COVID-19 in Congregate Settings: A Literature Review

Purpose: Virginia has numerous and varying congregate living facilities, to include correctional facilities, skilled nursing facilities, and 13 state-operated mental/behavioral health/rehabilitation facilities. The purpose of this literature review is to review COVID-19 trends in congregate settings and identify suggested mitigation efforts. Methods: The target population for the literature search was individuals in congregate living facilities. Both correctional facilities and nursing homes were included as congregate settings. Findings: Studies reviewed reported on disease transmission, the use of universal and serial testing, and reported additional information. Early and frequent testing to guide resident cohorting and exclusion of individuals from work was recommended. This includes the testing of asymptomatic individuals. Pre-emptive testing was associated with significant lower overall disease prevalence in one study. Conclusions: Researchers across studies recommended testing early and often to inform prompt cohorting of infected individuals and to guide infection control measure. As such, early and frequent testing of individuals living and working in congregate settings is an important tool in controlling the spread of COVID-19. Recommendations: In addition to frequent and early testing, further research regarding the spread and control of COVID-19 within Virginia congregate living facilities is recommended to inform future mitigation efforts

Lessons Learned: COVID-19 in Post-Corrections Secured Behavioral Rehabilitation

Background: The COVID-19 case rate on June 5, 2020, for prisoners in the United States (US) was 5.5 times higher than the US population case rate (Saloner et al., 2020). Secure facilities were challenged to mitigate the spread of COVID-19. One secure behavioral rehabilitation facility made many changes to facility and program protocols to meet this challenge. Methods: The purpose of this program evaluation was to assess newly implemented infection control measures at a secure behavioral rehabilitation facility and to inform policy and procedure recommendations for the mitigation of COVID-19 transmission in congregate living facilities in the future. Case rates, percent positivity, and case fatality rates were used as surrogate measures to evaluate this facility\u27s COVID-19 program. A PRECEDE/PROCEED logic model was used to guide the program evaluation. Results: Attack rates varied significantly by unit, from 1 resident case (3.94%) to 31 cases (92.26%). The 7-day rolling average ranged from 0.0% to 4.34% positivity during the study period, and 205/355.6 residents (57.56%) were infected during the 3-month study period. Conclusions: COVID-19 places significant logistical and human strain on residents, employees, and administrators of secured congregate settings. Despite extensive infection control measures the study facility experienced a significant number of cases, special hospitalizations, and deaths. Further research is recommended to define adequate infection control measures to vulnerable populations in such settings

Demonstration of safety of intravenous immunoglobulin in geriatric patients in a long-term, placebo-controlled study of Alzheimer's disease.

INTRODUCTION:We present safety results from a study of Gammagard Liquid intravenous immunoglobulin (IGIV) in patients with probable Alzheimer's disease. METHODS:This was a placebo-controlled double-blind study. Subjects were randomized to 400 mg/kg (n = 127), 200 mg/kg (n = 135) IGIV, or to 0.25% human albumin (n = 121) administered every 2 weeks ± 7 days for 18 months. RESULTS:Elevated risk ratios of IGIV versus placebo included chills (3.85) in 9.5% of IGIV-treated subjects (all doses), compared to 2.5% of placebo-treated subjects, and rash (3.08) in 15.3% of IGIV-treated subjects versus 5.0% of subjects treated with placebo. Subjects in the highest IGIV dose group had the lowest proportion of SAEs considered related to product (2 of 127 [1.6%]). Subjects treated with IGIV experienced a lower rate of respiratory and all other infections compared to placebo. DISCUSSION:IGIV-treated subjects did not experience higher rates of renal failure, lung injury, or thrombotic events than the placebo group. There were no unexpected safety findings. IGIV was well tolerated throughout 18 months of treatment in subjects aged 50-89 years

Sodium sulfate decomposition in dry atmospheres

Na2SO4 in silicate glass batches is an environmental issue, since it releases SOx upon decomposition. Decomposition of Na2SO4 in different environments is studied by mass-loss measurements combined with evolved gas analysis, and thermochemical modeling. The decomposition experiments are undertaken in dry, pure O2(g), Ar(g), N2(g), and air(g) at 95 kPa total pressure. Thermochemical calculations using the code F*A*C*T predict SO2(g), Na(g), Na2SO4(g), NaO(g), and, in some cases, NO(g) as major emission species. The concentrations of these species increase with temperature. Na2SO4 decomposition initiates at ≈1373 K. Isothermal decomposition exhibits linear behavior with respect to time in 1473 to 1673 Κ range. At 1673 K, the decomposition rate is 24 · 10^-4 mg/(mm2 min) in UHP (ultra-high purity) O2 and 69 · 10^-4 mg/(mm2 min) in UHP N2. Evolved gas analyses identify SO(g)/SO2(g) as the emitted pollutants. In O2-rich atmospheres, SO(g) is a significant product as well as SO2(g). In inert atmospheres, SO2(g) is the sole decomposition product. At 1673 Κ in UHP O2, the concentration is 55 ppm (by volume) for SO(g) and 61 ppm for SO2. At 1673 Κ in UHP N2, SO2(g) concentration is 651 ppm. The decomposition is described by a surface reaction mechanism, in which SOx is generated by surface rearrangement of sulfur-oxygen complexes on the Na2So4 melt surface. Inert atmospheres increase SOx emission by facilitating this rearrangement process. O2-rich atmospheres passivate the melt surface, which favors the emission of lighter molecules such as SO(g)

