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Characteristics of healthcare personnel with SARS-CoV-2 infection: 10 emerging infections program sites in the United States, April 2020–December 2021
- Nora Chea, Taniece Eure, Rebecca Alkis Ramirez, Maria Zlotorzynska, Gregory T. Blazek, Joelle Nadle, Jane Lee, Christopher A. Czaja, Helen Johnston, Devra Barter, Melissa Kellogg, Catherine Emanuel, James Meek, Monica Brackney, Stacy Carswell, Stepy Thomas, Scott K. Fridkin, Lucy E. Wilson, Rebecca Perlmutter, Kaytlynn Marceaux-Galli, Ashley Fell, Sara Lovett, Sarah Lim, Ruth Lynfield, Sarah Shrum Davis, Erin C. Phipps, Marla Sievers, Ghinwa Dumyati, Christopher Myers, Christine Hurley, Erin Licherdell, Rebecca Pierce, Valerie L. S. Ocampo, Eric W. Hall, Christopher Wilson, Cullen Adre, Erika Kirtz, Tiffanie M. Markus, Kathryn Billings, Ian D Plumb, Glen R. Abedi, Jade James-Gist, Shelley S. Magill, Cheri T. Grigg
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- Journal:
- Infection Control & Hospital Epidemiology , First View
- Published online by Cambridge University Press:
- 21 May 2024, pp. 1-9
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Background:
Understanding characteristics of healthcare personnel (HCP) with SARS-CoV-2 infection supports the development and prioritization of interventions to protect this important workforce. We report detailed characteristics of HCP who tested positive for SARS-CoV-2 from April 20, 2020 through December 31, 2021.
Methods:CDC collaborated with Emerging Infections Program sites in 10 states to interview HCP with SARS-CoV-2 infection (case-HCP) about their demographics, underlying medical conditions, healthcare roles, exposures, personal protective equipment (PPE) use, and COVID-19 vaccination status. We grouped case-HCP by healthcare role. To describe residential social vulnerability, we merged geocoded HCP residential addresses with CDC/ATSDR Social Vulnerability Index (SVI) values at the census tract level. We defined highest and lowest SVI quartiles as high and low social vulnerability, respectively.
Results:Our analysis included 7,531 case-HCP. Most case-HCP with roles as certified nursing assistant (CNA) (444, 61.3%), medical assistant (252, 65.3%), or home healthcare worker (HHW) (225, 59.5%) reported their race and ethnicity as either non-Hispanic Black or Hispanic. More than one third of HHWs (166, 45.2%), CNAs (283, 41.7%), and medical assistants (138, 37.9%) reported a residential address in the high social vulnerability category. The proportion of case-HCP who reported using recommended PPE at all times when caring for patients with COVID-19 was lowest among HHWs compared with other roles.
Conclusions:To mitigate SARS-CoV-2 infection risk in healthcare settings, infection prevention, and control interventions should be specific to HCP roles and educational backgrounds. Additional interventions are needed to address high social vulnerability among HHWs, CNAs, and medical assistants.
2 Higher White Matter Hyperintensity Load Adversely Affects Pre-Post Proximal Cognitive Training Performance in Healthy Older Adults
- Emanuel M Boutzoukas, Andrew O’Shea, Jessica N Kraft, Cheshire Hardcastle, Nicole D Evangelista, Hanna K Hausman, Alejandro Albizu, Emily J Van Etten, Pradyumna K Bharadwaj, Samantha G Smith, Hyun Song, Eric C Porges, Alex Hishaw, Steven T DeKosky, Samuel S Wu, Michael Marsiske, Gene E Alexander, Ronald Cohen, Adam J Woods
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 671-672
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Objective:
Cognitive training has shown promise for improving cognition in older adults. Aging involves a variety of neuroanatomical changes that may affect response to cognitive training. White matter hyperintensities (WMH) are one common age-related brain change, as evidenced by T2-weighted and Fluid Attenuated Inversion Recovery (FLAIR) MRI. WMH are associated with older age, suggestive of cerebral small vessel disease, and reflect decreased white matter integrity. Higher WMH load associates with reduced threshold for clinical expression of cognitive impairment and dementia. The effects of WMH on response to cognitive training interventions are relatively unknown. The current study assessed (a) proximal cognitive training performance following a 3-month randomized control trial and (b) the contribution of baseline whole-brain WMH load, defined as total lesion volume (TLV), on pre-post proximal training change.
