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To determine if the high-level personal protective equipment used in the treatment of high-consequence infectious diseases is effective at stopping the spread of pathogens to healthcare personnel (HCP) while doffing.
Background:
Personal protective equipment (PPE) is fundamental to the safety of HCPs. HCPs treating patients with high-consequence infectious diseases use several layers of PPE, forming complex protective ensembles. With high-containment PPE, step-by-step procedures are often used for donning and doffing to minimize contamination risk to the HCP, but these procedures are rarely empirically validated and instead rely on following infection prevention best practices.
Methods:
A doffing protocol video for a high-containment PPE ensemble was evaluated to determine potential contamination pathways. These potential pathways were tested using fluorescence and genetically marked bacteriophages.
Results:
The experiments revealed existing protocols permit contamination pathways allowing for transmission of bacteriophages to HCPs. Updates to the doffing protocols were generated based on the discovered contamination pathways. This updated doffing protocol eliminated the movement of viable bacteriophages from the outside of the PPE to the skin of the HCP.
Conclusions:
Our results illustrate the need for quantitative, scientific investigations of infection prevention practices, such as doffing PPE.
A confluence of societal changes, particularly hardening racial attitudes following the Indian Mutiny in 1857 and the Morant Bay Rebellion in 1865, resulted in widescale disillusionment with imperial humanitarian projects in the middle decades of the nineteenth century. As this article demonstrates, however, the membership and income of the Aborigines’ Protection Society (APS) increased at precisely the moments when this disillusionment was at its sharpest. This article combines quantitative and qualitative methods to assess the nature of the Society's mid-century membership base, demonstrating that, rather than a monolithic decline, a humanitarian polarization took place in response to imperial crises that led some (largely Tories) to disillusionment and others (largely Whigs) to entrenchment. Furthermore, by attending to discursive trends within speeches at APS annual meetings as well as in private correspondence between members and the secretary of the Society, I explore how APS members explained the connection between their own lives and the treatment of distant Indigenous peoples in the colonies. Finding that British Indigenous rights activism was only seldomly expressed in terms of Indigenous peoples themselves, I show that support for the APS was most commonly related to concerns for friends and family living in the colonies, along with disquiet about the impact of colonial injustices on international competition. This enabled Indigenous rights activists to continue their efforts in the face of disillusionment with the capabilities of racialized “others.”
To highlight the promise of Jordan Pascoe’s Kant’s Theory of Labour, my comments concern the diagnostic and prescriptive dimensions of the book’s excellent intersectional critique of dependent labour relations. The diagnostic dimension of Pascoe’s critique establishes that the organisation of dependent labour relations is a neglected problem of Kantian justice. The prescriptive dimension offers solutions to this problem but is underdeveloped. To enhance the book’s prescriptive dimension, I draw on the noted Africana philosopher W. E. B. Du Bois for guidance. For Du Bois, a constitutional republic ought to strive for the abolition of a ‘second’ slavery following the abolition of de jure black chattel slavery with the end of the American Civil War. Given Du Bois’ call for meaningful Emancipation, I argue that philosophers should reinterpret the Kantian normative ideal of freedom as universal independence to uproot the postbellum conditions of second slavery.
Pentastiridius leporinus (Hemiptera: Cixiidae) is the main vector of an emerging and fast spreading sugar beet disease, the syndrome ‘basses richesses’ (SBR), in different European countries. The disease is caused by the γ-3-proteobacterium ‘Candidatus Arsenophonus phytopathogenicus’ and the phytoplasma ‘Candidatus Phytoplasma solani’ which are exclusively transmitted by planthoppers and can lead to a significant loss of sugar content and yield. Monitoring of this insect vector is important for disease management. However, the morphological identification is time consuming and challenging as two additional cixiid species Reptalus quinquecostatus and Hyalesthes obsoletus with a very close morphology have been reported in sugar beet fields. Further, identification of females and nymphs of P. leporinus at species level based on taxonomic key is not possible. In this study, an isothermal nucleic acid amplification based on recombinase polymerase amplification (RPA) was developed to specifically detect P. leporinus. In addition, real-time RPA was developed to detect both adults (male and female) and nymph stages using pure or crude nucleic acid extracts. The sensitivity of the real-time RPA for detection of P. leporinus was comparable to real-time PCR, but a shorter time (< 7 min) was required. This is a first report for real-time RPA application for P. leporinus detection using crude nucleic acid templates which can be applied for fast and specific detection of this vector in the field.
