Utility of Fear Severity and Individual Resilience Scoring as a Surge Capacity, Triage Management Tool during Large-Scale, Bio-event Disasters

Threats of bioterrorism and emerging infectious disease pandemics may result in fear related consequences. Fear based signs and symptoms, if left undetected and untreated, may be extremely debilitating and lead to chronic problems with risk of permanent damage to the brain’s locus coeruleus stress response circuits. The triage management of susceptible, exposed, and infectious victims seeking care must be sensitive and specific enough to identify individuals with excessive levels of fear in order to address the nuances of fear-based symptoms at the initial point of contact. These acute conditions, which include hyper-vigilant fear, are best managed by timely and effective information, rapid evaluation, and possibly medication that uniquely addresses the locus-coeruleus driven noradrenalin overactivation. This article recommends that a fear and resilience (FR) checklist be included as an essential triage tool to identify those most at risk. This checklist has the utility of rapid usage and capacity to respond to limitations brought about by surge capacity requirements. Whereas the utility of such a checklist is evident, predictive validity studies will be required in the future. It is important to note that a unique feature of the FR Checklist is that in addition to identifying individuals who are emotionally, medically, and socially hypo-resilient, it simultaneously identifies individuals who are hyper-resilient who can be asked to volunteer and thus rapidly expand the surge capacity

Validation of suitable internal control genes for expression studies in aging.

Quantitative data from experiments of gene expression are often normalized through levels of housekeeping genes transcription by assuming that expression of these genes is highly uniform. This practice is being questioned as it becomes increasingly clear that the level of housekeeping genes expression may vary considerably in certain biological samples. To date, the validation of reference genes in aging has received little attention and suitable reference genes have not yet been defined. Our aim was to evaluate the expression stability of frequently used reference genes in human peripheral blood mononuclear cells with respect to aging. Using quantitative RT-PCR, we carried out an extensive evaluation of five housekeeping genes, i.e. 18s rRNA, ACTB, GAPDH, HPRT1 and GUSB, for stability of expression in samples from donors in the age range 35-74 years. The consistency in the expression stability was quantified on the basis of the coefficient of variation and two algorithms termed geNorm and NormFinder. Our results indicated GUSB be the most suitable transcript and 18s the least for accurate normalization in PBMCs. We also demonstrated that aging is a confounding factor with respect to stability of 18s, HPRT1 and ACTB expression, which were particularly prone to variability in aged donors

Justification for a Nuclear Global Health Workforce: multidisciplinary analysis of risk, survivability & preparedness, with emphasis on the triage management of thermal burns

An assessment of the risks of nuclear conflict and the global preparedness to deal with such a catastrophe. Includes a proposal for triage and management of burn injuries based on a model of what would happen if there was a nuclear attack on Washington DC. Summarises the need for a global nuclear workforce to establish guidelines and strategies to address a nuclear event, the risk of which would appear to be increasingly likely given current world geopolitics

Plant-pollinator interactions over 120 years: loss of species, co-occurrence, and function

Using historic data sets, we quantified the degree to which global change over 120 years disrupted plant-pollinator interactions in a temperate forest understory community in Illinois, USA. We found degradation of interaction network structure and function and extirpation of 50% of bee species. Network changes can be attributed to shifts in forb and bee phenologies resulting in temporal mismatches, nonrandom species extinctions, and loss of spatial co-occurrences between extant species in modified landscapes. Quantity and quality of pollination services have declined through time. The historic network showed flexibility in response to disturbance; however, our data suggest that networks will be less resilient to future changes

Chronic Health Crises and Emergency Medicine in War-torn Yemen, Exacerbated by the COVID-19 Pandemic

