Responses to infectious disease outbreaks in supported living environments for individuals with neurodevelopmental disorders: a scoping review.

Background: Individuals with neurodevelopmental disorders (NDD) are facing unprecedented challenges due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Congregate living, and conditions associated with NDD place increased challenges during infectious disease outbreaks and there is a need to understand evidence-based response procedures. The aim was to (1) map and synthesize literature regarding emergency response protocol in supported living environments for individuals with NDD and (2) identify gaps in the literature of response protocols in supported living environments for individuals with NDD. Methods: A scoping review was conducted to understand the published literature on emergency response across supported living environments for individuals with NDD during emergency situations and infectious disease outbreaks. Results: The ten studies included in the review detailed protocols including treatment, testing, isolation, surveillance, improved cleaning, use of protective equipment, and contact with public health professionals. The environment of supported living settings, and symptoms associated with NDD impacted the spread and severity of disease. Conclusion: The research findings highlight the susceptibility, severity and impact of infectious disease outbreaks for individuals with NDD in supported living environments. This research will promote the establishment and development of appropriate care and response during emergency situations in supported living environments.

Intrinsic to extrinsic phonon lifetime transition in a GaAs-AlAs superlattice.

We have measured the lifetimes of two zone-center longitudinal acoustic phonon modes, at 320 and 640 GHz, in a 14 nm GaAs/2 nm AlAs superlattice structure. By comparing measurements at 296 and 79 K we separate the intrinsic contribution to phonon lifetime determined by phonon-phonon scattering from the extrinsic contribution due to defects and interface roughness. At 296 K, the 320 GHz phonon lifetime has approximately equal contributions from intrinsic and extrinsic scattering, whilst at 640 GHz it is dominated by extrinsic effects. These measurements are compared with intrinsic and extrinsic scattering rates in the superlattice obtained from first-principles lattice dynamics calculations. The calculated room-temperature intrinsic lifetime of longitudinal phonons at 320 GHz is in agreement with the experimentally measured value of 0.9 ns. The model correctly predicts the transition from predominantly intrinsic to predominantly extrinsic scattering; however the predicted transition occurs at higher frequencies. Our analysis indicates that the 'interfacial atomic disorder' model is not entirely adequate and that the observed frequency dependence of the extrinsic scattering rate is likely to be determined by a finite correlation length of interface roughness.

Comparison of the synthesis of Ge nanocrystals in hafnium aluminum oxide and silicon oxide matrices.

Growth of germanium (Ge) nanocrystals in silicon (Si) oxide and hafnium aluminum oxide (HfAlO) is examined. In Si oxide, nanocrystals were able to form at annealing temperatures of 800 degrees C to 1000 degrees C. Nanocrystals formed at 800 degrees C were round and approximately 8 nm in diameter, at 900 degrees C they become facetted and at 1000 degrees C they become spherical again. In HfAlO, at 800 degrees C nanocrystals formed are relatively smaller (approximately 3 nm in diameter) and lower in density. While at 900 degrees C and 1000 degrees C, nanocrystals did not form due to out-diffusion of Ge. Different nanocrystal formation characteristics in the matrices are attributed to differences in their crystallization temperatures.

The effect of nitrogen pressure during molecular beam epitaxy growth of InAsN quantum dots.

The influence of N flux during molecular beam epitaxy growth of InAsN quantum dots was studied. Growth of InAsN dots under high N flux was shown to give rise to an abnormal growth behaviour compared to InAs dots and InAsN dots with lower nitrogen content. Cubic In(x)Ga(1-x)N (x = 0.21 ± 0.01) crystallites were found in samples grown with an excessive N flux. The crystallites are likely to form ∼0.6 monolayers (MLs) after the quantum dots have nucleated, when the quantum dot changes growth mode. In addition, it is shown that a bimodal size distribution of InAsN quantum dots was generated in the wetting layer during the dot growth, as opposed to nucleation at N-induced dislocations at the substrate surface. The bimodal distribution may be explained by an increased energy barrier, in the presence of nitrogen, for atomic incorporation into the dots.

The influence of substrate temperature on InAsN quantum dots grown by molecular beam epitaxy.

The effect of substrate temperature, 390-480 °C, during molecular beam epitaxy growth of InAsN quantum dots has been studied. The quantum dot formation was studied in situ, and it is shown that the quantum dots are close to fully relaxed within 4 monolayers (ML) of InAsN deposition. Further, the indium concentration was estimated to be 84%, 67%, 55% and 31% for 4 ML thick quantum dots grown at 390, 420, 450 and 480 °C, respectively. Thus, Ga incorporation was demonstrated at all substrate temperatures. The dot diameter and height increased from 23 to 38 nm, and 2.5 to 8.9 nm, respectively, when the growth temperature was increased from 390 to 480 °C. The 5 K photoluminescence intensity and wavelength both increased with substrate temperature.

