This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical.

In Canada, recreational use of cannabis was legalized in October 2018. This policy change along with recent publications evaluating the efficacy of cannabis for the medical treatment of epilepsy and media awareness about its use have increased the public interest about this agent. The Canadian League Against Epilepsy Medical Therapeutics Committee, along with a multidisciplinary group of experts and Canadian Epilepsy Alliance representatives, has developed a position statement about the use of medical cannabis for epilepsy. This article addresses the current Canadian legal framework, recent publications about its efficacy and safety profile, and our understanding of the clinical issues that should be considered when contemplating cannabis use for medical purposes.

Introduction: Intravenous insertion (IVI) is identified by children as extremely painful and the resultant distress can have lasting negative consequences. There is an urgent need to effectively manage such procedures. Our primary objective was to compare the pain and distress of IVI with the addition of humanoid robot-based distraction to standard care, versus standard care alone. Methods: This two-armed randomized controlled trial (RCT) was conducted from April 2017 to May 2018 at the Stollery Children's Hospital emergency department (ED). Children aged 6 to 11 years who required IVI were included. Exclusion criteria included hearing or visual impairments, neurocognitive delays, sensory impairment to pain, previous enrolment, and discretion of the ED clinical staff. Primary outcomes were measured using the Observational Scale of Behavioural Distress-Revised (OSBD-R) (distress) and the Faces Pain Scale-Revised (FPS-R) (pain). A total of 426 pediatric patients were screened and 340 were excluded. Results: We recruited 86 children, of which 55% (47/86) were male; 9% (7/82) were premature at birth; 82% (67/82) had a previous ED visit; 30% (25/82) required previous hospitalization; 78% (64/82) had previous IV placement and 96% (78/81) received topical anesthesia. The mean total OSBD-R score was 1.49 ± 2.36 (standard care) compared to 0.78 ± 1.32 (robot group) (p = 0.047). The median FPS-R during the IV procedure was 4 (IQR 2,6) in the standard care group alone, compared to 2 (IQR 0,4) with the addition of humanoid robot-based distraction (p = 0.10). Change in parental state anxiety pre-procedure versus post-procedure was not significantly different between groups (p = 0.49). Parental satisfaction with the IV start was 93% (39/42) in the robot arm compared to 74% (29/39) in the standard care arm (p = 0.03). Parents were also more satisfied with management of their child's pain in the robot group (95% very satisfied) compared with standard care (72% very satisfied) (p = 0.002). Conclusion: A statistically significant reduction in distress was observed with the addition of robot-based distraction to standard care. Humanoid robot-based distraction therapy reduces distress and to a lesser extent, pain, in children undergoing IVI in the ED. Further trials are required to confirm utility in other age groups and settings.

Current methods of control recruitment for case-control studies can be slow (a particular issue for outbreak investigations), resource-intensive and subject to a range of biases. Commercial market panels are a potential source of rapidly recruited controls. Our study evaluated food exposure data from these panel controls, compared with an established reference dataset. Market panel data were collected from two companies using retrospective internet-based surveys; these were compared with reference data from the National Diet and Nutrition Survey (NDNS). We used logistic regression to calculate adjusted odds ratios to compare exposure to each of the 71 food items between the market panel and NDNS participants. We compared 2103 panel controls with 2696 reference participants. Adjusted for socio-demographic factors, exposure to 90% of foods was statistically different between both panels and the reference data. However, these differences were likely to be of limited practical importance for 89% of Panel A foods and 79% of Panel B foods. Market panel food exposures were comparable with reference data for common food exposures but more likely to be different for uncommon exposures. This approach should be considered for outbreak investigation, in conjunction with other considerations such as population at risk, timeliness of response and study resources.

Jurassic dykes of western Dronning Maud Land (Antarctica) form a minor component of the Karoo large igneous province. An extensive local dyke swarm intrudes Neoproterozoic gneisses and Jurassic syenite plutons on the margins of the Jutulstraumen palaeo rift in the Svedrupfjella region. The dykes were intruded in three distinct episodes (~204, ~176 and ~170 Ma). The 204 Ma dykes are overwhelminglylow-Ti, olivine tholeiites including some primitive (picritic) compositions (MgO >12 wt.%; Fe2O3 >12 wt.%; Cr >1000 ppm; Ni >600 ppm). This 204 Ma event precedes the main Karoo volcanic event by~25 Ma, so anycorrelations to the wider province are difficult to make. However, it mayrecord the earliest phase of rift activity along the Jutulstraumen. The 176 Ma dyke event is more intimately associated with the two syenite plutons. The dykes are alkaline (basanite/ tephrite) and were small-degree melts from an enriched, locallyderived source and underwent at least some degree of interaction with a syenitic contaminant. This ~176 Ma dyke event is widespread elsewhere in the Karoo (southern Africa and Dronning Maud Land). Later-stage (170 Ma) felsic (phonolite–comendite) dykes intrude the 176 Ma basanite–tephrite suite and represent the last phase of magmatic activityin the region.

Numerical models used to simulate the lofting mechanisms of runway stones were developed to assess the threat to aircraft structures from runway debris impacts. An inflated aircraft tyre model, which was validated by comparison with experimental indentation tests, showed that over-rolling of stones under typical take-off conditions led to only modest vertical loft velocities of less than 5 m/s. Experiments using a drop weight impactor simulated a section of aircraft tyre descending upon stones. These tests demonstrated that lofting was achieved for impacts with low rubber thickness. However, for impacts with greater rubber thickness, lofting was suppressed. Using more realistic tyre geometries resulted in launches with backspin, but only horizontally along the ground in the direction of the tyre axis. The speed at which launches occurred was proportional to the rate of descent of the tyre section and would consequently determine the loft speeds due to potential asperity lofting.

