Guidelines for Frontline Health Care Staff Safety for COVID-19.

This document establishes safety guidelines for physicians, nurses, and allied health care and facility staff who may be exposed to patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a health care facility. SARS-CoV-2 infection is highly contagious and places health care workers at risk for infection resulting in coronavirus disease (COVID-19). Physicians, nurses, and allied health care and facility staff in all frontline environments must be provided and utilize necessary personal protective equipment (PPE). It is important that health care staff adopt a universal set of guidelines in which to conduct themselves in order to minimize infection with the SARS-CoV-2 contagion. The establishment of these guidelines is necessary in this viral pandemic since such directives can create a standard of safety that is universally accepted. These guidelines establish a framework to provide consistency among health care facilities and staff from the time the staff member arrives at the health care facility until they return home. These guidelines provide a practical description of the minimum necessary protection for physicians, nurses, and allied health care and facility staff against SARS-CoV-2 infection.

Biogeochemical plant-soil interaction: variable element composition in leaves of four plant species collected along a south-north transect at the southern tip of Norway.

Leaves from four different plant species (birch, willow, juniper, and heather) together with samples of the soil O and C horizons were collected at 44-46 sites along a south-to-north transect extending inland for 200 km from the southern tip of Norway. The transect covers one of the steepest vegetation gradients on Earth, crossing six vegetation zones. Juniper and heather are evergreen, and preferably exclude potentially toxic elements to avoid their accumulation in assimilating tissues, birch and willow shed their leaves in autumn together with the load of potentially toxic elements, and thus can tolerate the uptake of such elements. The plant leaves show the highest concentrations for B, Ca, K, Mg, Mn, P, Rb and S. In the soil O-horizon Ag, Au, As, Bi, Cu, Ge, Hg, In, Pb, Sb, Se, Sn, Te and W are enriched with respect to the C-horizon, whilst Mn and Rb are depleted. Cadmium, Sr and Zn are enriched in willow and Cs, Na and Tl in heather. In terms of concentration gradients from the coast inland, two different patterns are detected: 1) short range with an almost exponential decrease of concentrations from the coast, which appears to be typical for seaspray-related element input, and 2) long range with an almost linear decrease of concentrations with distance from the coast. These patterns differ among the four species, even for one and the same element. Inter-element correlation is different from material to material. Along the transect each of the different plants at the same site individually adapts to the available element combination. High linear correlations in the plants occur between the lanthanides (La, Ce, Y), and interestingly, between P and Ti. The plant/soil system appears highly non-linear and self-regulated.

Consumption of psychoactive substances among 535 women entering a Lyon prison (France) between June 2004 and December 2008.

BACKGROUND: In France, recent data on the consumption of psychoactive substances (PASs) among women entering prison are virtually nonexistent. The objective of this study was to describe the characteristics of female entrants at Montluc prison in Lyon (France) and to estimate their PAS consumption. METHODS: Between June 1, 2004 and December 31, 2008, of 841 women entering the Lyon correctional facility, 535 had an entrance interview, conducted by a nurse, during which a questionnaire was systematically proposed; 306 detainees did not have this interview and could not be included in the study because of an immediate transfer to another prison or emergency hospitalization. Socioeconomic and incarceration characteristics, PAS consumption, as well as consumption level (occasional, regular, abusive or dependence) and psychological distress of the 535 interviewed detainees were systematically noted. This psychological distress was defined by the presence in the entrant talks or behavior suggesting clinical symptoms such as anxiety, depression, delusion, delirium, and mood or behavior disorders. Descriptive analysis was undertaken with the Chi(2) test and Fisher's exact test for differences between the proportions observed. RESULTS: The average age of the 534 responding detainees was 31.5 years; 59.2% had had no ongoing professional activity in the 12 months prior to incarceration, and 21.6% had already been imprisoned before; 37.5% of the entrants reported dependence on tobacco and 13.7% on alcohol; 6.6% reported regular, abusive use or dependence on cannabis, 20.4% on psychotropic medications, and 7.7% on other drugs (heroin, cocaine, synthetic drugs) in the 6 months preceding their incarceration; 39.2% of the consumers at risk reported using at least two substances; 7.1% of detainees were on opioid substitution treatment. A multiple correspondence factor analysis was used to note specific characteristics of three groups of PAS consumers. CONCLUSIONS: More frequent among young women detainees, overall PAS consumption was quite close to that of male entrants, was greater than in the general female population, and was very often accompanied by psychological distress. Effective screening upon entry into detention should be carried out so that female consumers can be offered psychological and/or psychiatric care adapted to a prison environment.