Participants and Methods:Sixty-two healthy older adults ages 65-84 completed either adaptive cognitive training (CT; n=31) or educational training control (ET; n=31) interventions. Participants assigned to CT completed 20 hours of attention/processing speed training and 20 hours of working memory training delivered through commercially-available Posit Science BrainHQ. ET participants completed 40 hours of educational videos. All participants also underwent sham or active transcranial direct current stimulation (tDCS) as an adjunctive intervention, although not a variable of interest in the current study. Multimodal MRI scans were acquired during the baseline visit. T1- and T2-weighted FLAIR images were processed using the Lesion Segmentation Tool (LST) for SPM12. The Lesion Prediction Algorithm of LST automatically segmented brain tissue and calculated lesion maps. A lesion threshold of 0.30 was applied to calculate TLV. A log transformation was applied to TLV to normalize the distribution of WMH. Repeated-measures analysis of covariance (RM-ANCOVA) assessed pre/post change in proximal composite (Total Training Composite) and sub-composite (Processing Speed Training Composite, Working Memory Training Composite) measures in the CT group compared to their ET counterparts, controlling for age, sex, years of education and tDCS group. Linear regression assessed the effect of TLV on post-intervention proximal composite and sub-composite, controlling for baseline performance, intervention assignment, age, sex, years of education, multisite scanner differences, estimated total intracranial volume, and binarized cardiovascular disease risk.
Results:RM-ANCOVA revealed two-way group*time interactions such that those assigned cognitive training demonstrated greater improvement on proximal composite (Total Training Composite) and sub-composite (Processing Speed Training Composite, Working Memory Training Composite) measures compared to their ET counterparts. Multiple linear regression showed higher baseline TLV associated with lower pre-post change on Processing Speed Training sub-composite (ß = -0.19, p = 0.04) but not other composite measures.
Conclusions:These findings demonstrate the utility of cognitive training for improving postintervention proximal performance in older adults. Additionally, pre-post proximal processing speed training change appear to be particularly sensitive to white matter hyperintensity load versus working memory training change. These data suggest that TLV may serve as an important factor for consideration when planning processing speed-based cognitive training interventions for remediation of cognitive decline in older adults.
6 Adjunctive Transcranial Direct Current Stimulation and Cognitive Training Alters Default Mode and Frontoparietal Control Network Connectivity in Older Adults
- Hanna K Hausman, Jessica N Kraft, Cheshire Hardcastle, Nicole D Evangelista, Emanuel M Boutzoukas, Andrew O’Shea, Alejandro Albizu, Emily J Van Etten, Pradyumna K Bharadwaj, Hyun Song, Samantha G Smith, Eric S Porges, Georg A Hishaw, Samuel Wu, Steven DeKosky, Gene E Alexander, Michael Marsiske, Ronald A Cohen, Adam J Woods
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 675-676
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Objective:
Aging is associated with disruptions in functional connectivity within the default mode (DMN), frontoparietal control (FPCN), and cingulo-opercular (CON) resting-state networks. Greater within-network connectivity predicts better cognitive performance in older adults. Therefore, strengthening network connectivity, through targeted intervention strategies, may help prevent age-related cognitive decline or progression to dementia. Small studies have demonstrated synergistic effects of combining transcranial direct current stimulation (tDCS) and cognitive training (CT) on strengthening network connectivity; however, this association has yet to be rigorously tested on a large scale. The current study leverages longitudinal data from the first-ever Phase III clinical trial for tDCS to examine the efficacy of an adjunctive tDCS and CT intervention on modulating network connectivity in older adults.
Participants and Methods:This sample included 209 older adults (mean age = 71.6) from the Augmenting Cognitive Training in Older Adults multisite trial. Participants completed 40 hours of CT over 12 weeks, which included 8 attention, processing speed, and working memory tasks. Participants were randomized into active or sham stimulation groups, and tDCS was administered during CT daily for two weeks then weekly for 10 weeks. For both stimulation groups, two electrodes in saline-soaked 5x7 cm2 sponges were placed at F3 (cathode) and F4 (anode) using the 10-20 measurement system. The active group received 2mA of current for 20 minutes. The sham group received 2mA for 30 seconds, then no current for the remaining 20 minutes.
Participants underwent resting-state fMRI at baseline and post-intervention. CONN toolbox was used to preprocess imaging data and conduct region of interest (ROI-ROI) connectivity analyses. The Artifact Detection Toolbox, using intermediate settings, identified outlier volumes. Two participants were excluded for having greater than 50% of volumes flagged as outliers. ROI-ROI analyses modeled the interaction between tDCS group (active versus sham) and occasion (baseline connectivity versus postintervention connectivity) for the DMN, FPCN, and CON controlling for age, sex, education, site, and adherence.