In January 2009, the IAEA EMRAS II (Environmental Modelling for Radiation Safety II) program was launched. The goal of the program is to develop, compare and test models for the assessment of radiological impacts to the public and the environment due to radionuclides being released or already existing in the environment; to help countries build and harmonize their capabilities; and to model the movement of radionuclides in the environment. Within EMRAS II, nine working groups are active; this paper will focus on the activities of Working Group 1: Reference Methodologies for Controlling Discharges of Routine Releases. Within this working group environmental transfer and dose assessment models are tested under different scenarios by participating countries and the results compared. This process allows each participating country to identify characteristics of their models that need to be refined. The goal of this working group is to identify reference methodologies for the assessment of exposures to the public due to routine discharges of radionuclides to the terrestrial and aquatic environments. Several different models are being applied to estimate the transfer of radionuclides in the environment for various scenarios. The first phase of the project involves a scenario of nuclear power reactor with a coastal location which routinely (continuously) discharges 60Co, 85Kr, 131I, and 137Cs to the atmosphere and 60Co, 137Cs, and 90Sr to the marine environment. In this scenario many of the parameters and characteristics of the representative group were given to the modellers and cannot be altered. Various models have been used by the different participants in this inter-comparison (PC-CREAM, CROM, IMPACT, CLRP POSEIDON, SYMBIOSE and others). This first scenario is to enable a comparison of the radionuclide transport and dose modelling. These scenarios will facilitate the development of reference methodologies for controlled discharges.

A cDNA clone encoding a full length putative collagen has been isolated in a screen of a mixed stage Globodera pallida expression library. Comparison of the deduced amino acid sequence of this molecule with other collagens suggests it is a cuticular collagen and a member of the col-8 subfamily of collagen genes. Northern blots show the gene is expressed specifically in gravid, adult females of the parasite as compared to second (invasive) stage juveniles and virgin females. Preliminary immunocytochemical studies indicate this collagen is present in areas other than the cuticle; these findings and the potential functional role of this collagen are discussed.

Glycosylation variants of the virulent Leishmania major clone VI21 were generated by mutagenesis with N-methyl-N-nitroso-N-nitroguanidine and selected using the galactose-specific lectin Ricinus communis II (RCA II). Three mutants, 4B9, 1D1 and 1C12, which failed to bind RCA II, were found to have an altered expression of lipophosphoglycan (LPG), a molecule implicated in the attachment to host macrophages and survival within the phagolysosome. There were differences in the antigenicity, molecular weight and localization of LPG from mutant parasites as compared to V121. Expression of gp63, a surface molecule also implicated in attachment to macrophages, was unaltered. All 3 mutants caused disease when injected into genetically susceptible BALB/c mice but lesions developed at a much slower rate than those caused by the virulent V121 clone. This slow rate of lesion development did not correlate with promastigotes' ability to invade macrophages in vitro. Karyotype analysis showed that there was a reduction in the size of chromosome band number 2 in all 3 mutants. The differences in LPG and chromosome band 2 were retained by mutant clones following passage through mice, suggesting that these phenotypes are stable. Although the mutant parasites were infective and caused lesions, the changed structure of the LPG appeared to influence the virulence of the parasites.

In this paper we describe various techniques, some of which are already used by devotees of the art, which relate certain maximal subgroups of the Mathieu group M24, as seen in the MOG, to matrix groups over finite fields. We hope to bring out the wealth of algebraic structure underlying the device and to enable the reader to move freely between these matrices and permutations. Perhaps the MOG was mis-named as simply an “octad generator”; in this paper we intend to show that it is in reality a natural diagram of the binary Golay code.

Genetic linkage of schizophrenia to markers at 5q11.2–13.3 had been reported previously in five Icelandic and two British families, but attempts at replication in independent samples have been unsuccessful. We report here an update on the diagnoses and results of linkage analyses using newer highly polymorphic microsatellite markers at or near the loci D5S76 and D5S39 in the original sample of pedigrees and in two new family samples from Iceland and from Britain. The new results show a reduction in evidence for linkage in the original sample and evidence against linkage in the two new family samples. Although it is possible that a rare locus is present, perhaps in the region 5p14.1–13.1 rather than 5q11.2–13.3, it appears most likely that the original positive lod scores represent an exaggeration of the ‘true’ lod scores due to random effects and that the small lod scores we now obtain could have arisen by chance.

Nano-sized dispersions have been employed as precursor inks for the spray deposition of contacts to both Si and CdTe materials. In the case of Si, nano-sized Al particles (nano-Al) were dispersed and spray deposited onto p-type Si. Annealing above the eutectic temperature causes alloy formation yielding a p+ layer with p ∼ 10−4 Ω•cm. For CdTe, nano-sized Te particles (nano-Te) were dispersed and sprayed onto CdTe/CdS/SnO2/glass heterostructures. Contact to the CdTe layer occurred during a 30 min anneal in He (T = 215 to 255 °C). These solar cells were finished by spin-coating the Te layer with Ag paint and subsequently annealing in air (100 °C / 1 h). This approach produces solar cells with open circuit voltages (Voc) from 720 to 800 mV, short circuit current densities (Jsc) from 18 to 20 mA/cm2 and efficiencies up to 10.3%. The performance of these cells was similar to those produced using the standard NREL contact.