Vernal Pool: A Participatory Art Project About Place + Precipitation

Produced by Karen Miranda Abel with Jessica Marion Barr, Vernal Pool is an immersive, elemental water installation created as a participatory, contemplative inquiry into our transitory interrelationships with water and landscape. From November 2013 to April 2014, 114 individuals across Canada and abroad gathered snow samples as a form of extrinsic artistic practice about place and precipitation. With the arrival of spring, the reservoir of melted snow was convened for four days at Toronto’s historic Gladstone Hotel to create Vernal Pool

Calidad de la dispensarización familiar, en el sector número 2 del Puesto de Salud San Judas del Municipio de Jinotega; según el modelo de salud familiar y comunitario II Semestre año 2015.

El Modelo de salud familiar y comunitario se basa en un esquema de manejo de los determinantes de salud a nivel de las personas, las familias y la comunidad. Enfatiza en la dispensarización y los diagnósticos comunitarios, busca garantizar el acceso y mejorar el funcionamiento de la atención a los grupos poblacionales, especialmente los que viven en condiciones de extrema y alta pobreza. Este estudio se realizó en el Puesto de Salud San Judas Tadeo ubicado en la periferia sur del municipio de Jinotega, está dividido en 3 sectores urbanos los cuales son atendidos según las normativas del MOSAFC, con el objetivo de describir la calidad de la dispensarización familiar, en el sector número 2 en el II Semestre año 2015. Mediante el análisis estadísticos de las fichas dispensariales de una muestra 337 fichas revisadas del universo; es un estudio descriptivo en el que se encontró que se han dispensarizado un total de 2411 familias del sector 2 del Puesto de Salud San Judas, de las cuales se disponen únicamente 2274 fichas y de estas, todas contiene al menos un dato errado que convierte a la ficha en inadecuada, además casi todas contenían la clasificación adecuada del grado dispensarial para cada individuo de la familia, lo que hace posible clasificar a la población en estudio según factores de riesgo asociados, menciona que las subvariables que con más dificultad fueron llenadas son aquellas de la información de la familia, haciendo que se dificulte emprender el control y seguimiento oportuno de enfermedades que pudiesen afectar a la población. Por lo que es de utilidad recomendar que se instauren estrategias para corregir las debilidades que tiene el personal que realiza la dispensarización; realizando capacitaciones sobre el MOSAFC y la correcta recolección de los datos de la ficha familiar en relación a los parámetros con que cada variable debe ser completad

Capturing norovirus transmission

Human norovirus is a leading cause of gastroenteritis and is efficiently transmitted between humans and around the globe. The burden of norovirus infections in the global community and in health-care settings warrant the availability of outbreak prevention strategies and control measures that are tailored to the pathogen, outbreak setting and population at risk. A better understanding of viral and host determinants of transmission would aid in developing and fine-tuning such efforts. Here, we describe mechanisms of transmission, available model systems for studying norovirus transmission and their strengths and weaknesses as well as future research strategies

Measures to enhance angiotensin-receptor blocker prescribing efficiency in Belgium following generic losartan: impact and implications for the future

Objective: Compare the utilisation of losartan before and after the availability of generics in Belgium and its inclusion in the reference price system, which changed its reimbursement status. Determine the impact of reforms on expenditure/defined daily dose (DDD) for losartan and overall reimbursed expenditure for the angiotensin-receptor blockers (ARBs). Methods: Interrupted time-series analysis of monthly reimbursed prescriptions was used for all patients in Belgium covered by the social health insurance system prescribed an ARB alone or in combination between January 2007 and August 2011; that is, 42 months before generic losartan was included in the reference price system (July 2010) to 13 months after. Key findings: A significant increase in losartan utilisation was seen following its change in reimbursement status whereas all other ARBs still required prior approval for reimbursement. Losartan utilisation increased from 18% of all single ARBs on a moving annual total (MAT) DDD basis just before the inclusion of losartan in the reference price system to 24% on a MAT basis 12 months after this. During this period, total ARB utilisation increased by 1%, consequently representing both new and switched patients. Reimbursed expenditure for losartan decreased 40% 12 months after its inclusion in the reference price system despite a 22% increase in utilisation. Total ARB expenditure reduced by 15% during this period. Conclusion: The reforms, including altering the prescribing regulations for losartan, significantly enhanced its utilisation, reduced its expenditure/DDD and reduced overall ARB expenditure in Belgium. No further measures are suggested for Belgium with more ARBs losing or about to lose their patents. There has been no change in the utilisation patterns of losartan in countries following generic availability where there are no specific demand-side measures. These findings confirm that multiple measures are needed to change physician prescribing patterns

