CDC COVID-19 vaccination program: Healthcare provider compliance with COVID-19 vaccine requirements and recommendations.

The COVID-19 Vaccination Provider Oversight (CVPO) program was implemented by the Centers for Disease Control and Prevention (CDC) to ensure the proper management and administration of COVID-19 vaccines by healthcare providers participating in the CDC COVID-19 Vaccination Program. As part of the CVPO program, the 64 CDC-funded immunization program awardees conducted site visits with participating healthcare providers. We evaluated healthcare provider adherence to CVPO program requirements between May 2021 and May 2023. CVPO program site visit data was collected using a REDCap database. The proportion of site visits conducted by U.S. Department of Health and Human Services (HHS) region was calculated. Chi-square statistics for healthcare provider compliance with CVPO program requirements were presented to assess variation in compliance by provider type. The proportion of healthcare providers receiving a site visit ranged from 7.9 % to 37.2 % across HHS regions. Healthcare provider compliance was high for COVID-19 vaccine preparation, administration, and error reporting categories (>90 %). Healthcare provider compliance was lowest for vaccine storage and handling and reporting requirements (79.9 % and 82.6 %, respectively). Public health providers demonstrated significantly higher overall compliance as compared to all other included healthcare provider types (p-value < 0.05). The observed high healthcare provider compliance, coupled with thorough follow-up efforts by awardees to address any non-compliance concerns, highlights the success of jurisdictions supporting healthcare providers with proper vaccine management, administration, and safety procedures. Further research can strengthen vaccine storage, handling, and administration practices for future widespread vaccination efforts.

The use of environmental scenarios to project future health effects: a scoping review.

Environmental risks are a substantial factor in the current burden of disease, and their role is likely to increase in the future. Model-based scenario analysis is used extensively in environmental sciences to explore the potential effects of human activities on the environment. In this Review, we examine the literature on scenarios modelling environmental effects on health to identify the most relevant findings, common methods used, and important research gaps. Health outcomes and measures related to climate change (n=106) and air pollution (n=30) were most frequently studied. Studies examining future disease burden due to changes or policies related to dietary risks were much less common (n=10). Only a few studies assessed more than two environmental risks (n=3), even though risks can accumulate and interact with each other. Studies predominantly covered high-income countries and Asia. Sociodemographic, vulnerability, and health-system changes were rarely accounted for; thus, assessing the full effect of future environmental changes in an integrative way is not yet possible. We recommend that future models incorporate a broader set of determinants of health to more adequately capture their effect, as well as the effect of mitigation and adaptation efforts.

Promising Practices Observed in High-Throughput COVID-19 Vaccination Sites in the United States, February-May 2021.

Objectives. To identify promising practices for implementing COVID-19 vaccination sites. Methods. The Centers for Disease Control and Prevention (CDC) and Federal Emergency Management Agency (FEMA) assessed high-throughput COVID-19 vaccination sites across the United States, including Puerto Rico, after COVID-19 vaccinations began. Site assessors conducted site observations and interviews with site staff. Qualitative data were compiled and thematically analyzed. Results. CDC and FEMA conducted 134 assessments of high-throughput vaccination sites in 25 states and Puerto Rico from February 12 to May 28, 2021. Promising practices were identified across facility, clinical, and cross-cutting operational areas and related to 6 main themes: addressing health equity, leveraging partnerships, optimizing site design and flow, communicating through visual cues, using quick response codes, and prioritizing risk management and quality control. Conclusions. These practices might help planning and implementation of future vaccination operations for COVID-19, influenza, and other vaccine-preventable diseases. Public Health Implications. These practices can be considered by vaccination planners and providers to strengthen their vaccination site plans and implementation of future high-throughput vaccination sites. (Am J Public Health. 2023;113(8):909-918. https://doi.org/10.2105/AJPH.2023.307331).

From COVID-19 to Green Recovery with natural capital accounting.

The COVID-19 pandemic and related social and economic emergencies induced massive public spending and increased global debt. Economic recovery is now an opportunity to rebuild natural capital alongside financial, physical, social and human capital, for long-term societal benefit. Yet, current decision-making is dominated by economic imperatives and information systems that do not consider society's dependence on natural capital and the ecosystem services it provides. New international standards for natural capital accounting (NCA) are now available to integrate environmental information into government decision-making. By revealing the effects of policies that influence natural capital, NCA supports identification, implementation and monitoring of Green Recovery pathways, including where environment and economy are most positively interlinked.

