Objectives: We compared rates of myopericarditis adverse events and evaluated potential risk factors of development. We compared rates of dermatological–neurological adverse events (severe and serious) with other adverse events in a specific population of deployed US military personnel who received or did not receive ACAM2000 vaccine (ie, Vaccinia smallpox live vaccine). Methods: Up to 20,000 military personnel recipients were enrolled in a prospective observational cohort study: up to 15,000 ACAM2000 recipients in cohort 1 and up to 5,000 military personnel who were eligible for ACAM2000 vaccination but were not vaccinated due to recent vaccination or characteristics of their contacts in cohort 2. Enrollment was at a 3:1 ratio, respectively. Serum specimens and data were collected at the initial visit and 10 days later (cf, window of 6–17 days). Study participants with evidence, either clinical or laboratory, of possible myopericarditis were referred to a blinded independent review committee for further evaluation and adjudication. The primary analysis was logistic regression with adjudicated myopericarditis as the dependent variable and age, sex, race, and exercise regimen as the independent variables. Results: Initial data and serum specimens were obtained from 14,667 participants (cohort 1, N = 10,825; cohort 2, N = 3,842). According to protocol, 2 visits were completed by 12,110 participants (cohort 1, N = 8,945; cohort 2, N = 3,165), and 125 participants (cohort 1, N = 111; cohort 2, N = 14) were referred for myopericarditis adjudication, of whom 1 had confirmed myocarditis, 5 had suspected myocarditis, 1 had suspected pericarditis, and 54 (cohort 1, N = 44; cohort 2, N = 10) had subclinical myopericarditis. The unadjusted myopericarditis rates were 5.7 per 1,000 (95% CI, 4.3–7.5) for cohort 1 and 3.2 per 1,000 (95% CI, 1.7–5.8) for cohort 2. The unadjusted and adjusted odds ratios for myopericarditis for cohort 1 and cohort 2 were 1.8 (95% CI, 0.9–3.6) and 1.3 (95% CI, 0.6–2.6), respectively. At least 1 serious adverse event was experienced by 117 participants (1.1%) in cohort 1 and 13 (0.3%) in cohort 2. No serious and severe neurological or dermatological adverse events were reported. Conclusions: ACAM2000 vaccination was associated with a modest but nonsignificant increase in the risk of myopericarditis in this prudently screened, young and healthy service-member population. The adjusted OR was 1.3 and the unadjusted OR was 1.8. Overall, all but 7 cases were subclinical. Citation: Faix DJ, Gordon DM, Perry LN, et al. Prospective safety surveillance study of ACAM2000 smallpox vaccine in deploying military personnel. Vaccine 2020;38:7323–7330.

Hobby metal detectorists search for archaeological finds as individuals and within groups, the latter being the focus of this article. Such groups come together as “clubs” and “meetings,” but also as part of large, often commercially run events typically known as “rallies.” All these activities are attractive to detectorists because they provide them with access to land to search, along with the promise of making interesting (even valuable) discoveries, and they have a social dimension. They are common in England and also well established in several countries in northwest Europe, partly due to changing legislation. Although policies and mechanisms are often in place for collaboration with individual detectorists and even local metal-detecting clubs, larger events (not least, the large-scale commercial rallies increasingly occurring in England) present challenges for professional archaeologists, specifically in relation to the capacity to properly record finds and manage potential damage to the historic environment. To respond appropriately to these changes, a greater understanding of detectorists’ events is needed. For this reason, we explore and define the scale, nature, and diversity of group events, relating them to different legislative and cultural contexts in Flanders (Belgium), England (and Wales), and Finland. Subsequently, we outline challenges associated with group events and identify possible ways forward.

Hobby metal detecting is a controversial subject. Legal and policy approaches differ widely across national and regional contexts, and the attitudes of archaeologists and heritage professionals towards detectorists are often polarized and based on ethical or emotive arguments. We, the European Public Finds Recording Network (EPFRN), have implemented collaborative approaches towards detectorist communities in our respective contexts (Denmark, England and Wales, Finland, Flanders, and the Netherlands). Although our motivations are affected by our national circumstances, we base our work on an agreed set of goals, practices, and visions. This article presents the EPFRN's vision statement and provides insight into its underlying thoughts. We hope to create a debate on how to develop best practice approaches that acknowledge the inherent challenges of hobby metal detecting while realizing its potential.