Assessment of Human Health Risks from Chemically Contaminated Lake Fishes In Greece

Objectives were to conduct screening level surveys of locally consumed fish tissues in vicinities of two lakes (Kastoria and Pamvotis) in Greece to determine the presence of halogenated organic compounds and determine carcinogenic and non-carcinogenic human health risks associated with the consumption of sampled fish tissues. Results estimate the Incremental Lifetime Cancer Risks (ILCR) and Hazard Index (HI) values for the two local populations using site-specific population data. These results were compared to analyses conducted using U.S. Environmental Protection Agency default values in an effort to determine the applicability of USEPA default values to assessments of risks in non U.S. populations. Using site specific data, 87 % of the mean ILCRs calculated for total populations and sub-populations (i.e. female adult, female youth, male adult and male youth) consuming fishes from the two lakes we studied were above USEPA’s acceptable cancer risk of 1.0E-06; 53 % of the mean HIs were greater than 1.0. The USEPA default value (0.054 kg/d) for ingestion rate (IR) is considerably lower than the mean site specific IRs derived from populations in vicinity of Lake Kastoria (0.20; min.=0.09; max.=0.29 kg/d) and Lake Pamvotis (0.10; min.=0.01; max.=0.21 kg/d). These differences point to the need for the development of default values specific to the regions and population consumption patterns within Greece

Right to Serve, Right to Lead: Lives and Legacies of the USCT

This is a catalog for an exhibit that follows the evolution of African-American participation in the Civil War, from slaves, to contrabands, to soldiers of the United States Colored Troops (USCT), as well as the lives of black veterans beyond the war, and their ultimate military and social legacy. Using a variety of period items, it creates a narrative that stretches from the Antebellum Period to the current day. In doing so, the exhibit shows how black sacrifice on the battlefield redefined the war\u27s purpose throughout the divided nation, how Jim Crowe suppressed the memory of black participation after Reconstruction, and how the illustrious African-American military tradition left by the USCT endures to this day in their modern heirs

Economic valuation of the potential health benefits from foods enriched with plant sterols in Canada

Background: Increased consumption of foods containing plant sterols has the potential to reduce the incidence of coronary heart disease (CHD) and thus reduce costs associated with treating that disease in a significant way. This paper reports the results of an investigation of the potential monetary benefits of allowing foods enriched with plant sterols to be marketed in Canada. Objective: The objective of this research was to estimate the annual savings that would accrue to Canada's single-payer publicly funded health care system if plant sterols were approved for use. If foods containing plant sterols are consumed at a sufficient rate, a reduction in CHD should follow. Given the significant costs associated with CHD, approval of plant sterols in Canada has important public policy implications. Design: This research employs a variation of traditional cost-of-illness analysis entailing four steps: (1) estimation of a ‘success rate’ (proportion of persons who would consume plant sterols at the necessary rate); (2) presumption of blood cholesterol reduction due to plant sterol consumption; (3) assumption of reduction in CHD that follows from blood cholesterol reduction; and (4) calculation of cost savings associated with reduced incidence of CHD. Results: Calculations were carried out for four scenarios: ideal, optimistic, pessimistic, and very pessimistic. It was estimated that between $38 million (very pessimistic scenario) and $2.45 billion (ideal scenario) could be saved annually by Canada's health care system with plant sterol-enriched food products being made available for sale. Conclusion: Significant expenditure reductions within Canada's publicly funded health care system could be realized with plant sterols approved for sale. Reduced CHD resulting from lower blood cholesterol levels would lessen the financial burden of disease in Canada

Variation in Isoprene Emission from Quercus rubra: Sources, Causes, and Consequences for Estimating Fluxes