Enterobacter cloacae bloodstream infections traced to contaminated human albumin.

In August 1996, a patient in Kansas developed an Enterobacter cloacae bloodstream infection (BSI) shortly after receiving Albuminar, a brand of human albumin. Albuminar contamination was suspected. A case-control study of patients with primary gram-negative bacterial BSIs showed that patients with E. cloacae BSIs were significantly more likely than patients with non-E. cloacae gram-negative BSIs to have received Albuminar within 3 days of developing their BSIs (3 of 5 vs. 0 of 9; OR, undefined; P=.03). The E. cloacae isolate from the Kansas patient was found by pulsed-field gel electrophoresis to be identical to the isolate from the patient's Albuminar vial, to isolates from 2 previously unopened Albuminar vials, and to an isolate from a Wisconsin patient who had received Albuminar. A worldwide recall of approximately 116,000 Albuminar vials took place. This multistate outbreak was detected because of clinical astuteness and prompt reporting. Combined epidemiological and laboratory approaches are valuable when investigating potentially contaminated blood components and plasma derivatives.

Inactivated poliovirus vaccine protects transgenic poliovirus receptor mice against type 3 poliovirus challenge.

Transgenic (Tg) mice expressing the human poliovirus receptor (PVR) were vaccinated with inactivated poliovirus vaccine (IPV) and evaluated for induced immunity against type 3 poliomyelitis. One injection of monovalent type 3 IPV elicited protective immunity against wild-type poliovirus. In contrast, 2 injections of trivalent IPV were required for protection. Neutralizing antibody response and protection were vaccine dose-dependent. Administration of polio-immune mouse plasma protected unimmunized mice, demonstrating that neutralizing antibody was sufficient for immunity. IPV heated to remove its D antigen component did not induce protection in Tg PVR mice. IPV derived from a wild-type poliovirus strain gave better protection against wild-type viral challenge than IPV derived from an attenuated poliovirus strain. The newly developed Tg PVR mouse-protection test may be useful in evaluating existing IPV potency tests and for attempts to improve formulations of trivalent IPV or combined vaccines for childhood immunization schedules.

Rowell's syndrome: report of a case.

A 47-year-old woman presented with a long-standing history of an erythema multiforme-like eruption in association with lupus erythematosus. Unusual laboratory and immunologic findings were consistent with a diagnosis of Rowell's syndrome, which includes lupus erythematosus in association with erythema multiforme-like skin lesions, a speckled antinuclear antibody pattern, and a positive rheumatoid factor. We believe that our patient meets the criteria for this rarely reported entity.

Familial lichen sclerosus et atrophicus in association with CREST syndrome: a case report.

Lichen sclerosus et atrophicus is an uncommon disease which appears to be multifactorial in aetiology. We describe a case of a young woman with CREST syndrome (calcinosis, Raynaud's phenomenon, oesophageal dysfunction, sclerodactyly and telangiectasia) who has a documented family history of two sisters with lichen sclerosus et atrophicus. She presented with vulvar pruritus in association with dyspareunia, and biopsy of atrophic white vulvar lesions was consistent with lichen sclerosus et atrophicus. Lichen sclerosus et atrophicus has been previously noted to occur in association with morphoea and lichen planus, although it has never been reported in conjunction with CREST syndrome.

Rabies vaccine standardization: International Collaborative Study for the Characterization of the fifth International Standard for Rabies Vaccine.

A collaborative study was carried out to establish a replacement for the International Standard for Rabies Vaccine, the stocks of which are exhausted. Three rabies vaccines for human use derived from different rabies virus strains and prepared on different cell culture substrates were compared with the International Standard for Rabies Vaccine using in vivo and in vitro assay methods in a collaborative study involving 14 participants. The proposed fifth International Standard (PISRAV) which was derived from the same virus strain as the present international standard preparation, the Pitman Moore (PM) strain, was found to be approximately twice as potent relative to the International Standard in immunogenicity assays as in antigenicity assays. On the other hand another vaccine, derived from the LEP strain, was considerably more potent in antigenicity assays than in immunogenicity assays. The glycoprotein of the proposed replacement standard measured in antigenicity assays appeared to be stable at +37 degrees C for 245 days, whereas the immunogenicity of the proposed replacement vaccine was sensitive to this heat treatment and the vaccine lost 66% of its immunogenic potency. The results of this study indicate that the NIH protection test should continue to form the primary basis for potency assay of rabies vaccine as glycoprotein content does not appear to correlate with immunogenic potency for different types of vaccine. The vaccine coded PISRAV has been established as the fifth International Standard for Rabies Vaccine and a potency of 16 International Units of Rabies Vaccine (based on the immunogenicity assays) assigned to the contents of each ampoule. Each ampoule has also been assigned a unitage of 10 IU of PM Rabies Virus Glycoprotein and 135 IU of PM Rabies Virus Ribonucleoprotein.