Results:Compared to sham, the active group demonstrated ROI-ROI increases in functional connectivity within the DMN following intervention (left temporal to right temporal [T(202) = 2.78, pFDR < 0.05] and left temporal to right dorsal medial prefrontal cortex [T(202) = 2.74, pFDR < 0.05]. In contrast, compared to sham, the active group demonstrated ROI-ROI decreases in functional connectivity within the FPCN following intervention (left dorsal prefrontal cortex to left temporal [T(202) = -2.96, pFDR < 0.05] and left dorsal prefrontal cortex to left lateral prefrontal cortex [T(202) = -2.77, pFDR < 0.05]). There were no significant interactions detected for CON regions.
Conclusions:These findings (a) demonstrate the feasibility of modulating network connectivity using tDCS and CT and (b) provide important information regarding the pattern of connectivity changes occurring at these intervention parameters in older adults. Importantly, the active stimulation group showed increases in connectivity within the DMN (a network particularly vulnerable to aging and implicated in Alzheimer’s disease) but decreases in connectivity between left frontal and temporal FPCN regions. Future analyses from this trial will evaluate the association between these changes in connectivity and cognitive performance post-intervention and at a one-year timepoint.
9 Connecting memory and functional brain networks in older adults: a resting state fMRI study
- Jori L Waner, Hanna K Hausman, Jessica N Kraft, Cheshire Hardcastle, Nicole D Evangelista, Andrew O’Shea, Alejandro Albizu, Emanuel M Boutzoukas, Emily J Van Etten, Pradyumna K Bharadwaj, Hyun Song, Samantha G Smith, Steven T DeKosky, Georg A Hishaw, Samuel S Wu, Michael Marsiske, Ronald Cohen, Gene E Alexander, Eric C Porges, Adam J Woods
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 527-528
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Objective:
Nonpathological aging has been linked to decline in both verbal and visuospatial memory abilities in older adults. Disruptions in resting-state functional connectivity within well-characterized, higherorder cognitive brain networks have also been coupled with poorer memory functioning in healthy older adults and in older adults with dementia. However, there is a paucity of research on the association between higherorder functional connectivity and verbal and visuospatial memory performance in the older adult population. The current study examines the association between resting-state functional connectivity within the cingulo-opercular network (CON), frontoparietal control network (FPCN), and default mode network (DMN) and verbal and visuospatial learning and memory in a large sample of healthy older adults. We hypothesized that greater within-network CON and FPCN functional connectivity would be associated with better immediate verbal and visuospatial memory recall. Additionally, we predicted that within-network DMN functional connectivity would be associated with improvements in delayed verbal and visuospatial memory recall. This study helps to glean insight into whether within-network CON, FPCN, or DMN functional connectivity is associated with verbal and visuospatial memory abilities in later life.
Participants and Methods:330 healthy older adults between 65 and 89 years old (mean age = 71.6 ± 5.2) were recruited at the University of Florida (n = 222) and the University of Arizona (n = 108). Participants underwent resting-state fMRI and completed verbal memory (Hopkins Verbal Learning Test - Revised [HVLT-R]) and visuospatial memory (Brief Visuospatial Memory Test - Revised [BVMT-R]) measures. Immediate (total) and delayed recall scores on the HVLT-R and BVMT-R were calculated using each test manual’s scoring criteria. Learning ratios on the HVLT-R and BVMT-R were quantified by dividing the number of stimuli (verbal or visuospatial) learned between the first and third trials by the number of stimuli not recalled after the first learning trial. CONN Toolbox was used to extract average within-network connectivity values for CON, FPCN, and DMN. Hierarchical regressions were conducted, controlling for sex, race, ethnicity, years of education, number of invalid scans, and scanner site.
Results:Greater CON connectivity was significantly associated with better HVLT-R immediate (total) recall (ß = 0.16, p = 0.01), HVLT-R learning ratio (ß = 0.16, p = 0.01), BVMT-R immediate (total) recall (ß = 0.14, p = 0.02), and BVMT-R delayed recall performance (ß = 0.15, p = 0.01). Greater FPCN connectivity was associated with better BVMT-R learning ratio (ß = 0.13, p = 0.04). HVLT-R delayed recall performance was not associated with connectivity in any network, and DMN connectivity was not significantly related to any measure.
Conclusions:Connectivity within CON demonstrated a robust relationship with different components of memory function as well across verbal and visuospatial domains. In contrast, FPCN only evidenced a relationship with visuospatial learning, and DMN was not significantly associated with memory measures. These data suggest that CON may be a valuable target in longitudinal studies of age-related memory changes, but also a possible target in future non-invasive interventions to attenuate memory decline in older adults.