Studying liquid jet impacts on a liquid pool is crucial for various engineering and environmental applications. During jet impact, the free surface of the pool deforms and a cavity is generated. Simultaneously, the free surface of the cavity extends radially outward and forms a rim. Eventually the cavity collapses by means of gas inertia and surface tension. Our numerical investigation using an axisymmetric model in Basilisk C explores cavity collapse dynamics under different impact velocities and gas densities. We validate our model against theory and experiments across a previously unexplored parameter range. Our results show two distinct regimes in the cavity collapse mechanism. By considering forces pulling along the interface, we derive scaling arguments for the time of closure and maximum radius of the cavity, based on the Weber number. For jets with uniform constant velocity from tip to tail and $We \leqslant 150$, the cavity closure is capillary-dominated and happens below the surface (deep seal). In contrast, for $We \geqslant 180$ the cavity closure happens above the surface (surface seal) and is dominated by the gas entrainment and the pressure gradient that it causes. Additionally, we monitor gas velocity and pressure throughout the impact process. This analysis reveals three critical moments of maximum gas velocity: before impact, at the instant of cavity collapse and during droplet ejection following cavity collapse. Our results provide information for understanding pollutant transport during droplet impacts on large bodies of water, and other engineering applications, like additive manufacturing, lithography and needle-free injections.
Litigation funding has become an essential ingredient in collective actions for breaches of competition law brought in the Competition Appeal Tribunal (CAT). In the recent PACCAR proceedings, the Supreme Court was asked to rule on the nature and enforceability of litigation funding agreements (LFAs) between third-party litigation funders and group representatives where the success fee is determined as a percentage of the damages award.1 The Court held with a 4:1 majority (Lady Rose dissenting)2 that the LFAs in question are damages-based fee agreements (DBAs) and, as such, unenforceable. This judgment has wide-ranging consequences, as the CAT is unlikely to allow collective actions to proceed if the funding agreements cannot be relied on. The decision has caused uncertainty and upheaval in the funding market as a considerable number of funding agreements in collective proceedings contain DBAs. It also triggered legal challenges in collective proceedings where funders are seeking to amend the funding agreements to deal with the Supreme Court ruling.3 The fall-out from the decision suggests that funding rules for collective actions may need more legislative attention – litigation funding was given some thought during the drafting of the opt-out action regime, but the legal framework for litigation funding remains fragmented and open to interpretation.4
To describe an outbreak of sequence type (ST)2 Clostridioides difficile infection (CDI) detected by a recently implemented multilocus sequence type (MLST)-based prospective genomic surveillance system using Oxford Nanopore Technologies (ONT) sequencing.
Setting:
Hemato-oncology ward of a public tertiary referral centre.
Methods:
From February 2022, we began prospectively sequencing all C. difficile isolated from inpatients at our institution on the ONT MinION device, with the output being an MLST. Bed-movement data are used to construct real-time ST-specific incidence charts based on ward exposures over the preceding three months.
Results:
Between February and October 2022, 76 of 118 (64.4%) CDI cases were successfully sequenced. There was wide ST variation across cases and the hospital, with only four different STs being seen in >4 patients. A clear predominance of ST2 CDI cases emerged among patients with exposure to our hemato-oncology ward between May and October 2022, which totalled ten patients. There was no detectable rise in overall CDI incidence for the ward or hospital due to the outbreak. Following a change in cleaning product to an accelerated hydrogen peroxide wipe and several other interventions, no further outbreak-associated ST2 cases were detected. A retrospective phylogenetic analysis using original sequence data showed clustering of the suspected outbreak cases, with the exception of two cases that were retrospectively excluded from the outbreak.
Conclusions:
Prospective genomic surveillance of C. difficile using ONT sequencing permitted the identification of an outbreak of ST2 CDI that would have otherwise gone undetected.
The crystal structure of brimonidine hydrogen tartrate has been solved and refined using synchrotron X-ray powder diffraction data and optimized using density functional techniques. Brimonidine hydrogen tartrate crystallizes in space group P21 (#4) with a = 7.56032(2), b = 7.35278(2), c = 30.10149(9) Å, β = 90.1992(2)°, V = 1673.312(10) Å3, and Z = 4 at 295 K. The crystal structure consists of alternating layers of cations and anions parallel to the ab-plane. Each of the hydrogen tartrate anions is linked to itself by very strong charge-assisted O–H⋯O hydrogen bonds into chains along the a-axis. Each hydroxyl group of each tartrate acts as a donor in an O–H⋯O or O–H⋯N hydrogen bond. One of these is intramolecular, but the other three are intermolecular. These hydrogen bonds link the hydrogen tartrate anions into layers parallel to the ab-plane and also link the anion–cation layers. The protonated N atoms act as donors in N–H⋯O or N–H⋯N hydrogen bonds to the carboxyl groups of the tartrates and to a ring nitrogen atom. These link the cations and anions, as well as providing cation–cation links. The amino N atoms of the cations form N–H⋯O hydrogen bonds to hydroxyl groups of the anions. The powder pattern has been submitted to ICDD for inclusion in the Powder Diffraction File™ (PDF®)
The Turkish government’s suppression of private heroin factories and its monopolization of opium exports brought the state into conflict with a large numbers of Istanbul residents who sought to profit from the lucrative trade in opiates. Sites of clandestine drug production spread across the urban and suburban landscape, inspiring public alarm and new policing measures. The article examines the human networks behind these production sites, investigating how they utilized the diversity of their members and contacts in the search for profit and the evasion of the state, and how this diversity was interpreted in press and public debate.
