Emergency departments are high-risk settings for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) surface contamination. Environmental surface samples were obtained in rooms with patients suspected of having COVID-19 who did or did not undergo aerosol-generating procedures (AGPs). SARS-CoV-2 RNA surface contamination was most frequent in rooms occupied by coronavirus disease 2019 (COVID-19) patients who received no AGPs.

This article is a clinical guide which discusses the “state-of-the-art” usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies. There is a clear and broad consensus (more than 70 international expert endorsers), based on 6 decades of experience, for the recommendations herein exposited. They are based on empirical evidence and expert opinion—this guide is presented as a new specialist-consensus standard. The guide provides practical clinical advice, and is the basis for the rational use of these drugs, particularly because it improves and updates knowledge, and corrects the various misconceptions that have hitherto been prominent in the literature, partly due to insufficient knowledge of pharmacology. The guide suggests that MAOIs should always be considered in cases of treatment-resistant depression (including those melancholic in nature), and prior to electroconvulsive therapy—while taking into account of patient preference. In selected cases, they may be considered earlier in the treatment algorithm than has previously been customary, and should not be regarded as drugs of last resort; they may prove decisively effective when many other treatments have failed. The guide clarifies key points on the concomitant use of incorrectly proscribed drugs such as methylphenidate and some tricyclic antidepressants. It also illustrates the straightforward “bridging” methods that may be used to transition simply and safely from other antidepressants to MAOIs.

Background: Aerosol-generating procedures (AGPs) performed on COVID-19–positive patients raise concerns about the dissemination of SARS-CoV-2 via aerosols and droplets. Infectious aerosols and droplets generated by SARS-CoV-2–positive patient AGPs or through direct COVID-19 patient coughing or exhalation could potentially contaminate surfaces, leading to the indirect spread of SARS-CoV-2 via fomites within the emergency department (ED). We sampled surfaces of ED patient rooms occupied by known SARS-CoV-2–positive patients or patients under investigation for COVID-19 and undergoing an AGP to determine the frequency of room contamination with SARS-CoV-2 RNA. Methods: Swabs were collected from 5 room surfaces in the ED following AGPs performed on patients under investigation for COVID-19 or positive for SARS-CoV-2. High- and low-touch surfaces 6 feet (2 m) from the patient (door handle and return vent, respectively) and reusable medical equipment were swabbed. Swabs were tested for SARS-CoV-2 RNA by RT-qPCR; positive samples were cultured in Vero E6 cells. Patient COVID-19 results were confirmed through the electronic medical record. Results: In total, 203 rooms were sampled: 43 SARS-CoV-2–positive patients with an AGP, 44 SARS-CoV-2–positive patients who did not have an AGP, and 116 SARS-CoV-2–negative patients with an AGP, for a total of 1,015 swabs. Overall, SARS-CoV-2 RNA was detected on 36 (3.5%) surfaces from 29 rooms (14.3%) (Table 1). RNA contamination was detected more frequently in rooms occupied by SARS-CoV-2–positive patients who did not have an AGP than rooms occupied by COVID-19 patients (30% vs 14%). SARS-CoV-2 RNA was also detected in rooms occupied by SARS-CoV-2–negative patients undergoing an AGP (9%). SARS-CoV-2 RNA was most frequently detected on air vents (n = 15), bedrails (n = 10), equipment and vital signs monitors (n = 4 each), and door handles (n = 3). One bedrail was positive by culture and confirmed by an RT-qPCR cycle threshold reduction from >40 to 13. Conclusions: We detected SARS-CoV-2 RNA contamination on room surfaces in the ED, regardless of patient AGP or COVID-19 status; however, RNA contamination of room surfaces was most common in rooms occupied by SARS-CoV-2–positive patients who did not have an AGP, which may be attributable to stage of disease and viral shedding. SARS-CoV-2 RNA contamination was also present in rooms where APGs were performed on SARS-CoV-2–negative patients, suggesting carryover from previous patients. SARS-CoV-2 RNA was found most often on room air-return vents, further emphasizing the importance of aerosols in the spread of SARS-CoV-2.

Funding: None

Disclosures: None

Concerns persist regarding possible false-negative results that may compromise COVID-19 containment. Although obtaining a true false-negative rate is infeasible, using real-life observations, the data suggest a possible false-negative rate of ˜2.3%. Use of a sensitive, amplified RNA platform should reassure healthcare systems.

It is well established that late-type main-sequence (MS) stars display a relationship between X-ray activity and the Rossby number, Ro, the ratio of rotation period to the convective turnover time. This manifests itself as a saturated regime (where X-ray activity is constant) and an unsaturated regime (where X-ray activity anti-correlates with Rossby number). However, this relationship breaks down for the fastest rotators. We cross-correlated SuperWASP visually classified photometric light curves and All-Sky Automated Survey for Supernovae automatically classified photometric light curves with XMM-Newton X-ray observations to identify 3 178 stars displaying a photometrically defined rotational modulation in their light curve and corresponding X-ray observations. We fitted a power-law to characterise the rotation–activity relation of 900 MS stars. We identified that automatically classified rotationally modulated light curves are not as reliable as visually classified light curves for this work. We found a power-law index in the unsaturated regime of G- to M-type stars of $\beta=-1.84\,\pm\,0.18$ for the SuperWASP catalogue, in line with the canonical value of $\beta=-2$ . We find evidence of supersaturation in the fastest rotating K-type stars, with a power-law index of $\beta_{s}=1.42\pm0.26$ .

