospitals in Maryland. From 9/21/2020 to 12/3/2020, 2887 patients simultaneously received the Sofia® SARS rapid antigen FIA and SARS-CoV-2 RT-PCR assays on admission through the ED.
Rapid antigen results and symptom assessment guided initial patient placement while confirmatory RT-PCR was pending. The sensitivity, specificity, positive and negative predictive values of the rapid antigen assay were calculated relative to RT-PCR, overall and separately for symptomatic and asymptomatic patients. Assay sensitivity was compared to RT-PCR cycle threshold (Ct) values. Assay turnaround times were compared. Clinical characteristics of RT-PCR positive patients and potential exposures from false-negative antigen assays were evaluated.
Overall agreement, sensitivity, and specificity for all patients was 97.9%, 76.6% (95% confidence interval (CI): 71%, 82%), and 99.7% (95% CI: 99%, 100%), respectively. No differences in performance were seen between asymptomatic and symptomatic individuals. As RT-PCR Ct increased, sensitivity of the antigen assay decreased. Mean turnaround time for the antigen assay and RT-PCR was 1.2 (95% CI: 1.0, 1.3) and 20.1 (95% CI: 18.9, 40.3) hours, respectively (p<0.001). No transmission from antigen-negative/RT-PCR-positive patients was identified.
While not a replacement for RT-PCR for detection of all SARS-CoV-2 infections, the Sofia® SARS antigen FIA has clinical utility for potential initial timely patient placement.
To investigate the current epidemiology of melioidosis in Yangon, Myanmar, between June 2017 and May 2019 we conducted enhanced surveillance for melioidosis in four tertiary hospitals in Yangon, where the disease was first discovered in 1911. Oxidase-positive Gram-negative rods were obtained from the microbiology laboratories and further analysed at the Department of Medical Research. Analysis included culture on Ashdown agar, the three disc sensitivity test (gentamicin, colistin and co-amoxiclav), latex agglutination, API 20 NE, antibiotic susceptibility testing, and a subset underwent molecular confirmation with a Burkholderia pseudomallei specific assay. Twenty one of 364 isolates (5.7%) were confirmed as B. pseudomallei and were mostly susceptible to the antibiotics used in standard therapy for melioidosis. Ten patients were from Yangon Region, nine were from Ayeyarwaddy region, and one each was from Kayin and Rakhine States. A history of soil contact was given by seven patients, five had diabetes mellitus and one had renal insufficiency. The patients presented with septicaemia (12 cases), pneumonia (three cases), urinary tract infection (two cases) and wound infection (four cases). Eighteen patients survived to hospital discharge. This study highlights the likelihood that melioidosis may be far more common, but underdiagnosed, in more rural parts of Myanmar as in other countries in SE Asia.
Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders.
Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder).
NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6).
NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
In the US, approximately 10,000 spinal cord injuries yearly result in permanent disability. Most spinal cord injuries are caused by motor vehicle collisions (40%), violence (30%), falls (20%), and sporting accidents (6%). Although spinal fractures can occur in any age group, the peak incidence is in males from ages 18 to 25. Certain conditions predispose to spinal fracture, spinal cord injury, or dislocation: old age, rheumatoid arthritis, osteoporosis, and spinal stenosis.
Ethnohistoric accounts indicate that the people of Australia's Channel Country engaged in activities rarely recorded elsewhere on the continent, including food storage, aquaculture and possible cultivation, yet there has been little archaeological fieldwork to verify these accounts. Here, the authors report on a collaborative research project initiated by the Mithaka people addressing this lack of archaeological investigation. The results show that Mithaka Country has a substantial and diverse archaeological record, including numerous large stone quarries, multiple ritual structures and substantial dwellings. Our archaeological research revealed unknown aspects, such as the scale of Mithaka quarrying, which could stimulate re-evaluation of Aboriginal socio-economic systems in parts of ancient Australia.
Adelges tsugae Annand (Hemiptera: Adelgidae), a nonindigenous insect pest of hemlock (Tsuga spp.) (Pinaceae) in eastern North America, spends most of its life cycle within an ovisac, which resembles a woolly white mass on twigs. We evaluated the probability of detecting adelgid wool with Velcro®-covered balls when taking an increasing number of samples per tree (field sampling) and number of trees per simulated stand. We examined the relationship between the detection of adelgid wool using this technique and the incidence of A. tsugae-infested twigs by sampling lower-crown branch tips of the same trees. We found that the probability of detecting wool with ball sampling increased with number of ball samples per tree, with number of trees per simulated stand, and with increasing incidence of ovisacs in the lower crown. When sampling an individual tree, we found that 20 ball samples per tree achieved a targeted precision level of 0.75, but when sampling a stand, we found that 10 ball samples per tree took the least time for the range of simulated A. tsugae infestations we tested. These sample sizes are recommended for detection of A. tsugae infestations on an individual tree and in a hemlock stand.
Separating and reattaching turbulent flows induced by a forward-facing step subjected to an incoming fully developed turbulent channel flow are studied using direct numerical simulation. The step height is one quarter of the channel height, and the Reynolds number based on friction velocity and half-channel height at the inlet is 180. The three-dimensional spatio-temporal characteristics of separation bubbles upstream and downstream of the step are analysed with particular attention to the effects of impinging hairpin structures and the topology of principal stretching. Immediately upstream of the step, the fluctuating vorticity parallel to the mean streamlines is significant. On the frontal surface of the step, strong spanwise skin friction appears in the form of alternating positive and negative values in vertical strips. Over the step, the principal stretching switches orientation along a curve emanating from the leading edge, which is termed the principal stretching line (PSL). The reverse flows upstream and downstream of the step possess dominant and harmonic frequencies that mirror those of the incoming flow. As a hairpin structure leans over the step, the associated vorticity is deformed by the principal stretching. Specifically, PSL marks the lower bound of the deformed hairpin legs, and an opposite-signed pair of counter-rotating quasi-streamwise vortices are induced near the top surface of the step. Consequently, the separation bubbles upstream of and over the step are enlarged and suppressed, respectively. For a sufficiently strong hairpin structure interacting with the step, an open-type separation occurs upstream of the step, while dual separation bubbles appear over the step.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE), underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate masks and respirators exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
The 2 arms of the study included (1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment and (2) PPE treatment with MBL for 5 cycles of decontamination to determine maintenance of PPE performance.
MBL treatment was used to inactivate coronaviruses on 3 N95 filtering facepiece respirator (FFR) and 2 medical mask models. We inoculated FFR and medical mask materials with 3 coronaviruses, including SARS-CoV-2, and we treated them with 10 µM MB and exposed them to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5 cycles of decontamination using multiple US and international test methods, and the process was compared with the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Overall, MBL robustly and consistently inactivated all 3 coronaviruses with 99.8% to >99.9% virus inactivation across all FFRs and medical masks tested. FFR and medical mask integrity was maintained after 5 cycles of MBL treatment, whereas 1 FFR model failed after 5 cycles of VHP+O3.
MBL treatment decontaminated respirators and masks by inactivating 3 tested coronaviruses without compromising integrity through 5 cycles of decontamination. MBL decontamination is effective, is low cost, and does not require specialized equipment, making it applicable in low- to high-resource settings.
Chest radiography compares left ventricular decompression in the same patient supported with extracorporeal membrane oxygenation with atrial septal fenestration and subsequently supported with left ventricular assist device with apical cannulation.