The effect of adding physician recommendation in digitally-enabled outreach for COVID-19 vaccination in socially/economically disadvantaged populations.

INTRODUCTION: People from backgrounds that are economically/socially disadvantaged experienced disproportionately high COVID-19 death rates and had lower vaccination rates. Effective outreach strategies for increasing vaccine uptake during the pandemic are not fully known. Among patients receiving care at a Federally Qualified Health Center, we tested whether community engaged digitally-enabled outreach from a trusted clinician messenger increased COVID vaccine uptake. STUDY DESIGN, SETTING, AND PARTICIPANTS: A 3-parallel-arm randomized controlled trial with a hybrid effectiveness-implementation design was conducted among patients ≥ 18 years old on study enrollment during 2021 with 1,650 assigned in 3:10:20 ratio; 2,328 were later selected for two subsequent implementation rounds. INTERVENTIONS: From April 13 to June 10, 2021, patients were proactively sent a text-messaging invitation to make an appointment for vaccination as part of the routine practice with a link to frequently asked questions (Arm 1, n = 150) with added personalized clinician recommendation alone (Arm 2, n = 500) or with enabled 2-way SMS messaging feature (Arm 3, n = 1,000). Further implementation used messaging addressing vaccine hesitancy (n = 1,323) or adverse reactions to vaccines (n = 1,005). MAIN OUTCOMES AND MEASURES: The primary outcome was the completion of the first SARS-Cov-2 vaccine dose determined at 14, 30 and 90 days after outreach. RESULTS: Of 1,650 patients in effectiveness Arms, 61% was female. Vaccination rates for Arms 1, 2, and 3, were 6% (n = 9), 5.4% (n = 27) and 3.3% (n = 33) at 14 days, and 11.5% (n = 17), 11.6% (n = 58), and 8.5% (n = 85) at 90 days, respectively, which were similar in pairwise comparisons. At 90 days, vaccination rates were similar across the two implementation rounds (3.9% vs. 3.6%) and were similar to the rate (3.3%) among patients who were not selected for intervention arms or implementation rounds (n = 8,671). CONCLUSIONS: Digitally-enabled outreach that included SMS messaging outreach augmented with clinician recommendations did not improve COVID-19 vaccination rates. TRIAL REGISTRATION: This study is registered at ClinicalTrails.gov Identifier: NC-T04952376.

The Effect of Adding Physician Recommendation in Digitally-Enabled Outreach for COVID-19 Vaccination in Socially/Economically Disadvantaged Populations Subtitle: A Randomized Controlled Trial.

Introduction: People from backgrounds that are economically/socially disadvantaged experienced disproportionately high COVID-19 death rates and had lower vaccination rates. Effective outreach strategies for increasing vaccine uptake during the pandemic are not fully known. Among patients receiving care at a Federally Qualified Health Center, we tested whether community engaged digitally-enabled outreach increased COVID vaccine uptake. Study Design Setting and Participants: A 3-parallel-arm randomized controlled trial with a hybrid effectiveness-implementation design was conducted among patients ≥18 years old on study enrollment during 2021 with 1,650 assigned in 3:10:20 ratio; 2,328 were later selected for two subsequent implementation rounds. Interventions: From April 13 to June 10, 2021, patients were proactively sent a text-messaging invitation to make an appointment for vaccination as part of the routine practice (Arm 1, n=150) with added personalized clinician recommendation alone (Arm 2, n=500) or with an explicit nudge for answers to frequently asked questions (Arm 3, n=1,000). Further implementation used messaging addressing vaccine hesitancy (n=1,323) or adverse reactions to vaccines (n=1,005). Main Outcomes and Measures: The primary outcome was the completion of the first SARS-Cov-2 vaccine dose determined at 14, 30 and 90 days after outreach. Results: Of 1,650 patients in effectiveness Arms, 61% was female. Vaccination rates for Arms 1, 2, and 3, were 6% (n=9), 5.4% (n=27) and 3.3% (n=33) at 14 days, and 11.5% (n=17), 11.6% (n=58), and 8.5% (n=85) at 90 days, respectively, which were similar in pairwise comparisons. At 90 days, vaccination rates were similar across the two implementation rounds (3.9% vs. 3.6%) and were similar to the rate (3.3%) among patients who were not selected for intervention arms or implementation rounds (n=8,671). Conclusions: Digitally-enabled outreach that included SMS messaging outreach augmented with clinician recommendations did not improve COVID-19 vaccination rates. Trial Registration: This study is registered at ClinicalTrails.gov Identifier: NC-T04952376.

Effect of Ca2+ and Zn2+ on UO2 dissolution rates.