Population-based screening in a municipality after a primary school outbreak of the SARSCoV-2 Alpha variant, the Netherlands, December 2020–February 2021

An outbreak of SARS-CoV-2 Alpha variant (Pango lineage B.1.1.7) was detected at a primary school (School X) in Lansingerland, the Netherlands, in December 2020. The outbreak was studied retrospectively, and population-based screening was used to assess the extent of virus circulation and decelerate transmission. Cases were SARS-CoV-2 laboratory confirmed and were residents of Lansingerland (November 16(th) 2020 until February 22(th) 2021), or had an epidemiological link with School X or neighbouring schools. The SARS-CoV-2 variant was determined using variant PCR or whole genome sequencing. A questionnaire primarily assessed clinical symptoms. A total of 77 Alpha variant cases were found with an epidemiological link to School X, 16 Alpha variant cases linked to the neighbouring schools, and 146 Alpha variant cases among residents of Lansingerland without a link to the schools. The mean number of self-reported symptoms was not significantly different among Alpha variant infected individuals compared to non-Alpha infected individuals. The secondary attack rate (SAR) among Alpha variant exposed individuals in households was 52% higher compared to non-Alpha variant exposed individuals (p = 0.010), with the mean household age, and mean number of children and adults per household as confounders. Sequence analysis of 60 Alpha variant sequences obtained from cases confirmed virus transmission between School X and neighbouring schools, and showed that multiple introductions of the Alpha variant had already taken place in Lansingerland at the time of the study. The alpha variant caused a large outbreak at both locations of School X, and subsequently spread to neighbouring schools, and households. Population-based screening (together with other public health measures) nearly stopped transmission of the outbreak strain, but did not prevent variant replacement in the Lansingerland municipality

Laminate polyethylene window development for large aperture millimeter receivers

New experiments that target the B-mode polarization signals in the Cosmic Microwave Background require more sensitivity, more detectors, and thus larger-aperture millimeter-wavelength telescopes, than previous experiments. These larger apertures require ever larger vacuum windows to house cryogenic optics. Scaling up conventional vacuum windows, such as those made of High Density Polyethylene (HDPE), require a corresponding increase in the thickness of the window material to handle the extra force from the atmospheric pressure. Thicker windows cause more transmission loss at ambient temperatures, increasing optical loading and decreasing sensitivity. We have developed the use of woven High Modulus Polyethylene (HMPE), a material 100 times stronger than HDPE, to manufacture stronger, thinner windows using a pressurized hot lamination process. We discuss the development of a specialty autoclave for generating thin laminate vacuum windows and the optical and mechanical characterization of full scale science grade windows, with the goal of developing a new window suitable for BICEP Array cryostats and for future CMB applications

Monitoring SARS-CoV-2 Circulation and Diversity through Community Wastewater Sequencing, the Netherlands and Belgium

Severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) has rapidly become a major global health problem, and public health surveillance is crucial to monitor and prevent virus spread. Wastewater-based epidemiology has been proposed as an addition to disease-based surveillance because virus is shed in the feces of ≈40% of infected persons. We used next-generation sequencing of sewage samples to evaluate the diversity of SARS-CoV-2 at the community level in the Netherlands and Belgium. Phylogenetic analysis revealed the presence of the most prevalent clades (19A, 20A, and 20B) and clustering of sewage samples with clinical samples from the same region. We distinguished multiple clades within a single sewage sample by using low-frequency variant analysis. In addition, several novel mutations in the SARS-CoV-2 genome were detected. Our results illustrate how wastewater can be used to investigate the diversity of SARS-CoV-2 viruses circulating in a community and identify new outbreaks