Psychosis spectrum features, neurocognition and functioning in a longitudinal study of youth with 22q11.2 deletion syndrome
- Raquel E. Gur, Donna M. McDonald-McGinn, Tyler M. Moore, R. Sean Gallagher, Emily McClellan, Lauren White, Kosha Ruparel, Noah Hillman, T. Blaine Crowley, Daniel E. McGinn, Elaine Zackai, Beverly S. Emanuel, Monica E. Calkins, David R. Roalf, Ruben C. Gur
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- Journal:
- Psychological Medicine / Volume 53 / Issue 14 / October 2023
- Published online by Cambridge University Press:
- 29 March 2023, pp. 6763-6772
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Background
Neuropsychiatric disorders are common in 22q11.2 Deletion Syndrome (22q11DS) with about 25% of affected individuals developing schizophrenia spectrum disorders by young adulthood. Longitudinal evaluation of psychosis spectrum features and neurocognition can establish developmental trajectories and impact on functional outcome.
Methods157 youth with 22q11DS were assessed longitudinally for psychopathology focusing on psychosis spectrum symptoms, neurocognitive performance and global functioning. We contrasted the pattern of positive and negative psychosis spectrum symptoms and neurocognitive performance differentiating those with more prominent Psychosis Spectrum symptoms (PS+) to those without prominent psychosis symptoms (PS−).
ResultsWe identified differences in the trajectories of psychosis symptoms and neurocognitive performance between the groups. The PS+ group showed age associated increase in symptom severity, especially negative symptoms and general nonspecific symptoms. Correspondingly, their level of functioning was worse and deteriorated more steeply than the PS− group. Neurocognitive performance was generally comparable in PS+ and PS− groups and demonstrated a similar age-related trajectory. However, worsening executive functioning distinguished the PS+ group from PS− counterparts. Notably, of the three executive function measures examined, only working memory showed a significant difference between the groups in rate of change. Finally, structural equation modeling showed that neurocognitive decline drove the clinical change.
ConclusionsYouth with 22q11DS and more prominent psychosis features show worsening of symptoms and functional decline driven by neurocognitive decline, most related to executive functions and specifically working memory. The results underscore the importance of working memory in the developmental progression of psychosis.
Psychiatric disorders in 22q11.2 deletion syndrome are prevalent but undertreated
- S. X. Tang, J. J. Yi, M. E. Calkins, D. A. Whinna, C. G. Kohler, M. C. Souders, D. M. McDonald-McGinn, E. H. Zackai, B. S. Emanuel, R. C. Gur, R. E. Gur
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- Psychological Medicine / Volume 44 / Issue 6 / April 2014
- Published online by Cambridge University Press:
- 09 September 2013, pp. 1267-1277
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Background
Chromosome 22q11.2 deletion syndrome (22q11DS) is a common genetic disorder with high rates of psychosis and other psychopathologies, but few studies discuss treatment. Our aim was to characterize the prevalence and treatment of major psychiatric illnesses in a well-characterized sample of individuals with 22q11DS.
MethodThis was a cross-sectional study of 112 individuals aged 8 to 45 years with a confirmed diagnosis of 22q11DS. Each participant was administered a modified Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) and the Structured Interview for Prodromal Syndromes (SIPS). Phenotypes assessed were threshold and subthreshold psychosis, depression, mania, generalized and separation anxiety, obsessions/compulsions, inattention/hyperactivity and substance use. Histories of mental health care and current psychotropic treatment were obtained.
ResultsPsychopathology was common, with 79% of individuals meeting diagnostic criteria for a disorder at the time of assessment. Diagnoses of psychosis were made in 11% of cases, attenuated positive symptom syndrome (APS) in 21%, and 47% experienced significant subthreshold symptoms. Peak occurrence of psychosis risk was during adolescence (62% of those aged 12–17 years). Criteria for a mood disorder were met by 14%, for anxiety disorder 34% and for attention deficit hyperactivity disorder (ADHD) 31%. Mental health care had been received by 63% of individuals in their lifetime, but only 40% continued therapy and 39% used psychotropics. Antipsychotics were used by 42% of participants with psychosis and none of the participants with APS. Half of those at risk for psychosis were receiving no mental health care.
ConclusionsPsychopathology is common in 22q11DS but is not adequately treated or clinically followed. Particular attention should be paid to subthreshold psychotic symptoms, especially in adolescents.
