879 research outputs found

    Preliminary Investigation of Continuous Self-Improvement, Confidence, & Resilience

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    https://fuse.franklin.edu/ss2018/1039/thumbnail.jp

    Quantifying the Risk to Health Care Workers of Cough as an Aerosol Generating Event in an Ambulance Setting: A Research Report

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    © 2022 The Author(s). Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Introduction and Objective: United Kingdom Health Security Agency (UKHSA) guidance related to mask use for health care workers in a non-aerosol generating procedure (AGP) setting has remained as Level 2 water repellent paper mask (surgical mask) only. Energetic respiratory events, such as coughing, can generate vast numbers of droplets and aerosols. Coughing, considered to be a non-AGP event, frequently occurs in the relatively small, confined space of an ambulance (∼25 m3 ). The report seeks to explore whether existing research can provide an indication of the risk to ambulance staff, via aerosol transmission, of an acute respiratory infection (ARI) during a coughing event within the clinical setting of an ambulance. Methods: International bibliographic databases were searched (CINAHL Plus, SCOPUS, PubMed, and CENTRAL) using appropriate search strings and a combination of relevant medical subject headings with appropriate truncation. Methodological filters were not applied. Papers without an English language abstract were excluded from the review. Grey literature was sought by searching specialist databases OpenGrey and GreyNet, as well as key organizations’ websites. The initial search identified 2,405 articles. Following screening, along with forward and backward citation of key papers identified within the literature search, 36 papers were deemed eligible for the scoping review. Discussion: Attempts to replicate a clinical environment to investigate the risk of transmission of airborne viruses to health care workers during a coughing event provided evidence for the generation of respirable aerosol particles and thus potential transmission of pathogens. In cases of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), potential to infect versus true airborne transmission is a debate that continues, but there is general consensus that a large variation of cough characteristics and aerosol generation amongst individuals exists. Studies widely endorsed face masks as a source control device, but there were conflicting views about the impact of mask leakage. Conclusion: Further research is required to provide clarity of the risk to health care workers when caring for a coughing patient in the confined clinical ambulance setting and to provide an evidence base to assist in the determination of appropriate respiratory protective equipment (RPE).Peer reviewe

    Clostridium difficile infection among veterans health administration patients

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    OBJECTIVETo report on the prevalence and incidence of Clostridium difficile infection (CDI) from 2009 to 2013 among Veterans Healthcare Administration patientsDESIGNA retrospective descriptive analysis of data extracted from a large electronic medical record (EMR) databaseSETTINGData were acquired from VHA healthcare records from 2009 to 2013 that included outpatient clinical visits, long-term care, and hospitalized care as well as pharmacy and laboratory information.RESULTSIn 2009, there were 10,207 CDI episodes, and in 2013, there were 12,143 CDI episodes, an increase of 19.0%. The overall CDI rate increased by 8.4% from 193 episodes per 100,000 patient years in 2009 to 209 episodes per 100,000 patient years in 2013. Of the CDI episodes identified in 2009, 58% were identified during a hospitalization, and 42% were identified in an outpatient setting. In 2013, 44% of the CDI episodes were identified in an outpatient setting.CONCLUSIONThis is one of the largest studies that has utilized timely EMR data to describe the current CDI epidemiology at the VHA. Despite an aging population with greater burden of comorbidity than the general US population, our data show that VHA CDI rates stabilized between 2011 and 2013 following increases likely attributable to the introduction of the more sensitive nucleic acid amplification tests (NAATs). The findings in this report will help establish an accurate benchmark against which both current and future VA CDI prevention initiatives can be measured.Infect. Control Hosp. Epidemiol. 2015;36(9):1038–1045</jats:sec

    Reading Kipling’s The Land Through a Lens of Archaeology, Landscape, and English Nationalism

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    Rudyard Kipling was enchanted by the Sussex landscape surrounding his house, Bateman’s. Many of his stories and poems are set in this landscape, and draw on its rich history, archaeology, and folklore. In this paper we examine Kipling’s 1917 poem The Land, which weaves together strands of landscape archaeology and nationalist origin mythology. The Land is the story of a single Sussex field, its colonial landowners from Roman Britain to the present, and the generations of the peasant Hobden family who care for it. In examining the poem we consider the notions of Englishness that Kipling conjures, their disconnection from the realities of rural Sussex, their contexts of war and revolution, and the uses of archaeology in the creation of nationalist myth

    Galicia3D seismic volume: Connections between the western termination of the S reflector and eastern termination of the Peridotite Ridge

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    European Geosciences Union General Assembly 2015 (EGU2015), 12-17 April 2015, Vienna, Austria.-- 1 pageIn June thru September, 2013, a 3D reflection and a long offset seismic experiment were conducted at the Galicia rifted margin by investigators from the US, UK, Germany, and Spain. The 3D multichannel experiment covered 64 km by 20 km (1280 km2), using the RV Marcus Langseth. Four streamers 6 km long were deployed at 12.5 m hydrophone channel spacing. The streamers were 200 m apart. Two airgun arrays, each 3300 cu in, were fired alternately every 37.5 m, to collectively yield a 400 m wide sail line consisting of 8 CMP lines at 50 m spacing. We draw attention to the region from the Peridotite Ridge, PR, (on the west) and the western terminus of the S reflector (on the east). The S reflector is generally thought to separate continental crust and pre- and syn-rift sediment above, and serpentinized upper mantle below. In 2D and 3D seismic reflection data, the S reflector is very bright, generally horizontal, and is terminated very abruptly at the western end. The latter is particularly clear in the 3D volume. It is about 10-15 km wide between the end of the S reflector and the midpoint of the PR. In this interval, there appear to be fault bounded blocks that may be either continental crust or pre- or syn-rift sediments. The PR is a virtually straight, N-S ridge, without apparent fault offsets. The crest of the PR is at about 4800 mbsl at the S extent and is at 6070 mbsl at the N extent of the 3D volume. The crest is approximately linear in map view or N-S extent. Both sides, East and West of the PR, appear to show landslides and other mass wasting during the late stage of the syn-rifting interval. The PR rarely shows internal seismic structure in 2D and 3D. Most importantly, under the basin to the east of the PR there are substantially more recognizable structures connecting the S reflector and the PR. These were much less interpretable in previous 2D seismic profilesPeer Reviewe