Clinical Validation of Companion Diagnostics for the Selection of Patients with Non-Small Cell Lung Cancer Tumors Harboring Epidermal Growth Factor Receptor Exon 20 Insertion Mutations for Treatment with Amivantamab.

Amivantamab, an epidermal growth factor receptor (EGFR)-c-Met bispecific antibody, targets activating/resistance EGFR mutations and MET mutations/amplifications. In the ongoing CHRYSALIS study (ClinicalTrials.gov Identifier: NCT02609776), amivantamab demonstrated antitumor activity in patients with non-small cell lung cancer harboring EGFR exon 20 insertion mutations (ex20ins) that progressed on or after platinum-based chemotherapy, a population in which amivantamab use has been approved by the US Food and Drug Administration. This bridging study clinically validated two novel candidate companion diagnostics (CDx) for use in detecting EGFR ex20ins in plasma and tumor tissue, Guardant360 CDx and Oncomine Dx Target Test (ODxT), respectively. From the 81 patients in the CHRYSALIS efficacy population, 78 plasma and 51 tissue samples were tested. Guardant360 CDx identified 62 positive (16 negative), and ODxT identified 39 positive (3 negative), samples with EGFR ex20ins. Baseline demographic and clinical characteristics were similar between the CHRYSALIS-, Guardant360 CDx-, and ODxT-identified populations. Agreement with local PCR/next-generation sequencing tests used for enrollment into CHRYSALIS demonstrated high adjusted negative (99.6% and 99.9%) and positive (100% for both) predictive values with the Guardant360 CDx and ODxT tests, respectively. Overall response rates were comparable between the CHRYSALIS, Guardant360 CDx, and ODxT populations. Both the plasma- and tissue-based diagnostic tests provided accurate, comprehensive, and complementary approaches to identifying patients with EGFR ex20ins who could benefit from amivantamab therapy.

Range of motion following percutaneous fixation of pediatric supracondylar humerus fracture is independent of anterior osseous fragment resorption.

The objective of this study was to understand postoperative resorption of the anterior osseous fragment following closed reduction and percutaneous pinning (CRPP) of pediatric supracondylar humerus fractures and its effect on final range of motion (ROM). Eighty-six patients that underwent CRPP had sagittal and or axial plane deformities resulting in an anterior fragment. Humerocapitellar angle (HCA), anterior humeral line (AHL) and angle of rotation (AoR) were measured. A total of 11 (12.8%) patients failed to resorb the anterior fragment, 10 (90.9%) had satisfactory ROM. HCA initially was acceptable in 40 (46.5%) patients, and 37 (92.5%) demonstrated acceptable ROM. Final HCA was acceptable in 44 (51.2%) patients and 42 (95.4%) had acceptable final ROM. AHL was in the anterior third of the capitellum in 35 (40.6%) patients and 33 (94.3%) had acceptable ROM. Final AHL was in the anterior third of the capitellum in 43 (50.0%) patients and 41 (95.3%) had acceptable final ROM. No difference was found between acceptable ROM and HCA or AHL at either follow-up. Sixty-five and 21 patients had an AoR of 0° and between 23 and 36°, respectively. A total of 59 (90.7%) patients with an AoR of 0°, and 18 (85.7%) patients with an AoR of 23-36° displayed acceptable ROM. A total of 57 (87.7%) patients with an AoR of 0° and 18 (85.7%) with an AoR of 23-36° resorbed the anterior fragment. No association was found between rotational deformity and postoperative ROM or fragment resorption. Postoperative sagittal and axial plane alignment, HCA, AHL, AoR and resorption of the anterior osseous fragment does not correlate with final ROM.

Provision of Pediatric Immunization Services During the COVID-19 Pandemic: an Assessment of Capacity Among Pediatric Immunization Providers Participating in the Vaccines for Children Program - United States, May 2020.

Recent reports suggest that routine childhood immunization coverage might have decreased during the coronavirus disease 2019 (COVID-19) pandemic (1,2). To assess the capacity of pediatric health care practices to provide immunization services to children during the pandemic, a survey of practices participating in the Vaccines for Children (VFC) program was conducted during May 12-20, 2020. Data were weighted to account for the sampling design; thus, all percentages reported are weighted. Among 1,933 responding practices, 1,727 (89.8%) were currently open; 1,397 (81.1%) of these reported offering immunization services to all of their patients. When asked whether the practice would likely be able to accommodate new patients to assist with provision of immunization services through August, 1,135 (59.1%) respondents answered affirmatively. These results suggest that health care providers appear to have the capacity to deliver routinely recommended childhood vaccines, allowing children to catch up on vaccines that might have been delayed as a result of COVID-19-related effects on the provision of or demand for routine well child care. Health care providers and immunization programs should educate parents on the need to return for well-child and immunization visits or refer patients to other practices, if they are unable to provide services (3).

Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration - United States, 2020.

On March 13, 2020, the president of the United States declared a national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic (1). With reports of laboratory-confirmed cases in all 50 states by that time (2), disruptions were anticipated in the U.S. health care system's ability to continue providing routine preventive and other nonemergency care. In addition, many states and localities issued shelter-in-place or stay-at-home orders to reduce the spread of COVID-19, limiting movement outside the home to essential activities (3). On March 24, CDC posted guidance emphasizing the importance of routine well child care and immunization, particularly for children aged ≤24 months, when many childhood vaccines are recommended.

Intraosseous lipoma of the clavicle with extraosseous extension.

Intraosseous lipomas are rare primary benign bone tumors which present with highly nonspecific radiographic features that may lead to equivocal diagnoses. Advanced imaging studies such as MRI with and without contrast and, in some selected cases, tissue sample analyses are required in the diagnostic pathway. Here we describe the second case in the literature of an intraosseous lipoma of the clavicle and the first with extraosseous extension. Subsequent to histologic confirmation the lesion was monitored with clinical and radiologic evaluation.

Evaluation of temperature stability among different types and grades of vaccine storage units: Data from continuous temperature monitoring devices.

OBJECTIVE: To evaluate the ability of different types of vaccine storage units to maintain appropriate temperatures for the storage of vaccines and to characterize deviations from recommended temperatures. DATA SOURCES: Continuous temperature monitoring devices, or digital data loggers, from vaccine providers who participated in a continuous temperature monitoring pilot project. STUDY DESIGN: We computed descriptive statistics on the percentage of runtime with an out-of-range temperature, or excursion, for different storage unit types (freezers and refrigerators) and for different storage unit grades (household-grade combination, household-grade stand alone, and purpose-built or pharmaceutical grade). We developed frequency histograms for the percentage of storage unit runtime outside of the normal range. We plotted the duration and temperature extrema for identified excursions. Analyses were stratified by storage unit type and grade. RESULTS: Household-grade combination units underperformed relative to household-grade stand-alone and purpose-built units. Among refrigerators, household-grade combination units operated in the normal temperature range an average of 98.9% of their observed runtime, which was lower than 99.4% (p value = 0.038) for household-grade stand-alone and 99.9% (p value < 0.001) for purpose-built units. Among freezers, household-grade combination units operated in the normal temperature range an average of 95.0% of their observed runtime, which was lower than 99.3% (p value < 0.001) for household-grade stand-alone units and 99.7% (p value < 0.001) for purpose-built units. CONCLUSION: These findings, in particular the underperformance of household-grade combination units relative to household-grade stand-alone and purpose-built units, support current CDC recommendations to avoid the use of household-grade combination storage units when possible.

Typology of coastal urban vulnerability under rapid urbanization.

Coastal areas are urbanizing at unprecedented rates, particularly in low- and middle-income countries. Combinations of long-standing and emerging problems in these urban areas generate vulnerability for human well-being and ecosystems alike. This baseline study provides a spatially explicit global systematization of these problems into typical urban vulnerability profiles for the year 2000 using largely sub-national data. Using 11 indicator datasets for urban expansion, urban population growth, marginalization of poor populations, government effectiveness, exposures and damages to climate-related extreme events, low-lying settlement, and wetlands prevalence, a cluster analysis reveals a global typology of seven clearly distinguishable clusters, or urban profiles of vulnerability. Each profile is characterized by a specific data-value combination of indicators representing mechanisms that generate vulnerability. Using 21 studies for testing the plausibility, we identify seven key profile-based vulnerabilities for urban populations, which are relevant in the context of global urbanization, expansion, and climate change. We show which urban coasts are similar in this regard. Sensitivity and exposure to extreme climate-related events, and government effectiveness, are the most important factors for the huge asymmetries of vulnerability between profiles. Against the background of underlying global trends we propose entry points for profile-based vulnerability reduction. The study provides a baseline for further pattern analysis in the rapidly urbanizing coastal fringe as data availability increases. We propose to explore socio-ecologically similar coastal urban areas as a basis for sharing experience and vulnerability-reducing measures among them.