Isoprene is the dominant volatile organic compound produced in many forest systems. Uncertainty in estimates of leaf level isoprene emission rate stems from an insufficient understanding of the patterns and processes controlling isoprene emission capacity in plant leaves. Previous studies suggest that variation in isoprene emission capacity is substantial; however, it is not known at what scale emission capacity is the most variable. Identifying the sources of variation in emission capacity has implications for conducting measurements and for model development, which will ultimately improve emission estimates and models of tropospheric chemistry. In addition, understanding the sources of variation will help to develop a comprehensive understanding of the physiological controls over isoprene emission. This study applied a variance partitioning approach to identify the major sources of variation in isoprene emission capacity from two populations of northern red oak (Quercus rubra) over three growing seasons. Specifically, we evaluated variation due to climate, populations, trees, branches, leaves, seasons, and years. Overall, the dominant source of variation was the effect of a moderate drought event. In the years without drought events, variation among individual trees (intraspecific) explained approximately 60% of the total variance. Within the midseason, isoprene emission capacity of sun leaves varied by a factor of 2 among trees. During the third year a moderate 20-day drought event caused isoprene emission capacity to decrease fourfold, and the relative importance of intraspecific variation was reduced to 24% of total variance. Overall, ambient temperature, light, and a drought index were poor predictors of isoprene emission capacity over a 0 to 14-day period across growing seasons. The drought event captured in this study emphasizes the need to incorporate environmental influences into leaf level emission models

Demographic predictors of experiences of homelessness among lesbian, gay, bisexual, trans, gender-diverse and queer-identifying (LGBTIQ) young people in Australia

Homelessness among young lesbian, gay, bisexual, trans, gender-diverse and queer-identifying (LGBTQ+) persons is highly prevalent and constitutes a structural risk to health and future life chances. However, the distribution of homelessness burden is among different LGBTQ+ subgroups is poorly understood. An Australia-wide cross-sectional online survey was conducted involving 6,481 LGBTQ+ participants aged 14–21 years during 2019. Single-predictor logistic regression analyses identified factors associated with both lifetime and recent experiences of homelessness. Analyses also explored associations between recent (<12 months) experiences of homelessness, experiences of harassment, alcohol consumption, and psychological distress. Higher odds of experiencing homelessness were observed for trans and gender-diverse young people, individuals who identified with sexual identity labels other than lesbian, gay or bisexual, racially-minoritized persons, disabled persons and individuals from a religious family or household, compared to their respective counterparts. Experiencing homelessness was associated with higher levels of alcohol consumption and higher prevalence of experiencing verbal, physical and sexual harassment, but only modestly associated with higher levels of psychological distress. Homelessness risk and burden is unevenly distributed among LGBTQ+ youth and is linked to outcomes which may potentiate future homelessness. Interventions addressing homelessness among this group must be optimized for those subgroups most vulnerable to experiencing homelessness

Efficacy and Safety of Alirocumab as Add-on Therapy in High–Cardiovascular-Risk Patients With Hypercholesterolemia Not Adequately Controlled With Atorvastatin (20 or 40 mg) or Rosuvastatin (10 or 20 mg)::Design and Rationale of the ODYSSEY OPTIONS Studies

The phase 3 ODYSSEY OPTIONS studies (OPTIONS I, NCT01730040; OPTIONS II, NCT01730053) are multicenter, multinational, randomized, double-blind, active-comparator, 24-week studies evaluating the efficacy and safety of alirocumab, a fully human monoclonal antibody targeting proprotein convertase subtilisin/kexin type 9, as add-on therapy in ∼ 650 high-cardiovascular (CV)-risk patients whose low-density lipoprotein cholesterol (LDL-C) levels are ≥100 mg/dL or ≥70 mg/dL according to the CV-risk category, high and very high CV risk, respectively, with atorvastatin (20–40 mg/d) or rosuvastatin (10–20 mg/d). Patients are randomized to receive alirocumab 75 mg via a single, subcutaneous, 1-mL injection by prefilled pen every 2 weeks (Q2W) as add-on therapy to atorvastatin (20–40 mg) or rosuvastatin (10–20 mg); or to receive ezetimibe 10 mg/d as add-on therapy to statin; or to receive statin up-titration; or to switch from atorvastatin to rosuvastatin (OPTIONS I only). At week 12, based on week 8 LDL-C levels, the alirocumab dose may be increased from 75 mg to 150 mg Q2W if LDL-C levels remain ≥100 mg/dL or ≥70 mg/dL in patients with high or very high CV risk, respectively. The primary efficacy endpoint in both studies is difference in percent change in calculated LDL-C from baseline to week 24 in the alirocumab vs control arms. The studies may provide guidance to inform clinical decision-making when patients with CV risk require additional lipid-lowering therapy to further reduce LDL-C levels. The flexibility of the alirocumab dosing regimen allows for individualized therapy based on the degree of LDL-C reduction required to achieve the desired LDL-C level