Clinical and Virological Outcome of Monoclonal Antibody Therapies Across SARS-CoV-2 Variants in 245 Immunocompromised Patients:a multicenter prospective cohort study

Background. Immunocompromised patients (ICPs) have an increased risk for a severe and prolonged COVID-19. SARS-CoV-2 monoclonal antibodies (mAbs) were extensively used in these patients, but data from randomized trials that focus on ICPs are lacking. We evaluated the clinical and virological outcome of COVID-19 in ICPs treated with mAbs across SARS-CoV-2 variants. Methods. In this multicenter prospective cohort study, we enrolled B-cell- and/or T-cell-deficient patients treated with casirivimab/imdevimab, sotrovimab, or tixagevimab/cilgavimab. SARS-CoV-2 RNA was quantified and sequenced weekly, and time to viral clearance, viral genome mutations, hospitalization, and death rates were registered. Results. Two hundred and forty five patients infected with the Delta (50%) or Omicron BA.1, 2, or 5 (50%) variant were enrolled. Sixty-seven percent were vaccinated; 78 treated as outpatients, of whom 2 required hospital admission, but both survived. Of the 159 patients hospitalized at time of treatment, 43 (27%) required mechanical ventilation or died. The median time to viral clearance was 14 days (interquartile range, 7-22); however, it took &gt;30 days in 15%. Resistance-associated spike mutations emerged in 9 patients in whom the median time to viral clearance was 63 days (95% confidence interval, 57-69; P &lt; .001). Spike mutations were observed in 1 of 42 (2.4%) patients after treatment with 2 active mAbs, in 5 of 34 (14.7%) treated with actual monotherapy (sotrovimab), and 3 of 20 (12%) treated with functional monotherapy (ie, tixagevimab/cilgavimab against tixagevimab-resistant variant). Conclusions. Despite treatment with mAbs, morbidity and mortality of COVID-19 in ICPs remained substantial. Combination antiviral therapy should be further explored and may be preferred in severely ICPs.</p

Improving hand hygiene compliance in nursing homes: Protocol for a cluster randomized controlled trial (HANDSOME Study)

Background: Hand hygiene compliance is considered the most (cost-)effective measure for preventing health care-associated infections. While hand hygiene interventions have frequently been implemented and assessed in hospitals, there is limited knowledge about hand hygiene compliance in other health care settings and which interventions and implementation methods are effective. Objective: This study aims to evaluate the effect of a multimodal intervention to increase hand hygiene compliance of nurses in nursing homes through a cluster randomized controlled trial (HANDSOME study). Methods: Nursing homes were randomly allocated to 1 of 3 trial arms: Receiving the intervention at a predetermined date, receiving the identical intervention after an infectious disease outbreak, or serving as a control arm. Hand hygiene was evaluated in nursing homes by direct observation at 4 timepoints. We documented compliance with the World Health Organization's 5 moments of hand hygiene, specifically before touching a patient, before a clean/aseptic procedure, after body fluid exposure risk, after touching a patient, and after touching patient surroundings. The primary outcome is hand hygiene compliance of the nurses to the standards of the World Health Organization. The secondary outcome is infectious disease incidence among residents. Infectious disease incidence was documented by a staff member at each nursing home unit. Outcomes will be compared with the presence of norovirus, rhinovirus, and Escherichia coli on surfaces in the nursing homes, as measured using quantitative polymerase chain reaction. Results: The study was funded in September 2015. Data collection started in October 2016 and was completed in October 2017. Data analysis will be completed in 2020. Conclusions: HANDSOME studies the effectiveness of a hand hygiene intervention specifically for the nursing hom