Technological advances have led to better patient outcomes and the expansion of clinical services in paediatric cardiology. This expansion creates an ever-growing workload for clinicians, which has led to workflow and staffing issues that need to be addressed. The objective of this study was the development of a novel tool to measure the clinical workload of a paediatric cardiology service in Cape Town, South Africa: The patient encounter index is a tool designed to quantify clinical workload. It is defined as a ratio of the measured duration of clinical work to the total time available for such work. This index was implemented as part of a prospective cross-sectional study design. Clinical workload data were collected over a 10-day period using time-and-motion sampling. Clinicians were contractually expected to spend 50% of their daily workload on patient care. The median patient encounter index for the Western Cape Paediatric Cardiac Service was 0.81 (range 0.19–1.09), reflecting that 81% of total contractual working time was spent on clinical activities. This study describes the development and implementation of a novel tool for clinical workload quantification and describes its application to a busy paediatric cardiology service in Cape Town, South Africa. This tool prospectively quantifies clinical workload which may directly influence patient outcomes. Implementation of this novel tool in the described setting clearly demonstrated the excessive workload of the clinical service and facilitated effective motivation for improved allocation of resources.

The Occupational Safety and Health Act of 1970 requires that every worker be provided with a safe and healthful workplace and authorizes the Occupational Safety and Health Administration (OSHA) to conduct workplace inspections. OSHA conducts workplace inspections in hospitals and checks for compliance with the Bloodborne Pathogens Standard, the Enforcement Policy and Procedures for Occupational Exposure to Tuberculosis, and the Hazardous Chemicals Standards, among others. The hospital epidemiologist bears considerable responsibility for developing and implementing plans to protect employees from occupational exposures to infectious hazards such as bloodborne pathogens and tuberculosis. To prepare for an inspection, the hospital epidemiologist must understand the basis on which OSHA operates and must proceed in a thoughtful, coordinated manner.

We have used confocal laser scanning microscopy (CLSM), high-voltage electron microscopy (HVEM), and intracellular recording techniques to study volume changes in cultured Aplysia pacemaker neurons. Hyper- and hypo-tonic artificial sea water (ASW) decreased the pacemaker frequency and led to depolarization and hyperpolarization, respectively. However, when negative or positive current was injected into neurons in normal ASW, the frequency decreased with hyperpolarization but increased with depolarization. This suggests that the membrane potential is not the only factor underlying the reduction of the pacemaker activity.

Changes in cell volume were monitored with a CLSM and paralleled progressive changes in osmolarity. The neurons swelled and shrank nonuniformly, and, although an optical section through the middle of the cell was monitored every 4 s for as long as 14 min, a regulatory volume decrease or increase was never observed, indicating an osmometer-like behavior. The time course of shrinkage was faster than swelling after returning to control ASW after a hypotonic shock, reflecting a possible mechanical stress on the cytoskeleton.

Thick sections observed in the HVEM confirmed that membrane infoldings were present in our cultured Aplysia neurons. We hypothesize that a change in length of the latter in shrunken and swollen neurons could provide an explanation on the ultrastructural level for the increase and decrease in membrane surface area observed by CLSM. We conclude that by combining a confocal microscope with an electrophysiological set-up, three-dimensional morphology and physiological properties can be studied in living cells in real-time. This approach provides the means to correlate cell volume-related alterations and physiology.

On November 15, 1994, the Occupational Safety and Health Administration (OSHA) published in the Federal Register (59:58884-58956) the draft of a proposed revision of the Respiratory Protection Standard. One of OSHA's oldest standards, the Respiratory Protection Standard defines the conduct of the employer (eg, hospital) with respect to respirator training, fit testing, medical examinations, use, storage, and so on. The proposed revision appears to have been drafted with no consideration for its effect on healthcare workers or the healthcare industry. SHEA has prepared the following comments to OSHA, which have been submitted to the docket and will be presented at public hearings later this month.

On October 8, 1993, the Occupational Safety and Health Administration (OSHA) issued mandatory guidelines that establish an enforcement policy for protecting exposed workers against tuberculosis (TB). The instructions, issued to OSHA regional administrators and compliance officers nationwide, cover both the application of specific OSHA standards that are pertinent to TB inspections and of the OSH Act's general duty clause, which obligates employers to provide safe and healthful workplaces. OSHA's guidelines are effective immediately, except for the respirator requirements, which will become effective on January 6,1994. Employers found in violation of the guidelines can be fined. Those states that run their own job safety and health programs were given 30 days to advise OSHA on their plans for enforcement against TB.