The impact of iodinated contrast media in hospital wastewater on drinking water quality in North Carolina

Iodinated trihalomethanes (iodo-THMs) are an unregulated class of disinfection byproduct (DBP) of increasing public health concern due to their elevated toxicity in comparison to regulated THMs, even at their lower occurrence concentrations. Iodinated contrast media (ICM), specifically iohexol because of its prevalence in North Carolina, are a major source of iodine in surface waters that receive wastewater effluent due to their biological inactivity and persistence through wastewater treatment. Many of these waters feed downstream drinking water treatment plants (DWTPs). This study investigated whether the presence of iohexol in drinking water sources can lead to the formation of iodo-THMs in disinfected drinking water impacted by upstream medical waste discharges by determining the conditions under which iohexol releases iodine to form iodo-THMs and applying equivalent conditions to natural waters and DWTP samples. Using tryptophan as a surrogate for natural organic matter (NOM) in surface waters, reactions with chlorine in the presence and absence of up to 5 mg/L iohexol formed only chloroform, while similar reactions involving monochloramine yielded no detectable THMs. Samples collected from four points in a DWTP were characterized and confirmed the presence of tryptophan-like NOM, associated with wastewater effluent, in each sample. Subsequent reactions of source water, post-powdered activated carbon (PAC), and post-ozonation samples with chlorine and monochloramine (target disinfectant residual of 3 mg/L as Cl2) in the presence and absence of 5 mg/L iohexol were evaluated to determine iodo-THM formation. Chlorination of samples showed formation of chloroform, bromodichloromethane, and dibromochloromethane, as well as two iodo-THMs, dichloroiodomethane and bromodiiodomethane, regardless of iohexol addition, while chlorodiiodomethane formed only after chlorination of source water in the presence of the iohexol. Chlorination of post-ozonation samples produced less iodo-THM formation compared to chlorination of source water and post-PAC samples. Though iodine was already present in sampled waters, chloramination yielded no quantifiable iodo-THMs even after iohexol addition, but yielded chloroform in reactions with source water, though at much lower concentrations than with equivalent disinfectant residuals after chlorination. These findings suggest that the combination of ozonation and monochloramine disinfection can decrease formation of iodo-THMs in drinking water; however, significant reduction of iodine-containing precursors in surface drinking water sources may only be possible with regulations on medical waste discharge into sewage systems, or with substitution of ICM alternatives that do not contain DBP precursors.Bachelor of Science in Public Healt

Foregrounding the Margins: A Dialogue about Literacy, Learning, and Social Annotation

Annotation, or the addition of a note to a text, enables readers-as-writers to make their thinking visible. This article, which is structured as a dialogue among four literacy educators, discusses the potential for social annotation to transform literacy learning, assessment, and teacher education. Collectively, the authors argue for social annotation as a vital and transformative practice in hybrid and post-pandemic education. The authors reflect on their personal and pedagogical uses of annotation, sharing related resources for educators across K-12 and higher education contexts

Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times the global rate, and reducing OD in India will be essential in meeting Sustainable Development Goal (SDG) 6.2 and improving global public health. The government of India launched the Swachh Bharat Mission (SBM) in 2014 with one key goal for all Indian states to achieve OD-free (ODF) status by 2019. Despite reports from the Government of India on the success of SBM, the true ODF status of Indian states is still unknown. A systematic review of peer-reviewed literature was conducted to assess the impact of SBM on OD in India, evaluate the barriers to reducing OD, and provide recommendations for future interventions to reduce or eliminate OD in India. A total of 237 publications were screened, and 22 were selected for inclusion. While the Prime Minister declared India ODF in 2019, studies suggest that the government monitoring system overestimates numbers of ODF villages and toilet coverage. Reasons for households’ continued OD practice include financial constraints, lack of water supply, governmental mistrust, cultural beliefs, and personal preference. Community incentives and penalties have been used to encourage proper sanitation practices with varying success. Overarching strategies and approaches that have worked well across study districts to reduce OD include high involvement of district leadership and innovative behavior-change and local community mobilization campaigns