[Characteristics of alcohol-dependent male inmates]. / Caractéristiques des personnes alcoolodépendantes incarcérées en maison d'arrêt.

OBJECTIVE: The objective of this study was to compare social and penal characteristics and consumption of psychoactive substances by alcohol-dependent and non-dependent inmates of the Lyon's prison in 2004. METHODS: The study was carried out among 2033 male adults incarcerated between January 1st and December 31st 2004. An administered questionnaire was proposed during the arrival visit to record social, administrative and penal data. Use of tobacco, alcohol and illicit drugs was quantified. RESULTS: In all, 1898 questionnaires were analysed. Comparison between alcohol-dependent (n=356) versus non alcohol-dependent inmates (n=1542), revealed that the alcohol-dependent population was older, mean age (34 years old versus 30 years, p<0.001), and had a higher unemployment rate (50% versus 39.4%, p<0.001). Alcohol addicts were more often repeated offenders (62% versus 50.7%, p=0.001), had a higher rate of Subutex mixture (11% versus 3.2%, p<0.001) and presented more psychic suffering (21% versus 6%, p<0.001). Multivariate analysis identified use of psychotop drugs, use of psychoactive substances, age and familial situation as significantly and independently associated with the abusise alcohol consumption. CONCLUSION: Because of an elevated prevalence of alcohol dependence among arriving penitentiary inmates, effective screening is needed to prevent withdrawal syndrome and propose care adapted to the specific features of this dependent population: social insecurity and polydrug abuse.

[Psychoactive substance use among newly incarcerated prison inmates]. / Consommation de substances psycho actives chez les personnes entrant en prison.

The objective of this study was to describe the population of incoming prisoners in Lyon's prisons and to estimate the proportion of those who are drug users in order to adapt the psychological care which is made available at the time of entrance. During the entrance interview briefing session, a questionnaire was given to each new adult male inmate between January 1st and December 31st 2003. The mean age of new prisoners was 31 years old: 68.5% did not have regular employment in the last 12 months prior to their incarceration, and 52.8% had already been previously imprisoned. More than 64.0% of inmates declared either a regular use, an abusive use or dependence on tobacco, 16.5% on cannabis, 16.1% on alcohol, 2.5% on psychotropic medication, and 4.1% on other drugs (heroine, cocaine, or synthetic drugs). Moreover, 42.0% of drug users declared either a regular use, abusive consumption or dependence on at least two psycho active substances. These results confirm the need for effective screening for drug use upon entry into prison as a means of ensuring that appropriate psychological and/or psychiatric care of drug users, which is suitably adapted to the prison environment, can be provided.

The effect of the new Massachusetts Bay sewage outfall on the concentrations of metals and bacterial spores in nearby bottom and suspended sediments.

Since the new outfall for Boston's treated sewage effluent began operation on September 6, 2000, no change has been observed in concentrations of silver or Clostridium perfringens spores (an ecologically benign tracer of sewage), in bottom sediments at a site 2.5 km west of the outfall. In suspended sediment samples collected with a time-series sediment trap located 1.3 km south of the outfall, silver and C. perfringens spores increased by 38% and 103%, respectively, in post-outfall samples while chromium, copper, and zinc showed no change. All metal concentrations in sediments are <50% of warning levels established by the Massachusetts Water Resources Authority. An 11-year data set of bottom sediment characteristics collected three times per year prior to outfall startup provides perspective for the interpretation of post-outfall data. A greater than twofold increase in concentrations of sewage tracers (silver and C. perfringens) was observed in muddy sediments following the exceptional storm of December 11-16, 1992 that presumably moved contaminated inshore sediment offshore.

Evaluation of the embryo transfer procedure proposed by the International Embryo Transfer Society as a method of controlling vertical transmission of Neospora caninum in cattle.