INTRODUCTION: Much of Yemen’s infrastructure and healthcare system has been destroyed by the ongoing civil war that began in late 2014. This has created a dire situation that has led to food insecurity, water shortages, uncontrolled outbreaks of infectious disease and further failings within the healthcare system. This has greatly impacted the practice of emergency medicine (EM), and is now compounded by the coronavirus disease 2019 (COVID-19) global pandemic. METHODS: We conducted a systematic review of the current state of emergency and disaster medicine in Yemen, followed by unstructured qualitative interviews with EM workers, performed by either direct discussion or via phone calls, to capture their lived experience, observations on and perceptions of the challenges facing EM in Yemen. We summarize and present our findings in this paper. RESULTS: Emergency medical services (EMS) in Yemen are severely depleted. Across the country as a whole, there are only 10 healthcare workers for every 10,000 people – less than half of the WHO benchmark for basic health coverage – and only five physicians, less than one third the world average; 18% of the country’s 333 districts have no qualified physicians at all. Ambulances and basic medical equipment are in short supply. As a result of the ongoing war, only 50% of the 5056 pre-war hospitals and health facilities are functional. In June 2020, Yemen recorded a 27% mortality rate of Yemenis who were confirmed to have COVID-19, more than five times the global average and among the highest in the world at that time. CONCLUSION: In recent years, serious efforts to develop an advanced EM presence in Yemen and cultivate improvements in EMS have been stymied or have failed outright due to the ongoing challenges. Yemen’s chronically under-resourced healthcare sector is ill-equipped to deal with the additional strain of COVID-19

Checklist of bees (Hymenoptera: Apoidea) from small diversified vegetable farms in south-western Montana

Background Over three years (2013-2015), we sampled bees using nets and bowl traps on four diversified vegetable farms in Gallatin County, Montana, USA, as part of a study evaluating the use of wildflower strips for supporting wild bees and crop pollination services on farmlands (Delphia et al. In prep). We document 202 species and morphospecies from 32 genera within five families, of which 25 species represent the first published state records for Montana. This study increases our overall understanding of the distribution of wild bee species associated with agroecosystems of the northern US Rockies, which is important for efforts aimed at conserving bee biodiversity and supporting sustainable crop pollination systems on farmlands. New information We provide a species list of wild bees associated with diversified farmlands in Montana and increase the number of published bee species records in the state from 374 to at least 399. The list includes new distributional records for 25 wild bee species, including two species that represent considerable expansions of their known ranges, Lasioglossum (Dialictus) clematisellum (Cockerell 1904) with previously published records from New Mexico, Arizona, California and Utah and Melissodes (Eumelissodes) niveus Robertson 1895 which was reported to range from New York to Minnesota and Kansas, south to North Carolina, Alabama and Mississippi

Current Response and Management Decisions of the European Union to the COVID-19 Outbreak: A Review

COVID-19 has proven to be a formidable challenge for many countries in the European Union to manage effectively. The European Union has implemented numerous strategies to face emerging issues. Member States have adopted measures such as the closure of borders and significant limitations on the mobility of people to mitigate the spread of the virus. An unprecedented crisis coordination effort between Member States has facilitated the ability to purchase equipment, personal protective equipment, and other medical supplies. Attention has also been focused on providing substantive money for research to find a vaccine and promote effective treatment therapies. Financial support has been made available to protect worker salaries and businesses to help facilitate a return to a functional economy. Lessons learned to date from COVID-19 in the European Union are many; the current crisis highlights the need to think about future pandemics from a population-based management approach and apply outside the box critical thinking. Due to the complexity, intensity, and frequency of complex disasters, global leaders in healthcare, government, and business will need to pivot from siloed approaches to decision-making to embrace multidisciplinary and transdisciplinary levels of cooperation. This cooperation requires courage and leadership to recognize that changes are necessary to avoid making the same mistakes we have planned countless times on avoiding. This study focuses on the European Union’s initial response to the COVID-19 pandemic, starting with how the European Union first learned and processed the global information arising out of China, followed by the incremental population-based medicine/management decisions made that currently are defining the European Union’s capacity and capability. The capacity to organize, deliver, and monitor care to a specific clinical population under a population-based management target includes strict social distancing strategies, contact testing and tracing, testing for the virus antigen and its antibodies, isolation, and treatment modalities such as new mitigating medications, and finally, a vaccine