Contributors
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- By Luis G. Acevedo, Schahram Akbarian, Ioanna Andreou, Krishnarao Appasani, Raghu K. Appasani, Julia Arand, David M. Ashley, Alexander R. Ball, Yehudit Bergman, Marina Bibikova, Angela Bithell, Francesca Bonafè, Eric E. Bouhassira, Victoria L. Boyd, Noel J. Buckley, Lars Olov Bygren, Claudio M. Caldarera, Gemma Carvill, James W. F. Catto, Sarah Derks, Ewa Dudziec, Jeffrey D. Falk, Jian-Bing Fan, Joseph M. Fernandez, David E. Fisher, Emanuela Fiumana, Tamara B. Franklin, Fei Gao, Arkadiusz Gertych, Emanuele Giordano, David Goldman, Markus Grammel, Carlo Guarnieri, Kevin L. Gunderson, Victoria (Fatemeh) G. Haghighi, Xu Han, Yong-Mahn Han, Howard C. Hang, Aditi Hazra, Laura B.K. Herzing, Norbert Hochstein, Robin Holliday, Dorothee Honsel, Mary A. Jelinek, Guanyu Ji, Yan Jiang, Atsushi Kaneda, Richard A. Katz, Hyemin Kim, Richard Kroon, Tapas K. Kundu, Benoit Labonté, Daeyoup Lee, Konstantin Lepikhov, Andrea Linnemann-Florl, Dirk Loeffert, Dylan Maixner, Isabelle M. Mansuy, Andreas Missel, D. V. Mohankrishna, Joana Carvalho Moreira de Mello, Paolo G. Morselli, Rituparna Mukhopadhyay, Claudio Muscari, Takashi Nagano, Frank Narz, Shuji Ogino, Carlo M. Oranges, Shari Orlanski, Alice Pasini, Ralf Peist, Lygia V. Pereira, Andrey Poleshko, Claire Rougeulle, Thea Rütjes, Ana Sanz, Benjamin G. Schroeder, Gerald Schock, Kornel Schuebel, B. Ruthrotha Selvi, Hogyu Seo, Natalia Shalginskikh, Andrew Sharp, Jun S. Song, Lennart Suckau, Azim Surani, Jian Tajbakhsh, Gustavo Turecki, Céline Vallot, Manon van Engeland, Jörn Walter, Nicholas C. Wong, Mark Wossidlo, Honglong Wu, Yurong Xin, Zhixiang Yan, Yu-Ying Yang, Mingzhi Ye, Kyoko Yokomori, Sephorah Zaman, Weihua Zeng, Gerald Zon
- Edited by Krishnarao Appasani
- Foreword by Azim Surani, University of Cambridge
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- Book:
- Epigenomics
- Published online:
- 05 August 2012
- Print publication:
- 02 August 2012, pp x-xxiv
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- By Kumar Alagappan, Janet G. Alteveer, Kim Askew, Paul S. Auerbach, Katherine Bakes, Kip Benko, Paul D. Biddinger, Victoria Brazil, Anthony FT Brown, Andrew K. Chang, Alice Chiao, Wendy C. Coates, Jamie Collings, Gilbert Abou Dagher, Jonathan E. Davis, Peter DeBlieux, Alessandro Dellai, Emily Doelger, Pamela L. Dyne, Gino Farina, Robert Galli, Gus M. Garmel, Daniel Garza, Laleh Gharahbaghian, Gregory H. Gilbert, Michael A. Gisondi, Steven Go, Jeffrey M. Goodloe, Swaminatha V. Gurudevan, Micelle J. Haydel, Stephen R. Hayden, Corey R. Heitz, Gregory W. Hendey, Mel Herbert, Cherri Hobgood, Michelle Huston, Loretta Jackson-Williams, Anja K. Jaehne, Mary Beth Johnson, H. Brendan Kelleher, Peter G Kumasaka, Melissa J. Lamberson, Mary Lanctot-Herbert, Erik Laurin, Brian Lin, Michelle Lin, Douglas Lowery-North, Sharon E. Mace, S. V. Mahadevan, Thomas M. Mailhot, Diku Mandavia, David E. Manthey, Jorge A. Martinez, Amal Mattu, Lynne McCullough, Steve McLaughlin, Timothy Meyers, Gregory J. Moran, Randall T. Myers, Christopher R.H. Newton, Flavia Nobay, Robert L. Norris, Catherine Oliver, Jennifer A. Oman, Rita Oregon, Phillips Perera, Susan B. Promes, Emanuel P. Rivers, John S. Rose, Carolyn J. Sachs, Jairo I. Santanilla, Rawle A. Seupaul, Fred A. Severyn, Ghazala Q. Sharieff, Lee W. Shockley, Stefanie Simmons, Barry C. Simon, Shannon Sovndal, George Sternbach, Matthew Strehlow, Eustacia (Jo) Su, Stuart P. Swadron, Jeffrey A. Tabas, Sophie Terp, R. Jason Thurman, David A. Wald, Sarah R. Williams, Teresa S. Wu, Ken Zafren
- Edited by S. V. Mahadevan, Stanford University School of Medicine, California, Gus M. Garmel
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- Book:
- An Introduction to Clinical Emergency Medicine
- Published online:
- 05 May 2012
- Print publication:
- 10 April 2012, pp xi-xvi
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Bullying behaviours among students in Pavia, Italy: prevalence and association with stress and cannabis use
- V. Martinelli, N. Brondino, S. Rossi, R. Panigati, R. Magnani, M. Cappucciati, L. Vecchia, S. Tinelli, E. Emanuele, P. Politi
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 20 / Issue 4 / December 2011
- Published online by Cambridge University Press:
- 25 May 2011, pp. 339-343
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Background.