Elicitation of broadly protective sarbecovirus immunity by receptor-binding domain nanoparticle vaccines

Understanding vaccine-elicited protection against SARS-CoV-2 variants and other sarbecoviruses is key for guiding public health policies. We show that a clinical stage multivalent SARS-CoV-2 spike receptor-binding domain nanoparticle vaccine (RBD-NP) protects mice from SARS-CoV-2 challenge after a single immunization, indicating a potential dose-sparing strategy. We benchmarked serum neutralizing activity elicited by RBD-NP in non-human primates against a lead prefusion-stabilized SARS-CoV-2 spike (HexaPro) using a panel of circulating mutants. Polyclonal antibodies elicited by both vaccines are similarly resilient to many RBD residue substitutions tested although mutations at and surrounding position 484 have negative consequences for neutralization. Mosaic and cocktail nanoparticle immunogens displaying multiple sarbecovirus RBDs elicit broad neutralizing activity in mice and protect mice against SARS-CoV challenge even in the absence of SARS-CoV RBD in the vaccine. This study provides proof of principle that multivalent sarbecovirus RBD-NPs induce heterotypic protection and motivates advancing such broadly protective sarbecovirus vaccines to the clinic

Training Transfer Design Theories Revisited For Application To Virtual Environments

Training transfer, a dated issue, takes new perspective when considering designing a virtual environment (VE) best suited for application to the real-world. A review of three key design theories is provided. An outline follows of the basic components, limitations, and future directions for Identical Elements Theory, Principles Theory, and Near and Far Transfer Theory. Discussion surrounding theory applicability to a variety of fields including route mapping, medical, and pilot training encourages serious evaluation of the evidence supporting any one theory capable of accounting for all training transfer from VE systems and the probability of training capable of transferring for all fields. Copyright 2010 by Human Factors and Ergonomics Society, Inc. All rights reserved

The Utility Of Adaptive Automation In Intelligence, Surveillance, And Reconnaissance Operations

The Intelligence, Surveillance and Reconnaissance (ISR) missions require much attention from the operator to identify changes in the environment, detect threats, and relay information. The longer time spent on task, the more diligent the operator must be. However, vigilance literature shows that operator performance deteriorates over time, known as the vigilance decrement, and rate of decline is greater with more demanding tasks. ISR operations are multi-tasking environments and thus induce higher levels of stress and workload in the operator, often associated with a reduction in performance. The goal is to identify the solution for optimized stress, workload, and performance. Adaptive automation is the proposed answer. Adaptive automation is expected to mitigate the negative effects caused by a sustained attention, multi-tasking assignment. Adaptive automation refers to a system capability designed for sharing work cooperatively with a human. In so doing, the human is maintained in-the-loop and maximum human-machine potential is achieved within the working environment. An ISR simulated environment was developed, requiring participants to identify intelligence updates symbolized by a change detection task using military icons, detect threats in route, respond verbally to radio communications. Participants drove the Unmanned Ground Vehicle (UGV) using a joystick through a designated route displayed on the screen or monitored the UGV as it autonomously was guided through the mission via waypoints. Adaptive scenarios were those in which both modes of control were implemented throughout 24 minute missions, dependent upon workload evoked by the change detection task (number of icons changed, rate of change, and number of icons in view). The benefit of such research is effectively employing a system capability to reduce operator stress and improve performance, ultimately saving lives