Optical matching of ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) satellite image pairs is used to determine the surface velocities of major glaciers across the central Karakoram. The ASTER images were acquired in 2006 and 2007, and cover a 60×120km region over Baltoro glacier, Pakistan, and areas to the north and west. The surface velocities were compared with differential global position system (GPS) data collected on Baltoro glacier in summer 2005. The ASTER measurements reveal fine details about ice dynamics in this region. For example, glaciers are found to be active over their termini even where they are very heavily debris-covered. The characteristics of several surge-type glaciers were measured, with terminus advances of several hundred meters per year and the displacement of trunk glaciers as surge glaciers pushed into them. This study is the first synthesis of glacier velocities across this region, and provides a baseline against which both past and future changes can be compared.

Our object of study is a rational map  defined by homogeneous forms $g_{1},\ldots ,g_{n}$ , of the same degree $d$ , in the homogeneous coordinate ring $R=k[x_{1},\ldots ,x_{s}]$ of $\mathbb{P}_{k}^{s-1}$ . Our goal is to relate properties of $\unicode[STIX]{x1D6F9}$ , of the homogeneous coordinate ring $A=k[g_{1},\ldots ,g_{n}]$ of the variety parameterized by $\unicode[STIX]{x1D6F9}$ , and of the Rees algebra ${\mathcal{R}}(I)$ , the bihomogeneous coordinate ring of the graph of $\unicode[STIX]{x1D6F9}$ . For a regular map $\unicode[STIX]{x1D6F9}$ , for instance, we prove that ${\mathcal{R}}(I)$ satisfies Serre’s condition $R_{i}$ , for some $i>0$ , if and only if $A$ satisfies $R_{i-1}$ and $\unicode[STIX]{x1D6F9}$ is birational onto its image. Thus, in particular, $\unicode[STIX]{x1D6F9}$ is birational onto its image if and only if ${\mathcal{R}}(I)$ satisfies $R_{1}$ . Either condition has implications for the shape of the core, namely, $\text{core}(I)$ is the multiplier ideal of $I^{s}$ and $\text{core}(I)=(x_{1},\ldots ,x_{s})^{sd-s+1}.$ Conversely, for $s=2$ , either equality for the core implies birationality. In addition, by means of the generalized rows of the syzygy matrix of $g_{1},\ldots ,g_{n}$ , we give an explicit method to reduce the nonbirational case to the birational one when $s=2$ .

In 2010, Business Ethics Quarterly published ten articles that considered the potential contributions to business ethics research arising from recent scholarship in a variety of philosophical and social scientific fields (strategic management, political philosophy, restorative justice, international business, legal studies, ethical theory, ethical leadership studies, organization theory, marketing, and corporate governance and finance). Here we offer short responses to those articles by members of Business Ethics Quarterly’s editorial board and editorial team.

Critically-ill patients experience an extent of hyperinflammation, cellular immune dysfunction, oxidative stress and mitochondrial dysfunction. Supplementation with key nutrients, such as glutamine and antioxidants, is most likely to have a favourable effect on these physiological derangements, leading to an improvement in clinical outcomes. The results of two meta-analyses suggest that glutamine and antioxidants may be associated with improved survival. The purpose of the present paper is to report the background rationale and study protocol for the evaluation of the effect of high-dose glutamine and antioxidant supplementation on mortality in a large-scale randomized trial in 1200 mechanically-ventilated, critically-ill patients. Patients admitted to an intensive care unit (ICU) with clinical evidence of severe organ dysfunction will be randomized to one of four treatments in a 2×2 factorial design: (1) glutamine; (2) antioxidant therapy; (3) glutamine and antioxidant therapy; (4) placebo. The primary outcome for this study is 28 d mortality. The secondary outcomes are duration of stay in ICU, adjudicated diagnosis of infection, multiple organ dysfunction, duration of mechanical ventilation, length of stay in hospital and health-related quality of life at 3 and 6 months. A novel design feature is the combined use of parenteral and enteral study nutrients dissociated from the nutrition support. The therapeutic strategies tested in the randomized trial may lead to less morbidity and improved survival in critically-ill patients. The trial will be conducted in approximately twenty tertiary-care ICU in Canada and the first results are expected in 2009.

In situ transmission electron microscopy is an established experimental technique that permits direct observation of the dynamics and mechanisms of dislocation motion and deformation behavior. In this article, we detail the development of a novel specimen goniometer that allows real-time observations of the mechanical response of materials to indentation loads. The technology of the scanning tunneling microscope is adopted to allow nanometer-scale positioning of a sharp, conductive diamond tip onto the edge of an electron-transparent sample. This allows application of loads to nanometer-scale material volumes coupled with simultaneous imaging of the material’s response. The emphasis in this report is qualitative and technique oriented, with particular attention given to sample geometry and other technical requirements. Examples of the deformation of aluminum and titanium carbide as well as the fracture of silicon will be presented.