Afforestation for climate change mitigation: Potentials, risks and trade-offs.

Afforestation is considered a cost-effective and readily available climate change mitigation option. In recent studies afforestation is presented as a major solution to limit climate change. However, estimates of afforestation potential vary widely. Moreover, the risks in global mitigation policy and the negative trade-offs with food security are often not considered. Here we present a new approach to assess the economic potential of afforestation with the IMAGE 3.0 integrated assessment model framework. In addition, we discuss the role of afforestation in mitigation pathways and the effects of afforestation on the food system under increasingly ambitious climate targets. We show that afforestation has a mitigation potential of 4.9 GtCO2 /year at 200 US$/tCO2 in 2050 leading to large-scale application in an SSP2 scenario aiming for 2°C (410 GtCO2 cumulative up to 2100). Afforestation reduces the overall costs of mitigation policy. However, it may lead to lower mitigation ambition and lock-in situations in other sectors. Moreover, it bears risks to implementation and permanence as the negative emissions are increasingly located in regions with high investment risks and weak governance, for example in Sub-Saharan Africa. Afforestation also requires large amounts of land (up to 1,100 Mha) leading to large reductions in agricultural land. The increased competition for land could lead to higher food prices and an increased population at risk of hunger. Our results confirm that afforestation has substantial potential for mitigation. At the same time, we highlight that major risks and trade-offs are involved. Pathways aiming to limit climate change to 2°C or even 1.5°C need to minimize these risks and trade-offs in order to achieve mitigation sustainably.

Metastatic vertebral lesion mimicking an atypical hemangioma with negative 18F-FDG positron emission tomography-computed tomography.

Atypical hemangiomas of the spine can mimic metastatic lesions on magnetic resonance imaging, therefore making this distinction is a diagnostic challenge. In most cases, this conundrum can usually be solved with positron emission tomography/computed tomography images, because hemangiomas do not usually present with increased uptake while metastatic lesions do. Here we present a case of a patient with a unique diagnosis, myxoid liposarcoma, in which the vertebral metastatic lesion did not present with increased uptake in positron emission tomography/computed tomography scans. While keeping the imaging particularity of this rare sarcoma in mind, proceeding with a biopsy when the suspicion of metastasis remains high will help elucidate the diagnosis and allow for proper management.

Data for long-term marginal abatement cost curves of non-CO2 greenhouse gases.

This dataset represents long-term marginal abatement cost (MAC) curves of all major emission sources of non-CO2 greenhouse gases (GHGs); methane (CH4), nitrous oxide (N2O) and fluorinated gases (HFCs, PFCs and SF6). The work is based on existing short-term MAC curve datasets and recent literature on individual mitigation measures. The data represent a comprehensive set of MAC curves, covering all major non-CO2 emission sources for 26 aggregated world regions. They are suitable for long-term global mitigation scenario development, as dynamical elements (technological progress, removal of implementation barriers) are included. The data is related to the research article: "Long-term marginal abatement cost curves of non-CO 2 greenhouse gases" [1].

Building Ion-Conduction Highways in Polymeric Electrolytes by Manipulating Protein Configuration.

Solid polymer electrolytes play a critical role in the development of safe, flexible, and all-solid-state energy storage devices. However, the low ion conductivity has been the primary challenge impeding them from practical applications. Here, we propose a new biotechnology to fabricate novel protein-ceramic hybrid nanofillers for simultaneously boosting the ionic conductivity, mechanical properties, and even adhesion properties of solid polymer electrolytes. This hybrid nanofiller is fabricated by coating ion-conductive soy proteins onto TiO2 nanoparticles via a controlled denaturation process in appropriate solvents and conditions. It is found that the chain configuration and protein/TiO2 interactions in the hybrid nanofiller play critical roles in improving not only the mechanical properties but also the ion conductivity, electrochemical stability, and adhesion properties. Particularly, the ion conductivity is improved by one magnitude from 5 × 10-6 to 6 × 10-5 S/cm at room temperature. To understand the possible mechanisms, we perform molecular simulation to study the chain configuration and protein/TiO2 interactions. Simulation results indicate that the denaturation environment and procedures can significantly change the protein configuration and the protein/TiO2 interactions, both of which are found to be critical for the ion conductivity and mechanical properties of the resultant solid composite electrolytes. This study indicates that biotechnology of manipulating protein configuration can bring novel and promising strategies to build unique ion channels for fast ion conduction in solid polymer electrolytes.