Adaptive Automation As A Task Switching And Task Congruence Challenge

Adaptive automation refers to a system capability that enables task sharing between a human operator and a system. The purpose for this type of collaborative sharing is to maintain a moderate level of task load, particularly in a multi-tasking environment. However, some costs might accrue from switching automation on and off, as is shown from task switching literature. Additionally, it is possible that congruency between task demand and the level of automation affects performance. Thus, before system-controlled adaptive automation is implemented into an operational environment, the goal for the present experiment is to examine the costs associated with turning automation on and off and to investigate the effects of demand/automation congruence. Analysis of the congruence effects revealed performance to benefit from higher levels of automation, regardless of task load. Task switching caused by adaptive automation was found to be detrimental to performance during periods of high task demand, but was beneficial during periods of low demand. Copyright 2011 by Human Factors and Ergonomics Society, Inc. All rights reserved

Effectiveness of the Swachh Bharat Mission and barriers to ending open defecation in India: a systematic review

In 2016, nearly 60% of the population of India practiced open defecation (OD), which was 4 times the global rate, and reducing OD in India will be essential in meeting Sustainable Development Goal (SDG) 6.2 and improving global public health. The government of India launched the Swachh Bharat Mission (SBM) in 2014 with one key goal for all Indian states to achieve OD-free (ODF) status by 2019. Despite reports from the Government of India on the success of SBM, the true ODF status of Indian states is still unknown. A systematic review of peer-reviewed literature was conducted to assess the impact of SBM on OD in India, evaluate the barriers to reducing OD, and provide recommendations for future interventions to reduce or eliminate OD in India. A total of 237 publications were screened, and 22 were selected for inclusion. While the Prime Minister declared India ODF in 2019, studies suggest that the government monitoring system overestimates numbers of ODF villages and toilet coverage. Reasons for households’ continued OD practice include financial constraints, lack of water supply, governmental mistrust, cultural beliefs, and personal preference. Community incentives and penalties have been used to encourage proper sanitation practices with varying success. Overarching strategies and approaches that have worked well across study districts to reduce OD include high involvement of district leadership and innovative behavior-change and local community mobilization campaigns

Interventions to address unsafe child feces disposal practices in the Asia-Pacific region: a systematic review

Despite clear evidence of the adverse health impacts of unsafe child feces disposal (CFD), there is little evidence of the effectiveness of interventions targeting the improvement of unsafe CFD practices in the Asia-Pacific region. A systematic review of the literature was conducted to identify and evaluate the quality of both behavior change and hardware interventions targeting the improvement of CFD practices in this region. A total of 695 articles were screened, and 15 studies were included. The combined hardware and behavior change interventions reported the highest rates of safe CFD (SCFD) post-intervention; however, these interventions were of lower quality. Four interventions focused specifically on improving SCFD practices, while the remaining seven studies evaluated the impacts of large-scale interventions, such as India's MANTRA and Total Sanitation Campaign programs, on unsafe CFD practices. Large-scale programs and hardware interventions are important for providing communities with the infrastructure necessary to improve unsafe CFD practices, but such interventions may be improved by the addition of a behavioral change component. With little evidence available on the effectiveness of behavioral interventions on reducing unsafe CFD in the Asia-Pacific region, future work should focus on how behavior change models combined with hardware interventions impact unsafe CFD. HIGHLIGHTS The Asia-Pacific region has high rates of unsafe child feces disposal (CFD).; There is little evidence on the effectiveness of sanitation interventions targeting the improvement of unsafe CFD practices.; Hardware interventions may be improved by the addition of a behavioral change component.; Future work should focus on how behavior change models combined with hardware interventions address unsafe CFD practices.

Thermodynamically coupled biosensors for detecting neutralizing antibodies against SARS-CoV-2 variants.

We designed a protein biosensor that uses thermodynamic coupling for sensitive and rapid detection of neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants in serum. The biosensor is a switchable, caged luciferase-receptor-binding domain (RBD) construct that detects serum-antibody interference with the binding of virus RBD to angiotensin-converting enzyme 2 (ACE-2) as a proxy for neutralization. Our coupling approach does not require target modification and can better distinguish sample-to-sample differences in analyte binding affinity and abundance than traditional competition-based assays