Targeted Social Distancing Designs for Pandemic Influenza

Local community networks can mitigate pandemic influenza in the absence of vaccine and antiviral drugs

Establishing a Community of Practice for Doctoral Studies Amidst the COVID-19 Pandemic

In this discussion paper, we describe our experience completing the first year of the doctorate in nursing program at a large urban academic centre during the COVID-19 pandemic. We highlight the current nursing shortage and the importance of supporting all nursing students, including nurses in doctoral programs, towards successful graduation. We describe the development of a virtual community of practice incorporating five key strategies: Building community, fostering collaboration, strengthening connection, enhancing creativity, and promoting consistency. We believe that utilizing these strategies will contribute to our success and may be relevant to nursing leaders seeking to support the development of more doctorally prepared nurses. Participation in a community of practice early on in doctoral education will not only better prepare students for success in their program, but also continued success as they progress through their careers. It is important for students to not only make connections with peers in their area of academic study, but to also reach out to peers in other disciplines to improve both individual and interdisciplinary growth. Program administrators and educators can encourage the formation of community of practice among novice doctoral students. This encouragement can be achieved using a virtual platform, or in-person networking opportunities. Inviting incoming graduate students to connect with each other and with students from previous cohorts also fosters community of practice formation. Résumé Dans ce texte de discussion, nous décrivons notre expérience relative à la première année du doctorat en sciences infirmières dans un grand centre universitaire urbain pendant la pandémie de COVID-19. Nous soulignons la pénurie actuelle d’infirmières et l’importance de soutenir toutes les étudiantes en sciences infirmières, y compris les infirmières inscrites à un programme de doctorat, vers la réussite de leurs études. Nous décrivons le développement d’une communauté virtuelle de pratique intégrant cinq stratégies clés : créer une communauté, favoriser la collaboration, renforcer les liens, mettre en valeur la créativité et promouvoir la cohérence. Nous pensons que l’utilisation de ces stratégies contribuera à notre succès et pourrait être pertinente pour les infirmières chefs de file qui cherchent à soutenir le développement d’un plus grand nombre d’infirmières préparées au doctorat. La participation à une communauté de pratique dès le début de la formation doctorale permettra non seulement de mieux préparer les étudiantes à réussir dans leur programme, mais favorisera également leur poursuite d’une carrière fructueuse. Il est important pour les étudiantes d’établir des liens non seulement avec des pairs dans leur domaine d’études universitaires, mais qu’ils entrent également en contact avec des pairs d’autres disciplines pour améliorer à la fois leur croissance individuelle et interdisciplinaire. Les administratrices de programme et les enseignantes peuvent encourager la formation d’une communauté de pratique parmi les doctorantes novices. Cet encouragement peut être réalisé à l’aide d’une plateforme virtuelle ou d’occasions de réseautage en personne. Inviter les étudiantes diplômées à entrer en contact les unes avec les autres et avec les étudiantes des cohortes précédentes favorise également la formation d’une communauté de pratique

The connections of the insular VEN area in great apes: A histologically-guided ex vivo diffusion tractography study

We mapped the connections of the insular von Economo neuron (VEN) area in ex vivo brains of a bonobo, an orangutan and two gorillas with high angular resolution diffusion MRI imaging acquired in 36 h imaging sessions for each brain. The apes died of natural causes without neurological disorders. The localization of the insular VEN area was based on cresyl violet-stained histological sections from each brain that were coregistered with structural and diffusion images from the same individuals. Diffusion MRI tractography showed that the insular VEN area is connected with olfactory, gustatory, visual and other sensory systems, as well as systems for the mediation of appetite, reward, aversion and motivation. The insular VEN area in apes is most strongly connected with frontopolar cortex, which could support their capacity to choose voluntarily among alternative courses of action particularly in exploring for food resources. The frontopolar cortex may also support their capacity to take note of potential resources for harvesting in the future (prospective memory). All of these faculties may support insight and volitional choice when contemplating courses of action as opposed to rule-based decision-making

Effective, Robust Design of Community Mitigation for Pandemic Influenza: A Systematic Examination of Proposed US Guidance