Potency assay of antibodies against rabies. A report on a collaborative study.

The relative potencies of a number of rabies immunoglobulin preparations were estimated in an international collaborative study comprising eight laboratories in five countries. Two assay methods were used: a virus neutralization test in mice (MNT) and a virus neutralization test in cell culture (RFFIT). Differences between the results obtained by the two methods, which have been reported, could not be generally corroborated. The results indicate that in some laboratories the MNT cause difficulties and give results different from those obtained by RFFIT. In other laboratories such difficulties are not encountered. The results seem to indicate that the RFFIT is a more reliable method than the MNT.

The effect of strain differences on the assay of rabies virus glycoprotein by single radial immunodiffusion.

Antigenic differences between rabies virus strains used for vaccine manufacture can be demonstrated using monoclonal antibodies. We have shown that these differences are sufficiently large to affect the potency values of vaccines measured in single radial immunodiffusion (SRD) assays if the reference and test vaccines are antigenically heterologous. The production of reagents for use in SRD assays for each strain of rabies virus should be considered.

Sensitization induced in guinea pigs with beta-propiolactone-treated serum albumin: experimental evidence for the cause of allergic reactions in humans receiving human diploid cell rabies vaccines.

beta-Propiolactone-treated (BPL-T) homologous serum albumin caused anaphylaxis in guinea pigs with a frequency and severity equal to that of guinea pigs inoculated with human albumin. Untreated guinea pig serum albumin did not cause any reactions in these animals. Some recipients of current rabies vaccine produced in human diploid cells available in the USA develop systemic allergic reactions, usually following booster immunization. The BPL-T human albumin component of the vaccines was believed to be the cause of the complications. Our studies support this conclusion.

Use of the single radial immunodiffusion test as a replacement for the NIH mouse potency test for rabies vaccine.

The method currently recommended by the World Health Organization (WHO) for the potency assay of rabies vaccine is the NIH mouse potency test, a highly variable test requiring large numbers of animals. The Single Radial Immunodiffusion (SRID) test, an in vitro test, has been used successfully for the quantitation of hemagglutinin in inactivated influenza vaccine and is being evaluated for its utility as an assay for the rabies virus glycoprotein, considered to be the major protective antigen, of rabies vaccine. Potency values calculated using the SRID test were compared with those calculated using the NIH test for rabies vaccines produced in cell culture. The within-test variability was significantly lower with the SRID test but the potency values were generally higher than those from the NIH test. Vaccines which assay below the minimum acceptable potency value (2.5 International Units/ml) in the NIH test generally gave values above that level in the SRID test. The implications of these results on rabies vaccine control testing are discussed.

A collaborative study to establish an International Standard Rabies immunoglobulin of human origin.

Because the supply of the International Standard for Anti-rabies Serum was very low, the WHO initiated a search for a replacement product. The US Food and Drug Administration agreed to undertake a collaborative study using a human rabies immunoglobulin previously purchased for use as a US standard. The potency of this product was determined, in International Units (IU) per millilitre using the rapid fluorescent focus inhibition test for measuring rabies antibody. The mean potency value was found to be 59 IU per ampoule. In June 1984 this preparation was accepted by WHO as the International Standard for Rabies Immunoglobulin.

Comparison studies on potency tests for rabies vaccines.

Eleven laboratories from eight countries and four continents took part in a collaborative study to evaluate experimental procedures to be used in selecting the new standard reference rabies vaccine prepared in human diploid cell cultures. The following procedures were used : (a) the NIH potency test in mice, (b) the antibody binding technique (by either mouse inoculation or the tissue culture method), (c) virus-neutralizing antibody levels in mice used for the NIH test, and (d) antibody induction in human volunteers treated with vaccine alone and in combination with human rabies gamma globulin. The four methods used for determination of rabies antibodies were mouse inoculation, rapid fluorescent focus inhibition, plaque reduction and complement fixation techniques. All results were expressed in International Units as compared to the standard WHO serum and vaccine preparations. In general, a close correlation was noted in results from different laboratories, and it was recommended that the future rabies standard vaccine should be evaluated by three testing procedures, the NIH test, the antibody-binding technique, and antibody levels in mice used for the NIH test.