This study examined the prevalence of students’ reported experiences of bullying and victimization in primary and secondary schools and their association with levels of perceived stress and cannabis use.
Methods.We consecutively enrolled 407 students attending three secondary schools in Pavia (Italy). Bullying and victimization were measured using the retrospective bullying questionnaire (RQB). The 10-item perceived stress scale (PSS-10) was used to assess the degree to which situations in life were perceived as stressful. Data on demographic characteristics and cannabis use in the previous 6 months were also collected.
Results.There were 328 victims (80.6%) and 221 bullies (52.1%). The results of the stepwise regression analysis with bullying as the dependent variable were significant with either male sex (R2 = 0.030, p = 0.024) or PSS-10 scores (R2 = 0.056, p = 0.036) in the model. With victimization as the dependent variable, only the PSS-10 scores were retained in the model as an independent predictor variable (R2 = 0.048, p < 0.001).
Conclusions.The results from this study indicate that the level of perceived stress has an independent association with both bullying and victimization. Further studies are needed to clarify the psychobiological links between stress, cannabis use and bullying behaviours.
Importance of the carrier state as a source of Staphylococcus aureus in wound sepsis*
- Frank M. Calia, Emanuel Wolinsky, Edward A. Mortimer, Jr, Jerome S. Abrams, Charles H. Rammelkamp, Jr
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- Journal:
- Journal of Hygiene / Volume 67 / Issue 1 / March 1969
- Published online by Cambridge University Press:
- 15 May 2009, pp. 49-57
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The relationship of pre-operative nasal and skin carriage of Staphylococcus aureus to wound colonization and sepsis was studied in 269 patients. Thirty-seven per cent of 96 carriers developed wound colonization as compared to 16 % among non-carriers (a statistically significant difference). The wound sepsis rates were 17 % and 9 % respectively. The combination of nasal and skin carriage was an important factor, since the sepsis rate among skin carriers (most of whom were nasal carriers as well) was 22%. Among carriers, the homologous strain was recovered from the majority of wound colonizations and from all instances of wound sepsis. A carrier strain also was recovered from 52% of the wounds colonized and from 50% of septic wounds in the entire study group. Profuse nasal carriage resulted in a significantly greater number of septic wounds (31%) than sparse carriage (9%). Wound cultures before closure, and skin from the initial incision site only once yielded a patient's carrier strain or a strain of Staph. aureus that was later recovered from the wound. The results indicate that measures designed to control the carrier state or to isolate the wound from the external environment should reduce wound sepsis by approximately one half.
Excellent technical aid was furnished by Eleanor Ford, R. N., Edith E. Silverman, Adrienne Marus, M. S., and Patricia Welch.
A multilevel analysis of cognitive dysfunction and psychopathology associated with chromosome 22q11.2 deletion syndrome in children
- TONY J. SIMON, JOEL P. BISH, CARRIE E. BEARDEN, LIJUN DING, SAMANTHA FERRANTE, VY NGUYEN, JAMES C. GEE, DONNA M. McDONALD–McGINN, ELAINE H. ZACKAI, BEVERLY S. EMANUEL
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- Development and Psychopathology / Volume 17 / Issue 3 / September 2005
- Published online by Cambridge University Press:
- 01 November 2005, pp. 753-784
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We present a multilevel approach to developing potential explanations of cognitive impairments and psychopathologies common to individuals with chromosome 22q11.2 deletion syndrome. Results presented support our hypothesis of posterior parietal dysfunction as a central determinant of characteristic visuospatial and numerical cognitive impairments. Converging data suggest that brain development anomalies, primarily tissue reductions in the posterior brain and changes to the corpus callosum, may affect parietal connectivity. Further findings indicate that dysfunction in “frontal” attention systems may explain some executive cognition impairments observed in affected children, and that there may be links between these domains of cognitive function and some of the serious psychiatric conditions, such as attention-deficit/hyperactivity disorder, autism, and schizophrenia, that have elevated incidence rates in the syndrome. Linking the neural structure and the cognitive processing levels in this way enabled us to develop an elaborate structure/function mapping hypothesis for the impairments that are observed. We show also, that in the case of the catechol-O-methyltransferase gene, a fairly direct relationship between gene expression, cognitive function, and psychopathology exists in the affected population. Beyond that, we introduce the idea that variation in other genes may further explain the phenotypic variation in cognitive function and possibly the anomalies in brain development.