The Culicidae mosquito family breeds in various natural and artificial water bodies. Phytotelmata are plant structures that hold water and are used by many mosquito species during their life cycle. Mosquitoes are disease vectors, and phytotelmata play an important role in harbouring them. Investigating these phytotelmata will facilitate to develop appropriate site specific vector control strategy. Approximately 750 phytotelmata in 16 locations on Car Nicobar Island was examined. Mosquito larvae were collected from different habitats such as tree holes, root holes, leaf axils, and bamboo stumps. On average, the number of larvae per 10 ml of water ranged from 0.003 to 3.833. Among the 16 mosquito species identified, there were vectors of malaria (Anopheles sundaicus), dengue (Aedes aegypti and Aedes albopictus) and filariasis (Culex quinquefasciatus), belonging to seven genera. The most common phytotelmata were coconut trees (17.5%) followed by Java apple trees (10.3%) and bamboo stumps (7.1%). The most widespread mosquito species was Aedes edwardsi, followed by Aedes malayensis and Ae. albopictus, and the per cent of phytotelmata that contained these species were 42.6, 22.0, and 16.8% respectively. Anopheles mosquitoes had the highest container index (6.1%) in root holes, while Aedes and Culex mosquitoes were more frequently found in bamboo stumps. The alpha biodiversity indices indicated that the mosquito population in Car Nicobar Island was highly diverse (S = 16; DMg = 36.9). Tree holes showed the highest diversity, as all 16 species were collected from them. Assessment of phytotelmata, there is a significant relationship observed between mosquito genus, village, habitat, and tree families, on the remote island of Car Nicobar. Considering the presence of disease-transmitting mosquito vectors in the phytotelmata, these habitats should be considered when implementing control measures to eliminate mosquito-borne infections.
The genus Ancyrocephalus sensu lato is a large assemblage of species of dactylogyrid monopisthocotyleans without clear taxonomic boundaries. Despite an urgent need for revision, only three representatives of this taxon have been molecularly characterised so far. We found specimens of Ancyrocephalus curtus, a previously non-genotyped species, in gills of Perccottus glenii caught in the River Syumnyur, Amur Basin, Russia. The aim of this study was to assess the phylogenetic position of this parasite using partial sequences of 28S rRNA gene. In the phylogenetic tree, A. curtus appeared as a sister taxon to the dactylogyrine genus Gobioecetes. The new molecular evidence supports the hypothesis about the non-monophyletic status of Ancyrocephalus sensu lato.
We show that, in some ranked ballot elections, it may be possible to violate the secret vote. There are so many ways to rank even a handful of candidates that many possible rankings might not be cast by any voter. So, a vote buyer could pay someone to rank the candidates a certain way and then use the announced election results to verify that the voter followed through. We examine the feasibility of this attack both theoretically and empirically, focusing on instant runoff voting (IRV). Although many IRV elections have few enough candidates that this scheme is not feasible, we use data from San Francisco and a proposed election rule change in Oakland to show that some important IRV elections can have large numbers of unused rankings. There is no evidence that this vote-buying scheme has ever been used. However, its existence has implications for the administration and security of IRV elections. This scheme is more feasible when more candidates can be ranked in the election and when the election results report all the ways that candidates were ranked.
Given the historical nature of gender consciousness against the backdrop of the nation's social system transformations and the deficiencies related to physical and mental determinism commonly found in research on the performance of female gender roles, this study innovatively uses Butler's agency approach to examine gender consciousness. Women in China have experienced the female liberation movement of “equality between men and women” under the Chinese socialist regime as well as the movement of “women's return to the family” after the introduction of the market economy. The current study uses the agency approach to present the processes of post-1980s Chinese women when balancing their paid work, housework, and childcare roles and the contradictions therein as well as the ideologies they have adopted to resolve such contradictions. This study comprehensively examines the effect of conservative and non-conservative ideologies on the gender consciousness and behavior of women acting under their own agency. The findings, which are based on a comparison of the gender consciousness and behavior of various cohorts, yield the conclusion that post-1980s women expect non-conservative behavior in the future but choose conservative behaviors strategically. Such strategic behavioral choices deepen inner gender role-related conflicts.
The Christian mystical tradition approaches the apocalyptic as praxis – a way of living that renounces the world as it is, lives proleptically into a counter-world of God's reign and practices indifferent freedom in the meantime to love God and neighbour. Although concerns about the ethical viability of such a disposition have merit, this essay demonstrates its constructive possibility through recourse to two archives: the writings of Evagrius of Pontus and the witness of Francis of Assisi. By recovering a scriptural distinction between world and creation, and by emphasising the posture of holy indifference, apocalyptic praxis offers a resource and guide.