Tonsuritermes, a new soldierless termite genus and two new species from South America (Blattaria: Isoptera: Termitidae: Apicotermitinae).

A new genus, Tonsuritermes Cancello Constantini gen. nov., is described from South America. The main morphological features of the new genus are a remarkable frontal gland and protibia with two rows of spine-like bristles. Two new species of Tonsuritermes are described: T. tucki Cancello Constantini sp. nov. and T. mathewsi Cancello Constantini sp. nov. Comparisons, measurements, a map, histology of the frontal gland, and illustration of all fundamental morphological aspects are provided.

Post-traumatic cervical spine epidural hematoma: Incidence and risk factors.

BACKGROUND: The incidence and risk factors for post-traumatic cervical epidural hematoma are not well described in the current literature. Our aim was to determine the incidence and associated risk factors for post-traumatic cervical spine epidural hematoma (SEH). METHODS: We performed a retrospective review of our institution's prospectively collected data submitted to the state trauma registry, using ICD-9 codes, for all patients activated as a trauma with cervical spine injuries, between the years 2010 and 2014. Patients with MRI available were classified based on the presence of cervical epidural hematoma (CEH) or no hematoma (NEH). For our second analysis, we classified patients with cord compression associated with an epidural hematoma (CC) and no cord compression (NCC). Potential risk factors evaluated included: INR, PTT, albumin and platelets levels, radiographic findings of Ankylosing Spondylitis (AS), and ISS. No conflicts of interest exist and/or funding was used for this study. RESULTS: 497 out of 1810 trauma activations met our inclusion criteria. 46 patients (2.5%) were found to have a post-traumatic cervical SEH (CEH). Of the CEH cohort, 76% were male, with 72% Caucasian, and a mean age of 55 years. 27 patients (5.4%) were found to have cervical cord compression at the level of the SEH. Of the CC arm, 78% were male, with 67% Caucasian, and a mean age of 56 years. A higher ISS and an elevated INR were found to be associated with epidural hematoma causing cord compression. CONCLUSIONS: An incidence of 2.5% is reported for post-traumatic cervical spine epidural hematoma. Of these, 59% had associated spinal cord compression. Patients with a higher ISS and elevated INR levels are at a higher risk for developing this potentially devastating.

Quantifying the Relationship Between the Transverse Acetabular Ligament and the Radiographic Teardrop.

BACKGROUND: The transverse acetabular ligament (TAL) has been described as an anatomic landmark to guide in the positioning of the acetabular component during total hip arthroplasty. On plain films, the radiographic teardrop (RT) has similarly been used as a measure of appropriate cup positioning. The goal of this study is to quantify the distance and location between the anatomic TAL and RT landmarks to aid in the positioning of acetabular component. METHODS: Sixteen randomly selected cadaveric pelvises (eight males, eight females) underwent dissection. Radiographic markers were placed bilaterally at the anteromedial insertions of the TAL, and true anteroposterior pelvic radiographs of the cadavers were obtained. Distances between the markers and the lateral borders of the RT were measured. RESULTS: The mean distance between the anteromedial insertion of the TAL and the lateral border of the RT in the male specimens was 11.8 (99% confidence interval, 11.4-12.2) mm. In the female specimens, the TAL to RT distance was shorter, with a mean of 8.4 (99% CI, 7.2-9.6) mm. There was a statistically significant difference between male and female cadavers (P < .01). CONCLUSION: The distance between the RT and TAL differs between males and females. Understanding the distance between these anatomic and radiographic landmarks should aid surgeons in obtaining a more accurate degree of acetabular component medialization and can serve as a guide to minimize overmedialization in order to achieve more accurate and reproducible placement of acetabular components during a total hip arthroplasty.

No Soldier Left Behind: The Veterans Court Solution.

This paper concerns one of the newer iterations of problem-solving courts: veterans treatment courts. We trace the history of problem solving court implementation and explore the functioning of an established veterans court. The focus of this exploratory, qualitative study is the courthouse workgroup and their interactions both within the veterans court and with more traditional criminal courts and criminal justice agencies. We summarize the literature on problem solving courts and the experience, insights and suggestions of the members of the court we examined.