We thank the children and families that participated in our studies and the staff of the 22q and You Center at the Children's Hospital of Philadelphia. This work was supported by grants from the NIH (R01HD42974 and R01HD46159) and the Philadelphia Foundation to T.J.S., Grant PO1DC02027 to B.S.E., and Grant M01-RR00240 to the Children's Hospital of Philadelphia.
Theory for producing a single-phase rarefaction shock wave in a shock tube
- S. H. FERGASON, T. L. HO, B. M. ARGROW, G. EMANUEL
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- Journal:
- Journal of Fluid Mechanics / Volume 445 / 25 October 2001
- Published online by Cambridge University Press:
- 16 October 2001, pp. 37-54
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Although predicted early in the 20th century, a single-phase vapour rarefaction shock wave has yet to be demonstrated experimentally. Results from a previous shock tube experiment appear to indicate a rarefaction shock wave. These results are discussed and their interpretation challenged. In preparation for a new shock tube experiment, a global theory is developed, utilizing a van der Waals fluid, for demonstrating a single-phase vapour rarefaction shock wave in the incident flow of the shock tube. The flow consists of four uniform regions separated by three constant-speed discontinuities: a rarefaction shock, a compression shock, and a contact surface. Entropy jumps and upstream supersonic Mach number conditions are verified for both shock waves. The conceptual van der Waals model is applied to the fluid perfluoro-tripentylamine (FC-70, C15F33N) analytically, and verified with computational simulations. The analysis predicts a small region of initial states that may be used to unequivocally demonstrate the existence of a single-phase vapour rarefaction shock wave. Simulation results in the form of representative sets of thermodynamic state data (pressure, density, Mach number, and fundamental derivative of gas dynamics) are presented.
Looking Backward, Looking Forward: MLA Members Speak
- April Alliston, Elizabeth Ammons, Jean Arnold, Nina Baym, Sandra L. Beckett, Peter G. Beidler, Roger A. Berger, Sandra Bermann, J.J. Wilson, Troy Boone, Alison Booth, Wayne C. Booth, James Phelan, Marie Borroff, Ihab Hassan, Ulrich Weisstein, Zack Bowen, Jill Campbell, Dan Campion, Jay Caplan, Maurice Charney, Beverly Lyon Clark, Robert A. Colby, Thomas C. Coleman III, Nicole Cooley, Richard Dellamora, Morris Dickstein, Terrell Dixon, Emory Elliott, Caryl Emerson, Ann W. Engar, Lars Engle, Kai Hammermeister, N. N. Feltes, Mary Anne Ferguson, Annie Finch, Shelley Fisher Fishkin, Jerry Aline Flieger, Norman Friedman, Rosemarie Garland-Thomson, Sandra M. Gilbert, Laurie Grobman, George Guida, Liselotte Gumpel, R. K. Gupta, Florence Howe, Cathy L. Jrade, Richard A. Kaye, Calhoun Winton, Murray Krieger, Robert Langbaum, Richard A. Lanham, Marilee Lindemann, Paul Michael Lützeler, Thomas J. Lynn, Juliet Flower MacCannell, Michelle A. Massé, Irving Massey, Georges May, Christian W. Hallstein, Gita May, Lucy McDiarmid, Ellen Messer-Davidow, Koritha Mitchell, Robin Smiles, Kenyatta Albeny, George Monteiro, Joel Myerson, Alan Nadel, Ashton Nichols, Jeffrey Nishimura, Neal Oxenhandler, David Palumbo-Liu, Vincent P. Pecora, David Porter, Nancy Potter, Ronald C. Rosbottom, Elias L. Rivers, Gerhard F. Strasser, J. L. Styan, Marianna De Marco Torgovnick, Gary Totten, David van Leer, Asha Varadharajan, Orrin N. C. Wang, Sharon Willis, Louise E. Wright, Donald A. Yates, Takayuki Yokota-Murakami, Richard E. Zeikowitz, Angelika Bammer, Dale Bauer, Karl Beckson, Betsy A. Bowen, Stacey Donohue, Sheila Emerson, Gwendolyn Audrey Foster, Jay L. Halio, Karl Kroeber, Terence Hawkes, William B. Hunter, Mary Jambus, Willard F. King, Nancy K. Miller, Jody Norton, Ann Pellegrini, S. P. Rosenbaum, Lorie Roth, Robert Scholes, Joanne Shattock, Rosemary T. VanArsdel, Alfred Bendixen, Alarma Kathleen Brown, Michael J. Kiskis, Debra A. Castillo, Rey Chow, John F. Crossen, Robert F. Fleissner, Regenia Gagnier, Nicholas Howe, M. Thomas Inge, Frank Mehring, Hyungji Park, Jahan Ramazani, Kenneth M. Roemer, Deborah D. Rogers, A. LaVonne