OBJECTIVE: To evaluate efficacy of embryo transfer into seronegative recipients, using the procedure proposed by the International Embryo Transfer Society (IETS), for preventing vertical transmission of Neospora caninum in cattle. DESIGN: Prospective clinical trial. ANIMALS: 87 recipient cows and heifers and their embryo transfer calves from 22 donors originating from 9 dairy herds. PROCEDURE: Neospora caninum serologic status of donors and recipients was determined before collection and transfer of embryos. Viable embryos were washed and treated with trypsin. Recipients in experimental groups A (n = 50) and B (29) were seronegative and received embryos from seropositive and seronegative donors, respectively. Recipients in group C (n = 8) were seropositive and received embryos from seronegative or seropositive donors. Antibody titers against N caninum were determined monthly during pregnancy in recipients and in calf blood samples collected at birth. Tissues collected from stillborn calves and aborted fetuses were analyzed histologically and by immunohistochemical (IHC) methods. RESULTS: 76 calves and 11 fetuses and stillborn calves were examined. All calves from groups A and B were seronegative (n = 70) or lacked evidence of infection by use of tissue analysis (9). In group C, 5 of 6 calves were seropositive at birth, and IHC results were positive for 1 of 2 calves. Vertical transmission rate was significantly lower in groups A and B (0%) than in group C (75%). CONCLUSION AND CLINICAL RELEVANCE: Embryo transfer into seronegative recipients, using the procedure proposed by IETS, is an effective way to prevent vertical transmission of N caninum. Results provide support for pretransfer testing of all embryo transfer recipients.

Aeolian dust in Colorado Plateau soils: nutrient inputs and recent change in source.

Aeolian dust (windblown silt and clay) is an important component in arid-land ecosystems because it may contribute to soil formation and furnish essential nutrients. Few geologic surfaces, however, have been characterized with respect to dust-accumulation history and resultant nutrient enrichment. We have developed a combination of methods to identify the presence of aeolian dust in arid regions and to evaluate the roles of this dust in ecosystem processes. Unconsolidated sandy sediment on isolated surfaces in the Canyonlands region of the Colorado Plateau differs greatly in mineralogical and chemical composition from associated bedrock, mainly aeolian sandstone. Detrital magnetite in the surficial deposits produces moderately high values of magnetic susceptibility, but magnetite is absent in nearby bedrock. A component of the surficial deposits must be aeolian to account for the abundance of magnetite, which formed originally in far-distant igneous rocks. Particle-size analysis suggests that the aeolian dust component is typically as much as 20-30%. Dust inputs have enriched the sediments in many elements, including P, Mg, Na, K, and Mo, as well as Ca, at sites where bedrock lacks calcite cement. Soil-surface biologic crusts are effective dust traps that apparently record a change in dust sources over the past several decades. Some of the recently fallen dust may result from human disturbance of land surfaces that are far from the Canyonlands, such as the Mojave Desert. Some land-use practices in the study area have the potential to deplete soil fertility by means of wind-erosion removal of aeolian silt.

Combined immunoextraction approach coupled to a chemiluminescence enzyme immunoassay for the determination of trace levels of salbutamol and clenbuterol in tissue samples.

A monoclonal immunoglobulin G1 (IgG1) antisalbutamol, which exhibits a 75% cross-reactivity with clenbuterol, has been used in the setup of an immunoaffinity chromatography method and a chemiluminescence enzyme immunoassay for the extraction and the quantification of salbutamol and clenbuterol in tissue samples. After analytical validation, the proposed methodology was applied to liver, kidney and muscle samples obtained from calves and pigs treated with these beta 2-agonists (100 micrograms per kg of body weight) for 10 d. This methodology allowed the quantification of both drugs until 6 d after the final dose. At this time, however, salbutamol and clenbuterol were concentrated in the liver. Our results indicate that the liver is the preferred tissue to sample for the detection of illegal use of beta 2-agonists as growth promoters, in the absence of urine samples.

Comparative efficacy of cimetidine, famotidine, ranitidine, and mylanta in postoperative stress ulcers. Gastric pH control and ulcer prevention in patients undergoing coronary artery bypass graft surgery.

