2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a Novel Emerging Coronavirus

2019 Novel Coronavirus (2019-nCoV) is an emerging infectious disease closely related to MERS-CoV and SARS-CoV that was first reported in Wuhan City, Hubei Province, China in December 2019. As of January 2020, cases of 2019-nCoV are continuing to be reported in other Eastern Asian countries as well as in the United States, Europe, Australia, and numerous other countries. An unusually high volume of domestic and international travel corresponding to the beginning of the 2020 Chinese New Year complicated initial identification and containment of infected persons. Due to the rapidly rising number of cases and reported deaths, all countries should be considered at risk of imported 2019-nCoV. Therefore, it is essential for prehospital, clinic, and emergency department personnel to be able to rapidly assess 2019-nCoV risk and take immediate actions if indicated. The Identify-Isolate-Inform (3I) tool, originally conceived for the initial detection and management of Ebola virus and later adjusted for other infectious agents, can be adapted for any emerging infectious disease. This paper reports a modification of the 3I tool for use in the initial detection and management of patients under investigation for 2019-nCoV. After initial assessment for symptoms and epidemiological risk factors, including travel to affected areas and exposure to confirmed 2019-nCoV patients within 14 days, patients are classified in a risk-stratified system. Upon confirmation of a suspected 2019-nCoV case, affected persons must immediately be placed in airborne infection isolation and the appropriate public health agencies notified. This modified 3I tool will assist emergency and primary care clinicians, as well as out-of-hospital providers, in effectively managing persons with suspected or confirmed 2019-nCoV

A Positive-Pressure Environment Disposable Shield (PEDS) for COVID-19 Health Care Worker Protection.

The COVID-19 pandemic has strained health care system resources and reduced the availability of life-sustaining and medical-grade personal protective equipment (PPE) though the combination of increased demand and disrupted manufacturing supply chains. As a result of these shortages, many health care providers have temporarily used largely untested, improvised PPE (iPPE). Lack of quality control for makeshift PPE and frequent repurposing of used items to conserve supplies increase both the risk of provider infection and nosocomial spread to uninfected patients. One strategy to reduce risk of infection and preserve existing equipment is the implementation of secondary barrier devices placed directly over patients or providers. The authors describe an inexpensive, disposable, positive-pressure head isolation unit that can be rapidly constructed from materials readily available in nearly all health care settings for under five US dollars. The unit was successfully deployed in Taiwan during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak, and again during the COVID-19 pandemic. The iPPE worn directly by the health care workers (HCWs) can be donned prior to patient contact in the presence of an air source. This strategy may be more protective than a covering placed over the patient in an aerosol-generating environment, which requires the HCW to be in close contact with the patient prior to securing the protective device

Dusty Cometary Globules in W5

We report the discovery of four dusty cometary tails around low mass stars in two young clusters belonging to the W5 star forming region. Fits to the observed emission profiles from 24 micron observations with the Spitzer Space Telescope give tail lifetimes < 30 Myr, but more likely < 5 Myr. This result suggests that the cometary phase is a short lived phenomenon, occurring after photoevaporation by a nearby O star has removed gas from the outer disk of a young low mass star (see also Balog et al. 2006; Balog et al. 2008).Comment: 11 pages, 3 figures. Accepted for publication to ApJ Letter

How Does Restored Habitat For Chinook Salmon ( Oncorhynchus Tshawytscha ) In The Merced River In California Compare With Other Chinook Streams?

The amount of time and money spent on restoring rivers for declining populations of salmon has grown substantially in recent decades. But despite the infusion of resources, many studies suggest that salmon populations are continuing to decline, leading some to question the effectiveness of restoration efforts. Here we examine whether a particular form of salmon restoration—channel reconfiguration with gravel augmentation—generates physical and biological habitat that is comparable with other streams that support salmon. We compared a suite of habitat features known to influence the various life stages of Chinook salmon in a restoration project in California's Merced River with 19 other streams that also support Chinook that we surveyed in the same geographic region. Our survey showed that riffle habitats in the restored site of the Merced River have flow discharge and depth, substrate and food web characteristics that cannot be distinguished from other streams that support Chinook, suggesting that these factors are unlikely to be bottlenecks to salmon recovery in the Merced. However, compared with other streams in the region, the Merced has minimal riparian cover, fewer undercut banks, less woody debris and higher water temperatures, suggesting that these factors might limit salmon recovery. After identifying aspects in the Merced that differ from other streams, we used principal components analysis to correlate salmon densities to independent axes of environmental variation measured during our survey. These analyses suggested that salmon densities tend to be greatest in streams that have more undercut banks and woody debris and lower water temperatures. These are the same environmental factors that appear to be missing from the Merced River restoration effort. Collectively, our results narrow the set of candidate factors that may limit salmon recovery in channel reconfiguration restoration efforts. Copyright © 2012 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97512/1/rra1604.pd