Brown Ruoff, Regina M. Schwartz, John T. Shawcross, Brenda R. Silver, Andrew von Hendy, Virginia Wright Wexman, Britta Zangen, A. Owen Aldridge, Paula R. Backscheider, Roland Bartel, E. M. Forster, Milton Birnbaum, Jonathan Bishop, Crystal Downing, Frank H. Ellis, Roberto Forns-Broggi, James R. Giles, Mary E. Giles, Susan Blair Green, Madelyn Gutwirth, Constance B. Hieatt, Titi Adepitan, Edgar C. Knowlton, Jr., Emanuel Mussman, Sally Todd Nelson, Robert O. Preyer, David Diego Rodriguez, Guy Stern, James Thorpe, Robert J. Wilson, Rebecca S. Beal, Joyce Simutis, Betsy Bowden, Sara Cooper, Wheeler Winston Dixon, Tarek el Ariss, Richard Jewell, John W. Kronik, Wendy Martin, Stuart Y. McDougal, Hugo Méndez-Ramírez, Ivy Schweitzer, Armand E. Singer, G. Thomas Tanselle, Tom Bishop, Mary Ann Caws, Marcel Gutwirth, Christophe Ippolito, Lawrence D. Kritzman, James Longenbach, Tim McCracken, Wolfe S. Molitor, Diane Quantic, Gregory Rabassa, Ellen M. Tsagaris, Anthony C. Yu, Betty Jean Craige, Wendell V. Harris, J. Hillis Miller, Jesse G. Swan, Helene Zimmer-Loew, Peter Berek, James Chandler, Hanna K. Charney, Philip Cohen, Judith Fetterley, Herbert Lindenberger, Julia Reinhard Lupton, Maximillian E. Novak, Richard Ohmann, Marjorie Perloff, Mark Reynolds, James Sledd, Harriet Turner, Marie Umeh, Flavia Aloya, Regina Barreca, Konrad Bieber, Ellis Hanson, William J. Hyde, Holly A. Laird, David Leverenz, Allen Michie, J. Wesley Miller, Marvin Rosenberg, Daniel R. Schwarz, Elizabeth Welt Trahan, Jean Fagan Yellin
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 115 / Issue 7 / December 2000
- Published online by Cambridge University Press:
- 23 October 2020, pp. 1986-2078
- Print publication:
- December 2000
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Performance and blood chemistry in lambs following fasting and transport
- G. M. J. Horton, J. A. Baldwin, S. M. Emanuele, J. E. Wohlt, L. R. McDowell
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- Journal:
- Animal Science / Volume 62 / Issue 1 / February 1996
- Published online by Cambridge University Press:
- 02 September 2010, pp. 49-56
- Print publication:
- February 1996
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Thirty-six 5-month-old Dorset ram lambs (28·7 kg) were used to investigate the effects of fasting and transport on performance and selected blood parameters. Three treatment groups (no. = 12) were: (1) control-food and water, without transport; (2) fasting for 72 h, without transport; and (3) transport in a trailer to a nearby auction-barn, then driven 8 h/day for 3 days without food or water for a total of 72 h. Lambs were given a total mixed diet containing 163 g/kg crude protein throughout the 28-day post-transport period. Both fasted and transported lambs consumed less food than the control group during the first 7 days post treatment (P < 0·05). Water intake was similar for all treatment groups on the 1st day post transport, after which both fasted and transport lambs drank less ivater than control lambs during the following 6 days (P < 0·05). Live-weight loss after the 3-day fast and transport period and subsequent body-weight gain during the 28-day realimentation period differed across all treatment groups (P < 0·05 and P < 0·09; (1) 1% and 305 g, (2) 14·8% and 343 g, and (3) 20·0% and 390 g, respectively, though control lambs had the highest weight gains over the 32-day experimental period. Plasma urea nitrogen was lower in both fasted and transported lambs on days 6, 7 and 11 compared with control lambs (P < 0·05). Plasma glucose concentrations on days 4 and 5 were lower in transported lambs than in fasted lambs, and highest in control lambs (P < 0·05); glucose concentration levels remained lower in both fasted and transported lambs than in control lambs on days 6 and 7 (P < 0·05). Plasma cortisol concentrations were highest in transported lambs during the 3-day transport period and for 2 days immediately following transport (P < 0·05). Effects of the 72 h fast were exacerbated by auction barn activity and subsequent transport, and compensatory gains by fasted and transport lambs were incomplete within the 28-day post transport period.