    The connexin 30 A88V mutant reduces cochlear gap junction expression and confers long-term protection against hearing loss

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    Mutations in the genes that encode the gap junction proteins connexin 26 (Cx26, encoded by GJB2) and Cx30 (GJB6) are the leading cause of hereditary hearing loss. That said, the Cx30 p.Ala88Val (A88V) mutant causes Clouston syndrome, but not hearing loss. Here, we report that the Cx30-A88V mutant, despite being toxic to inner ear-derived HEI-OC1 cells, conferred remarkable long-term protection against age-related high frequency hearing loss in Cx30(A88V/A88V) mice. During early development, there were no overt structural differences in the cochlea between genotypes, including a normal complement of hair cells; however, the supporting cell Cx30 gap junction plaques in mutant mice were reduced in size. In adulthood, Cx30(A88V/A88V) mutant mice had a reduction of cochlear Cx30 mRNA and protein, yet a full complement of hair cells. Conversely, the age-related high frequency hearing loss in Cx30(+/+) and Cx30(+/A88V) mice was due to extensive loss of outer hair cells. Our data suggest that the Cx30-A88V mutant confers long-term hearing protection and prevention of hair cell death, possibly via a feedback mechanism that leads to the reduction of total Cx30 gap junction expression in the cochlea

    Mice harbouring an oculodentodigital dysplasia-linked Cx43 G60S mutation have severe hearing loss

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    Given the importance of connexin43 (Cx43, encoded by GJA1) function in the central nervous system and sensory organ processing, we proposed that it would also be crucial in auditory function. To that end, hearing was examined in two mouse models of oculodentodigital dysplasia that globally express GJA1 mutations resulting in mild or severe loss of Cx43 function. Although Cx43(I130T/+) mutant mice, with similar to 50% Cx43 channel function, did not have any hearing loss, Cx43(G60S/+) mutant mice, with similar to 20% Cx43 channel function, had severe hearing loss. There was no evidence of inner ear sensory hair cell loss, suggesting that the mechanism for Cx43-linked hearing loss lies downstream in the auditory pathway. Since evidence suggests that Cx26 function is essential for hearing and may be protective against noise-induced hearing loss, we challenged Cx43(I130T/+) mice with a loud noise and found that they had a similar susceptibility to noise-induced hearing loss to that found in controls, suggesting that decreased Cx43 function does not sensitize the mice for environmentally induced hearing loss. Taken together, this study suggests that Cx43 plays an important role in baseline hearing and is essential for auditory processing. This article has an associated First Person interview with the first author of the paper

    Spectroscopic and Microscopic Investigation of the Corrosion of 316/316L Stainless Steel by Lead-Bismuth Eutectic (LBE) at Elevated Temperatures: Importance of Surface Preparation

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    The corrosion of steel by lead–bismuth eutectic (LBE) is an important issue in proposed nuclear transmutation schemes. Russian scientists at the IPPE exposed steel samples to oxygen-controlled LBE at temperatures up to 823 K and exposure times up to 3000 h. We have characterized these post-exposure steel samples and unexposed controls, using scanning electron microscopy (SEM), energy-dispersive X-ray analysis (EDAX) and X-ray photoelectron spectroscopy (XPS). Previous researchers have investigated the corrosion by LBE of steel of varying composition. In the present work, we compared two samples having the same composition (standard nuclear grade 316/316L) but different surface preparation: a cold-rolled sample was compared with an annealed sample. The cold-rolled sample had an order of magnitude less corrosion (i.e., both lower oxidation and less weight change) than the annealed sample. Sputter depth profiling of the exposed annealed sample and cold-rolled sample showed a marked difference in oxide layer composition between the annealed and cold-rolled samples. The annealed sample showed a complex oxide structure (iron oxide over chromium/iron oxide mixtures) of tens of microns thickness, while the cold-rolled sample was covered with a rather simple, primarily chromium oxide layer of ∼1 μm thickness

    Bovine Viral Diarrhea Virus Multiorgan Infection in Two White-Tailed Deer in Southeastern South Dakota

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    The susceptibility of wild ruminants, especially cervids, to bovine viral diarrhea virus (BVDV) has remained an enigma. Two white-tailed deer (Odocoileus virginianus) were submitted to the Animal Disease Research and Diagnostic Laboratory (ADRDL) in the fall of 2003 by the South Dakota Game Fish and Parks for chronic wasting disease (CWD) testing. Both animals were CWD negative. The animals were necropsied and histopathology, viral antigen detection, and virus isolation were performed. A noncytopathic (NCP) BVDV was isolated from the lungs and several other tissues of both animals. Formalin-fixed ear notches from both animals were positive for BVDV antigen by immunohistochemistry. The BVDV isolates were typed with the use of polymerase chain reaction in 59 untranslated region (UTR) and one isolate was typed a Type 2a and the other a Type 1b. Future field surveys to determine the incidence of BVDV along with experimental studies to determine if whitetailed deer fawns can be persistently infected with BVDV are neede
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