To determine the comparative efficacy of several histamine (H2)-receptor antagonists (cimetidine, famotidine, and ranitidine) and the antacid Mylanta-II (Stuart Pharmaceuticals, Wilmington, DE) in gastric pH control and the prevention of postoperative stress ulceration, a prospective, randomized study was performed in a homogeneous population of patients with elective coronary artery bypass. None of the 57 patients in the study population had a documented history of ulcer disease. There were four treatment groups, each with similar demographics (age and sex). Cimetidine-treated group consisted of 15, famotidine-treated group of 18, ranitidine-treated group of 19, and antacid-treated group of 5 patients. There was no hemodynamically significant postoperative gastrointestinal bleeding in any of the patients. When the agents were compared for efficacy of gastric pH control, statistically better pH control was found in the famotidine- and ranitidine-treated groups (P less than 0.003) than in the cimetidine-treated group (pH less than or equal to 4.0) during the 20-hour observation period. Side effects (hematologic and neurological) were noted only in the cimetidine-treated group. The results of this study indicate that in patients in postoperative intensive care, better gastric pH control, and thus prevention of gastric stress ulcers, is achieved with either famotidine or ranitidine rather than cimetidine or antacid.

Nutritional support of the chronically ill elderly female at risk for elective or urgent surgery.

Among the elderly, those at highest risk are the chronically ill, inactive patients. Assessing macronutrient requirements and outcome depends on longitudinal studies. Seven chronically ill, elderly female patients suffering from persistent infections, were studied monthly, over a 6-month period to determine their protein and energy requirements. Calorie and protein requirements were based on clinical status. The results of the nutrition support program were monitored using: weight change, nitrogen balance, serum albumin levels, alterations in anthropometric measurements (triceps skinfold thickness and arm muscle circumference), and immune function tests. Based on the 6-month study period data, the calculated mean energy requirement for weight maintenance was 98% of calculated basal energy expenditure (BEE) and the mean protein required for nitrogen balance, 0.8 g/kg desired body weight (DBW). Excess caloric administration resulted in weight gain, determined to be fat (and/or fluid) but not lean body mass. When surgery is contemplated, there should be a 30% (factorial) increase over these base-line values. It is inadvisable to allow elderly patients to sustain any starvation, period given their inability to produce increases in body cell mass even in this 6-month period.

Determination of ammonium in a buddingtonite sample by ion-chromatography.

An ion-chromatographic method for the direct determination of ammonium, potassium, and sodium in geologic materials is described. Samples are decomposed with a mixture of hydrofluoric and hydrochloric acids in a sealed polycarbonate bottle heated in a microwave oven. The ion-chromatograph separates the cations and determines them by conductivity measurement. The ammonium concentrations thus determined have been verified by use of an ammonia-specific electrode. A total of 32 analyses of ammonium salts by both techniques showed an average error of -4%, with a relative standard deviation (RSD) of 6%. The ammonium concentrations found in a buddingtonite sample had an RSD of 2.2% and their mean agreed with that obtained by the Kjeldahl method. By use of the prescribed dilution of the sample, detection limits of 0.1% can be achieved for all three cations.

Involvement of zinc in the regulation of pHi, motility, and acrosome reactions in sea urchin sperm.

When sperm of Strongylocentrotus purpuratus or Lytechinus pictus are diluted into seawater, motility is initiated; and when exposed to egg jelly, an acrosome reaction is induced. In the presence of a variety of structurally different metal chelators (0.1-1 mM EDTA, EGTA, phenanthroline, dipyridyl, cysteine, or dithiothreitol), motility initiation is delayed and the acrosome reaction is inhibited. Of the metals detected in the sperm of these two species, very low levels of Zn+2 (0.1 microM free Zn+2) uniquely prevent this chelator inhibition. L. pictus sperm concentrate 65Zn+2 from seawater, and EDTA removes 50% of the accumulated 65Zn+2 by 5 min. Since both sperm motility and acrosome reactions are in part regulated by intracellular pH (pHi), the effect of chelators on the sperm pHi was examined by using the fluorescent pH sensitive probe, 9-aminoacridine, EDTA depresses sperm pHi in both species, and 0.1 microM free Zn+2 reverses this pHi depression. When sperm are diluted into media that contain chelators, both NH4Cl and monensin (a Na+/H+ ionophore) increase the sperm pHi and reverse the chelator inhibition of sperm motility and acrosome reactions. The results of this study are consistent with the involvement of a trace metal (probably zinc) in the pHi regulation of sea urchin sperm and indicate a likely mechanism for the previously observed effects of chelators on sperm motility and acrosome reactions.