The dissolution of UO(2) in a continuously stirred tank reactor (CSTR) in the presence of Ca(2+) and Zn(2+) was investigated under experimental conditions relevant to contaminated groundwater systems. Complementary experiments were performed to investigate the effect of adsorption and precipitation reactions on UO(2) dissolution. The experiments were performed under anoxic and oxic conditions. Zn(2+) had a much greater inhibitory effect on UO(2) dissolution than did Ca(2+). This inhibition was most substantial under oxic conditions, where the experimental rate of UO(2) dissolution was 7 times lower in the presence of Ca(2+) and 1450 times lower in the presence of Zn(2+) than in water free of divalent cations. EXAFS and solution chemistry analyses of UO(2) solids recovered from a Ca experiment suggest that a Ca-U(VI) phase precipitated. The Zn carbonate hydrozincite [Zn(5)(CO(3))(2)(OH)(6)] or a structurally similar phase precipitated on the UO(2) solids recovered from experiments performed in the presence of Zn. These precipitated Ca and Zn phases can coat the UO(2) surface, inhibiting the oxidative dissolution of UO(2). Interactions with divalent groundwater cations have implications for the longevity of UO(2) and the mobilization of U(VI) from these solids in remediated subsurface environments, waste disposal sites, and natural uranium ores.

Oxidative Dissolution of Biogenic Uraninite in Groundwater at Old Rifle, CO.

Reductive bioremediation is currently being explored as a possible strategy for uranium-contaminated aquifers such as the Old Rifle site (Colorado). The stability of U(IV) phases under oxidizing conditions is key to the performance of this procedure. An in situ method was developed to study oxidative dissolution of biogenic uraninite (UO2), a desirable U(VI) bioreduction product, in the Old Rifle, CO, aquifer under different variable oxygen conditions. Overall uranium loss rates were 50-100 times slower than laboratory rates. After accounting for molecular diffusion through the sample holders, a reactive transport model using laboratory dissolution rates was able to predict overall uranium loss. The presence of biomass further retarded diffusion and oxidation rates. These results confirm the importance of diffusion in controlling in-aquifer U(IV) oxidation rates. Upon retrieval, uraninite was found to be free of U(VI), indicating dissolution occurred via oxidation and removal of surface atoms. Interaction of groundwater solutes such as Ca²âº or silicate with uraninite surfaces also may retard in-aquifer U loss rates. These results indicate that the prolonged stability of U(IV) species in aquifers is strongly influenced by permeability, the presence of bacterial cells and cell exudates, and groundwater geochemistry.

Delayed acquisition of neonatal reflexes in newborn primates receiving a thimerosal-containing hepatitis B vaccine: influence of gestational age and birth weight.

This study examined whether acquisition of neonatal reflexes in newborn rhesus macaques was influenced by receipt of a single neonatal dose of hepatitis B vaccine containing the preservative thimerosal (Th). Hepatitis B vaccine containing a weight-adjusted Th dose was administered to male macaques within 24 h of birth (n = 13). Unexposed animals received saline placebo (n = 4) or no injection (n = 3). Infants were tested daily for acquisition of nine survival, motor, and sensorimotor reflexes. In exposed animals there was a significant delay in the acquisition of root, snout, and suck reflexes, compared with unexposed animals. No neonatal responses were significantly delayed in unexposed animals. Gestational age (GA) and birth weight (BW) were not significantly correlated. Cox regression models were used to evaluate main effects and interactions of exposure with BW and GA as independent predictors and time-invariant covariates. Significant main effects remained for exposure on root and suck when controlling for GA and BW, such that exposed animals were relatively delayed in time-to-criterion. Interaction models indicated there were various interactions between exposure, GA, and BW and that inclusion of the relevant interaction terms significantly improved model fit. This, in turn, indicated that lower BW and/or lower GA exacerbated the adverse effects following vaccine exposure. This primate model provides a possible means of assessing adverse neurodevelopmental outcomes from neonatal Th-containing hepatitis B vaccine exposure, particularly in infants of lower GA or BW. The mechanisms underlying these effects and the requirements for Th requires further study.

WITHDRAWN: Delayed acquisition of neonatal reflexes in newborn primates receiving a thimerosal-containing Hepatitis B vaccine: Influence of gestational age and birth weight.

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Low-level mercury removal from groundwater using a synthetic chelating ligand.

Mercury is present in many industrial processes at low concentrations and is a cause for concern due to the propensity for mercury to bioaccumulate. As a cumulative toxin, introduction of mercury into the environment at any level has the potential to adversely affect ecologic systems. To date, no commercial precipitants are available that can irreversibly and permanently bind mercury. In the current work, selected commercial reagents were compared alongside the dianionic ligand 1,3-benzenediamidoethanethiolate (BDET(2-)) to test the feasibility of low-level (parts-per-billion, ppb) mercury treatment for groundwater near a chloralkali plant. Of all the reagents examined, only K(2)BDET was capable of reducing mercury concentrations to below instrumental detection limits of 0.05 ppb with the added benefit of producing a stable precipitate.

Cd, Hg, and Pb Compounds of Benzene-1,3-diamidoethanethiol (BDETH(2)).

Benzene-1,3-diamidoethanethiol (BDETH2) is an exceptional precipitant for removing soft heavy metals from water. The present work will detail the bonding arrangement of BDETH2 to the metals Cd, Hg, and Pb, along with the full characterization data of the BDET-M compounds. It was found that the Hg compound has a linear S-M-S geometry. The characterization data consisted of Mp, EA, IR, Raman, MS, XANES, EXAFS, and solid-state multinuclear NMR.