Lifetime inclusive fitness effects of cooperative polygamy in the acorn woodpecker

Although over 50 y have passed since W. D. Hamilton articulated kin selection and inclusive fitness as evolutionary explanations for altruistic behavior, quantifying inclusive fitness continues to be challenging. Here, using 30 y of data and two alternative methods, we outline an approach to measure lifetime inclusive fitness effects of cooperative polygamy (mate-sharing or cobreeding) in the cooperatively breeding acorn woodpecker Melanerpes formicivorus. For both sexes, the number of offspring (observed direct fitness) declined while the number of young parented by related cobreeders (observed indirect fitness effect) increased with cobreeding coalition size. Combining these two factors, the observed inclusive fitness effect of cobreeding was greater than breeding singly for males, while the pattern for females depended on whether fitness was age-weighted, as females breeding singly accrued greater fitness at younger ages than cobreeding females. Accounting for the fitness birds would have obtained by breeding singly, however, lifetime inclusive fitness effects declined with coalition size for males, but were greater for females breeding as duos compared to breeding singly, due largely to indirect fitness effects of kin. Our analyses provide a road map for, and demonstrate the importance of, quantifying indirect fitness as a powerful evolutionary force contributing to the costs and benefits of social behaviors.</p

Rapid Breast Cancer Disease Progression Following Cyclin Dependent Kinase 4 and 6 Inhibitor Discontinuation.

Background: CDK 4 and 6 inhibitors (CDK4/6i), which arrest unregulated cancer cell proliferation, show clinical efficacy in breast cancer. Unexpectedly, a patient treated on a CDK4/6i-based trial, as first-line therapy in metastatic breast cancer, developed rapid disease progression following discontinuation of study drug while receiving standard second-line therapy off trial. We thus sought to expand this observation within a population of patients treated similarly at The University of Texas MD Anderson Cancer Center. Methods: Using an IRB-approved protocol, 4 patients previously enrolled on CDK4/6i trials were analyzed for outcomes after discontinuing study drug. These patients were treated on a randomized trial of first-line endocrine therapy +/- a CDK4/6i. Rapid disease progression was defined as progression occurring within 4 months of CDK4/6i discontinuation. Results: In total, 4 patients developed rapid disease progression and died; 2 of whom died within 6 months of CDK4/6i discontinuation. Conclusion: This case series suggests a potential for rapid disease progression following CDK4/6i discontinuation. However, the clinical course following progression must be validated in large CDK4/6i clinical trials and standard-of-care cohorts. If confirmed, such observations may alter the algorithm for subsequent therapy in patients with disease progression on CDK4/6i. Nevertheless, the need remains to define a mechanistic basis for this rapid progression and formulate alternative therapeutic strategies

Light particle spectra from 35 MeV/nucleon 12C-induced reactions on 197Au

Energy spectra for p, d, t, 3He, 4He, and 6He from the reaction 12C+197Au at 35 MeV/nucleon are presented. A common intermediate rapidity source is identified using a moving source fit to the spectra that yields cross sections which are compared to analogous data at other bombarding energies and to several different models. The excitation function of the composite to proton ratios is compared with quantum statistical, hydrodynamic, and thermal models

The Correlation between X-ray spectral slope and FeKalpha line energy in radio-quiet active galactic nuclei

A significant correlation between FeKalpha line energy and X-ray spectral slope has been discovered among radio-quiet active galactic nuclei. The ionization stage of the bulk of the FeKalpha emitting material is not the same in all active galactic nuclei and is related to the shape of the X-ray continua. Active galactic nuclei with a steep X-ray spectrum tend to have a fluorescence FeKalpha line from highly ionized material. In the narrow-line Seyfert 1 galaxies with steeper X-ray spectrum (Gamma_X > 2.1), the FeKalpha line originates from highly ionized material. In the Seyfert 1 galaxies and quasars with flatter X-ray spectrum (Gamma_X < 2.1), bulk of the FeKalpha emission arises from near neutral or weakly ionized material. The correlation is an important observational characteristic related to the accretion process in radio quiet active galactic nuclei and is driven by a fundamental physical parameter which is likely to be the accretion rate relative to the Eddington rate.Comment: 4 pages, To apear in ApJ Letter

Beyond Documentation: 3D Data in Archaeology

As the costs associated with the collection of 3D data continue to plummet, there is little doubt that the number of available archaeology-related 3D datasets will increase dramatically in the coming decade. While our analytical procedures continue to evolve as new applications are contemplated, analyses of 3D data are increasing in frequency within the archaeological literature. In this article, we seek to provide a brief overview of a few examples from our own research and explore some possibilities that may add value to existing collections. In the following pages, we discuss some of the ways that 3D data have been used in studies of morphometrics, public archaeology, excavation, and comparative endeavors