BACKGROUND: The US government proposes pandemic influenza mitigation guidance that includes isolation and antiviral treatment of ill persons, voluntary household member quarantine and antiviral prophylaxis, social distancing of individuals, school closure, reduction of contacts at work, and prioritized vaccination. Is this the best strategy combination? Is choice of this strategy robust to pandemic uncertainties? What are critical enablers of community resilience? METHODS AND FINDINGS: We systematically simulate a broad range of pandemic scenarios and mitigation strategies using a networked, agent-based model of a community of explicit, multiply-overlapping social contact networks. We evaluate illness and societal burden for alterations in social networks, illness parameters, or intervention implementation. For a 1918-like pandemic, the best strategy minimizes illness to <1% of the population and combines network-based (e.g. school closure, social distancing of all with adults' contacts at work reduced), and case-based measures (e.g. antiviral treatment of the ill and prophylaxis of household members). We find choice of this best strategy robust to removal of enhanced transmission by the young, additional complexity in contact networks, and altered influenza natural history including extended viral shedding. Administration of age-group or randomly targeted 50% effective pre-pandemic vaccine with 7% population coverage (current US H5N1 vaccine stockpile) had minimal effect on outcomes. In order, mitigation success depends on rapid strategy implementation, high compliance, regional mitigation, and rigorous rescinding criteria; these are the critical enablers for community resilience. CONCLUSIONS: Systematic evaluation of feasible, recommended pandemic influenza interventions generally confirms the US community mitigation guidance yields best strategy choices for pandemic planning that are robust to a wide range of uncertainty. The best strategy combines network- and case-based interventions; network-based interventions are paramount. Because strategies must be applied rapidly, regionally, and stringently for greatest benefit, preparation and public education is required for long-lasting, high community compliance during a pandemic

Human neural stem cell transplantation in ALS: initial results from a phase I trial

We report the initial results from a phase I clinical trial for ALS. We transplanted GMP-grade, fetal human neural stem cells from natural in utero death (hNSCs) into the anterior horns of the spinal cord to test for the safety of both cells and neurosurgical procedures in these patients. The trial was approved by the Istituto Superiore di Sanit\ue0 and the competent Ethics Committees and was monitored by an external Safety Board

The untapped potential of seascape genomics in the North Pacific

Seascape genomics provides a powerful framework to evaluate the presence and strength of environmental pressures on marine organisms, as well as to forecast long term species stability under various perturbations. In the highly productive North Pacific, forage fishes, key trophic links across ecosystems, are also contending with a rapidly warming climate and a litany of associated oceanographic changes (e.g., changes in salinity, dissolved oxygen, pH, primary production, etc.). These changes can place substantial selective pressures on populations over space and time. While several population genomics studies have targeted forage fishes in the North Pacific, none have formally analyzed the interactions between genotype and environment. However, when population genomics studies provide collection location information and other critical data, it is possible to supplement a published genomic dataset with environmental data from existing public databases and perform “post hoc seascape genomics” analyses. In reviewing the literature, we find pertinent metadata (dates and locations of sample collection) are rarely provided. We identify specific factors that may impede the application of seascape genomics methods in the North Pacific. Finally, we present an approach for supplementing data in a reproducible way to allow for post hoc seascape genomics analysis, in instances when metadata are reported. Overall, our goal is to demonstrate – via literature review – the utility and importance of seascape genomics to understanding the long term health of forage fish species in the North Pacific

Receipt of medications for opioid use disorder among youth engaged in primary care: data from 6 health systems

PURPOSE: Little is known about prevalence and treatment of OUD among youth engaged in primary care (PC). Medications are the recommended treatment of opioid use disorder (OUD) for adolescents and young adults (youth). This study describes the prevalence of OUD, the prevalence of medication treatment for OUD, and patient characteristics associated with OUD treatment among youth engaged in PC. METHODS: This cross-sectional study includes youth aged 16-25 years engaged in PC. Eligible patients had ≥ 1 PC visit during fiscal years (FY) 2014-2016 in one of 6 health systems across 6 states. Data from electronic health records and insurance claims were used to identify OUD diagnoses, office-based OUD medication treatment, and patient demographic and clinical characteristics in the FY of the first PC visit during the study period. Descriptive analyses were conducted in all youth, and stratified by age (16-17, 18-21, 22-25 years). RESULTS: Among 303,262 eligible youth, 2131 (0.7%) had a documented OUD diagnosis. The prevalence of OUD increased by ascending age groups. About half of youth with OUD had documented depression or anxiety and one third had co-occurring substance use disorders. Receipt of medication for OUD was lowest among youth 16-17 years old (14%) and highest among those aged 22-25 (39%). CONCLUSIONS: In this study of youth engaged in 6 health systems across 6 states, there was low receipt of medication treatment, and high prevalence of other substance use disorders and mental health disorders. These findings indicate an urgent need to increase medication treatment for OUD and to integrate treatment for other substance use and mental health disorders